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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
What should I do about anal bleeding and anal fissures?
If a fissure is visible to the naked eye at the anal sphincter during a digital rectal examination, it is primarily considered an anal fissure. Anal fissures generally cause severe local pain and bleeding from the fissure. The fissure is primarily due to the local crack being stretched or opened, causing bleeding from small blood vessels, and the blood from the fissure is usually bright red. To treat bleeding from an anal fissure, it is first necessary to soften the stool, as the occurrence of an anal fissure is mainly related to dry stools and difficulty defecating. Once the stool is lubricated, it can reduce the need to exert excessive force during defecation, lowering the possibility of stretching the local fissure. Topical application of hemorrhoid cream at the fissure, or combined with oral medications that cool the blood and stop bleeding, may be used. If there is repeated bleeding from an anal fissure, surgical treatment is also recommended. (Please use medications under the guidance of a professional physician, and do not self-medicate.)
How to deal with external hemorrhoids bleeding?
If external hemorrhoids bleed without apparent reason, it may be due to the rupture of thrombosed external hemorrhoids, leading to bleeding. Firstly, it is necessary to disinfect and clean the local wound to avoid accumulation of blood or contaminants and feces, which may cause infection of the wound. If the bleeding does not stop, topical hemostatic drugs or oral hemostatic drugs should be used for symptomatic treatment. If external hemorrhoids bleed and are accompanied by severe prolapse of internal hemorrhoids, it is recommended that the patient undergo surgical treatment to remove and ligate both external and internal hemorrhoids at the same time. This can further prevent exacerbation of bleeding and fundamentally treat hemorrhoids. Patients with bleeding external hemorrhoids must have a light diet and avoid irritating foods such as chili peppers and seafood. (The use of medications should be under the guidance of a doctor.)
Anal fissure bleeding symptoms
The most common clinical symptoms of anal fissure, apart from the intense tearing pain in the anal area, include bleeding during bowel movements. The bleeding from anal fissures is typically bright red, and the amount of blood can increase with the severity of the condition due to repeated stretching of the fissure. Particularly during acute episodes of anal fissures or after defecation, bleeding from the local fissure can be more significant. Patients with bleeding anal fissures generally have a history of dry stools, so the first step in treating anal fissure bleeding is to lubricate the stool. Additionally, topical medications should be applied to the bleeding fissure to promote healing, and hemorrhoid creams with hemostatic properties can be used locally to help stop the bleeding. (Please use medications under the guidance of a professional physician, and do not self-medicate.)
How long does it take to recover after surgery for an anal fistula?
Healing after surgery for an anal fistula requires some time, and the longer healing duration is mainly related to two factors: The first reason is that anal fistula is a localized infectious disease of the anus with the presence of a fistula. The principle of surgery is primarily to remove the fistula. Therefore, after the surgery, the wound surface from the removed fistula wall is relatively large and requires time to heal. The second reason is that the local area around the anus is a contaminated wound, with feces passing through daily. Feces are a significant source of contamination, so the wound healing is influenced by the irritation from feces, resulting in a non-sterile wound environment. Consequently, the wound healing rate after the surgery is slower compared to the healing rate of sterile wounds in other body tissues. Therefore, the recovery time after anal fistula surgery is approximately 3 to 4 weeks.
How to quickly eliminate the flesh masses of external hemorrhoids?
If a patient has an external hemorrhoid that has enlarged and they want to quickly or completely eliminate it, it is recommended to directly perform surgical removal. External hemorrhoids generally include thrombotic external hemorrhoids, varicose cluster external hemorrhoids, and inflammatory edematous external hemorrhoids. There are also some skin tag-like or connective tissue external hemorrhoids that do not exhibit clinical symptoms, and do not require excessive intervention in treatment. However, during an acute attack of thrombotic or inflammatory edematous external hemorrhoids, due to congestion or increased pressure in the local hemorrhoidal nucleus, severe pain can occur. You can choose to press with dilute salt water to promote the dissipation of edema. Complete removal requires surgical excision to avoid recurrent flare-ups of the condition.
Do hemorrhoids require surgery?
When severe hemorrhoids are in an acute attack phase, it is necessary to undergo surgical treatment as soon as possible. Besides surgery, treatment options for hemorrhoids also include conservative medication to alleviate symptoms. For mild hemorrhoids, or those that flare up less frequently, the primary treatment is conservative topical medication. However, when hemorrhoids repeatedly prolapse, cause pain, and result in significant rectal bleeding, affecting the normal functioning of the patient’s body, it is advised to promptly proceed with hemorrhoidectomy surgery. This helps avoid complications such as severe pain that interferes with normal living, or significant bleeding that could lead to anemia in patients, thereby worsening the condition and increasing the difficulty of future treatments. (Please use medication under the guidance of a professional physician, and do not self-medicate.)
Can you have children with rectal prolapse?
If a patient is diagnosed with rectal prolapse, they can still have children. However, childbirth can potentially worsen rectal prolapse, especially during natural delivery, where excessive straining in the pelvic and anal areas can exacerbate the condition. Therefore, if a patient already has rectal prolapse, it is advised to consider surgical removal treatment before pregnancy. If rectal prolapse occurs during pregnancy, external wash medications and hot compresses can be used to promote retraction. If rectal prolapse occurs during delivery, surgical treatment can also be carried out after childbirth. However, it is recommended that patients with severe rectal prolapse undergo cesarean delivery to avoid the excessive strain during natural childbirth, which could worsen the prolapse.
Can an anal fistula be left untreated for a lifetime?
If diagnosed with an anal fistula, one should not forego treatment indefinitely, as an anal fistula is a localized infectious disease of the anal region. Without active treatment, the infection may further spread, increase the number of fistula branches, and potentially induce a high, complex anal fistula. There is also a risk that the fistula and the infection might penetrate the local anal sphincter, reaching the ischioanal fossa and causing other infectious diseases. The primary treatment method for anal fistulas is surgical, mainly involving fistulotomy with seton placement, which thoroughly removes the local infection, allowing the anal fistula to heal. Neglecting active treatment could worsen the condition or increase the difficulty of future surgeries.
Rectal prolapse treatment
Rectal prolapse is primarily categorized into mild rectal prolapse as well as moderate and severe rectal prolapse. Mild rectal prolapse generally occurs in the early stages of the illness or in children and can be treated conservatively. Conservative treatment mainly involves Chinese herbal retention enemas. On the other hand, moderate and severe rectal prolapse can result in the protrusion of the local mucosa outside the anus, presenting as cylindrical or cone-shaped prolapses. Treating moderate to severe hemorrhoidal prolapse requires surgical intervention. The main surgical methods include hemorrhoidal mucosectomy with stapling and local submucosal sclerosant injections. It is also important to caution postoperative patients against squatting for long periods or straining during constipation, as these actions can exacerbate symptoms of submucosal prolapse.
Difference between colon polyps and colon cancer
Colon polyps and colon cancer both belong to organic tumors of the colon mucosa, but the fundamental difference is that colon polyps are mostly benign, while colon cancer is a malignant cancer of the intestines. Both colon cancer and colon polyps require examination by electronic colonoscopy for a definitive diagnosis, and further pathological examination is needed. After the detection of colon polyps, it is necessary to promptly perform radiofrequency ablation surgery under electronic colonoscopy. After the detection of colon cancer, it is necessary to complete relevant pelvic and systemic examinations, and after clarifying the local lesions, surgical removal is performed. Postoperatively, based on the size of the cancerous mass and the extent of the lesion, radiation therapy or chemotherapy may be required.