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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
Can anal fissures cause itching?
In most cases, anal fissures do not cause itching. Clinically, anal fissures mainly lead to pain during defecation and minor bleeding, with significant pain during and after defecation, lasting about 10 to 20 minutes. Moreover, patients with later-stage anal fissures often have subcutaneous fistulae and external hemorrhoids. However, in the case of anal itching, the patient might also have anal eczema or perianal condyloma acuminatum, necessitating a visit to the proctology department of a hospital for a digital anal examination and local secretion tests for diagnosis. For early-stage anal fissures, conservative treatment with medications can be chosen, along with maintaining smooth bowel movements to avoid dry and hard stools. In the case of chronic anal fissures, surgical treatment is required.
Can external hemorrhoids be washed with hot water?
External hemorrhoids can be washed with warm water, but the temperature should not be too high, generally controlled below 40 degrees Celsius. Washing external hemorrhoids with warm water can promote local blood circulation and relieve the anal swelling caused by external hemorrhoids. At the same time, it can also remove secretions on the surface of the hemorrhoids, which helps to avoid inflammatory edema in external hemorrhoids. However, the water temperature must not be too high as it could scald the skin around the anus or cause dehydration of the perianal skin, leading to discomfort. Clinically, external hemorrhoids are mainly classified into four types: excess skin hemorrhoids, varicose vein hemorrhoids, thrombotic hemorrhoids, and inflammatory hemorrhoids. Depending on the type, the treatment methods differ. For inflammatory and thrombotic hemorrhoids, it is generally recommended to undergo early hemorrhoidectomy to prevent severe anal pain and serious impact on the patient's life.
What are the symptoms of internal hemorrhoids?
Internal hemorrhoids are a common condition in proctology, clinically characterized primarily by intermittent, painless rectal bleeding. The blood is bright red, often appearing in a jetting or dripping pattern after defecation or on toilet paper during wiping. Simultaneously, the clinical symptoms of internal hemorrhoids vary with their stages. For instance, grade I internal hemorrhoids mainly exhibit intermittent rectal bleeding without any prolapse of anal materials. Grade II internal hemorrhoids show symptoms of intermittent rectal bleeding accompanied by prolapse of anal materials, which can spontaneously reduce. Grade III internal hemorrhoids are characterized by prolapsed anal materials that cannot reduce on their own and require manual intervention. This stage also involves rectal bleeding. Grade IV internal hemorrhoids are the most severe, presenting with irreducible prolapsed materials that can become trapped or may protrude during coughing or walking. Rectal bleeding is also a symptom. Surgical treatment is essential for grade IV internal hemorrhoids.
How long does it take for a thrombosed external hemorrhoid lump to soften?
The lumps of thrombosed external hemorrhoids cannot be eliminated and can only be removed surgically by stripping the thrombus. After surgery, medications such as anal washes, red oil gauze strips, and golden ointment are used for dressing changes to completely cure thrombosed external hemorrhoids. Since the thrombus has already formed, local medications cannot dissolve it; stripping it surgically is the only option. Moreover, thrombosed external hemorrhoids cause patients to experience a distinct sensation of a foreign body in the anus as well as pain and swelling. Patients should pay adequate attention to these symptoms, otherwise, the thrombus might grow larger and may even lead to necrosis of the hemorrhoids. Patients should also develop good bowel habits, avoiding excessive straining or prolonged durations on the toilet, as these practices can easily trigger thrombosed external hemorrhoids or inflammatory external hemorrhoids, leading to significant pain and swelling in the anus. (Use medications under the guidance of a doctor)
Could rectal bleeding without pain be rectal cancer?
When experiencing painless rectal bleeding, it’s first important to consider hemorrhoids as the cause. Hemorrhoid bleeding typically presents as bright red blood, occurring mostly after defecation, and is painless and intermittent. Hemorrhoid bleeding may arise from inappropriate diet or excessive fatigue from staying up late. In contrast, bleeding from rectal cancer tends to be less in volume and often mixes with the stool, accompanied by increased frequency of defecation, mucus in the stool, changes in stool characteristics, or abdominal pain. Clinically, to rule out rectal cancer, it is often recommended that patients undergo a colonoscopy to check for any masses in the intestines. If a mass is present, a biopsy can determine if it's cancerous. Patients with rectal cancer generally exhibit symptoms like weight loss and anemia. Thus, for painless rectal bleeding, hemorrhoids are more generally considered, rather than rectal cancer at first thought.
How to eliminate the external hemorrhoids in postpartum women?
The external hemorrhoids in postpartum women are primarily due to the pathology of the anal cushions, which become pathologically hypertrophic and descend due to the compression of the rectum and anal canal during childbirth. This can lead to the enlargement of external hemorrhoidal nodules and even inflammatory edema. For such cases, it is generally recommended to first try conservative treatment with medications. For example, after defecation, a sitz bath using agents like anal washes or potassium permanganate solution can be used to reduce inflammation and swelling. Then, applying ointments like yellow ointment or other hemorrhoid creams can help reduce swelling and relieve pain. Oral medications like Diosmin tablets may also be needed to relieve swelling. At the same time, patients must develop good bowel habits, ensure smooth bowel movements, and avoid prolonged toilet sessions or excessive straining. These measures can significantly reduce the size of external hemorrhoidal nodules and even alleviate them. However, if the external hemorrhoidal nodules persist at the anus, an external hemorrhoidectomy can be directly performed.
Will the surgery for internal hemorrhoids prolapse be very painful?
Surgery for internal hemorrhoids is not very painful because anesthesia is required during the procedure. Clinically, the options for anesthesia include local infiltrative anesthesia, spinal anesthesia, and intravenous anesthesia. With such anesthesia, patients do not experience much pain during the surgery, especially with the latter two methods where patients do not feel any pain at all during the procedure. Moreover, surgery for prolapsed internal hemorrhoids primarily involves methods such as internal hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). The surgical wounds are relatively small, so postoperative pain is not very noticeable. Additionally, internal hemorrhoids are located above the dentate line of the anal canal, so if the external hemorrhoids are not severe, the patient will not experience significant pain after surgery, mainly feeling a sense of distension.
Do internal hemorrhoids definitely need to be pushed back in?
If internal hemorrhoids prolapse, they must be pushed back in because prolonged prolapse at the anus can lead to increased secretions in the anal area, causing itching. Moreover, internal hemorrhoids that prolapse can rub against underwear, resulting in damage, or even provoke inflammatory infections causing swelling and pain in the anus. Additionally, prolonged prolapsed hemorrhoids may also lead to poor local circulation, potentially forming blood clots, causing severe swelling and pain, and even possibly leading to necrosis of the hemorrhoids. Therefore, if internal hemorrhoids prolapse, they should be pushed back in as much as possible. If they cannot be pushed back, it is advisable to promptly visit the hospital's colorectal surgery department to consider procedures such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). After the surgery, it is crucial to adhere to changing dressings to avoid wound infection and inflammation. Furthermore, if the internal hemorrhoids repeatedly prolapse after being pushed back, surgical treatment is also necessary.
Is abdominal bloating and bloody stool indicative of rectal cancer?
This situation may not necessarily be rectal cancer; it could also be due to colitis or colorectal polyps, which then cause abdominal bloating and blood in the stool. For patients suspected of having rectal cancer, an initial electronic colonoscopy should be conducted. Abnormal masses can be detected in the rectal area, and a pathological biopsy is required to confirm whether it is rectal cancer. Furthermore, the main clinical symptoms of rectal cancer include an increased frequency of bowel movements, a strong urge to defecate, and more frequent bowel movements. There is also mucus and pus in the stool mixed with blood. For such cases, diagnosis requires an electronic colonoscopy and a pathological biopsy. Additionally, abdominal bloating and blood in the stool could also be due to inherent gastrointestinal dysfunction and internal hemorrhoids, which typically present bleeding as bright red blood.
Internal hemorrhoids that prolapse need to be operated on within a few days.
In clinical practice, if internal hemorrhoids prolapse and cannot retract for three to four days, then it is necessary to proceed with surgical treatment as soon as possible. This is because prolonged prolapse of internal hemorrhoids at the anus can lead to local swelling and even thrombosis. Severe cases may experience anal distension and pain, or necrosis of the hemorrhoids, thus early surgical intervention is recommended. The surgical options for prolapsed internal hemorrhoids include internal hemorrhoid ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization) among others. Postoperative dressing changes are crucial, as improper care can easily lead to pseudohealing or infection and edema. Typically, anal washes, hemorrhoidal suppositories, or hemorrhoidal ointments can be chosen for postoperative dressing. Moreover, it is important for patients to develop good bowel habits post-surgery, maintaining smooth bowel movements and avoiding hard, dry stools to prevent irritation to the wound, which could lead to bleeding or swelling.