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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
Anal fissure: hot compress or cold compress?
During the acute phase of an anal fissure, patients can choose either hot or cold compresses. The clinical symptoms suitable for hot and cold therapy differ. Hot compresses primarily involve the use of herbal washes, where heat helps the medicated solution penetrate the local fissure, promoting healing and contraction of the mucous membrane. The principle behind cold compresses is that, during the acute phase, when the local fissure pain is particularly intense, cold compresses can reduce or alleviate the pain. Besides conservative hot or cold compress treatments, surgery can also be an option after repeated occurrences. The surgical method typically involves an endoscopic loosening procedure. (Use of specific medications should be under the guidance of a doctor.)
What should I do if hemorrhoids prolapse during pregnancy?
During pregnancy, due to increased abdominal pressure, patients who already have hemorrhoids may experience internal swelling or even prolapse. To treat and alleviate prolapsed hemorrhoids during pregnancy, conservative treatment should be the first approach. Surgical treatments may lead to local pain due to wounds, which can cause false contractions. Conservative treatments can include using dilute salt water or potassium permanganate solution for local washing and hot compresses to promote mucosal retraction. Additionally, a hemorrhoid cream with safe ingredients specifically for pregnant women can be applied locally. If the prolapse is severe, surgery is recommended after delivery. (Please use medication under the guidance of a professional physician and do not self-medicate.)
Is anal prolapse rectal cancer?
Patients with a confirmed diagnosis of rectal cancer may experience varying degrees of anal heaviness and bloating. However, the presence of localized anal bloating and heaviness alone, without further examination, is not sufficient to diagnose rectal cancer. Sometimes, large hemorrhoids or excessive relaxation of the rectal mucosa compressing the anal opening can also result in localized anal bloating and heaviness. Additionally, certain anal or rectal inflammations can stimulate the intestinal mucosa and cause feelings of bloating and heaviness. Therefore, when these symptoms appear, further examinations such as an anoscopy or a colonoscopy are needed to clarify the cause of the symptoms, which will then allow for the selection of appropriate treatment methods. The presence of anal heaviness does not definitively indicate rectal cancer.
Will surgery still be performed if a perianal abscess has ruptured?
After a perianal abscess ruptures on its own, a fistula-in-ano has formed, which cannot be completely cured by conservative medication. The main treatment method is still surgery, so further surgical treatment is required after the rupture of the perianal abscess. The surgical approach for a perianal abscess or fistula mainly involves an incision and seton technique, preserving the function of the local sphincter as much as possible while thoroughly removing the infection foci to allow the growth of fresh granulation tissue. Post-operation care requires attention to dressing changes, especially during the early stages of the wound when there may be secretions. It is crucial to thoroughly remove these secretions and apply appropriate hemorrhoids ointment or growth-promoting agents to facilitate the healing and growth of the local mucosa.
Anal fistulas are secondary to what?
Anal fistulas primarily arise from local perianal abscesses that are not actively treated, repeatedly occur, or from severe pus cavity inflammation that causes the abscess to rupture locally, resulting in the formation of an anal fistula. An anal fistula typically has a characteristic internal opening and external opening, as well as a fistula tract connecting them. After the occurrence of an anal fistula, it is recommended that the patient undergo surgery as soon as possible. The surgical method mainly used for anal fistulas is the cutting and threading surgery. If it is a high-position complex anal fistula or there are multiple external openings and branches, the patient needs to complete related examinations, mainly focusing on local perianal color ultrasound or pelvic MRI, which are most important. After clarifying the direction of the fistula branches, a thorough and definitive surgical treatment for the anal fistula can be carried out.
What should I do if internal hemorrhoids have prolapsed and not retracted for two or three days?
If internal hemorrhoids prolapse and cannot be reduced back into the anus on their own, and even after they are manually repositioned by a patient or a doctor they prolapse again, it may indicate that local incarceration or necrosis has occurred. It is recommended to undergo surgery as soon as possible to prevent circulatory disturbances from prolonged prolapse, which can lead to necrotic changes in the local muscle tissues. The surgical methods primarily include hemorrhoidectomy with mixed hemorrhoid stripping and ligation, combined with an internal excision procedure. Additionally, sclerotherapy injections for internal hemorrhoids can be used to improve the overall treatment effects. After surgery, avoid straining during bowel movements to prevent local pain or bleeding.
Will internal hemorrhoids falling out be painful?
If internal hemorrhoids can retract back into the anus on their own after prolapse, they generally do not cause severe pain. However, if the prolapse lasts for a long time or occurs repeatedly, and if the mucous membrane of the hemorrhoid core ruptures and bleeds due to friction from walking or exercising, this can lead to pain due to the localized prolapse. It may even lead to congestion and swelling of the local hemorrhoid core after prolapse, thereby causing inflammatory edematous hemorrhoids, further intensifying the pain. Therefore, to avoid pain from internal hemorrhoids, or for those that prolapse and cannot retract back, it is advisable to actively use medications for treatment at the early stages of prolapse. For recurrent cases, direct internal hemorrhoid ligation surgery can also be performed.
The difference between perianal abscess and hemorrhoids
Perianal abscess and hemorrhoids are two different types of common anorectal diseases. When a perianal abscess occurs, the onset is generally sudden and there is severe pain in the anal area. Under the skin of the anal area or inside the anal canal, a submucosal abscess forms, encapsulating pus. Surgical treatment is required as soon as possible to prevent further spread of the abscess cavity. Hemorrhoids, on the other hand, are caused by the long-term and repeated accumulation of local tissues in the anal area, leading to the formation of blood clots or varicose vein masses. These generally occur near or around the dentate line, and may also be accompanied by skin tags of external hemorrhoids.
What should I do if my anal fissure doesn't heal?
If an anal fissure consistently fails to heal proactively, it may be due to the repeated expansion of the fissure, or recurrent instances of dry stools and bleeding, leading to ulcerative, infectious changes at the local fissure. This can progress into a chronic anal fissure. Chronic anal fissures have larger local wound surfaces, and the patient may also experience excessive tightness in the anal canal. The local fissure, wrapped within the tightened anal canal, does not drain well, making self-healing impossible. To treat chronic anal fissures, or recurrent fissures, it is recommended to perform a lateral internal sphincterotomy and further debride the local fissure to ensure complete healing of the anal fissure.
Is surgery necessary for thrombosed external hemorrhoids?
Thrombotic external hemorrhoids do not necessarily require surgery during the acute phase of an attack. If the thrombotic external hemorrhoids are mild, Chinese herbal medicine can be used for local topical application to relieve symptoms. Early-stage or mild thrombotic external hemorrhoids may only form small thrombi, and the pain experienced by the patient is not very intense. Therefore, one can opt to use Chinese herbal washes for hot compresses and fumigation, along with the application of hemorrhoid cream to alleviate symptoms. However, it is only recommended to perform excision surgery for thrombotic external hemorrhoids if they are acutely recurring over a long period or repeatedly, severely affecting the patient's life. (Please use medication under the guidance of a professional physician and avoid self-medication.)