

Chen Tian Jing

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

Can external hemorrhoids be eliminated?
External hemorrhoids are generally divided into skin tag-type external hemorrhoids, thrombotic external hemorrhoids, and inflammatory edematous external hemorrhoids; each type presents different clinical symptoms. If the condition is skin tag-type external hemorrhoids or connective tissue-type external hemorrhoids, the patient generally does not feel obvious symptoms, but these will not resolve on their own and require surgical removal. If skin tag-type or connective tissue-type external hemorrhoids do not affect the patient's normal life, it is possible to avoid excessive intervention and treatment. However, if it is thrombotic external hemorrhoids or inflammatory edematous external hemorrhoids, since there is significant pain during flare-ups that affects the patient’s normal life, surgical removal and treatment should be performed as soon as possible.

Do anal fistulas need surgery even if there are no symptoms?
After the formation of an anal fistula, it does not always lead to acute episodes over a long period. Acute episodes of an anal fistula, causing infectious symptoms, occur only when there is a severe localized damp-heat condition. Therefore, the symptoms of an anal fistula are intermittent. The absence of symptoms does not mean that the anal fistula is completely cured or will not recur. Therefore, if an anal fistula is diagnosed, it is necessary to undergo surgical treatment as soon as possible to avoid repeated episodes due to lack of active treatment. Long-term repeated episodes of an anal fistula can lead to thickening of the fistula wall and an increase in branching. Even if an anal fistula is not actively treated over many years, it may even induce carcinogenesis in the local fistula wall.

How to improve anal fissure bleeding?
To improve anal fissure and bleeding, the first step is to treat constipation by softening the stool, as most anal fissures are caused by dry stools tearing the local skin and mucous membranes of the anus, leading to bleeding from these tears. For those experiencing pain and bleeding due to anal fissures, it is advisable to apply sesame oil around the anus before each bowel movement to prevent irritations from stool aggravating the fissure, which can cause recurrent pain and bleeding. After defecation, hemorrhoid cream can be applied for hemostatic treatment, and medicinal herbal solutions can be used for local compression and hot compresses to promote the growth and healing of the fissure. (Note: Medications should be used under the guidance of a doctor.)

Do internal hemorrhoids require surgery?
The clinical symptoms of internal hemorrhoids are numerous, and surgery is only recommended if the internal hemorrhoids frequently recur, or if the clinical symptoms are severe. Severe internal hemorrhoids are primarily characterized by substantial rectal bleeding or recurrent prolapses, and due to repeated prolapses, friction on the local mucosa may even cause anal pain. A severe symptom of prolapsed internal hemorrhoids is that after each prolapse, the patient needs to manually reposition them, accompanied by jet-like or dripping fresh red rectal bleeding. Surgical methods for internal hemorrhoids mainly include hemorrhoidectomy with ligation or local injection of sclerosing agents.

What should I do about an anal fistula?
Anal fistula is a disease that occurs when repeated infections in the anal crypts extend to the surface of the skin around the anus. Once formed, there are typical fistula tracts with both internal and external openings. Simple anti-inflammatory drug treatments can only relieve the symptoms of inflammation during the acute phase of an anal fistula. For the fistula tracts themselves, these treatments do not completely cure the condition. It is recommended that patients with an anal fistula undergo a fistulotomy as soon as they are diagnosed. Through surgery, the fistula tract and its walls can be completely excised, completely removing the local lesion, thereby further accelerating the regrowth of fresh granulation tissue locally.

What medicine to take for fecal incontinence?
There are many causes of fecal incontinence, and it is first necessary to further clarify the cause. Most cases of fecal incontinence are mainly due to excessive relaxation of the local anal sphincter or damage to the patient's nervous system, thus requiring oral medication to treat the nervous system. When there is relaxation of the local anal sphincter, simply taking oral medication does not have significant local therapeutic effects. The most effective method is to directly perform a sphincter tightening surgery. After the local sphincter is tightened surgically, it can control the excretion of feces, thereby further alleviating the situation of fecal incontinence. If the patient also has a neurological disorder, it is necessary to actively treat the underlying disease. (The use of medications should be done under the guidance of a doctor.)

Can rectal prolapse cause stool deformity?
Rectal prolapse primarily refers to the excessive relaxation of the rectal mucosa. It may manifest as relaxation of the rectal mucosa due to the prolapse, and may also result in rectal prolapse. Patients with rectal prolapse may experience deformed stools, mainly because the prolapse overly crowds the anal opening, preventing feces from being normally expelled from the body. When feces are expelled through the anus, the local mucosal compression can cause the stools to appear in thin strips or in a flattened shape. Patients with rectal mucosal prolapse are advised to undergo examinations as soon as possible and actively receive treatment. Options include traditional Chinese medicine retention enemas, combined with oral qi-boosting medications. If the prolapse recurs, or has resulted in rectal prolapse, surgical treatment is recommended.

Will internal hemorrhoids be painful?
If internal hemorrhoids experience local mucosal rupture or repeated prolapse leading to friction of the mucosa, it is likely to cause pain and even bleeding. To avoid pain caused by internal hemorrhoids, it is recommended that patients use hemorrhoid suppositories for local administration in the rectum for early flare-ups to reduce swelling, relieve pain, and cool and stop bleeding. If internal hemorrhoids prolapse and cannot retract back into the anal canal on their own after each prolapse, it is suggested that patients consider surgery to ligate and excise the affected internal hemorrhoids, or inject sclerosants under the mucosa of the hemorrhoids to cause local mucosal consolidation and shedding. Patients with internal hemorrhoids are advised not to strain excessively during bowel movements to avoid worsening local congestion and edema.

How is an anal fistula treated?
The treatment methods for anal fistula mainly involve surgery. Conservative medication for anal fistula does not provide a definitive cure but can alleviate the inflammatory symptoms triggered during acute episodes by using anti-inflammatory symptomatic drugs. The surgical method primarily used for anal fistula is the fistulotomy with seton placement. This procedure involves cutting the local sphincter either partially or completely using a thread, while preserving the function of the surrounding sphincter and thoroughly removing the fistula tract wall to further eliminate the local lesions. After the surgery, due to the large wound area, it is recommended that patients stay in the hospital for dressing changes and symptomatic treatment to avoid complications like poor healing leading to pseudo-healing or wound infection. (Medication should be used under the guidance of a doctor.)

Does a perianal abscess require hospitalization?
Perianal abscess is a common acute onset disease in proctology. If surgery is performed for a perianal abscess, it is recommended that the patient be hospitalized. Hospitalization observation is mainly for the local wound, to prevent recurrence and infection, and to ensure early proper wound dressing and drainage work, laying a good foundation for granulation growth post-surgery. The general hospitalization duration is about one week to ten days. In some cases, where the symptoms are severe or the abscess cavity is large, the hospital stay may extend to 20 days. During hospitalization, it is necessary for a professional proctologist to disinfect and change dressings of the local wound, and it is important to wash with saline water after each bowel movement.