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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
Differences between minimally invasive surgery and traditional surgery for perianal abscess
In clinical practice, perianal abscesses are primarily due to infection and inflammation of the anal glands, which then leads to the formation of red and swollen masses around the anus, causing pain and swelling near the anus. If not treated surgically in a timely manner, it can lead to necrotizing fasciitis or anal fistulas. Minimally invasive surgery for perianal abscesses mainly aims to minimize damage to the anal sphincter during the procedure. Techniques such as loop drainage can be employed to preserve it, whereas traditional surgery generally involves larger incisions, but provides better drainage and has a lower recurrence rate post-operatively. However, leakage or moisture in the anal area can occur after traditional surgery. For minimally invasive surgery for perianal abscesses, there is a relatively higher recurrence rate since the drainage may not be as effective. However, the integrity of the anus post-surgery is better preserved and incidents of leakage are less frequent. The choice of surgical method should still be based on the severity of the perianal abscess.
Can internal hemorrhoids be treated with wet compresses?
After prolapse of internal hemorrhoids, moist compresses can be applied, but the therapeutic effect of moist compresses is not significant. The prolapse of internal hemorrhoids mainly occurs when the anal cushion pathologically enlarges and shifts downward, leading to the prolapse. If the prolapsed hemorrhoids cannot be retracted back into the anus, this can lead to incarcerated edema, causing swelling and pain around the anus. If the incarceration lasts too long, it can induce local thrombosis or even necrosis. In such cases, it is recommended to opt for surgical treatment as soon as possible. Common surgical methods include internal hemorrhoid ligation, internal hemorrhoid excision, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). After surgery, it is advisable to use anal washes or potassium permanganate solutions for sitz baths, and then apply topical treatments such as hemorrhoid creams, red oil gauze strips, and yellow ointments to promote postoperative recovery. Moreover, patients should develop good bowel habits after surgery to maintain smooth bowel movements, which further aids recovery. (Under the guidance of a doctor for medication use)
Can external hemorrhoids be punctured?
External hemorrhoids should not be punctured because they are located at the anus, which is at the end of the digestive tract and often contaminated by feces and excretions. If punctured, it can easily lead to local infection, causing pain and increased secretion, and worsening necrosis of the external hemorrhoids. Therefore, external hemorrhoids should be treated as soon as possible with hemorrhoidectomy, rather than being punctured by oneself. After surgical treatment, it is also necessary to use anal cleansers, red oil gauze, and golden ointment for dressing changes to promote the healing of the wound. Moreover, patients should maintain smooth bowel movements to avoid hard and dry stools or frequent diarrhea. In terms of diet, it is advisable to consume foods rich in roughage to ensure smooth bowel movements and to avoid fishy seafood and similar foods.
How to relieve the pain of external hemorrhoids?
When there is pain in an external hemorrhoidal tag, it is often due to inflammatory edema or the formation of a thrombus, leading to pain. In such cases, it is advisable to first use an anal cleansing agent or a potassium permanganate solution for a sitz bath after defecation. The duration of the sitz bath should be controlled between five to ten minutes, which can effectively reduce swelling and relieve pain. After the sitz bath, applying external remedies such as Yellow Ointment or Musk Hemorrhoids Cream can also help reduce swelling and alleviate pain. For particularly severe pain, directly using diclofenac sodium suppositories inserted into the anus can provide anti-inflammatory and analgesic effects. Additionally, for external hemorrhoids with inflammatory edema, it is also necessary to combine this with oral diosmin tablets to relieve discomfort. However, if the external hemorrhoidal tag remains swollen for a long period or if the thrombus does not resolve, it is advisable to consider early surgical excision of the external hemorrhoids, followed by diligent postoperative dressing changes.
How to determine if you have an anal fistula
First, you can judge whether you have an anal fistula based on symptoms. Patients with anal fistula often experience recurrent perianal swelling and pain, as well as discharge of pus and blood, which may also have a foul odor, with secretion often found on their underwear. In such cases, patients should consider whether they have an anal fistula. Additionally, patients with anal fistulas in the early stages often have perianal abscesses, which generally tend to form fistulas after the abscess ruptures spontaneously or is surgically drained. Patients can also visit the colorectal surgery department of a hospital for a digital rectal examination, where the fistula tract and the internal opening can be felt. MRI scans of the perianal region can also be performed to determine the type and severity of the anal fistula. Clinically, once an anal fistula is detected, it is advisable to opt for fistula excision surgery to completely cure the anal fistula by removing the internal opening and the fistula tract. Post-surgery, it is essential to persist with dressing changes to avoid wound infection and bleeding.
What is the best treatment for a minor anal fissure?
Minor anal fissures, which are early-stage fissures, mainly manifest as pain during defecation and minor bleeding, but the pain does not last long and is primarily associated with defecation. For minor fissures, it is generally recommended to choose conservative treatment with medications and dietary regulation to ensure smooth bowel movements. Typically, after defecation, one can choose to use an anal cleansing solution or a potassium permanganate solution for a sitz bath. After the sitz bath, apply Dragon Ball ointment or nitroglycerin ointment locally to promote the healing of the ulcerated surface. At the same time, in terms of diet, one should drink more water and consume foods rich in dietary fiber to maintain smooth bowel movements as much as possible, avoiding dry and hard stools, which also helps in the healing of minor anal fissures. Additionally, patients should pay attention to keeping the anal area dry and clean, avoid irritating the wound, and prevent infection that could exacerbate the condition.
Can a perianal abscess burst on its own after it forms pus?
After an anal abscess becomes purulent, one should not attempt to rupture it on their own. If purulence occurs, it is advised to perform local disinfection under a doctor's supervision, followed by incision and drainage or pus aspiration to prevent further infection. Attempting to rupture it on your own can easily lead to further aggravation of the local infection. After an anal abscess becomes purulent, the choice of incision location is crucial; once cut, it is necessary to maintain unobstructed drainage to avoid subsequent infection or even necrotizing fasciitis. In clinical practice regarding anal abscesses, it is advised to visit a colorectal surgery department at a hospital as soon as the abscess is detected, to undergo procedures such as incision and drainage or radical surgery of the anal abscess to avoid the later development of anal fistulas or necrotizing fasciitis. Post-surgery, medications such as red oil gauze strips, anal cleansing solutions, and aureomycin ointment are recommended for dressing changes.
How to differentiate rectal cancer from hemorrhoids
Rectal cancer is a malignant lesion, with clinical symptoms mainly causing an increase in the frequency of bowel movements, changes in stool characteristics such as grooved stools or stools with mucus and pus and blood. Severe patients may experience abdominal pain, weight loss, anemia, and other accompanying symptoms. Generally, low-lying rectal cancer can be seen during a digital rectal examination or with an anoscope. If the cancer is located higher up, an electronic colonoscopy is needed to see the cauliflower-like mass. Hemorrhoids, on the other hand, are benign lesions often caused by improper diet or poor bowel habits, leading to pathological hypertrophy and descent of the anal cushions. They are mostly characterized by intermittent painless rectal bleeding with bright red blood, along with a feeling of heaviness and a foreign body sensation in the anus.
How to relieve the pain of hemorrhoids
Most of the time, hemorrhoids do not cause pain. Pain from hemorrhoids is often considered to be due to inflammatory swelling, external hemorrhoid rupture, or thrombosis formation, which leads to pain. If you want to relieve the pain promptly, you can choose sodium diclofenac suppositories for anal insertion, which can have anti-inflammatory and analgesic effects. Later, after defecation, you can use anal washes or potassium permanganate solution for sitz baths, in conjunction with hemorrhoid cream for external application and oral Diosmin tablets to reduce swelling. If the symptoms do not improve significantly after four to five days of medication, it is necessary to go to the hospital’s coloproctology department for hemorrhoid surgery as soon as possible, such as hemorrhoidectomy, external hemorrhoid excision, and TST. Post-surgery, it is important to adhere to dressing changes to promote wound healing, and maintain smooth bowel movements.