mixed hemorrhoids
Introduction
Mixed introduction Mixed , also known as inside and outside. Mixed sputum occurs in the same direction of the anus in the same tooth line, varicose veins form a mass, internal and external connections, no obvious boundary is the main manifestation of rickets. Mixed sputum is a venous mass of the collaterals of the superior and inferior venous plexus. The internal and external venous plexus is varicose, enlarged, and communicates with each other. The sphincter sulcus disappears, and the inner iliac crest and the lateral iliac crest are formed as a whole. There are two main treatments for acne: self-therapy and surgery. Self-therapy is mainly regulated from several aspects such as diet, drug conditioning and exercise. Surgical treatment is also divided into many ways, traditional surgery, minimally invasive treatment, minimally invasive treatment methods, due to medical development, Chinese and Western medicine have taken some better methods. Surgical removal of hemorrhoids, of course, will be more thorough, not easy to relapse, the traditional method will be more painful, because the degree of pain is proportional to the size of the wound. Minimally invasive painless surgery can be considered. Minimally invasive surgery, using small wounds to sneak off, the wound surface is small, the wound recovery is fast, and the patient suffers little pain during the operation. basic knowledge The proportion of illness: 0.02%-0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia, anal fissure
Cause
Mixed sputum
Long-term sitting makes the lower venous return difficult. There is no venous valve in the rectal vein and the thin upper and lower venous wall is the basis of sputum formation. The direct causes are:
Local irritation and diet (25%):
The anus is cold, heated, constipated, diarrhea, excessive drinking and eating spicy food. The cause of mixed sputum can stimulate the anus and rectum, make the iliac venous plexus congestive, affect the venous blood return, and the resistance of the vein wall decreases. Causes mixing .
Increased intra-abdominal pressure (20%):
Due to intra-abdominal tumors, uterine tumors, ovarian tumors, prostatic hypertrophy, pregnancy, over-feeding or excessive sputum sputum, the cause of mixed sputum can increase the intra-abdominal pressure, hinder the blood flow back to the veins, leading to mixed sputum.
Increased anal venous pressure (23%):
Due to cirrhosis, liver congestion and incomplete cardiac function compensation, the anal canal congestion, increased pressure, affecting the blood flow of the rectal vein, leading to mixed sputum.
Habitual constipation (10%):
Habitual constipation, also known as functional constipation, refers to less than 3 bowel movements per week, or frequent bowel movements.
Prevention
Mixed cockroach prevention
First, the prevention of mixed cockroaches - daily life prevention.
1. Develop good habits and eat less spicy food.
2. Pay attention to changing position in daily life.
3, keep the stool smooth, eat more fiber-rich foods, such as sweet potatoes, corn, kelp, bamboo shoots, green leafy vegetables.
4, for diseases that can cause increased abdominal pressure, such as chronic cough, prostatic hypertrophy, etc. should be treated early.
5, commonly used warm water potassium permanganate water wash anus.
Second, the levator ani method is an effective method to prevent mixed sputum.
1. After waking up in the morning, practice once before going to sleep at night.
2, practice preparation for supine, closed eyes, tongue top superior, arms naturally placed in the system, mix thoroughly breathing, body relaxation, intention to keep anus.
3. Practice exercises.
(l) Inhale, close, and raise the anus. Inspiratory control is within 2-3 seconds.
(2) exhaled, loose, and anal. Breathing is also controlled within 2-3 seconds.
4, the number of exercises: one mention one loose for one time, each practice 30 to 50.
In case of mixed sputum inflammation, severe sputum prolapse, swelling or bleeding, it may be suspended.
Complication
Mixed sputum complications Complications anemia anal fissure
Mixed helium
One of the main symptoms of mixed sputum is the nucleus detachment. The nucleus removed from the anus is clamped by the sphincter, and the venous return is blocked. The arterial blood is still input to increase the volume of the nucleus until the arterial blood vessels are compressed. The thrombus is formed, and the nucleus becomes hard and painful. It is difficult to return to the anus. Inside. The traditional view is called "strength guilt." However, clinically, acne is more common in the formation of blood clots, so it is often accompanied by pain. When the nucleus is removed and cannot be returned, it is also called "incarcerated sputum". Long-term nucleus incarceration.
Mixed acne infection
After the incarceration of the nucleus, there are many different degrees of infection. The patient has symptoms such as urgency and weight, and anal bulge. At this time, the infection is mostly confined to the anus. If the force is reset, it will easily spread the infection, causing submucosal, perianal or ischial bone. Rectal fossa abscess, if the shed fungus emboli along the vein, plus improper use of antibiotics or no antibiotics, will form portal bacteremia or even sepsis, can also form a liver abscess. There have been reports of fatal portal vein sepsis associated with sacral incarceration.
Mixed necrosis of acne
The nucleus is incarcerated outside the anus. Due to a series of pathological changes, local metabolites accumulate, further aggravating local anal edema and aggravating the incarceration of the nucleus. This is a vicious circle. Therefore, incarceration of the internal hemorrhoids will inevitably lead to necrosis Necrosis at this time is often limited to the mucosal part of the nucleus, but it also invades other parts of the body. It has been reported in foreign countries that the thrombus in the nucleus spreads upward and the necrotic area extends to the rectal wall, resulting in severe sepsis in the pelvic cavity. Although this situation is rare, it must be highly valued by clinicians.
Hybrid anemia
Iron deficiency anemia caused by mixed blood loss, generally slow development, early symptoms or mild symptoms, severe anemia or rapid progress, there will be pale, tired, loss of appetite, palpitations, heart rate and Shortness of breath, edema, etc. after physical activity. Some patients may have neurological symptoms such as irritability, excitement, irritability, etc. Some people think that it is caused by a lack of iron-containing enzymes in the cells. All of these symptoms can be eliminated by correcting anemia and treating mixed sputum. Therefore, if you have mixed sputum, you should treat it as soon as possible to avoid the above symptoms and complicate the treatment.
Mixed cockroaches harm to women
Mixed sputum is also the most important fuse for vaginitis and cervical erosion. Because the anus is less than 3 cm from the female vagina, the secretion from the anus contains a lot of bacteria and E. coli. Unlimited breeding breeds directly erode into the vagina, forming a common gynaecological disease in women.
Therefore, the gynecological inflammation caused by improper treatment of such non-sexual relationships is the most deadly type of harm to women's health. Because the secretion is from the rectum, the secretion is the waste that is excreted in the human body through the digestive tract. Therefore, the female disease caused by the toxic substances discharged from the human body flowing into the vagina is very terrible. In a sense, such a direct Infection is highly likely to cause uterine tumors.
Symptom
Mixed sputum symptoms Common symptoms Itching, bloody constipation, anal secretions, multiple anal bulging, palpebral prolapse, connective tissue, external hemorrhoids, repeated bleeding, anal sphincter, relaxing eczema
Blood in the stool: painless, intermittent, bright red blood after the stool is a characteristic, but also a common symptom of guinea or mixed sputum early. The blood in the stool is often caused by the faeces rubbing the mucous membranes or defecating the feces, causing rupture of the dilated blood vessels. Most of the lighter cases are large cases or blood on the toilet paper, followed by blood drops, and the heavy ones are jet-like hemorrhage. The blood in the stool can often stop itself after a few days. This is important for diagnosis. Constipation, dry stools, alcohol and food irritating foods are all causes of bleeding. If long-term repeated bleeding, anemia can occur, clinical is not uncommon, should be differentiated from bleeding disorders.
Spasm prolapse: often late symptoms, more prolapsed after blood in the stool, due to the enlargement of the late corpus callosum, gradually separated from the muscle layer, was pushed out of the anus when defecation. The lighter only prolapses when the stool is in the stool, and then he can recover it by himself. The severe one needs to be pushed back by hand. The more serious one is to take out the anus outside with a little abdominal pressure, such as coughing, walking and other abdominal pressure slightly increase, the block is Can escape, reply difficult, and can not participate in labor. A small number of patients complained of prolapse is the first symptom.
Pain: Simple internal hemorrhoids have no pain, and a few have a feeling of falling. When the internal hemorrhoids or mixed hemorrhoids are incarcerated, and there is edema, infection, and necrosis, there are different degrees of pain.
Itching: late internal hemorrhoids, palate prolapse and anal sphincter relaxation, often secreted and discharged, due to secretion stimulation, there is often itching discomfort around the anus, and even skin eczema, the patient is extremely uncomfortable.
Mucus overflow: The rectal mucosa is stimulated by the nucleus for a long time, causing inflammatory exudation and increasing secretions. When the anal sphincter relaxes, it can flow out at any time, causing the anus skin to be stimulated and eczema and itching.
Examine
Mixed helium inspection
1, anus examination. Use both hands to gently pull the anus to the sides. Except for one period of sputum, most of the other three periods can be seen under the anus. It is best to observe the patient with prolapse immediately after bowel movement, so that the size, number and location of the block can be clearly seen, especially for the diagnosis of ringworm.
2, anal finger diagnosis.
3. Endoscopy. Observe the rectal mucosa for congestion, edema, ulcers, lumps, etc., and exclude other rectal diseases before observing the presence or absence of hemorrhoids on the dentate line. If there is hemorrhoids, it can be seen that the internal hemorrhoids protrude into the anoscope and appear dark red nodules. At this time, attention should be paid to the number, size and location of acne.
Diagnosis
Mixed diagnosis
diagnosis
First, the nature of the outside can be divided into:
1. Inflammatory mixed sputum.
2, thrombotic mixed hemorrhoids.
3. Connective tissue mixed sputum.
4, varicose mixed sputum. Clinically, both are mostly.
Second, the number can be divided into:
1. Simple mixed sputum.
2, multiple mixed sputum.
3, ring mixed .
4, complexity mixed .
Diagnostic criteria
It is divided into internal iliac crest, external iliac crest and mixed sputum on the dentate line and lower. The main symptoms are blood in the stool, prolapse, and pain.
First, internal hemorrhoids: occur above the dentate line, so that blood is the main symptom. According to the sag prolapse, it is divided into three phases: one phase has no prolapse. The second phase of the release can be paid by itself. In the third phase, you need to push it before you can take it.
Second, the external hemorrhoids: the anal canal and anal margin below the dentate line. Swelling and pain during seizure, clinically divided into four types:
1, inflammatory external hemorrhoids: often caused by anal skin damage and infection. The anal edge of the skin wrinkles the wall as a blister. The swelling is painful.
2, thrombotic external hemorrhoids: anal venous plexus rupture, blood leaking out of the blood vessels, the formation of blood clots in the subcutaneous uplift. It is characterized by sudden onset, local swelling and severe pain.
3, connective tissue external hemorrhoids: due to chronic inflammation, repeated inflammation, swelling, resulting in anal margin skin wrinkles become larger, connective tissue hyperplasia, the formation of varying sizes of skin.
4, varicose external hemorrhoids: subcutaneous varicose veins around the anal margin, lower abdominal pressure increased, increased during defecation, the symptoms can be reduced to varying degrees after returning to normal position.
Third, mixed : the same part of the tooth line and below. Clinically, there are symptoms of internal and external paralysis.
