Anal sinusitis and anal papillitis
Introduction
Introduction to anal sinusitis and anal papillitis Anal sinusitis (analsinusitis), also known as anal cryptitis, is an inflammatory lesion in the anal sinus and anal gland. It is an important potential infection, and about 85% of anorectal lesions are associated with anal sinus infection. Anal papillitis (analpapilla), also known as anal papillary hypertrophy, is an inflammatory hyperplastic lesion of chronic fibrosis of the anal papilla. Often associated with anal sinusitis, is a common complication of anal fissure, anal fistula, etc., anal papillary fibrosis proliferation, also known as anal papillary fibroids. Although Chinese medicine does not have this disease name, its clinical manifestations have long been described and included in the Tuen Mun, known as grape vines. basic knowledge The proportion of illness: 0.004%-0.007% Susceptible people: no specific population Mode of infection: non-infectious Complications: abdominal pain, bloating, anal pruritus
Cause
Anal sinusitis and anal papillitis
(1) Causes of the disease
1. Infection and injury 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 stool and cause infection and injury. The edge of the anal sinus has a free half-moon anal flap, which is also susceptible to dry feces. The block is scratched or torn when defecate. 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%.
2. The influence of sex hormones 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, so the level of sex hormones and anus The occurrence of sinusitis is closely related. 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.
3. The effect of embryonic development is 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. For some reason, abnormal fusion occurs between the anal and posterior intestines, and normal dentate lines and crypts cannot be formed, and irregular dentate lines and deep crypts are formed, which are 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.
(two) pathogenesis
Currently there are no related content description.
Prevention
Anal sinusitis and prevention of anal papillitis
prevention
1, diet adjustment, eat more fruits and vegetables, drink more water, fasting peppers, alcohol is prohibited.
2, keep the stool smooth, prevent constipation. Constipation can be properly applied to the intestines, or can be used.
3, appropriate oral anti-inflammatory drugs.
4, topical application of hemorrhoids suppository.
5, drug enema.
6, keep the anus clean, take a bath in the morning and evening.
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Anal sinusitis and complications of anal papillitis Complications abdominal pain, abdominal distension, anal pruritus
For patients with severe constipation, acute intestinal obstruction can be caused, which can show abdominal pain, vomiting, abdominal distension, anal cessation of defecation, and can be performed in the vertical position of the abdomen. The stepwise plane change of the liquid gas can be diagnosed. The disease. Other complications include anal papillary muscle hypertrophy, mainly manifested as anal discomfort, anal papillary prolapse, bleeding and pain, incarceration, anal itching and easy moisture.
Symptom
Anal sinusitis and anal papillitis symptoms Common symptoms Anal bulge anal slight painful pain... Anal pain anal gland secretion reduction anal canal polyps anal itching blood anal area redness and painful lumps varicose external hemorrhoids feces pus
1. Anal sinusitis: no obvious symptoms in the chronic phase, but often there is slight pain in the anus, bulging or discomfort, or reduced anal gland secretion, dry anal canal, poor bowel movements, etc., acute exacerbation pain, excretion More, hand paper accidentally with pus, burning discomfort, anal bulge, etc., if the anal sphincter is stimulated by inflammation, can cause mild or moderate spastic contraction of the sphincter, often short-term paroxysmal dull pain, or pain persistence In hours, severe pain can be caused by radioactive pain in the pudendal nerve, phrenic nerve, and perineal nerve.
2. Anal papillitis: generally no obvious symptoms, when the nipple hypertrophy out of the anus, visible such as nipple-shaped, different sizes of prolapse, the surface covered the skin, acute phase or incarceration, visible edema, congestion and necrosis.
Examine
Anal sinusitis and anal papillitis examination
Anal microscopy, anal sinusitis can be seen deeper crypts, congestion, edema, acute seizures can be seen in the crypt secretions, or pus, obvious tenderness, anal papillitis visible triangle, arched, papillary growth, surface Cover the skin. In the acute attack, the anal sinus secretion increased, showing pus or pus, anal flap, anal papilla redness.
Diagnosis
Diagnosis of anal sinusitis and anal papillitis
Diagnostic criteria
1. Clinical manifestations of mild pain in the anus, swelling of the anal gland, dryness of the anal canal, poor bowel movements; or burning pain in the anal canal during defecation, or radiation pain in the perineum, the possibility of anal sinusitis should be thought, if the anus It is possible for anal papillitis to occur in the presence of connective tissue hyperplasia of varying sizes and the incarceration of the prolapse.
2. Anal microscopic examination of anal sinusitis see crypts obviously 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 anal pain caused by dysentery, enteritis, etc., and pus and blood will be differentiated; the former is the congestion of the anal crypt, edema and deepening, and 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.
