1.What is perianorectal abscess?
Perianorectal abscess is medically referred to as an abscess formed by acute or chronic purulent infection in the perianal space, which is called “dirty poison”, “anal carbuncle”, “stork mouth gangrene”, etc. in Chinese medicine. The formation of this abscess is mainly due to purulent inflammation caused by anal sinusitis, in which bacteria invade further into the anorectal area from the infected anal sinus, anal gland ducts and anal glands, and once they “settle” there, they cause purulent inflammation. At this time, there can be severe pain, redness, swelling and fever around the anorectum, and even general discomfort, difficulty in urination, followed by the breakdown of pus. If the wound does not heal for a long time after the ulcer, an anal fistula will be formed.
In addition to sinusitis, which is the main cause of perianorectal abscess, systemic tuberculosis, ulcerative colitis, clonorchiasis, cancer of the rectum and anal canal, as well as foreign body into the anus and trauma to the anorectum can cause perianorectal infection and abscess formation. Infection of hemorrhoids and anal fissures can also cause abscesses.
Therefore, as the name implies, perianorectal abscess is the formation of a pus-flowing mass around the anus and rectum.
2.How do patients know early that they have perianal abscess?
Generally speaking, the onset of any disease has a process, but most perianal abscesses have an acute onset and often appear as pus-filled masses without notice. The disease can occur in people of any age, but it is more common in young adults between the ages of 20 and 40, and more often in men than in women. Since it is often not easy for patients to notice it themselves at the initial stage of infection, when there are self-conscious symptoms, an abscess has already formed. Therefore, in the earliest initial stage of perianal abscess, patients themselves are easy to ignore and not alert themselves, so they are often caught off guard and unaware of the sudden perianal swelling and pain, breaking and flowing pus. Some patients also think that they have a boil on their buttocks because of the excessive fire toxicity, and let it develop without thinking about it. These are all situations that are frequently encountered in clinical work. Therefore, when you feel a lump protruding next to the anus that is hard and painful to touch, and later the swelling and pain expand and become softer, with local heat and a redder color around it, consider whether you have a perianal abscess. And when the lump breaks down and flows pus, it can contaminate the underwear. Patients often feel dampness in the anus with obvious discharge, which indicates that the abscess has broken down and flowed pus. At this time you should first consider whether you are suffering from perianal abscess.
3.How should patients deal with perianal abscess in the early stage by themselves?
When you feel the pain and swelling in the anus, generally speaking, according to the medical staging, it is already in the early stage. At this time, one can feel the local redness, swelling and heat pain in the anus, uncomfortable anal swelling, tiredness, weakness, weakness, loss of appetite, thirst for water and dry stools. If you have not yet gone to the hospital, you can use 1:5000 potassium permanganate solution to sit in the anus for 10 minutes each time, 1 to 2 times a day. You can also use 30 grams each of rhubarb, amaranth, and mannitol, decocted in water for half an hour, about 1000 ml, first smoked and then washed in the anal bath, 15 minutes each time, 1 to 2 times a day. Also can be used rhubarb, cypress, mannite 50 grams each, water decoction as above fumigation sitz bath. If you can’t buy medicine temporarily, you can use 1:1000 salt water sitz bath anus, after the sitz bath topical application of Ma Yinglong musk hemorrhoid cream or gentamycin eye ointment, erythromycin eye ointment. At the same time, take certain oral anti-inflammatory drugs such as cotrimoxazole, spiramycin, and oxyfluoxacin tablets. If the symptoms cannot be controlled and the condition tends to worsen after the above-mentioned self-treatment at home, you should go to a qualified hospital for medical consultation. After consultation, through the physician’s clear diagnosis, according to medical advice for the next step of systematic treatment. Do not miss the opportunity of the disease and lose the best time to treat the disease.
4.How to take care of perianal abscess after fever?
After suffering from perianal abscess, before the anal abscess breaks down and flows pus, a number of patients will have feverish symptoms similar to cold. This is due to bacterial infection in the body, which is considered by Chinese medicine to be the result of the struggle between good and evil. If the blood test is performed at this time, many patients will have an increased white blood cell count, which indicates the presence of bacterial infection. Therefore, it is important to know that this is a normal phenomenon that occurs during the development of the disease and there is no need to panic about it. If you can’t go to the hospital in time, you should have antipyretic medication at home, such as paracetamol and panacea, which can be taken orally according to the instructions. At the same time, drink more water, more soup, to seaweed soup, winter melon soup, cucumber soup, etc. is better, but also can be used to make mung bean porridge to take. Pay attention to rest and avoid strenuous activities and physical labor. If the body temperature does not subside, use a hot water bag with frozen water and ice in the refrigerator for external application, can be applied to the forehead, swollen and painful areas next to the anus. If you have the An Gong Niu Huang Wan and other antipyretic drugs at home, you can take 1 capsule orally. The condition should be closely observed. Family members should cooperate with the patient to pay attention to changes in breathing, pulse, and other changes, pay attention to the mental condition, and always care about the patient’s condition. 1 hour or so can measure the body temperature, pay attention to the changes in body temperature, and be prepared to go to the hospital if the high temperature does not subside.
5.How should the family members of patients with perianorectal abscess perform psychological care after surgery?
After the surgery of perianorectal abscess patients, as the patients’ relatives or friends, they have the responsibility and obligation to take care of the patients and offer their caring hearts. And there is a lot to learn in these inconspicuous companions. Although most people do not specialize in psychology, they are not unfamiliar with it. For example, when a person is ill and anxious, friends and relatives use sincere and earnest words to persuade them to recuperate, drop their worries and encourage the patient to build up confidence, which is, in fact, a kind of psychotherapy. Therefore, the answer to the question of whether or not psychotherapy can be performed during a visit to a patient should be yes. Psychotherapy includes very rich contents, and the most common one is the easiest one – reasoning and guidance method, that is, using words to convince, explain, encourage and advise the patient to get rid of or reduce the psychological burden, so that the condition can be improved. In order to get the desired effect, there should be preparation before the visit, which mainly includes: to understand the nature of the patient’s disease, what is the condition, what is the prognosis, what is the current main psychological contradiction, etc., when visiting or accompanying these practical problems, targeted. For example, if the patient is mainly worried that his disease is not cured, we should try to tell other examples of how to cure the same disease; if the patient is mainly anxious, eager to cure, friends and relatives should do everything possible to stabilize the patient’s impatience, to make clear the truth that “the disease is like a mountain, the disease is like a silk”; if the patient is blindly optimistic, we should warn him that taking the disease lightly will “suffer a big loss”, tell some of the serious consequences of not treating If the patient is blindly optimistic, he should be warned that taking the disease lightly will “suffer big losses” and tell some examples of serious consequences without serious treatment. In addition, in general, hospitalized patients miss the important unfinished work at home or in the unit, so friends and relatives should report some news that will make them happy, and pay attention to the principle of “reporting good news but not bad news” to patients.
Confidence is very important to overcome the disease, and patients should be helped and encouraged to build and strengthen their confidence, which is especially important for chronic diseases that do not heal and difficult diseases that do not heal well. Among the patients with perianorectal abscess, some suffer from high deep abscesses and some suffer from complex multiple abscesses, which are more serious compared to other anal diseases. Some friends and relatives, when they see the emaciated face and painful expression of the patient, can’t help but cry in front of the patient, which will add new mental pressure to the patient. Because the patient is always watching you, they infer the severity of their condition and prognosis from your words and actions, even an expression and a look, especially those who are critically ill.
Perianorectal abscess is a common and frequent disease in anorectal diseases, and it can be completely cured through careful treatment by doctors and active cooperation of patients, as well as the joint efforts of patients’ family members and friends, which is where our common confidence lies.
Finally, it is important to note that family members and friends should not pretend to understand, give the patient random ideas, and not to comment on the patient’s treating doctor and the drugs used. Because such irresponsible comments not only fail to achieve the psychotherapeutic effect, on the contrary, it will also play a destructive role in the treatment.
6, perianal abscess patients after surgery to maintain optimism why is conducive to early recovery, how to maintain optimism?
As the old saying goes, “happiness to forget your worries” is meaningful for healthy people, and it is even more important for inpatients. When suffering from perianorectal abscess, the patient’s anal pain, swelling and pus flow is a bad stimulus for him, which can easily cause a bad mood. Everything around the patient may seem unpleasant to him, and if he is slightly displeased, he will have nameless anger; some of them show melancholy and lie in bed with their heads covered; some of them, because of the disease torture and pain, over-excitedly think that the society is unfair to them, and show temperamental anger; some of them are restricted in various activities after hospitalization, and thus are jealous of the freedom of healthy people. These are all undesirable psychological states of hospitalized patients.
Medical psychology research confirms that bad emotions such as tension, fear, anxiety, sadness, anger, etc., will make the psychological balance of a person out of balance, which in turn will make the physiological function out of balance, making the immune function of the body that is sick even lower and the endocrine function out of balance. Patients are mentally depressed and depressed, which can also cause diet and rest to be affected. Obviously, these are harmful to the recovery of patients with perianorectal abscess. On the contrary, setting up a correct “disease view”, being cheerful and optimistic, and eliminating bad emotions will keep the psychological and physiological functions in dynamic balance, thus mobilizing the potential anti-disease ability in the body, actively cooperating with treatment, promoting wound healing, and recovering health as soon as possible. So, how to maintain optimism in hospitalized patients?
(1) Correct understanding of disease: living in a big world, the social and natural environment is constantly changing, influenced by various external and internal factors, it is impossible to never get sick. Moreover, perianorectal abscess is not an incurable disease, it can be cured. In this way, you can stabilize your emotions and thus make your mind open.
(2) Change of mind: As the saying goes, “an open mind can remove a hundred diseases”. Inpatients should not frown, meditate, but to talk with patients, to friends and relatives to confide in the misery, to vent depression, so as to achieve joy to forget.
(3) control emotions: learn to control their emotions with reason, take appropriate ways to vent bad emotions, such as walking indoors or outdoors, enjoying the moon, listening to music, etc., do not anger others, so as to get the care and help of relatives, colleagues and patients, their mood will be calm, quiet in order to have fun.
By maintaining optimism, establishing a healthy psychology and cultivating a positive state of mind for oneself so that one’s body can recover as soon as possible, this is a wise choice for many patients with perianorectal abscess.
7.How can patients with perianorectal abscess overcome the psychological tension before surgery?
According to the condition, most patients with perianorectal abscess need open surgery, and patients often have the psychological fear of surgery (such as fear of surgery pain, fear of accident, fear of incision not healing after surgery, fear of surgery complications or even fear of disability or death), thus appearing panic, restlessness, insomnia and nightmares, which is unfavorable to the success of surgery.
It is very important to overcome the preoperative psychological tension. First, trust the hospital and believe that the doctor’s decision to operate is not a rash one, but a responsible medical measure taken after careful analysis of the pros and cons of surgery and no surgery, and in the fundamental interests of the patient, thus strengthening his confidence in the success of the operation, taking the initiative and cooperating closely. Second, self-suggestion and self-association should be carried out. Such as preoperative suggestion of mental and physical relaxation will result in less damage during surgery, faster recovery after surgery, and smooth and successful surgery; such as association of early recovery will usher in a happy and beautiful life, etc., and thus achieve a state of relaxed mind. Thirdly, it is important to realize that adequate sleep and sufficient nutrition are important guarantees for early recovery, and thus implement them. Fourth, it is important to understand that although the surgery itself is somewhat painful, it is temporary and unavoidable, and the medical staff will do everything possible to reduce the patient’s pain, while the surgery will eradicate the disease. Fifth, patients should know that perianorectal abscess is a very effective treatment route through surgery, and that only through surgery can the aggravation and spread of the disease be avoided. In this way, patients will be open-minded and calm before they are about to undergo surgery, thus overcoming their nervousness.
8.How to perform qigong exercise after anorectal perineal abscess patients and why qigong can cure the disease?
The survival of human beings requires constant metabolism, such as the respiratory exchange of gases, the digestion and absorption of food, and the circulation of blood, which is called the “biochemical way” in ancient times. The function of qigong is to strengthen this “qi-chemistry” of human body through various exercise means, such as posture breathing and intentional exercise, in order to ensure the normal conduct of human life activities.
(1) Balance yin and yang: The human body relies on the “yin and yang” of the organism to constantly move and change in order to maintain a dynamic balance to sustain its life activities, and this process is called “yin and yang secret” in Chinese medicine. According to the properties of yin and yang, movement is yang and stillness is yin, so qigong believes that “the person is yin and yang” and “yin and yang, movement and stillness”. Movement and static unity, qi and blood and smooth, all diseases are not born, is to be able to exhaust their natural years. Therefore, when practicing gong, we should “move outside and move inside, and move in stillness”; “seek stillness in movement, and move and move with mutual roots”, in order to have yin and yang secret.
(2) harmonize the role of qi and blood: the harmonization of qi and blood, is also an important factor in the body’s life activities. Qi and blood imbalance will produce disease. However, qigong mainly exercises “qi”, how does it affect the “blood”? Chinese medicine believes that qi is the handsome of blood, “qi line is blood line”, “qi stagnation is blood stagnation”, so there is “blood is not good without qi, qi is not attached to blood” said. Therefore, although qigong is the exercise of “qi”, but it can indirectly have an important impact on the blood, so as to achieve the purpose of reconciliation of qi and blood.
(3) dredge the role of meridians: meridians link the various parts of the body into a unified whole, is the body’s qi and blood running and transmission channels, its smooth or not, directly affect the operation of qi and blood, and the smooth flow of the meridian system is to rely on the “gas” to promote the role and achieve. Therefore, when practicing to a certain extent, we often feel the phenomenon of “internal qi” running in the body and accelerating blood circulation.
(4) Cultivation of true qi: true qi is also called “yuan qi”. It is born from the innate essence, nourished and supplemented by the water and grain essence of the latter, and is the driving force of human life activities. The practice of gong is to make it more abundant through various means of exercise. People who have practiced gong must feel that not only is the Dantian gas sufficient, clear and energetic at the time of practicing gong, but they also feel energetic for a longer period of time after practicing gong, which is the role of cultivating true qi.
As a post-operative patient with perianorectal abscess, qigong should be practiced mainly in a sitting or horizontal posture, with both hands protecting the umbilicus, and with the intention of guarding the Dantian or the perineum. When holding the breath, count the numbers silently, accompanied by lightly lifting the anus, 20 to 30 times per minute, for 5 minutes each time. Then relax your breath, inhale loudly and do it again from the beginning. Each time for about 10 minutes, 1 to 2 times a day. It has good effect on the recovery of anal function and the growth and healing of wounds.
9.How do patients with perianorectal abscess perform physical exercise and effective health care after surgery?
Patients with perianorectal abscess are discharged from the hospital after surgery, and how to carry out physical exercise in the future is the primary problem in front of the majority of patients. According to the elaborate research and observation of Mr. Takenouchi, a famous Han doctor in Tokyo, Japan, it is believed that insisting on jogging exercise for about one hour every day can stimulate the palms of the feet, which are associated with all internal organs, and can promote blood flow throughout the body, as well as make the stool flow smoothly, which can help restore the function of the anus and improve the local blood circulation in the anus, so that the blood, which has been stagnant in the lower body for a long time, can return to the heart relatively smoothly. At the same time, you can also try to develop the habit of walking more. In people’s daily lives, the best fitness habit to develop every day is to “walk more”. For example: every day you can intentionally not use the elevator, but to climb up and down the stairs; when you get home from work, you can intentionally get off the bus one stop earlier to walk, etc.. Walking” fitness method, not only can improve the local anal, rectal blood circulation, but also can improve and enhance the function of internal organs, eliminate psychological tension, etc., with a “multi-benefit” effect.
In addition, the introduction of a smoke burning therapy. The Tonggu point is located at the root of the little toe of the human foot. Since the Tonggu point is one of the points located on the path of the bladder meridian, smoke cauterization of the Tonggu point can smooth the operation of the bladder meridian and promote blood flow throughout the body. When smoke-burning the acupuncture point, care should be taken to keep the point as close to the skin as possible while causing a burning sensation. Generally repeated about 7 times to achieve the effect of preventing the recurrence of disease. Of course, a variety of exercise methods are valuable to adhere to, to persevere, cultivate the body, will receive the expected results.
10.How should patients with perianorectal abscess take care of themselves at home and what should they pay attention to?
In our clinical work, there are many patients with perianorectal abscess who tell about their situation at home and fail to receive timely medical treatment or wrong medication due to ignorance of medical knowledge, and their families urgently need to know about nursing care in order to help patients alleviate their pain and overcome difficulties. According to our years of medical clinical experience, we believe that we should pay attention to the following aspects.
(1) When anorectal perianal abscess starts, 2.5% iodine and 70% alcohol can be used to rub the local area; topical application of plucking cream, ichthyolite ointment, yulu cream or pounding fresh dandelion, ziziphiopogon, horsetail, etc. on the local area; local hot compress, etc. If the inflammation does not subside and the systemic symptoms are significantly aggravated, you should go to hospital for treatment.
(2) When perianorectal abscesses are formed, do not squeeze them with your hands to avoid spreading the infection.
(3) Develop the habit of having bowel movements on time every day and keep the bowels open. When the stool is dry, take a laxative (paraffin oil) or use a topical open plug. Also to prevent diarrhea, pay attention to dietary hygiene.
(4) Eat less spicy and stimulating food, do not drink excessively, and eat more fresh vegetables, fruits and food containing coarse fiber.
(5) timely treatment of chronic diseases that can increase abdominal pressure, such as habitual constipation, chronic cough, etc.
(6) for sedentary workers, to do interval exercises and other physical exercise, such as anal exercise. The method is to force the arm muscles to contract inward so that the anus is lifted upward.
(7) Chronic diseases at the anus should be treated promptly. Use hot salt water or ordinary hot water to take a sitz bath every day, or use the Chinese medicine Wu Bei Zi Tang (Wu Bei Zi, Mang Nian, Sang Sang Sang, Thornbush, Lian Fang each 30 grams boiled with water) to first smoke and then wash to reduce swelling and relieve pain.