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Chen Tian Jing
Colorectal Surgery
About me
Master's degree, specializing in research and treatment of colorectal surgery.
Proficient in diseases
Mixed hemorrhoids, internal hemorrhoids, external hemorrhoids, anal papillitis, perianal abscess, anal fistula, anal sinusitis, anal fissure, perianal abscess, pruritus ani.
Voices
Does anal fistula surgery hurt?
Anal fistula surgery primarily involves fistulotomy and ligation, with the surgery’s difficulty and potential for pain depending largely on the severity of the condition and the type of anesthesia used. If local anesthesia is used, patients may experience localized pain six hours post-surgery, especially in cases where the fistula is deep or complex, as the larger surgical wounds tend to cause more intense pain. If a spinal anesthesia method is used, incorporating methylene blue injection for nerve block during surgery, postoperative pain may be slightly less intense. Generally, localized pain might occur after 12 hours. If the pain is severe, patients can be treated with oral or topical pain-relieving medication.
What should I do if I have hemorrhoids bleeding and anal fissures?
Hemorrhoids can lead to local bleeding, and anal fissures can similarly cause bleeding in the local anal area during bowel movements. Therefore, if it is clearly diagnosed as hemorrhoids combined with an anal fissure, and the patient is experiencing bleeding, it is necessary to carry out hemostatic treatment as soon as possible to avoid further exacerbation of bleeding, which may lead to symptoms of anemia in the patient. Both hemorrhoids and anal fissure bleeding can temporarily be managed with oral hemostatic drugs. If the hemorrhoidal bleeding is more severe, direct ligation of the hemorrhoids can be performed. Bleeding from an anal fissure mainly manifests as bleeding from a local fissure, primarily caused by dry stools, so patients with an anal fissure who experience bleeding must receive treatment that softens the stool and facilitates bowel movements. If both hemorrhoids and anal fissures are present and recur frequently, and conservative medication does not easily heal the condition, a mixed hemorrhoidectomy which includes an external peeling and internal ligation surgery combined with a lateral internal sphincterotomy can be performed. (Note: This answer is for reference only. Medication should be taken under the guidance of a professional physician, and one should not medicate blindly.)
Can a perianal abscess be treated with hot compresses?
Hot compress therapy for perianal abscesses is typically chosen after surgery. Prior to surgery, due to the formation of a typical pus cavity in the perianal abscess and the encapsulation of pus fluid, it is an acute infectious foci. Using hot compress therapy can easily lead to further aggravation of the local infection or spread of the pus cavity, which may worsen the condition. Therefore, hot compresses are not recommended before surgery. After promptly conducting surgery on a perianal abscess, since the local wound contains infectious material, it is suitable to fumigate and apply hot compresses postoperatively to disinfect the local wound further, and to manage residual fecal matter to prevent infection. Additionally, changing dressings is necessary to promote the fresh growth of normal granulation tissue, thus leading to the proper healing of the wound rather than pseudohealing or infection.
Thrombotic external hemorrhoids: how many days to relieve pain?
The duration of pain associated with thrombosed external hemorrhoids mainly depends on the size of the thrombosis formed. If medications are not actively used, the pain may not be significantly alleviated. Options include using traditional Chinese medicine washes as hot compresses or applying hemorrhoid cream locally to relieve symptoms. After pharmacological treatment, pain generally subsides in about a week. However, certain thrombosed external hemorrhoids may not shrink on their own due to significant local congestion or thrombosis, thus medication alone may not completely relieve pain or produce significant clinical effects. The primary treatment method still required is surgical intervention, mainly using thrombectomy. (Medications should be used under the guidance of a doctor according to the specific situation.)
Can anal fistulas be left untreated?
If an explicit diagnosis of anal fistula is made, it cannot go untreated. If the anal fistula is localized around the anus but not actively treated and surgically removed, it is very likely to cause branching of the fistula tract or spread to the ischioanal fossa, as well as thickening of the fistula wall. This can exacerbate the symptoms of local infection, causing an increase in stabbing pain or purulent secretions. Prolonged, recurrent episodes of anal fistula may also lead to carcinogenic changes in the fistula wall due to inflammatory stimuli. Therefore, once an anal fistula is diagnosed, it is necessary to promptly undergo surgical treatment with fistulotomy and seton placement to prevent the condition from worsening and complicating later treatments.
What is the best treatment for anal fistula?
The primary treatment method for anal fistulas is surgery, which mainly involves the use of a local seton thread. This method allows the surgeons to excise or remove the affected area of the anal fistula while preserving the normal contractile function of the local anal sphincter. This precaution helps prevent excessive removal that could lead to sphincter relaxation or excessive loosening of the anus. As the local sphincter naturally repairs itself and the seton falls out post-surgery, it ensures the proper healing of the local wound. Postoperative care for anal fistula surgery also involves proper drainage and disinfection of the local wound. Daily application of oil gauze and changing of anti-inflammatory medications on the local wound are recommended. This helps in reducing inflammation and facilitating drainage, thereby preventing the occurrence of local pseudohealing.
What department should I go to for anal fistula?
If you suspect you have an anal fistula, it is recommended to register with a proctology department for examination and treatment. The examination of an anal fistula mainly involves digital rectal examination, local perianal ultrasound, and probing with a probe. Typically, an anal fistula will have an external opening in the local anal area, and when the doctor touches near the dentate line of the anal canal with their index finger, an internal opening will be found in the anal crypt. Pressing on the local internal opening will cause secretions to flow out from it. Anal fistulas are relatively easy to diagnose, but further examinations such as perianal ultrasound and pelvic MRI are needed to clarify the direction of the fistula tract and the extent of the lesion. The treatment of an anal fistula primarily involves surgery, using techniques such as fistulotomy with seton placement to remove the local infection.
Initial symptoms of perianal abscess
The primary cause of perianal abscesses is recurrent infections at the anal crypts, also known as repeated episodes of cryptitis. Generally, when cryptitis recurs and forms a local infection foci, early symptoms of a perianal abscess include pain in the anus and anal canal, accompanied by pus discharge from the anal canal. When the condition progresses to a certain extent, there will be hard pus pockets or pus formation. Once the infection within the pus pocket completely turns into pus, the patient will experience intense pain, manifesting as throbbing pain. Therefore, to alleviate the pain, it is necessary to promptly incise and drain the pus and further remove the local infection foci completely.
Will fecal incontinence heal on its own?
The causes of fecal incontinence in the anal region are primarily considered to be due to local organic lesions, or disturbances in nerve control, which can also lead to incontinence. If fecal incontinence is caused by either of these two reasons, it generally will not heal on its own. Severe diarrhea or acute intestinal infections can also cause fecal incontinence due to an increased frequency of bowel movements and acute inflammatory edema of the local intestinal mucosa. This can be alleviated by taking oral anti-inflammatory and anti-diarrheal medications. If the incontinence is caused by excessive relaxation of the anal sphincter, surgical treatment can be considered. If it is due to other neurogenic changes, active treatment of the primary disease is needed.
Can internal hemorrhoids heal by themselves?
The vast majority of internal hemorrhoid bleeding is not self-healing. Only a small amount of mucosal bleeding or if the patient actively takes care of themselves after bleeding, there might be a tendency to self-heal. Internal hemorrhoid bleeding is mainly caused by excessive local congestion pressure or hard stools piercing the local mucosal skin, leading to bleeding, generally related to poor dietary habits and defecation habits of the patient. Therefore, to achieve self-healing from internal hemorrhoid bleeding, the patient firstly needs to adjust their diet and defecation habits to avoid repeated occurrences of bleeding during bowel movements. If the bleeding is significant or lasts for a long time and cannot heal on its own, it is recommended that the patient seek treatment as soon as possible to avoid long-term internal hemorrhoid bleeding which could lead to anemia.