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Yu Xu Chao
Colorectal Surgery
About me
Chief physician, master's degree graduate, engaged in colorectal surgery for six years, proficient in using integrated traditional Chinese and Western medicine to treat colorectal diseases.
Proficient in diseases
Has rich clinical experience in anal diseases, specializes in using a combination of Chinese and Western medicine methods to treat internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, anal fissures, anal fistulas, perianal abscesses, rectal prolapse, anal stenosis, constipation, inflammatory bowel disease, colorectal tumors, etc.
Voices
What are the early symptoms of perianal abscess?
The early symptoms of a perianal abscess mainly manifest as a red and swollen lump around the anus, which is noticeably painful to touch, and feels warm. As the lump grows and purulence develops, a fluctuation sensation can be felt upon touching. In severe cases, patients may even experience systemic symptoms such as fever and night sweats. For a perianal abscess, it is recommended that patients visit the proctology department of a hospital as soon as possible to undergo procedures like incision and drainage of the abscess, or a radical surgery for perianal abscess. Relying solely on medication can delay treatment and cause the abscess to spread further, potentially leading to necrotizing fasciitis or anal fistula. A perianal abscess is typically caused by an infection of the anal glands, which spreads from inside the anal canal to the surrounding areas. Simple medication treatment cannot eradicate the infection source; therefore, it is advisable to opt for surgical treatment as soon as a perianal abscess is detected.
How to treat bleeding from internal hemorrhoids?
In clinical practice, for internal hemorrhoids with bleeding, conservative medication or surgical treatment are often used. The specific treatment method mainly depends on the severity of the bleeding from internal hemorrhoids and whether the patient also has anemia. For early-stage internal hemorrhoid bleeding, which is intermittent and infrequent, conservative medication treatment is usually recommended. Commonly used medications include hemorrhoid suppositories or ointments for anal administration, and oral hemostatic medications can also effectively improve bleeding from internal hemorrhoids. Meanwhile, it is advised that patients maintain a light diet, avoid spicy, stimulating, and dry foods, and ensure smooth bowel movements to alleviate bleeding from internal hemorrhoids. However, if a patient's bleeding from internal hemorrhoids has led to chronic hemorrhagic anemia or even severe anemia, surgical treatment is recommended. Options might include sclerotherapy injections for internal hemorrhoids, internal hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (transanal hemorrhoidal dearterialization) and other surgical methods. (Please follow medical advice when using medications.)
Second-degree internal hemorrhoids, what is the best way to treat them?
Second-degree internal hemorrhoids mainly refer to the intermittent rectal bleeding and anal prolapse caused by internal hemorrhoids, but the prolapsed tissues can retract back into the anus on their own after defecation. For this condition, it is generally recommended to use conservative medication treatments, change dietary habits, and develop good bowel habits to alleviate symptoms and prevent the progression of the prolapse. For example, patients can eat more foods rich in roughage to facilitate smoother bowel movements. It's also advised not to sit too long during defecation or strain excessively. After defecation, it is beneficial to perform anal exercises and take sits baths using anal washes or warm saline solution for five to ten minutes to promote local circulation and ease the prolapse. Additionally, patients should regularly perform anal exercises and maintain an active lifestyle. When using hemorrhoid suppositories or creams, it is important to choose the appropriate medication based on the symptoms.
How to deal with occasional bleeding from external hemorrhoids?
Occasional bleeding from external hemorrhoids is mainly due to damage to the hemorrhoids, which leads to bleeding, usually accompanied by pain and a foreign body sensation in the anus. In such cases, if the bleeding is not severe and the pain is mild, it means the damage to the external hemorrhoids is not serious. For these cases, one can choose to use an anal cleansing agent for sitz baths to achieve anti-inflammatory and antibacterial effects, and then apply hemorrhoid cream and other medications externally to promote healing of the sores. At the same time, patients should wear loose, breathable cotton underwear to avoid frequent friction on the external hemorrhoids, which can worsen the damage. If the damage to the external hemorrhoids is severe, or if there is swelling or thrombosis, it is advised to go to the hospital's anorectal surgery department as soon as possible to undergo a hemorrhoidectomy. After the surgery, patients must persist in changing dressings to promote wound healing.
How to eliminate a two-centimeter external hemorrhoid?
The external hemorrhoid is about two centimeters in size, which indicates that it's relatively large. This condition can cause feelings of a foreign object in the anus, itching, and even moisture around the anal area, leading to anal eczema. If one wishes to completely eliminate it, it is advisable to go to the hospital's proctology department as soon as possible to have a hemorrhoidectomy. Post-surgery, one should choose anal cleaning solutions or potassium permanganate solution for sitz baths, complemented by external applications of medicines such as Jing Huang Gao or hemorrhoid creams. At the same time, the patient's diet should consist of light and easily digestible food to prevent dry and hard stools, which will aid in the healing of the surgical site. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid sitting or squatting for long periods. Regularly performing anal lifting exercises can prevent the recurrence of external hemorrhoids. If patients prefer not to undergo surgery, conservative medical treatment can be used to reduce the size of the external hemorrhoids, but it cannot completely eliminate them.
Why do internal hemorrhoids prolapse without pain, itching, or bleeding?
Internal hemorrhoids that prolapse but do not hurt, itch, or bleed are primarily due to the large size of the prolapsed hemorrhoids and severe varicose veins underneath them, which leads to prolapse. At this time, they are less likely to bleed and will not cause itching. Since internal hemorrhoids are located above the dentate line in the anal canal, at the end of the rectum, and are innervated by the autonomic nervous system, they also do not cause pain. However, if internal hemorrhoids remain prolapsed at the anus for a long time, they can easily lead to local inflammatory edema, causing local pain and even a significant increase in secretion from the anal area. Therefore, when internal hemorrhoids prolapse, they should be pushed back into the anus as soon as possible. If repositioning is not possible, it is recommended to promptly undergo a hemorrhoid banding procedure, and regularly perform pelvic floor exercises to ensure smooth bowel movements.
Do external hemorrhoids require surgery?
If external hemorrhoids do not cause any discomfort to the patient, then it is possible to delay surgical treatment in this situation. This is because the treatment of external hemorrhoids is primarily based on their clinical symptoms to choose different treatment methods. If it is simply a case of redundant skin hemorrhoids, where the patient only experiences a slight foreign body sensation in the anus, surgical intervention is not necessary. The patient only needs to maintain smooth bowel movements, perform more anal lifting exercises, avoid prolonged sitting and squatting, and take a warm saltwater sitz bath after defecation to prevent exacerbation of the external hemorrhoids. However, if the external hemorrhoid node develops inflammatory edema or thrombosis, causing anal swelling and pain, and the patient is unable to walk normally, it is then recommended to promptly visit the proctology department of a hospital to undergo external hemorrhoidectomy, to prevent worsening of the inflammatory edema or thrombosis, leading to significant anal swelling and pain.
How to treat hemorrhoids bleeding
In clinical practice, the treatment of hemorrhoidal bleeding primarily depends on the severity of the bleeding. If a patient experiences frequent hemorrhoidal bleeding and the volume of blood loss is significant, it is recommended to adopt surgical treatments early. Prolonged bleeding can lead to severe anemia, severely impacting the patient's health. Possible surgical options include sclerotherapy, internal hemorrhoid ligation, or surgeries like PPH and TST. However, if the hemorrhoidal bleeding is infrequent and the volume of blood loss is minimal, the first step should be to improve the diet. Consuming more seasonal fresh fruits and vegetables, maintaining smooth bowel movements, not spending too long on bowel movements or straining excessively, and using hemorrhoidal suppositories or ointments for anal administration after bowel movements are recommended.
How to solve internal hemorrhoids that are prolapsed and incarcerated?
In clinical practice, for cases where internal hemorrhoids prolapse and become incarcerated, surgical treatment is often recommended. This is because the prolapse of internal hemorrhoids indicates a significant displacement and that the hemorrhoids have been prolapsed for a long time, which can lead to incarceration. In such cases, there is a risk of localized swelling or thrombosis formation, causing anal swelling and pain, and in severe cases, necrosis of the prolapsed tissue. Therefore, it is advised to opt for surgical treatment as soon as possible for incarcerated internal hemorrhoidal prolapse. Surgical options include hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), and TST (Transanal hemorrhoidal dearterialization) among others. Anesthetic choices can range from local infiltration anesthesia, spinal anesthesia, to general intravenous anesthesia. With spinal and general anesthesia, the patient does not experience pain during surgery and does not feel fear of pain. Post-surgery, it is also necessary to select appropriate medications for dressing changes, such as anal washes, hemorrhoidal suppositories, and golden yellow ointment to promote wound healing.
What color is a prolapsed internal hemorrhoid?
If internal hemorrhoids prolapse, it indicates that the hemorrhoidal venous plexus is severely varicose and congested, and the anal cushion has pathologically enlarged and descended, leading to the prolapse of the internal hemorrhoids. The color of prolapsed internal hemorrhoids at the anal opening commonly appears as purple lumps or swellings. If the prolapsed hemorrhoids cannot retract back into the anus, even with manual assistance, this condition may lead to necrosis of the internal hemorrhoids. If necrosis occurs and results in localized thrombosis, the hemorrhoids may turn black. In such cases, prompt surgical treatment is required to prevent necrosis and worsening infection of the hemorrhoids. Surgical options include internal hemorrhoid ligation, PPH (procedure for prolapse and hemorrhoids), or TST (transanal hemorrhoidal dearterialization), as well as the traditional excision and ligation. Postoperatively, consistent wound dressing changes are necessary to promote healing.