Anal papillitis

Introduction

Introduction to anal papillitis Anal papillitis is a disease caused by anal sinusitis. This is because the anal sinus is the anal nipple on both sides. Therefore, the anal sinusitis first invades the anal nipple, causing anal papillitis, which makes it swollen and hypertrophy. Anal papillitis often associated with anal sinusitis, also known as anal papillary hypertrophy, is an inflammatory hyperplastic lesion of chronic fibrosis of the anal papilla. Injury or anal sinus inflammation during defecation can cause acute inflammation of the anal papilla, which causes hypertrophy of the anal papilla due to poor drainage and long-term stimulation of inflammation. basic knowledge The proportion of illness: 0.004%-0.007% Susceptible people: no specific population Mode of infection: non-infectious Complications: constipation, intestinal obstruction

Cause

Cause of anal papillitis

Infection and injury (15%):

The anal sinus is in the lower part of the sinus, the opening is upward, and it is in the shape of a bag. The drainage is poor. It is easy to store the feces and cause infection and injury. The edge of the anal sinus has a free half-moon anal flap, which is also vulnerable to scratching of dry feces. Teared when defeated. Increased frequency of bowel movements or intestinal inflammation, dysentery, diarrhea, constipation, etc., frequently stimulate the anal sinus and anal flap. Physical and local resistance is reduced, or there are chronic wasting diseases, feces and foreign bodies accumulate in the anal sinus, the sinus is blocked, the anal fluid secreted by the anal gland is not drained, and the feces are decomposed, the bacteria multiply, and the anal sinus is Inflamed and swollen. Common pathogens include Escherichia coli, Staphylococcus, Proteus, Aerobacter, Streptococcus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, etc., of which Escherichia coli accounts for 60% to 70%.

Sex hormones (20%):

Gao Yuejin et al (1985) pointed out that, like sebaceous glands, the development and function of anal glands are mainly regulated by human sex hormones. The level of sex hormones directly affects the proliferation and atrophy of anal glands. Therefore, the level of sex hormones and the occurrence of anal sinusitis close relationship. And sex hormones have the greatest effect on androgens. In a person's life, the mother's body brings more androgen than the mother, so the perianal infection is more, once developed into a long-term, with the level of androgen decreased, and the perianal infection can be self-healing. Men and young adults have higher levels of androgen, so anal gland infections increase, and perianal abscesses often occur in young adults. The level of senile sex hormones decreased significantly, and the anal glands atrophied. Therefore, anal sinusitis and perianal infection rarely occur in the elderly.

Congenital factors (35%):

It is believed that in the 7th week of embryonic development, the cloaca and anal membrane rupture and fuse with the hindgut. At this time, the dorsal part of the cloaca is derived from the anal canal, the dentate line and the lower part of the anal column. If for some reason, the anus is caused. Abnormal fusion between the membrane and the hindgut, can not form normal dentate lines and crypts, and form irregular dentate lines and deep crypts, susceptible to bacterial infection and injury after birth, forming anal sinusitis, perianal abscess And anal fistula. Clinical observation confirmed that the anal crypts of patients with perianal abscess and anal fistula are often abnormally deepened, which can be as deep as 3 to 10 mm, and the number can be increased to 3 to 13. The theory that embryonic development affects the anal sinus has been widely recognized by experts.

Prevention

Anal papillitis prevention

The anal nipple is located in the epithelial protrusion at the lower end of the rectal column of the tooth line. It has a cone-shaped tip pointing downwards, such as mung bean size, which is milky white, 2-6 pieces. Stimulated by chronic inflammation, it can be enlarged, such as columnar or pecan-like pedicle, and it can be misdiagnosed as rectal polyps with defecation. Anal papillary hypertrophy should be actively treated and preventive.

(1) Actively exercise, enhance physical fitness, improve blood circulation, strengthen local disease resistance, and prevent infection.

(2) Keep the anus clean, change the underwear frequently, and adhere to the daily cleaning of the anus, which has a positive effect on preventing infection.

(3) Actively prevent other anal diseases, such as anal cryptitis and anal papillitis, to avoid perianal abscess and anal fistula.

(4) Timely treatment of systemic diseases that can cause perianal abscess, such as ulcerative colitis, intestinal tuberculosis, etc.

(5) Do not sit on the wetland for a long time, so as to prevent the anus from being wet and wet, causing infection.

(6) Prevention of constipation and diarrhea is important for preventing perianal abscess and anal fistula formation.

(7) Once an anorectal abscess occurs, it should be treated early to prevent spread and spread.

Complication

Anal papillary complications Complications constipation intestinal obstruction

Constipation can cause intestinal obstruction.

Symptom

Anal papillitis symptoms Common symptoms Anal internal slight painful fall... Anal papillary hypertrophy anal bulge anal itching varicose external ankle pain Anal canal polyps feces pus and anal gland secretion reduce blood in the stool

1, anal discomfort and pain.

2, anal itching and easy to wet, rarely bleeding.

3, the fat nipples during defecation can be taken out of the anus, a white nodules.

Examine

Examination of anal papillitis

1, local examination of anal papillitis: finger anal examination can touch the hardened and enlarged anal nipple.

2, anal mirror examination: visible at the tooth line at the congestion and edema, small anal nipples such as triangular protrusions, large anal nipples such as soybeans or grape-like bulge, hard, smooth surface, small head pedicle, can be taken out of the anus. Its surface is covered with epidermis, which is gray or yellowish white.

Diagnosis

Diagnosis and differentiation of anal papillitis

diagnosis

1. Clinical manifestations of slight pain in the anus, swelling, anal gland secretion, anal canal dryness, poor bowel movements; or burning pain in the anal canal during defecation, or radioactive pain in the perineum, should consider the possibility of anal sinusitis. If the anus is formed by the growth of connective tissue of varying sizes in the anus, or with the incarceration of the prolapse, it may be an anal papillitis.

2. Anal microscopic examination of anal sinusitis, see crypts, obvious congestion, edema and deepening, increased secretions or pus and blood; anal papillitis see anal flap, anal papilla redness, triangular, arched, papillary growth, anal sinus There is a purulent or pus and bloody secretion that can be diagnosed.

Differential diagnosis

Anal sinusitis often needs to be differentiated from anal pain and pus and blood caused by dysentery and enteritis; the former is the congestion, edema and deepening of the anal crypt. It is not difficult to identify by transanal endoscopy.

Anal papillary hypertrophy and acne identification, the former covers the skin, the latter covers the mucosa, the two are easily distinguishable.

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