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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
Has the perianal abscess that was drained a month ago and is neither painful nor itchy healed?
This situation often shows good post-operative recovery. Whether this situation is completely resolved depends on whether anal fistulas develop later, as most perianal abscesses drained can easily form anal fistulas. This is because drainage of perianal abscesses merely removes pus and secretions as much as possible, but does not completely clear the internal opening of the abscess and infected tissues. Thus, anal fistulas are likely to form later, and the patient needs to continue monitoring. Moreover, it’s important to maintain a light diet, avoiding spicy, irritating, and dry-hot foods as much as possible while also keeping bowel movements smooth. Frequent constipation or diarrhea should be avoided as they can cause wound pain or lead to inflammation and infection of the anal glands, potentially causing recurrence of the perianal abscess or the formation of anal fistulas later. However, the current situation indicates a relatively good post-operative recovery.
How to relieve pain and swelling from internal hemorrhoids prolapse?
Internal hemorrhoids prolapse with pain and swelling. This is often due to inflammatory edema or thrombosis caused by the prolapse, which leads to pain and swelling. At this time, you can choose to apply lidocaine gel externally or apply golden ointment externally for anti-swelling and analgesic effects. You can also choose to insert sodium diclofenac suppositories into the anus, which has anti-inflammatory and analgesic effects, and take diosmin tablets orally to relieve anal swelling, as well as use anal cleansers or potassium permanganate solution for sitz baths to eliminate local bacteria and secretions, and reduce local infectious inflammation. After using the medication, it is still recommended to go to the hospital's proctology department as soon as possible for treatments like internal hemorrhoid banding, PPH, or TST, because the swelling of prolapsed internal hemorrhoids indicates a severe condition, and mere medication alone cannot achieve effective treatment outcomes.
Mild bleeding due to internal hemorrhoids prolapse.
Internal hemorrhoids have prolapsed with slight bleeding. This is primarily considered to be due to pathological hypertrophy and descent of the anal cushions, causing the internal hemorrhoids to prolapse and the mucosa of the hemorrhoids to erode, leading to symptoms of rectal bleeding. For such cases, if the prolapsed internal hemorrhoids cannot spontaneously reduce, it is necessary to promptly adopt surgical methods such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). If the prolapsed hemorrhoids can spontaneously reduce, conservative treatment with medication may be temporarily used, such as applying compound preparations like mixed hemorrhoid suppositories or Jiuhua suppositories anally. Moreover, attention should be paid to a light diet, avoiding foods such as fishy seafood. It is also important to maintain smooth bowel movements; thus, eating less cold, hard food and avoiding difficult defecation that can lead to prolonged toileting times.
How to eliminate a perianal abscess mass?
Perianal abscess nodules are primarily caused by inflammatory infections that lead to local fibrosis, which then forms the nodules. For these nodules, it is recommended to employ a one-time radical cure surgery for perianal abscesses, mainly to remove the internal opening and the inflamed infected tissues. Since a perianal abscess can form a fistula after bursting on its own, failing to completely remove the infected tissue may lead to the development of anal fistulas later. Therefore, clinically, for perianal abscess nodules, it is advised to treat them with a one-time radical cure surgery for perianal abscesses. Post-surgery, medications such as anal washes and red oil ointment gauze strips are chosen for dressing changes. As for early-stage perianal abscess nodules, these are mainly inflammatory infections causing red and swollen lumps, which gradually turn into purulent and liquefied masses. Once suppuration occurs, they can be opened and drained, thereby causing the nodules to disappear. The nodules formed after incision and drainage are mainly considered to be from inflammatory spread to fibrotic tissue, and thus, surgical removal is required in these cases.
Can you have intercourse during an anal fissure?
During an anal fissure, it is possible to have sexual intercourse without any impact on the fissure itself. For patients with an anal fissure, the main focus should be on maintaining smooth bowel movements and avoiding dry and hard stools to prevent irritating the wound, which can cause pain and bleeding. It is also important to avoid diarrhea, as frequent bowel movements can irritate the wound over time and worsen the fissure. Clinically, for early-stage anal fissures, conservative treatment with medications is often recommended, along with softening the stool. Commonly used medications include Dragon Balm ointment or nitroglycerin ointment. After defecation, patients can opt to use an anal wash or a potassium permanganate solution for sitz baths. However, for chronic anal fissures, it is generally advised to undergo fissure excision surgery as soon as possible, followed by regular dressing changes to promote healing of the wound. If an anal fissure is left untreated for a long time, it can lead to slight narrowing of the anal canal, which requires significant attention.
Can internal hemorrhoids that prolapse be treated conservatively without surgery?
If internal hemorrhoids can be manually reduced after prolapse, then surgery can be temporarily avoided, and conservative treatment can be administered. For example, the patient should ensure smooth defecation, perform anal lifting exercises after defecation, strengthen the anal sphincter, and prevent the recurrence of internal hemorrhoids. Additionally, the duration of defecation should not be too long, and excessive straining should be avoided to prevent worsening of the prolapsed hemorrhoids. Moreover, patients must pay attention to the hygiene around the anus, and cleanse the peri-anal area with warm saline water after each bowel movement. However, if the internal hemorrhoids cannot be manually reduced after prolapse, or if incarceration and swelling occur, causing anal distension and pain, it is necessary to visit the hospital's colorectal surgery department promptly to undergo internal hemorrhoid ligation, TST, PPH, or other surgical procedures, followed by dressing changes. Since unresolved internal hemorrhoid prolapse can easily lead to incarceration or even necrosis, it is crucial to arrange for surgery as soon as possible, and patients should develop good bowel habits to maintain smooth defecation.
Can internal hemorrhoids that protrude outside the anus be cured by taking medicine?
Internal hemorrhoids that prolapse outside the anus cannot be cured by medication alone. This is because when internal hemorrhoids prolapse, it indicates a significant pathological enlargement and downward displacement of the anal cushions, which are structural changes. Merely taking medication will not result in significant improvement; surgery is the primary option at this point. For this condition, surgical options such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization) can be employed. Consistent postoperative care and dressing changes can facilitate recovery. Because prolapsed internal hemorrhoids are located at the anal opening, if not treated surgically, they can lead to impaired blood flow, which may cause incarceration leading to edema or thrombosis, and even potentially result in infected necrosis. Therefore, early surgical intervention is required for prolapsed internal hemorrhoids. Additionally, patients should regularly perform anal sphincter exercises, avoid straining excessively during bowel movements, and not spend too much time on the toilet.
How long does it take for internal hemorrhoids to reposition after being pushed back in?
This situation mainly depends on how much the internal hemorrhoids have prolapsed and the severity of the prolapse. If the internal hemorrhoids can be pushed back in after prolapsing, it generally takes half an hour to an hour to reposition them. However, if the patient overexerts themselves or strains during coughing or defecation, the internal hemorrhoids may prolapse again. For patients whose internal hemorrhoids repeatedly prolapse, it is advisable to consider surgical treatment as soon as possible. Because repeated prolapse of internal hemorrhoids can lead to further pathological hypertrophy and descent of the anal cushion, in such cases of organic lesions, simple repositioning cannot solve the problem. It may even cause the prolapse to become larger over time and lead to complications like incarcerated edema, resulting in local thrombosis, swelling, and anal pain. Therefore, for patients with repeated prolapse, it is recommended to visit the hospital's colorectal surgery department for surgical treatment as soon as possible, such as internal hemorrhoid ligation, TST, and other surgical methods.
Is it better for the external opening of an anal fistula to be closed or not closed?
In clinical practice, it is generally best not to close the external opening of an anal fistula. Keeping the drainage unobstructed can prevent the infection from worsening or the formation of multiple branches. This is because when the fistula drains properly, the infectious secretions can flow out of the external opening. However, if the external opening does close, the infected tissues and secretions will accumulate within the fistula and then spread to the surrounding areas, forming branches and leading to an increase in the number of branches, thus creating a complex anal fistula and increasing the difficulty of future surgeries. Therefore, it is best not to close the external opening of an anal fistula. Clinically, the treatment for an anal fistula involves fistulectomy, which primarily involves removing the internal opening and the fistula. The external opening also needs to be treated. Postoperatively, medications such as erythromycin ointment gauze strips should be used for dressing changes.
How to quickly reduce hemorrhoid swelling
Inflammatory edema in hemorrhoids can lead to anal distension and pain in patients. Clinically, for the reduction of hemorrhoid swelling, options such as anal cleansing agents or potassium permanganate solutions can be used for sitz baths. The duration of the sitz bath should be controlled between five to six minutes, which can help in reducing swelling and relieving pain. After the sitz bath, applying Golden Ointment externally can also help in reducing swelling and relieving pain. Additionally, patients need to take oral Diosmin tablets to improve local blood circulation and prevent exacerbation of local swelling. Furthermore, patients should ensure smooth bowel movements, avoiding dry and hard stools to prevent irritation of the swollen hemorrhoids, thus worsening anal pain. They should also visit the hospital's proctology department as soon as possible for manual repositioning of the prolapsed hemorrhoids back into the anus. If repositioning is not possible, then surgical intervention, such as hemorrhoidectomy, must be considered promptly.