1. Why do people get hemorrhoids?
The cause of hemorrhoids is not yet fully understood, and it is generally believed that it is mainly related to the following factors.
(1) with the upright state of the human body: because the anorectum is located in the lower part of the trunk, people are often in an upright position, the anus is low relative to the heart, due to the factor of gravity, the anorectal part of the blood flow back to the heart is more difficult, easy to depress into hemorrhoids, while the animal heart is lower than the anal position, so far have not found animals with hemorrhoids.
(2) 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 at the beginning of the blood vessels so that blood can only flow in one direction and cannot flow back. However, there is no valve in the hemorrhoidal vein in the anal area, so the blood is easily trapped in the local area, leading to local varicose veins and the gradual formation of hemorrhoids.
(3) Related to infection 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 cause the walls of the hemorrhoidal plexus to become brittle, thin, varicose, and finally form hemorrhoids.
(4) It is related to constipation and prolonged bowel movement. When the dry and hard stools enter the rectal jug abdomen, they exert 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, leading to the expansion of the venous plexus and tortuous, which gradually forms varicose masses 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) Related to emphysema, chronic bronchitis and other diseases 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, genetics, 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 because of the softness of the hemorrhoid nucleus, while rectal cancer can be palpated through finger diagnosis in the rectum and anal canal with a hard and unsmooth mass in the shape 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) Asymptomatic hemorrhoids do not require treatment, and symptomatic hemorrhoids focus on reducing or eliminating symptoms rather than eliminating the nucleus itself.
(2) Non-surgical treatment is preferred for hemorrhoids. For stage I and II hemorrhoids, choose medication or add physical therapy; for stage III and IV hemorrhoids, surgical therapy is the mainstay.
(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) not to let the buttocks get cold.
(7) not to hold a position for a long time
(8) control the intake of alcohol, spicy and irritating food.
(9) Avoid sitting for a long time.
(10) Discuss with the doctor in time to receive proper treatment.
6.How to prevent anal fissure?
(1) Avoid spicy and stimulating foods and eat a coarse fiber diet.
(2) Develop regular bowel habits, actively prevent and control constipation, and keep the bowels open. After the formation of dry and hard stool, do not exert force, and use a 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 the occurrence of infection in the perianal area, as follows
(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 upwards, which is easily damaged and infected by the invasion of bacteria. 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 of the poor ability of the perianal space to resist infection, infection can easily spread in these spaces.
(2) Decreased systemic resistance: such as diabetes, old age and frailty, overexertion and decreased resistance in patients with tuberculosis, which can easily lead to perianal abscess.
(3) Local anal irritation and injury: such as frequent consumption of irritating foods such as chili peppers and alcohol will lead to local congestion of the anal canal and rectum, and local resistance will be 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 duct, as well as trauma to the anorectum or stabbing the anal canal rectum by chicken, duck and fish bones swallowed with food can lead to infection around the anorectum and the formation of perianal pus.
8.How should perianal abscess be treated?
In the early stage of perianal abscess, antibiotics and Chinese herbal medicines for clearing heat and detoxification can be taken internally and Chinese herbal ointments for clearing heat and detoxification and dispersing carbuncles can be applied externally, so that the inflammation can be controlled and will not 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?
Most of the 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 develop into anal fistulas, which are actually different stages of a disease.
10. Can an anal fistula become cancerous?
After long-term clinical observation, the majority of anal fistulas do not become cancerous, but a very small number of anal fistulas can become cancerous. The reasons 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 living in areas with a high incidence of colorectal cancer; people who have a long-term high-fat and low-fiber diet; people with a family history of colorectal cancer; patients with intestinal polyps and long-term colitis, especially those with 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; people who have had their gallbladders removed; and people who have received radiation therapy to the pelvis. High-risk groups need frequent self-examination and regular medical checkups.
12.What do you mean by artificial anus?
After cancer in the rectum, if the rectum is located very close to the anus, the tumor will be removed along with the original anus in order to remove the tumor radically. The original anus cannot defecate 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, and the stool will be naturally expelled 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, it is necessary to 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, which is beneficial 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 their lesions removed.
(3) Active prevention and treatment of schistosomiasis is significant to reduce the incidence of colorectal cancer.
(4) Screening for middle-aged people and above, especially those at high risk of colorectal cancer, including the application of fecal occult blood test, rectal finger examination, endoscopy and other measures, is important 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 a variety of 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 (three times more women than men in the United States), and there is a significant increase in the number of patients with constipation over 60 years of age, with a corresponding increase in incidence. 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, it is mainly the follicle hormone that acts, while after ovulation to menstruation it is controlled by luteinizing hormone, which has 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?
Colon transfer 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 according to the patient’s morbidity in clinical practice.
17.What are the side effects of taking laxatives for a long time?
Most laxatives have different degrees of toxic effects and side effects, and the following may occur when taken for a long time.
(1) They may stimulate the digestive tract causing nausea, vomiting, abdominal pain, etc.
(2) Some laxatives such as mannitol, which is a hypertonic laxative, can draw large amounts of water from the tissues of the intestinal wall and cause dehydration.
(3) Abuse of laxatives during pregnancy, especially in the second trimester, may lead to miscarriage.
(4) A small number of patients may develop allergic reactions, such as rash, allergic enteritis, etc.
(5) Long-term use can also reduce the stress of the nerve receptor cells in the intestinal wall, and even if there is enough stool in the intestine, it cannot produce normal peristalsis and defecation reflex, thus making constipation more difficult to treat.
(6) long-term use of senna, rhubarb, aloe and other irritating laxatives can lead to colon melanosis.
18.How to develop good bowel habits?
Defecation should be a certain rule, if often delayed stool time, can make the defecation reflex weak, causing habitual constipation. Therefore, to treat constipation, we must change the bad defecation habits and rebuild the normal defecation reflex and normal defecation function.
First of all, to develop the habit of regular defecation, whether or not the intention to defecate, it is best to squat once in a fixed period of time. This time should be chosen in the morning after waking up or other time that you think is appropriate. Of course, the formality is not helpful. In the bowel movement to focus on the bowel movement, do not do other things such as reading books, listening to music, etc.. By developing the habit of regular bowel movements, you can increase the normal bowel reflex.
Second, do not artificially control defecation, in the feces into the rectum when the desire to defecate immediately. For people who have habitual constipation, any urge to defecate, even if it is very weak, is valuable. Once the urge disappears, it is not so easy to have it again. The reason is that the intention to produce is not by the will of the person, ignore the intention, not timely to defecate, over time, the intention is inhibited, and feces in the colon stay too long, too much water is absorbed, the stool becomes dry, the result is not easy to discharge feces.
19.What fruits and vegetables can prevent constipation?
The prevention and treatment of constipation has a better effect on the following fruits: pears, peaches, bananas, oranges, mandarin oranges, watermelon, melon, sugar cane, water chestnuts, etc. These fruits are generally cold, with the effect of heat and intestinal, can directly stimulate the intestinal tract, increase intestinal peristalsis, while containing a variety of vitamins and a large amount of fiber. Cucumber, carrots, tomatoes and the above-mentioned fruits are similar, raw food also has a good laxative effect. Apple contains tannic acid, but sometimes not conducive to the treatment of constipation. Gui He is warm in nature and can affect the bowel movement of people with high fire energy. Vegetables containing more fiber include fungus, silver fungus, shiitake mushrooms, kelp, bok choy, mullein, pumpkin, etc. Fruits containing more oil such as pecans, sesame, melon seeds, etc. have laxative effect.