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21
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
Does rectal cancer vomit infect others?
Rectal cancer vomiting is not contagious. The vomiting in rectal cancer is primarily due to the growth of a tumor in the intestine that becomes too large, which then induces intestinal obstruction, causing the patient to vomit and be unable to eat. Furthermore, the vomit is not contagious, and rectal cancer itself is not a contagious disease. For patients with rectal cancer, it is essential to relieve the obstruction as soon as possible and to arrange surgery promptly. If sphincter preservation is possible, it should be attempted. Also, patients with rectal cancer should undergo a pathological biopsy to determine the type of cancer and whether it has spread. Patients with rectal cancer also need to be on a full-liquid diet. Foods with residues should be avoided as much as possible to not easily induce intestinal obstruction, leading to electrolyte disturbances or even causing the body to go into shock. Thus, it is crucial to pay sufficient attention to these issues.
Can an anal abscess without pus be treated without surgery?
Perianal abscesses require surgical treatment even if there is no pus present, as early-stage perianal abscesses are primarily characterized by pain and noticeable lumps near the anus, with the lumps typically being hard. This condition is mainly considered to be an infection and inflammation of the anal glands, which then infects the surrounding tissue, leading to the development of lumps. Surgical treatment should be undertaken as soon as possible even in the absence of pus, because as the infection worsens over time, it may lead to the formation of pus. Early treatment can be advantageous as the infected area is not very extensive, thus resulting in a smaller surgical wound. For early-stage perianal abscesses, a one-time radical surgery may be chosen to remove the internal opening and the infected tissue thoroughly, followed by postoperative care using medicated substances such as erythromycin ointment gauze, anal washes, or mupirocin ointment to promote healing of the surgical wound.
Does pressing on an internal hemorrhoid cause pain?
If internal hemorrhoids prolapse and become incarcerated or a thrombus forms locally, pressing on the area will cause pain, especially when the patient is walking or sitting, making the pain more apparent. For such cases, which are considered a severe stage of internal hemorrhoids, it's advisable to undertake surgical treatment as soon as possible. Clinically, treatment options for internal hemorrhoids include procedures like rubber band ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization), with continued dressing changes required post-surgery. However, if the prolapsed internal hemorrhoids can retract spontaneously or can be manually reduced, pressing on them generally does not cause pain because internal hemorrhoids are located above the dentate line in the anal canal, an area innervated by autonomic nerves, which are less sensitive to pain. In the absence of inflammation or thrombosis, pressing on the area will not typically cause pain. In such cases, patients should develop good bowel habits to prevent the further worsening of internal hemorrhoids.
The differences between stages one, two, and three of anal fissures.
In clinical practice, anal fissures are not categorized into stages one, two, or three; they are primarily classified as either acute or chronic anal fissures. Acute anal fissures, which occur in the early stages of the condition, are characterized by pain during defecation and minor bleeding. For such cases, the pain usually doesn’t last long, and conservative treatment with medication can be chosen. Topical applications such as dragon's pearl ointment or nitroglycerin ointment are generally used. It is also important to keep the anal region dry and clean, perhaps by using anal washes for sitz baths, while ensuring that the stool is soft to maintain smooth bowel movements. Chronic anal fissures, on the other hand, are mainly due to the development of scars on the ulcer surface. This condition involves prolonged pain and may include some narrowing of the anus. In such cases, surgical excision of the fissure may be necessary. Post-surgery treatment may include changing dressings with medications like red oil gauze strips, golden ointment, and anal washes. (Under the guidance of a doctor for medication use)
How to eliminate the flesh lump of external hemorrhoids
External hemorrhoids mainly consist of varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombotic external hemorrhoids. If the patient wants to completely remove them, in such cases, only external hemorrhoidectomy or external hemorrhoid stripping surgery can be performed. After the surgery, anal cleansers, red oil gauze strips, and golden ointment are used for dressing changes to promote wound healing. If the patient is unwilling to undergo surgery and opts for conservative treatment with medications alone, the external hemorrhoidal mass will not be completely eliminated but will only shrink slightly and improve clinical symptoms. To completely eliminate the external hemorrhoidal mass, surgical treatment is necessary. Moreover, after surgery, patients should develop good defecation habits, such as not spending too much time on defecation, not straining excessively, and performing more pelvic floor exercises after defecation to strengthen the anal sphincter muscles to help prevent recurrence of external hemorrhoids.
How long will it take for the perianal abscess anti-inflammatory medicine to work?
Once a perianal abscess is discovered in clinical practice, it's recommended to undergo surgical treatment as soon as possible, rather than using anti-inflammatory drugs for anti-infection treatment. This is because perianal abscesses are primarily caused by inflammation of the anal glands, leading to swelling and redness around the anus. Treating with only anti-inflammatory medications can temporarily control the condition, but the already infected tissues and the internal opening are not adequately treated. Improper diet or staying up late can lead to recurrence, or even lead to anal fistulas or necrotizing fasciitis. Therefore, for perianal abscesses, it is recommended to promptly undertake procedures such as incision and drainage of the perianal abscess, or a one-time radical surgery for perianal abscesses. However, for a minority of patients with perianal abscesses, such as subcutaneous perianal abscesses, if the area is relatively small, applying ichthammol ointment topically combined with oral administration of anti-inflammatory drugs or antibiotics can generally improve the condition within five to six days. (Please follow the doctor's advice regarding medications.)
How to reduce swelling when an anal fistula flares up?
An anal fistula flare-up can cause perianal swelling, pain, and discharge of pus and blood. For an anal fistula flare-up, initial conservative treatment with medications is an option, such as sitting baths using anal cleansing agents or potassium permanganate solutions after defecation. The sitting bath should last between five to ten minutes to help reduce swelling and relieve pain. After the bath, topical application of mupirocin ointment or other anti-inflammatory ointments like Golden Ointment may also be used to reduce swelling and inflammation. For severe infections, intravenous or oral antibiotics may be prescribed to reduce inflammation. However, clinically, it is recommended to opt for surgical removal of the anal fistula as early as possible. Early removal of the internal opening and the fistula tract is necessary for a complete cure of the anal fistula. If an anal fistula repeatedly flares up, it can easily lead to the formation of more fistula branches, forming complex anal fistulas, increasing the difficulty of later surgeries and enlarging the wound surface post-operation.
Is an anal fistula close to the anus considered high or low position?
In general, anal fistulas close to the anus are considered low anal fistulas. Clinically, anal fistulas are classified as either high or low based on the levator ani muscle as the boundary. Those located above the levator ani muscle are considered high anal fistulas, while those below are considered low anal fistulas. Clinically, the treatment for anal fistulas primarily involves surgical intervention. Options include fistulectomy, which involves the removal of the internal opening and the fistula tract. Post-surgery care may include the use of anal cleansing agents, red oil gauze strips, and golden ointment for dressing changes to promote wound healing. It is important to maintain smooth bowel movements and consume a light diet. High, complex anal fistulas may easily damage the anal sphincter or even the anorectal ring, leading to fecal incontinence. Therefore, during surgery, the thread hanging method may be chosen to avoid excessive damage to the anal sphincter.
The difference between internal and external hemorrhoids
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. Clinically, they are mainly characterized by intermittent, painless rectal bleeding. The blood is bright red, often dripping or spraying after defecation. If internal hemorrhoids worsen, they can prolapse and even become strangulated and edematous, causing anal swelling and pain. External hemorrhoids, on the other hand, are located below the dentate line in the anal canal, and are innervated by the spinal nerves, making them more sensitive to pain. Clinically, they are categorized into skin tag-type external hemorrhoids, varicose vein-type external hemorrhoids, inflammatory external hemorrhoids, and thrombotic external hemorrhoids. Skin tag-type and varicose vein-type external hemorrhoids primarily cause a sensation of a foreign body and itching in the anus, while inflammatory or thrombotic external hemorrhoids can lead to an increase in perianal secretions and anal swelling and pain, necessitating prompt surgical removal of the external hemorrhoids.
Can internal hemorrhoids burst by themselves?
Internal hemorrhoids that prolapse should not be burst forcibly. As internal hemorrhoids are located at the anus, they are continuously exposed to contaminants from fecal and secretion matter over time. If the prolapsed hemorrhoids burst, it could lead to local infections and even necrosis. Therefore, do not burst prolapsed hemorrhoids, but rather, try to push them back into the anus. If they cannot be reinserted, it is recommended to opt for surgical treatment early to avoid rupture or strangulated edema, which can lead to swelling, pain, or necrosis in the anal area. Surgical options include hemorrhoidal banding, PPH, or TST procedures. Post-surgery, treatments may include the use of anal washes, red ointment gauze, aureomycin ointment, etc. Moreover, patients should eat a light diet, maintain smooth bowel movements, and regularly perform pelvic floor exercises.