1. Why do people get hemorrhoids? The cause of hemorrhoids is not yet fully understood, it is generally believed that the following factors: (1) the upright state of the human body: because the anorectum is located in the lower part of the torso, people are often in an upright position, the anus is low relative to the heart, due to the factor of gravity, the anorectal area of the blood flow back to the heart is more difficult, easy to depress into hemorrhoids, and animal heart is lower than the position of the anus, so far not found There are animals with hemorrhoids. (2) It is related to the absence of valves in the hemorrhoidal veins. The veins in other parts of the body have many valves, which are like valves in the blood vessels that allow blood to flow in one direction only and not back. However, there are no valves in the hemorrhoidal veins in the anal area, and blood tends to stay in the local area, leading to local varicose veins and the gradual formation of hemorrhoids. (3) It is related to infectious factors. Inflammatory changes can often be seen in the hemorrhoidal tissue during a slide examination, so some scholars believe that infection and thrombosis of the hemorrhoidal venous plexus is the cause of the formation of hemorrhoids. Inflammation of the intima and perivenous inflammation of the vascular lining causes the walls of the hemorrhoidal plexus to become brittle, thin, varicose, and finally form hemorrhoids. (4) It is associated with constipation and prolonged bowel movements. When a dry hard stool enters the rectal jug abdomen, it exerts a certain pressure on the rectal wall and the upper part of the anal canal. The arteries and veins on the hemorrhoids between the hard stool and the rectum and long tube anal layer are squeezed by the stool, and the venous pressure is low and inelastic, so the blood return is easily obstructed. However, arterial pressure and high and elastic, not easy to be squeezed, blood can still continue to enter the anorectum. The venous reflux is blocked, and the blood that enters will accumulate in the venous plexus of the anorectum, causing the plexus to expand and become tortuous, which gradually forms varicose veins centered on small arteries in the long run, and finally increases in size to form hemorrhoids. (5) Related to diet. Too little fiber in the diet can lead to constipation, and drinking alcohol and eating spicy and irritating food can also stimulate anorectal congestion and impaired local blood circulation, which over time can lead to the formation of hemorrhoids. (6) It is associated with diseases such as emphysema and chronic bronchitis that increase abdominal pressure. High abdominal pressure can affect the blood return to the anorectal area and aggravate the varicose veins of hemorrhoids. In addition, cirrhosis of the liver and portal vein thrombosis can cause hyperpressure in the portal vein, which directly leads to a rise in pressure in the hemorrhoidal plexus, which is also a factor in the formation and aggravation of hemorrhoids. In addition, the formation of hemorrhoids may also be related to occupation, heredity, age, gender, etc. 2. How to distinguish between hemorrhoids and rectal cancer? Hemorrhoids and rectal cancer can both manifest clinically as blood in the stool, and it is often found that many patients mistakenly believe that blood in the stool is due to hemorrhoids and delay treatment, leading to very serious consequences. How to distinguish between them? First of all, the color of blood in stool: the color of blood in stool of hemorrhoids is bright red, while rectal cancer is mostly dark red or jam-colored with mucus. Rectal diagnosis is often impossible due to the softness of the hemorrhoid nucleus, while rectal cancer can be detected by finger diagnosis in the rectum and anal canal with a hard and unsmooth mass in the form of cauliflower or ulcer. Colonoscopy and pathological examination are the most reliable methods to distinguish hemorrhoids from rectal cancer. 3.Can hemorrhoids form cancer? Hemorrhoids are a benign disease and will not become cancerous. However, it has been reported that patients with a history of anal fistula, anal fissure and hemorrhoids have a higher incidence of anal canal cancer. 4.What are the principles of treatment for hemorrhoids? (1) No treatment is needed for asymptomatic hemorrhoids, and symptomatic hemorrhoids focus on reducing or eliminating symptoms rather than eliminating the nucleus itself; (2) Non-surgical treatment is preferred for hemorrhoids, and medication or additional physical therapy is chosen for stage I and II hemorrhoids; stage III and IV hemorrhoids are treated primarily with surgical therapy. (3) Timely treatment of systemic diseases related to the occurrence and development of hemorrhoids in order to eliminate the causes of hemorrhoids. 5.How to prevent hemorrhoids? (1) daily sitz bath; (2) keep the anus clean and hygienic; (3) prevent constipation; (4) prevent diarrhea; (5) not overly forceful defecation, soon squatting toilet; (6) do not let the buttocks get cold; (7) do not maintain a posture for a long time; (8) control the intake of alcohol, spicy stimulating food; (9) avoid prolonged sitting; (10) timely discussion with the doctor to receive the correct treatment. 6.How to prevent anal fissure? (1) Avoid spicy and stimulating food, and eat more coarse fiber diet. (2) Raise regular bowel habits, actively prevent and control constipation, and keep the bowels open. After the formation of dry and hard stool, don’t exert force, and use corked or warm saline enema to help defecate. (3) Promptly treat the primary diseases of anal fissure, such as anal sinusitis, Crohn’s disease and ulcerative colitis, etc. 7.How does perianal abscess occur? Simply put, it is caused by pus after bacterial infection. There are three main reasons for perianal infection: (1) Anal gland infection: the anal gland opens in the anal sinus at the junction of the anal canal and rectum, and the anal sinus is funnel-shaped and opens upward, which is easily damaged and infected by bacterial invasion. Once the anal sinus is infected, it will cause the anal gland to become infected and septic, and the inflammation will spread to the perianal space. Because the perianal interstitial space has poor resistance to infection, the infection can easily spread in these interstitial spaces. (2) Decreased systemic resistance: such as diabetes, old age and weakness, overexertion and decreased resistance in patients with tuberculosis, which are prone to perianal abscess. (3) Local anal irritation and injury: such as frequent consumption of irritating foods such as chili peppers and alcohol can lead to local congestion in the rectum of the anal canal, and local resistance is reduced and susceptible to infection. In addition, dry and hard feces rubbing the mucous membrane of the anal canal skin, dilute feces of diarrhea patients falling in the anal sinus leading to obstruction of the anal gland ducts, as well as trauma to the anorectum or stabbing the anorectum by chicken, duck and fish bones swallowed with food can lead to infection around the anorectum and the formation of perianal pus. 8.How to treat perianal abscess? Early perianal abscess can be treated with antibiotics and internal herbal medicines for clearing heat and detoxification as well as external application of herbal ointment for clearing heat and detoxification and eliminating carbuncles, which can control the inflammation and no longer continue to expand. However, although the symptoms of local swelling and pain can be reduced or even disappear in such cases, they often recur and still require surgery. The principle of treatment is that once a perianal abscess becomes pus, it should be incised and drained early. 9.Why does a perianal abscess form an anal fistula if it is not treated thoroughly? The majority of perianal abscesses are caused by the infection of the anal glands and spread to the surrounding area, so if the infected anal glands and sinuses are not treated during surgery, the perianal abscesses will not be cured and will develop into anal fistulas, which are actually different stages of a disease. 10. Can an anal fistula become cancerous? After long-term clinical observation, most of the anal fistulas will not become cancerous, but very few of them can become cancerous. The reasons for this are: (1) long-term chronic inflammatory stimulation, sometimes leading to tissue heterogeneous proliferation, further development will occur malignant transformation. (2) Some bacterial infections, such as Pseudomonas aeruginosa or Mycobacterium tuberculosis infection, may lead to cancer. (3) Long-term and heavy use of various topical drugs may lead to cancer. Although the incidence of carcinoma is low, it is more harmful once it occurs. Therefore, anal fistula should be treated in time to prevent the occurrence of cancer. 11.What are the high-risk factors of colorectal cancer? High-risk groups include: adults who live in areas with high incidence of colorectal cancer; those who eat high-fat and low-fiber diet for a long time; those who have family history of colorectal cancer; patients with intestinal polyps and long-term colitis, especially those who have a history of ulcerative colitis for more than 10 years; patients who have had cancer of the colon, uterus, ovaries and breast; patients with schistosomiasis; those who have had gallbladder removal; and those who have received radiation therapy to the pelvis. High-risk groups need frequent self-examination and regular medical checkups. 12.What is artificial anus? After cancer in the rectum, if the rectum is located very close to the anus, the tumor should be removed along with the original anus in order to remove the tumor radically. The original anus cannot be defecated normally, so the end of the large intestine must be made a passageway from outside the body to achieve the purpose of defecation. For this reason, scientists have designed a method to pull the proximal section of the resected large intestine from the left lower abdominal wall stoma to the outside of the body, so that the stool will be expelled naturally from the intestinal cavity of the abdominal wall opening, which is the artificial anus. Because the artificial anus disrupts the normal physiological state, the stool is rerouted from the abdominal wall, so the patient may have subjective thoughts such as inconvenience in life, that abdominal defecation is not good for personal hygiene and easy to occur odor. In fact, the artificial anus has its positive side. When defecating, the patient can feel it first, and will go to the bathroom to clean and wash, and handle it properly, and there is no odor, and the patient himself will find out the experience of handling it, and feel that it is convenient to use tools such as artificial anal pouch. However, it is important to note that patients should try not to give themselves diarrhea, and take appropriate medication and eat foods that contain a lot of fiber. The artificial anal canal should be dilated frequently with the finger in the early stages of application so that it is not narrowed. It is much better to use artificial anus than those who can barely keep the original anus and have great surgical trauma and cannot control the stool after surgery. 13.How to prevent colorectal cancer? (1) To prevent colorectal cancer, we should eat less high-fat diet and more fiber-rich foods such as fresh vegetables and fruits. The fiber content in food can promote intestinal peristalsis, assist in laxation and shorten the contact time between harmful substances in feces and intestinal mucosa, thus contributing to the prevention of rectal cancer. (2) Actively treat polyps and polyposis, and patients with colorectal adenoma, especially familial adenomatosis which is prone to cancer, should have the lesions removed. (3) Active prevention and treatment of schistosomiasis is meaningful to reduce the incidence of colorectal cancer. (4) Conducting screening for middle-aged and above, especially for high-risk groups prone to colorectal cancer, including the application of measures such as fecal occult blood examination, rectal finger examination and endoscopy, is of great significance for early detection, early diagnosis and early treatment. 14.What factors are related to the occurrence of constipation? According to the survey data of Tianjin Institute of Colorectal Research in May 1992, constipation is related to various factors such as gender, age, occupation, family history, water consumption and education level. The ratio of men to women with constipation is 1:2.75 (3 times more women than men in the United States), and the incidence of constipation increases significantly in patients over 60 years of age. Family history of constipation is also associated with prevalence, suggesting that genetics and environment may be a factor in constipation. The prevalence of constipation increased significantly in those who drank less than 1000 ml of water per day. The higher the level of education, the lower the prevalence. In addition, the prevalence was significantly higher in the frail and sickly than in the healthy, while smoking, alcohol consumption, childbirth and prevalence were not significantly related. 15.Why are women more likely to suffer from constipation? According to statistics, women account for the majority of patients who visit the clinic for constipation. Why are there more women suffering from constipation than men? One of the most important reasons is the hormonal effect. From menstruation to ovulation, the action is mainly by follicular hormones, while after ovulation to menstruation is controlled by luteinizing hormones, which have an inhibitory effect on the peristalsis of the large intestine, so we can probably conclude that this is the reason why women are more prone to constipation. In addition, women’s muscle strength is weaker, the movement of the large intestine to transmit stool is also relatively weak, and the abdominal pressure is relatively insufficient when forceful defecation, and the other is that women originally eat less than men, and if they deliberately diet again, the diet intake is less, resulting in a decrease in stool volume. It is worth mentioning that women are often affected by the surrounding environment and cause constipation. 16.What auxiliary tests can help diagnose constipation? Colonic transmission test, fecal imaging, balloon force-out test, rectal sensory function test, anorectal manometry, pelvic floor imaging, blood biochemical test, air-barium double contrast imaging, fiberoptic colonoscopy, etc. are auxiliary tests that can help diagnose constipation, which should be selected at clinical discretion according to the patient’s morbidity characteristics.