How Do I Choose the Best Cures for External Hemorrhoids?

External hemorrhoids are located below the tooth line and are masses formed by inflammation, hypertrophy, connective tissue hyperplasia, or thrombus stasis caused by external hemorrhoid varicose veins or anal marginal folds. The surface of the external hemorrhoids is covered with skin and can be seen. It cannot be sent into the anus. It is not easy to bleed. The main symptoms are pain and foreign body sensation. Clinical is often divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids and thrombotic external hemorrhoids.

External hemorrhoids are located below the tooth line and are masses formed by inflammation, hypertrophy, connective tissue hyperplasia, or thrombus stasis caused by external hemorrhoid varicose veins or anal marginal folds. The surface of the external hemorrhoids is covered with skin and can be seen. It cannot be sent into the anus. It is not easy to bleed. The main symptoms are pain and foreign body sensation. Clinical is often divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids and thrombotic external hemorrhoids.

Chinese name

external hemorrhoids

Foreign name

External piles

Location

Below the tooth line

Symptom

Pain and foreign body sensation

Causes of external hemorrhoids

External hemorrhoid anatomy

When the person is standing or sitting, the anorectum is in the lower part. Due to the pressure of gravity and organs, the upward flow of the veins is very difficult. The rectal vein and its branches lack venous valves, and the blood is not easy to return and stasis. The special arrangement of blood vessels passes through the muscle layer at different heights, which is easy to be affected by the pressure of fecal mass. The veins also pass through the loose tissue of the submucosa. The lack of stent fixation around the veins makes it easy to expand and flex.

External hemorrhoids professional relationship

People standing for a long time or sitting for a long time and travelling with long-term load will affect the venous return and slow the pelvic blood flow and congestion of abdominal organs, causing excessive filling of hemorrhoidal veins, decreased venous wall tension, easy blood stasis and expansion of blood vessels, and lack of exercise, Reduced peristalsis, sluggish feces, or habitual constipation, compressing and stimulating the veins, causing local congestion and impaired blood return, leading to increased pressure in the hemorrhoid vein and reduced resistance to the vein wall.

External hemorrhoid anus infection

Hemorrhoid venous plexus first expands varicose veins due to acute and chronic infection inflammation, venous wall elastic tissue gradually fibrosis, weakening, insufficient resistance, and other reasons cause varicose veins to gradually increase the formation of hemorrhoids.

Increased external anal venous pressure

Due to cirrhosis, liver congestion, and cardiac insufficiency, anal vein congestion and increased pressure can affect the rectal vein blood return.

Genetic relationship of external hemorrhoids

The vein wall is congenitally weak, and after the resistance decreases, it cannot tolerate intravascular pressure and gradually expands.

Local irritation of external hemorrhoids

Cold and heat in the anus, constipation, diarrhea, excessive drinking and spicy food can stimulate the anus and rectum, congest hemorrhoid venous plexus, affect venous blood return, and reduce the resistance of the venous wall.

Increased intra-abdominal pressure in external hemorrhoids

Intraabdominal malignancy, uterine malignancy, ovarian malignancy, prostatic hypertrophy, excessive pregnancy during pregnancy, or prolonged squatting in the toilet can increase abdominal pressure and prevent venous blood flow. Upper respiratory tract infections cause a cough, which causes increased abdominal pressure, which can cause hemorrhoids. Increased abdominal pressure is one of the important factors that cause hemorrhoids, such as cold cough, pregnancy, and continuous forced bowel movements will increase abdominal pressure to a certain extent. Before treating hemorrhoids like this, the cause must be clarified, dialectical analysis, and symptomatic treatment. Patients are advised to drink plenty of water in the fall to avoid spicy food, exercise properly, avoid excessive exertion when defecation or cold cough, and promptly seek medical treatment when hemorrhoids appear, early diagnosis and early treatment, to prevent the disease from aggravating and avoid pain.

External hemorrhoids are not contagious

Infectious diseases are diseases caused by viruses and bacteria and transmitted through air, food, and various other contacts. There are three necessary conditions for infectious diseases: source of infection, route of transmission, and target of transmission. The cause of the disease is a virus or a bacterium. The occurrence of hemorrhoids is not caused by a bacterial or viral infection. It is caused by venous reflux disorders, stasis, and varicose in the rectal and anal mucosa and muscular layer caused by various reasons. There is no direct relationship with bacterial infections. Sometimes the mucous membrane of the hemorrhoids is eroded, and even the infection of the pus becomes anal abscess, but it has little to do with the cause of the hemorrhoid itself, it is only a factor that induces hemorrhoids.

In addition, hemorrhoids themselves cannot produce pathogens. Therefore, patients with hemorrhoids themselves are not contagious. If a hemorrhoid patient has an intestinal infectious disease, then only the possibility of being infected with intestinal infectious disease can induce hemorrhoids over time, and it is impossible to develop hemorrhoid disease immediately.

Classification of external hemorrhoids

Connective tissue

Connective tissue external hemorrhoids are named for their morphology

Pituitary and neoplastic external hemorrhoids. This type of external hemorrhoids is thickened and enlarged skin with anal marginal folds, hyperplasia of connective tissue, no varicose veins in the hemorrhoids, very few blood vessels, wide and pointed bottom, yellowish brown or brownish black, prominent and easy to see, varying in size and shape. Sometimes there is only one, in the middle of the back or front of the anus, and sometimes several around the anus.

Etiology and pathology: It is often caused by constipation. When a dry stool passes through the anus, it excessively pulls the skin of the anus and tears the anal folds, causing infection, inflammation, edema, and fibrous tissue hyperplasia. After the inflammation has dissipated, the folds cannot return to normal, so multiple injuries will make the folds hypertrophy and become external hemorrhoids. Various inflammations of the anus and rectum, such as proctitis, anal stenosis, internal hemorrhoids, anal sinusitis, anal fistula, anal fissure, etc., are also the causes of connective tissue external hemorrhoids. In addition, anal surgery, such as hemorrhoidectomy, anal sinus resection, etc., due to skin removal, suture, ligation and other improper operations, will also affect anal lymphatic and blood return, often causing connective tissue external hemorrhoids.

If there is no inflammation in connective tissue external hemorrhoids, the patient only feels a local foreign body sensation or the anus is not easy to clean after defecation. A small amount of secretions and feces often accumulate, irritating the anus, and eczema and itching can occur. If inflamed, you feel pain and have difficulty sitting or walking. At first, it is only wrinkles and swellings, with accumulation of feces and secretions in the middle, dark red skin and shedding of the epidermis; due to repeated inflammatory stimuli, the outer skin of the anus has protrusions, soft and yellow, often on the posterior midline of the anus. When in front of or on the sides of the anus.

Varicose veins external hemorrhoids

Varicose external hemorrhoids are varicose veins of the external hemorrhoids below the tooth line, forming round, oval or prismatic soft masses at the anal margin. If there is edema, the shape becomes larger. In the motherland medicine, it belongs to the category of gas hemorrhoids. For example, "Acupuncture Experience Book · Hemorrhoid Leak Illustration" said: "Qi hemorrhoids, the sensation is immediately down." The disease is generally not painful, does not bleed, and only feels anal bulging or foreign body sensation. Mostly complicated with three-stage hemorrhoids and mixed hemorrhoids.

Etiology and pathology: Any cause of hemorrhoids can cause varicose external hemorrhoids. The main factors are: due to poor diet, sedentary or standing for a long time, long-term constipation or diarrhea stimulation, long-term continuous increase in abdominal pressure, and infection The injury caused the expansion of the external venous plexus, stasis, and flexion.

External hemorrhoids

Etiology and pathology: often due to infection after anal damage, or anal fissure caused by anal fissure inflammation and edema. Patients with hemorrhoids feel anal burning, itching, and symptoms worsen after defecation or excessive movement. During examination, anal folds were congested, swollen, and there was a small amount of secretions.

External hemorrhoids

Etiology and pathology: Thrombotic external hemorrhoids are the most common type of external hemorrhoids. Often due to excessive force during bowel movements, violent activity or coughing, rupture of the veins of the anal margin, blood exudates into connective tissue and becomes a blood clot. Round or oval masses are generated under the skin of the anus, ranging in size from the anal canal. Or outside the anal margin. The lump is soft at the beginning and hardens after a few days. If it is not inflamed, the mass can be completely absorbed and dissipated within 3 to 4 weeks without leaving traces; if it is repeatedly inflamed, the connective tissue in the mass proliferates and can become external hemorrhoids of connective tissue; if an infection occurs, an abscess can be generated.

After defecation or exertion, a round or oval mass suddenly appeared under the skin of the anal margin. The patient felt abnormal pain, and the pain worsened during movement or defecation. Due to sphincter spasm, I feel a foreign body sensation in the lower rectum and anus, preventing walking and restlessness. The surface of the mass is slightly darker, sometimes purple-red, slightly hard, and the tenderness is obvious. Sometimes it is absorbed by the blood clot within 2-3 days, the pain is reduced, and it can heal itself. Sometimes an anal fistula develops due to infection and suppuration of the epidermis.

The distinction between external hemorrhoids and internal hemorrhoids

External hemorrhoids are located below the tooth line, with pain and lumps as the main symptoms, and there are various sizes and shapes of skin tags around the anus. According to the different pathological characteristics, it can be divided into four types: varicose veins, connective tissues, thrombosis and inflammation. Among them, inflammatory external hemorrhoids are the most common, mainly manifested as anal marginal skin folds, redness, heat, pain, edema, and congestion, tenderness, increased pain during defecation, and a small amount of secretions, and some may be accompanied by general discomfort and fever.

Internal hemorrhoids that occur above the dentate line of the anal canal are generally not painful, so that blood and hemorrhoid prolapse are the main symptoms. In severe cases, blood will be sprayed, and the hemorrhoid may not be able to be repaid after the prolapse of the hemorrhoid nucleus. There will also be difficulty in stool, and it will not clean after cleaning , There is a sense of falling and swelling. According to the degree and clinical manifestations of internal hemorrhoids, they can be divided into three phases: hemorrhoids with blood during defecation during the first period, no prolapse, and nodular bulges on the dental floss; in the second period, hemorrhoids with blood, dripping or ejecting blood, Hemorrhoids prolapse and they can be self-contained after defecation; internal hemorrhoid prolapse occurs during defecation of the hemorrhoids or increases in abdominal pressure due to coughing, fatigue, and weight bearing, and must be paid by hand.

External hemorrhoid symptoms

Varicose veins external hemorrhoids

Vein clumps formed by anal subcutaneous dilated veins. If the infection recurs, thrombotic external hemorrhoids and connective tissue external hemorrhoids can form. Treatment can use local hot compresses and sitz baths to prevent infection.

Connective tissue external hemorrhoids

It is a skin cell formed by an increase in skin wrinkles around the anus. It has proliferated fibrous connective tissue and rarely dilates blood vessel skin cells. The bottom of the body is broad and the free tip is long. The shape can be single or multiple. Its presence affects the cleansing of the perianal area, and those with infection may have pain. The primary ones are mostly the consequences of thrombotic external hemorrhoids and anus surgery. Skin tagsusually soft and pliable. The surface is covered with normal skin epidermis. Hemorrhoids behind the anus are mostly secondary to anal fissures, and the harder swelling of the hemorrhoids often causes sphincter spasm and pain due to the stimulation of defecation.

For its treatment, laxatives are used to keep the perianal area clean to prevent infection. Conservative therapies can be applied to patients with local infections by hot compress sitz baths. When the treatment fails, the external skin of the external hemorrhoids is cut open under local anesthesia and all of them are removed.

External hemorrhoids

Typical symptoms of external hemorrhoid prolapse

Intravenous thrombosis due to venous inflammation of the inferior rectal venous plexus, or rupture of veins at the edge of the anus due to defecation and vigorous activity, penetrates into the subcutaneous tissue, causing local tissue to form a mass. The clinical manifestations are severe pain and local swelling, which is painful in the first place. The pain can relieve the local mass from softening and sucking after a few days, and finally, there are skin tags that become connective tissue external hemorrhoids. When a vein is ruptured, a local blood clot forms an infection accompanied by an abscess and anal fistula.

If the pain does not decrease within one hour of onset, you can consider thrombectomy under local anesthesia, make a spindle-shaped radiation incision on the skin of the mass, and remove the varicose vein to remove the thrombus, and the wound can heal by itself. For cases with mild pain for more than an hour, take conservative treatment to keep the stool open, apply a local hot compress, and apply an appropriate amount of analgesics. The mass can usually shrink and gradually dissipate and absorb.

1) There is pain in the lump of the anal margin, severe pain at the beginning, inconvenience in walking, and restlessness. After a few days, the lump became soft.

2) Connective tissue external hemorrhoids are often asymptomatic, with occasional anal itching, sag, or foreign body sensation. Complications can be painful.

External hemorrhoids

Inflammatory external hemorrhoids are mainly caused by infection of anal lesions. When anal infection occurs, local symptoms such as redness, swelling, fever, and pain will appear in the anal folds. Examination of the anus will reveal proliferative skin tags, anal folds are obviously congested and edema, and there will be a small amount of secretory logistics. Out. The conscious pain is relatively strong, and slight pain can cause severe pain. At the same time, it is accompanied by symptoms such as moist anus and itching.

Special population of external hemorrhoids

External hemorrhoids in women

There are no fewer women with external hemorrhoids than men. It is often said that ten people have nine hemorrhoids. This suggests the multiplicity of hemorrhoids such as external hemorrhoids. Experts remind that women should pay more attention to external hemorrhoids.

The cause of external hemorrhoids in women is closely related to women's unique physiological characteristics, such as menstrual period, pregnancy, puerperium, menopause, etc., which increase the burden on the anus and cause hemorrhoids, especially in late pregnancy. The fetus increases the pressure on the rectum, in addition to the difficulty of defecation In addition, at the same time, it prevents the rectal and anal venous blood from flowing back, which not only makes hemorrhoids prone, but also makes the original hemorrhoids even worse.

Because the pregnancy is not suitable for treatment, after the recovery of the reproductive body, if the symptoms are obvious, the treatment should be timely. In addition, some young women have external hemorrhoids, which also cause perianal abscess, and infections in the perianal area will also affect the vaginal opening, causing unnecessary gynecological inflammation and infection, so they should be treated as soon as possible. In short, women should pay attention to some anorectal diseases such as external hemorrhoids, prevent them early and avoid being troubled by them.

External hemorrhoids in children

Many parents are very concerned about how to treat external hemorrhoids in children. The hemorrhoids pointed out in medicine include internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids. Hemorrhoids are a chronic disease of one or more soft venous clusters formed by varicose veins at the bottom of the anorectal rectum and the anal mucosa. Usually, when the bowel movement continues to force, the venous pressure increases repeatedly, and the veins Will swell. Thrombosis can occur in both internal and external hemorrhoids. When a blood clot occurs, the blood in the hemorrhoids clots and causes pain.

How to treat external hemorrhoids in children

1. Eat normally and keep your stools open.

2. Keep local cleanliness.

3 Topical hemorrhoid cream.

External hemorrhoid harm

1. Although external hemorrhoids are not easy to bleed, it does not mean that there is no possibility of non-bleeding. After external hemorrhoids are scratched or inflamed, they will bleed. Long-term blood in the stool will cause anemia.

2. Blood in the stool or perianal bulging is a symptom of external hemorrhoids, but if you think that blood in the stool or any perianal discomfort is caused by hemorrhoids, paralysis will delay the intestinal tumor of the real disease, thus losing the best opportunity for treatment.

3 External hemorrhoid hemorrhoids outside the anus, increased secretions, induce anal pruritus or anal eczema. Female patients also cause gynecological diseases.

4 Because the external hemorrhoids are bulbs that grow outside the anus, they block the anus. When a gas is generated, the gas is often trapped inside because the pressure is not strong enough. Farts are exhaust gases emitted by the body, most of which are carbon dioxide, hydrogen and methane. Exhaust gas is present in the body for a long time. Excessive density can cause flatulence, or the compressive strength of blood vessels affects the normal contraction of the heart, which is prone to insufficient blood supply, such as dizziness, brain swelling, and weakness.

External hemorrhoid prevention and conditioning

Daily care for external hemorrhoids

1. Rehydration: The water in the body is easy to evaporate, and you need to replenish it in a timely manner. 7-8 cups per day is enough. You can drink a glass of honey or salt water on an empty stomach before getting up every day to help digestion.

2, diet should pay attention: avoid spicy, greasy and more irritating food, eat more fresh fruits or vegetables, such as apples, bananas, pears, greens, spinach, cabbage and other foods that are good for defecation, the best Avoid excessive smoking and drinking.

3, defecation should be good: maintain good defecation habits, do not squat in the toilet for a long time to read books, play games, it is best to control within 10 minutes, it is best to regularly defecate every day, do not tolerate patience and urine Defecation in reflex conditions.

4. Personal hygiene habits: Wash the residue around the anus with warm water every day. Do not wash it with hot water to promote the normal circulation of blood in the anus. Keep the anus clean and clean. Private items should be used exclusively and not mixed.

5. Sports: Actively participate in some outdoor sports, such as mountain climbing, walking, running, etc., to enhance resistance, promote blood circulation in the anus, and make the anal sphincter contract strong. Frequently used anus lifting and self-massage methods can effectively improve the blood flow around the anus.

External hemorrhoid diet conditioning

1. Increase foods high in fiber .

A high-fiber (cellulose product, cellulose information) diet can relieve or disappear symptoms in most patients, with effects similar to sphincterotomy and anal dilation.

2, "Eat without getting tired".

Coarse processed foods contain more nutrients and dietary fiber, which is suitable for constipation or hemorrhoid patients, and is conducive to smooth stool.

3. Correct bad eating habits.

Drinking alcohol for a long time not only damages the liver, but also promotes the formation of hemorrhoids. Hemorrhoid patients should quit drinking and avoid spicy food.

4. Treat the primary disease.

For patients with systemic chronic diseases, paying attention to nutrient supplementation and treatment can reduce the occurrence of hemorrhoids.

13 13 family prevention common sense of external hemorrhoids

1.Intake more water and fiber

Constipation is the biggest cause of hemorrhoids. To prevent constipation, drink plenty of water and eat more fiber-rich foods. Grains such as apples, beets, Brazil stone fruits, broccoli, cabbage vegetables, carrots, mung beans, guar bran, emperor beans, pears, peas, psyllium and whole wheat are all good choices.

2.Control weight

People who are overweight are more likely to develop hemorrhoids because their lower limbs are under greater stress. As a result, they are also more prone to varicose veins.

3.Clean

When your bowel movements are complete, your responsibility is not over. It is important to clean the anus gently. Some toilet papers are rough, while others contain harsh chemicals. Colorless (white), odorless toilet paper should be used. It's best to have a bidet in your home and rinse it every time you go.

4.Lubricate the anus

Once you increase your fiber and water intake, your stool will become softer and easier to excrete. You can also apply some vaseline to your anus to further promote smooth bowel movements and reduce pain. Dab some petroleum jelly with a cotton swab or finger and apply it to the inner half of the anus.

5. Use of drugs

There are various creams and suppositories on the market that specialize in hemorrhoids. Although these drugs do not usually eliminate your problem, they are mostly topical pain relievers, but they can relieve some discomfort. Do not use ibuprofen and aspirin to relieve pain. They can aggravate bleeding.

6. Don't sit still for a long time

Do not sit in a chair for several hours without stopping, even if you must, get up for at least 5 minutes per hour.

7. Don't squat the toilet for too long

It is best not to sit on the toilet for more than 5 minutes each time, especially not to read a book while sitting in the toilet. This is a very unhygienic habit.

8. Don't lift heavy objects

Lifting heavy objects or strenuous exercise is like excessive force during defecation. If you are prone to hemorrhoids, you should avoid excessive force.

9.Do not scratch the affected area

The affected part of the hemorrhoid may be itchy, but do not scratch it to relieve discomfort, as it will damage the fragile vein wall of the rectum and make the situation worse.

10.Push in by hand

Sometimes hemorrhoids refer to the protruding anal lining, not swollen veins. If you have this type of protruding hemorrhoids, try pushing it back into the anus. Hemorrhoids that hang out easily develop into blood clots.

11, sitting in warm water bath

Soaking your hips in warm water is probably the best way to treat it. Warm water promotes blood circulation in the affected area, helps to shrink the enlarged veins here, and can relieve pain.

12, sitting on the ring-shaped cymbal pillow

This kind of hollow cushion is suitable for people who need to sit for a long time, especially when your hemorrhoids attack.

13, how to prevent hemorrhoids in pregnant women

Pregnant women are particularly prone to hemorrhoids, in part because the uterus sits just above the blood vessels that communicate with the anal veins (blocking blood flow). If you are pregnant, the way to treat hemorrhoids is to lie on your left side for about 20 minutes every 4-6 hours. This reduces the weight of the lower body on important blood vessels.

External hemorrhoids physical therapy

Physical therapy (Physiotherapy or Physical Therapy) is a medical specialty that prevents, treats, and deals with movement problems caused by disease or injury. Mainly through the physical factors (acoustic-optical water-cooled electric heating power) in nature, using the principles of human physiology, etc., to provide appropriate non-invasive, non-drug treatment for local or systemic dysfunction or disease The patient's physical discomfort and pain are treated in such a way that it restores its original physiological function as much as possible.

Magnetic therapy (magnetotherapy), a method in which magnetic fields act on the human body to treat diseases. The magnetic field affects the human body's current distribution, the movement of charged particles, the permeability of the membrane system, and the orientation of magnetic moments of biopolymers, etc., changes the physiological and biochemical processes of tissue cells, produces analgesia, swelling, and promotes blood and lymph circulation And other effects.

Examination and treatment of external hemorrhoids

Generally check before external hemorrhoid surgery

The items to be checked before external hemorrhoid surgery are:

Urine routine, stool routine, biochemical examination, hemoglobin, white blood cell count and classification, red blood cell sedimentation rate, platelet count, and clotting time.

Urine routine

Including urine volume, specific gravity, color, acid-base reaction, urine protein, urine sugar detection and microscopic examination.

Stool routine

Including the appearance, hardness, color, smell and smell of stool, blood examination, microscopy and bacteriological examination, such as rectal tumor compression of the bowel cavity can make the stool flat, thin, and accompanied by dark red blood or mucus blood. . Mucus or pus and blood can be seen in the stool of acute and chronic enteritis, blood on the stool or blood on the stool, bright red, and internal hemorrhoids or anal fissures should be considered.

Biochemical tests

In the examination of anorectal diseases, it is often necessary to exclude some other disease factors, such as liver, kidney, heart and other diseases. Corresponding biochemical tests can be performed. Biochemical tests such as liver function and renal function before surgery are also one of the routine tests.

Hemoglobin

It mainly reflects the degree of anemia and the nature of the patient's anemia. It can also be used as one of the basis for the need for blood transfusion. Those with severe anemia caused by major internal hemorrhoids do not consider surgery.

WBC count and classification

The increase in white blood cell count indicates that the body's defense response to disease-causing damage is enhanced, which is a normal phenomenon of most infectious diseases and inflammatory processes. Patients with anal colorectal tumors who require chemotherapy or radiation therapy in clinical practice should pay close attention to the white blood cell count. The changes are drastic, and the treatment plan should be adjusted in time. The changes in the white blood cell count and classification are also closely related to the disease conversion.

Correct treatment of external hemorrhoids

The current methods of treating hemorrhoids can be summarized into two categories: conservative treatment and surgical treatment.

1. Conservative treatment refers to internal medicine, external medicine, suppositories, fumigation and washing.

2. Surgical treatment refers to methods such as drug injection, suture ligation, surgical resection, freezing, and laser.

External hemorrhoid surgery

It is generally believed that thrombotic external hemorrhoids require surgical treatment, varicose external hemorrhoids can be treated non-surgically, and connective tissue external hemorrhoids do not require surgical treatment.

(1) External hemorrhoids are named for their small hemorrhoids, broken blood vessels, and clots that form clots. The patient has severe pain in the anus. After 7 to 10 days of onset, although the pain is reduced after treatment, but the localized mass is hard, the thrombus needs to be removed by surgery. For some patients who are not suitable for surgery or unwilling to undergo surgery, non-surgical treatment is continued. The commonly used internal treatment method is to clear the heat and cool blood.

Select Liangxue Dihuang Decoction for flavor. The commonly used drugs are Shengdi, Danpi, Huaijiao, Scutellaria baicalensis, Shengdiyu and so on. Commonly used medicines are Qingjie tablets, 5 tablets each time, 3 times a day, orally. Common external treatments are fumigating and washing with Sophora flavescens decoction and Galla Chinensis decoction, or sitting in a hot bath with potassium permanganate in hot water for 20 minutes each time. After fumigation and washing, apply external hemorrhoid cream or golden cream, and change it daily.

(2) Varicose external hemorrhoids The treatment of varicose external hemorrhoids can be either surgical or non-surgical. Generally, the external hemorrhoidal venous plexus is stripped by surgery. Operation method: take a lateral position or lithotomy position, routinely sterilize and spread towels, and local anesthesia. Make a radial incision in the middle of the skin tags, remove the flaps on both sides, and trim the skin margin to make a spindle or radial wound. Apply hemostatic powder externally and put in a vaseline gauze for compression and fixation. Postoperative treatment: take a bath with Sophora flavescens decoction or a 1: 5000 hot solution of potassium permanganate daily after the operation, and then change the dressing to cure. If inflammation occurs, treat it symptomatically. For non-surgical treatment, the methods of clearing heat and dehumidifying and promoting blood circulation and dispersing blood stasis are selected. Oral infiltration and dehydration combined with Tongjing Huoxue decoction are usually taken orally. Commonly used are , Alisma, Cork, Scutellaria baicalensis, Danpi, Chiba, Angelica, Achyranthes, Chuanxiong drug. Or cooperate with the application of Chinese patent medicines such as Maren Pills and Runchang Tablets to keep the patients' stools open. Do not work hard while going to the toilet. Press the anus several times after the stool and contract the anus 20 times. Those without inflammation do not need external treatment. If the inflammation and edema occur, they can be smoked and washed with Sophora flavescens decoction or potassium permanganate in a bath.

(3) Connective tissue external hemorrhoids do not require special treatment, only general treatment. Require patients to adjust their bowel habits to avoid squatting for too long; sit in bath with warm water after bowel movements or before going to bed; keep the anus skin dry. When inflammatory swelling and pain occur, you can use fumigation and bathing, and apply external hemorrhoid cream, golden cream, etc., and you can also give antibiotics appropriately. If the external hemorrhoid flap is too large to affect the perianal cleanliness or repeated inflammation and edema, surgery can be performed as appropriate.

(4) Inflammatory external hemorrhoids only need to adjust the bowel habits to prevent constipation, avoid drinking and eating hot and irritating food, and then use potassium permanganate to sit in the bath or use spectrum irradiation treatment. If necessary, apply external hemorrhoid cream once daily. Or take metronidazole (metridium) 0.4 g twice daily. For those with long-term inflammatory edema, surgical resection can be performed. In the acute phase of inflammatory edema, take Chinese medicine internally according to TCM syndromes, and cooperate with external treatment methods such as fumigation, washing and external application.

Precautions for surgery

The choice of middle incision in external hemorrhoid surgery. When external hemorrhoids and external hemorrhoids of mixed hemorrhoids are surgically removed, because the anal wrinkle muscle is distributed radially in the anus, a radial incision is taken. The postoperative response is light, and the wound is neat and neat. Anal function. Most external hemorrhoids correspond to the arterial hemorrhoid arteries, so most of the incisions are at the lithotomy position 3, 7, 11 points. For large varicose external hemorrhoids or female anterior superficial hemorrhoids, a radial incision alone cannot be used to remove the external hemorrhoids. If too many skin tissues are left, postoperative inflammation, pain, and hyperplasia of the skin tissues may lead to superficial hemorrhoids; If the angle is removed to remove all external hemorrhoids, excessive anal canal skin damage will cause anal canal stenosis.

In order to make up for the above-mentioned shortcomings, small incisions can be added to one or both sides of the incision, the marginal venous plexus is peeled off, and the skin is fixed by suture. If the skin is poorly matched, it is prone to pain, edema, straight skin, and slow healing.

In external hemorrhoid surgery, attention should be paid to the orientation, size and anesthesia of the incision, and the change of the incision when the body position is changed to ensure that the wound is aligned.

The current methods of treating hemorrhoids can be summarized into two categories: conservative treatment and surgical treatment.

(1) Conservative treatment refers to internal medicine, external medicine, suppositories, fumigation and washing.

(2) Surgical treatment refers to methods such as drug injection, suture ligation, surgical resection, freezing, and laser.

Specific operation of external hemorrhoid surgery

[anesthesia]

Local anesthesia.

[Surgery steps]

Side lying position. After sterilizing the operation area with 1: 1000 Xinjieer disinfectant solution, make a radial incision or fusiform removal of a small piece of skin at the thrombus site, and a dark red blood clot can be seen. Use a hemostat to lightly press on both sides to remove it. When there is adhesion, it can be added for separation or block removal. Do not sew the wound, plug it with oil gauze [Figure 1].

[Postoperative treatment]

Postoperatively take a hot bath with 1: 5000 potassium permanganate 3 times a day.

External hemorrhoids

Oral medication : Oral therapy refers to a method of treating hemorrhoids with oral medication. Some professional drugs in this area can be used to treat hemorrhoids. Traditional Chinese medicine treats hemorrhoids by stressing the overall concept and dialectical treatment, that is, based on the theory of dialectical treatment, different treatments for different etiologies, pathologies, positions, different physiques, and ages. . According to traditional Chinese medicine, hemorrhoids are mostly damp, hot, wind, dry, fire, evil, and pulsating blood. As a result, qi and blood are stagnant, and the clumped disease is treated by purging fire and cooling blood, clearing heat and moistening, removing wind and dampness, and nourishing qi and nourishing blood. then. There are many single prescriptions and prescriptions for the treatment of hemorrhoids.

Treatment of thrombotic external hemorrhoids

Thrombotic external hemorrhoids are clinically frequently-occurring. For the treatment, surgical resection or surgical incision and stripping of blood are often used at present, and the patient suffers a lot. However, the treatment of this disease with warm saline sitting bath method can achieve wonderful results, which can save more than 95% of patients from the suffering of surgery. Now introduce this method as follows.

In 2000ml of warm water (temperature about 40 ° C), put two people in a salt bath with salt for about 10-15 minutes, twice a day. After 3 days of general treatment, the mass was significantly reduced, and the swelling and pain were reduced. After 1 week, the anal mass basically disappeared. If there is mild erosion and bleeding on the surface of the tumor, and the pain is more obvious, you can take anti-inflammatory drugs orally with local topical home hemorrhoid cream after taking a bath. This method is economical, simple, and effective, and it is worth clinical promotion. use.

Postoperative care for external hemorrhoids

Urinary retention : Urinary retention occurs in a very small number of patients within a few hours after surgery for external hemorrhoids. If the local anesthesia method is correct during the operation, it is mostly because these patients are emotionally stressed, and it is also related to the compression of the urethra by external dressings. If it is caused by the pressure of the dressing on the urethra, the dressing can be re-padd or a part of the dressing can be removed, so that the urination can generally be smooth.

Pain : Any degree of pain may occur after anesthesia after anesthesia. However, after using hemorrhoid surgery, long-acting analgesics and traditional Chinese medicine Xiaoyan analgesic cream are generally used without obvious pain, including no obvious pain during defecation . It is just that some patients have more external hemorrhoids, so there are more wounds, and they are not very thoughtful and comprehensive when injecting analgesics. There is not enough contact surface for Xiaoyanzhitong cream, and there may be a little pain and anal bloating.

Bleeding : Generally, there will be a small amount of bleeding in the surgical wounds of external hemorrhoids, especially on the day of surgery and after the first stool, it usually stops without special treatment. Just a small amount of bleeding at the surgical site after the stool, which may last 4-5 days. Generally, varicose vein external hemorrhoid surgical wounds are prone to bleeding. If the bleeding of the wound is obvious, the hemostatic measures should be taken again. You can take or inject some hemostatic medicine, and you can also use high-frequency electrocautery to burn and stop bleeding. If the bleeding point is obvious, you can also suture under local anesthesia to completely stop bleeding.

Edema : Generally, the edema is not very serious after the operation of external hemorrhoids. Of course, this depends on the physical condition of the patient, and some may have a certain degree of edema. Obvious edema can be used hot compress or warm bath.

Postoperative fever : There are not many patients with fever after external hemorrhoid surgery. Even if the temperature is not high, generally it does not exceed 38 ° C. This is because the patient is emotionally stressed and also the body's response to anesthesia surgery and stimulation. It is also called surgical fever. Most cases occur on the day of surgery or 1-3 days after surgery, and generally do not require treatment. However, if the body temperature rises 3 days after the operation, the cause of the fever must be checked, and the infection and other complications should be ruled out first.

Postoperative infection : The chance of surgical infection of external hemorrhoids should be said to be rare, if not severe. If the patient feels obvious swelling and pain at the wound, and it gradually increases, sometimes accompanied by a rise in body temperature, a wound infection may occur. If a wound infection is diagnosed after examination, it must be treated in time. First, a sufficient amount of antibiotics should be given, orally or by injection, and dressings for surgical wounds should be changed, especially after the stool must be disinfected and changed, and infection can be controlled.

External hemorrhoid medication

The recommended prescription is 10 grams each of peach kernel, safflower, angelica tail, chuanxiong, Sanling, and zedoary turmeric, heated half-basin with water at 40-50 ° C, sitting in the basin, and soaking the anus for about 15 minutes. Generally 1 to 2 times will be good, severe external hemorrhoids may take 4 to 5 times, and rarely relapse.

(1) Treatment measures for thrombotic external hemorrhoids: Patients of the second type are often named after hemorrhoids are small, blood vessels are damaged, and blood clots become clots. The patient has severe pain in the anus. Although the pain is reduced after treatment, but the localized mass is hard, the surgical thrombolysis is required. For some patients who are not suitable for surgery or unwilling to undergo surgery, non-surgical treatment is continued.

(2) Treatment of varicose veins external hemorrhoids: What medicine is taken for varicose veins external hemorrhoids? It is generally believed that this type of hemorrhoids can be treated with surgery or non-surgical therapy. Generally, surgical methods are used to strip the external hemorrhoidal venous plexus, while non-surgical methods use heat removal and dehumidification, and blood circulation and blood stasis.

(3) measures for connective tissue external hemorrhoids: introduced by andrologists, no special treatment is needed, only general treatment is required. Ask patients to adjust their bowel habits and avoid squatting for too long. When inflammatory swelling and pain occur, you can use fumigation and bathing, and apply external hemorrhoid cream, golden cream, etc., and you can also give antibiotics appropriately. If the external hemorrhoid flap is too large to affect the perianal cleanliness or repeated inflammation and edema, surgery can be performed as appropriate.

(4) Treatment measures for patients with inflammatory external hemorrhoids: mainly adjust bowel habits to avoid constipation, do not eat spicy food, and do not drink alcohol. Potassium permanganate after bath, or use spectrum irradiation treatment. If inflammatory edema occurs, it is best to undergo surgical resection.

7. Pain care after external hemorrhoid surgery

There are several ways of pain management after external hemorrhoid surgery:

1. Diet and nursing: After the hemorrhoid surgery, patients should eat common foods. They should eat more fruits and vegetables, avoid peppers, and avoid alcohol. Drink plenty of water and eat intestinal moisturizing beverages, such as honey, to promote urination, maintain smooth stools, reduce irritation to the incision, and reduce pain.

2. Psychological nursing: Nursing staff should establish a trusting relationship with patients; introduce knowledge about pain; eliminate stressors and reduce psychological stress; guide distraction. Psychological care for patients with pain is very important, introduce some to the patient

Knowledge of analgesia makes it fully prepared for postoperative pain.

3 Promote comfort: help patients choose the correct posture, comfortable and tidy bed units, good lighting and ventilation, suitable indoor temperature and humidity, avoid noise, strong light and other necessary conditions to promote comfort.

4 Relaxation therapy: Nursing staff can teach patients some ways to relieve pain, such as listening to music, slow rhythm breathing. Both Chinese qigong and Indian yoga can help the body relax and reduce muscle tension to reduce pain.

5. Cold compress method: Cold stimulation can reduce the sensitivity of nerve endings and reduce pain; it can also make capillaries shrink, reduce blood flow, reduce local congestion and edema. Because cold stimulation can inhibit the metabolism of bacterial cells, it can prevent the spread of inflammation.

6. Warm saline sitting bath method: Warm saline sitting bath can relax the anal sphincter, improve local blood circulation, promote inflammation subsidence, edema disappear, and reduce pain.

7. Suppository therapy: Hemorrhoid suppositories are used to protect the incision after hemorrhoidectomy, reduce the friction of feces on the wound, reduce postoperative pain, defecation pain, and anal bulging. Follow your doctor's advice.

Management of acute episodes of external hemorrhoids

Patients with external hemorrhoids, who often have acute attacks, should pay special attention. Acute attack of external hemorrhoids, one is thrombotic external hemorrhoids, one is inflammatory external hemorrhoids, connective tissue external hemorrhoids, varicose type external hemorrhoids, if it is self-treatment, one is to be careful not to have dry stools, warm water sitz bath, warm water can be used if conditions permit , Topical ointment, there is a hemorrhoid suppository ointment, and some antibiotic ointments are also a treatment for external hemorrhoids. These four types have thrombus external hemorrhoids and inflammatory external hemorrhoids. The pain in the early stages of the acute attack is obvious, usually within 1 to 3 days. After 3 days, the pain subsides and gradually relieves. If necessary, you can go to the hospital for anal and bowel specialists for treatment. External hemorrhoid attacks are more severe and require surgical treatment, and conservative treatment. If the symptoms do not alleviate during conservative treatment, you must go to a specialist hospital for a differential diagnosis. Is it external hemorrhoids?

How to relieve pain after external hemorrhoids

External hemorrhoids are a common anal disease. Because the anal area is rich in nerves and sensitive to pain, postoperative pain is common. The causes of postoperative pain are diverse. Although the analgesic effect of the drug is positive, various drugs have their side effects. It is difficult to accept repeated use of pain medication. Numerous approaches have been tried in clinical care to manage pain.

Pain care is an important part of patient care after external hemorrhoid surgery. Psychological care can increase the pain threshold. Dietary care can change stool characteristics and reduce local irritation to reduce pain. Cold stimulation can reduce local pain sensitivity. Relaxation therapy can distract patients' attention Strength, relieve pain, and can also apply local medicine treatment. By taking the above nursing measures, it has achieved satisfactory results in reducing the pain of patients with external hemorrhoids.

External hemorrhoid relaxation therapy

Nursing staff can teach patients some ways to relieve pain, such as listening to music, slow rhythm breathing. Both Chinese qigong and Indian yoga can help the body relax and reduce muscle tension to reduce pain.

The treatment of external hemorrhoids is generally:

1. Thrombosis external hemorrhoids. It is named for its small hemorrhoids, broken blood vessels, and clots that form clots. The patient has severe pain in the anus. After 7 to 10 days of onset, although the pain is reduced after treatment, but the localized mass is hard, the thrombus needs to be removed by surgery. For some patients who are not suitable for surgery or unwilling to undergo surgery, non-surgical treatment is continued.

2. Varicose external hemorrhoids. Varicose external hemorrhoids can be treated with or without surgery. Generally, surgical methods are used to strip the external hemorrhoidal venous plexus, while non-surgical methods use heat clearing and dehumidifying, and promoting blood circulation and blood stasis to keep patients' stools open. Do not work hard while going to the toilet. Press the anus several times after stool and shrink. Anal 20 times.

3. Connective tissue external hemorrhoids. No special treatment is needed, just general treatment. Require patients to adjust their bowel habits to avoid squatting for too long; take a bath with warm water after bowel movements or before going to bed; keep the anus skin dry. When inflammatory swelling and pain occur, you can use fumigation and bathing, and apply external hemorrhoid cream, golden cream, etc., and you can also give antibiotics appropriately.

4. Inflammatory external hemorrhoids. You only need to adjust your bowel habits to prevent constipation, avoid drinking and eating hot and irritating food, and then take a potassium permanganate bath or use spectrum irradiation treatment. If necessary, apply external hemorrhoid cream once daily. Or oral metronidazole (metridium) 0.4 g, 2 times a day. For those with long-term inflammatory edema, surgical resection can be performed.

Misunderstanding of external hemorrhoid treatment

Due to the formation of thrombotic external hemorrhoids due to anal vein damage or inflammation, patients often have a misunderstanding in the mood of urgent treatment.

1. One injection, never relapse This is often seen in some irresponsible advertisements, saying that the internal hemorrhoid sclerosing agent is used for injection treatment and will not recur. The characteristics of internal hemorrhoid sclerosis injection therapy are: positive effect, rapid effect, safe use, and no sequelae. But never recurring is a bit exaggerated.

2. Ten people have nine hemorrhoids, and it is wrong to think that there is no need to cure them. No treatment is needed for hemorrhoids without symptoms, but bleeding, prolapse, pain and other symptoms, but delaying treatment, can lead to malignant anemia, hemorrhoid incarcerated necrosis, canceration and so on.

3 The argument that thrombotic external hemorrhoids can become cancerous has disturbed some patients with hemorrhoids. In fact, modern medicine has not yet confirmed the possibility of hemorrhoids becoming cancerous, but long-term incurable disease will become a major cause of canceration. However, the early symptoms of rectal cancer are often similar to hemorrhoids, which can sometimes lead to misdiagnosis of rectal cancer and delay treatment time, which should be paid attention to.

4 Thrombotic external hemorrhoid surgery can cause fecal incontinence. This is unfounded rumor. Surgical treatment of hemorrhoids, as long as the method is correct, will not cause fecal incontinence.

5. Thrombotic external hemorrhoids recur well, and surgery is useless. Although hemorrhoids is a disease with a high recurrence rate, it is by no means necessary for surgery. Some hemorrhoids have severe symptoms and are difficult to treat. Clinical cure can only be achieved by surgery, and as long as postoperative care is taken, recurrence can be prevented.

6. Cryotherapy is good. Modern cryotherapy should be the first choice to treat hemorrhoids. It does open up a new way for hemorrhoids, and it has a good effect. However, cryotherapy is only suitable for internal hemorrhoids, and due to tissue necrosis after surgery, sometimes major bleeding. Therefore, whether to choose cryotherapy should be determined according to the condition, and the latest method may not be the best method.