anorectal disease
Introduction
Introduction to anorectal disease Anorectal disease is a common and frequently-occurring disease unique to humans. According to the relevant census data, the incidence of anorectal diseases such as hemorrhoids is 59.1%, and hemorrhoids account for 87.2% of all anorectal diseases, and among them, internal hemorrhoids are the most common, accounting for 52.19% of all anorectal diseases. Both men and women can get sick, the incidence rate of women is 67%, the incidence rate of men is 53.9%, and the incidence rate of women is high. Because female patients are generally reluctant to receive acne treatment, some statistics on clinical treatment of acne show that male acne More patients than women; can occur at any age, and people aged 20-40 are more common, and can gradually increase with age, so there are "ten people nine". basic knowledge The proportion of illness: 1% Susceptible people: no specific population Mode of infection: fecal-mouth transmission Complications: anemia, eczema, syncope
Cause
Cause of anorectal disease
The occurrence of anorectal disease is caused by a variety of factors, which can be divided into two categories: internal and external.
First, the internal cause
(1) Normal human anatomical factors are particularly prone to sputum formation.
(2) Physiological factors: The colon and rectum are the main organs for transporting food residues and retaining feces. After the food is decomposed and absorbed by the body, the residue often contains a lot of harmful substances, which are retained in the colorectal for a long time and can induce tumors.
(3) genetic factors: due to genetic defects, can produce multiple colon polyps, pj syndrome (melanoma-colony polyposis) and other hereditary anorectal diseases.
(4) Congenital diseases.
Second, external factors
(1) Poor bowel habits: When reading the toilet, the lower jaw reads and reads the newspaper, causing the squatting and defecation time to prolong, which is easy to cause blood stasis in the anorectal and induce disease. Smoking can buffer the bowel movements of the brain when going to the toilet, which can easily cause constipation. Excessive force during defecation, some people feel strong regardless of bowel movements, blindly and violently earned, can only make the rectum anus and pelvic floor muscles increase unnecessary burden and local blood stasis, leading to disease occurrence and development.
(2) abnormal bowel movements: diarrhea and constipation are important factors in the anorectal disease. Constipation is the biggest bane. Long-term retention of toxic substances in the rectum not only induces rectal cancer, but also accumulates feces and affects blood circulation. Applying force to solve the dry fecal block will inevitably cause the anus to bear a lot of pressure, resulting in a series of pathological changes such as blood stasis, swelling, and cracks. Diarrhea is often a clinical manifestation of colonic disease, diarrhea can also increase the chance of local infection of the anus, resulting in anal sinusitis, inflammatory external hemorrhoids, perianal abscess and other diseases.
(3) Dietary factors: It is natural that in daily life, dietary patterns or dietary varieties are inevitably changed. Such as the quality of food, the change of vegetable types and the increase or decrease of the amount of protein, fat, starch, cellulose, etc., the moisture intake, can directly affect the fecal composition, causing anorectal disease. People who drink alcohol for a long time or who like spicy food can stimulate the digestive tract mucosa due to alcohol and spicy substances, causing blood vessels to dilate, colonic dysfunction, and the incidence of anorectal diseases is significantly increased. According to the national census data, the incidence rate of those who like spicy food is 61.6%, and the incidence rate of those who drink alcohol is 64.6%, which is significantly higher than the total incidence rate.
(4) Occupational factors: standing or sedentary for a long time. Due to the erect or sitting posture, the anus rectum is in the lower part of the body, and the venous venous return is not smooth.
(5) Chronic diseases: such as long-term malnutrition, weak constitution, causing anal sphincter relaxation. Long-term suffering from chronic bronchitis, emphysema, abdominal pressure caused by cough and asthma, pelvic blood stasis. Chronic hepatitis, cirrhosis, diarrhea, colitis, etc. are all causes of anorectal disease. Therefore, in the prevention, we should pay attention to the general condition of the patient and take reasonable and effective preventive measures.
Prevention
Anorectal disease prevention
1. Eat low-fiber foods. Such as potatoes, pasta, beans and vegetables such as cabbage, cauliflower, onions, etc., they are easy to produce gas inside the stomach, leading to the occurrence of bloating.
2. Do not eat foods that are not easy to digest. Stir-fried beans, hard pancakes and other hard foods are not easy to digest, so the time spent in the stomach will be longer, resulting in more gas and cause abdominal distension.
3. Change the habit of gorging. Eating too fast or eating and eating bad habits, it is easy to swallow a lot of air; in addition, the usual straw drink will also make a lot of air into the stomach, causing abdominal distension.
4. Overcome bad feelings. Unpleasant emotions such as anxiety, anxiety, sadness, depression, depression, etc. may also weaken the digestive function, or stimulate the stomach to cause excessive stomach acid. As a result, the gas in the stomach may be excessive, causing the abdominal distension to increase.
5. Pay attention to exercise. It is necessary to stick to an appropriate amount of exercise for about 1 hour every day, which not only helps to overcome bad emotions, but also helps the digestive system maintain normal functions.
6. Moderately supplement fiber food. High-fiber foods do not only cause bloating. Sometimes, on the contrary, after eating high-fat foods, sometimes it will reduce the bloating. The reason is that high-fat foods are difficult to digest and absorb, so staying in the stomach often takes a long time, and once a fiber is added, the blocked digestive system is likely to be quickly cleared.
Complication
Anorectal complications Complications anemia eczema syncope
First, lead to anemia: so that patients with blood as the main symptoms of acne, often anemia. If you do not get timely treatment, you will appear pale, fatigue, dizziness, weakness, standing for a long time after standing for a long time, can lead to collapse or fainting.
Second, lead to skin eczema: due to spasm and sphincter relaxation, mucus out of the anus to stimulate the skin, resulting in itchy skin and anal eczema.
Third, lead to deterioration of the rectum: If the hemorrhoids can not be treated in time, the lesions will continue to increase, causing lesions in the cells of the lesion area, leading to the development of rectal lesions.
Fourth, women with acne can cause gynecological inflammation: If hemorrhoids hemorrhage or inflammation often lead to a large number of germs, causing various vaginitis, urethritis, cystitis, annexitis and other urinary gynecological inflammation.
Symptom
Anorectal symptoms Common symptoms Loss constipation Loss of appetite, bloody stool, granules, diarrhea, urinary frequency
1, perianal abscess:
Acute suppurative infection occurs in the anal canal, soft tissue around or around the rectum, and an abscess is formed, which is called anal canal and abscess around the rectum. It is characterized by self-rupture, or an anal fistula often formed after surgical incision and drainage. It is a common anorectal disease. Common pathogens include Escherichia coli, Staphylococcus aureus, Streptococcus and Pseudomonas aeruginosa, occasionally anaerobic bacteria and Mycobacterium tuberculosis, often mixed infections of various bacteria. Subcutaneous abscess around the anus is the most common, mostly caused by anal gland infection through the lower part of the external sphincter skin outward or directly outward.
2, anal fissure:
Anal fissure is a small ulcer formed after a laceration of the anal canal in the dentate line. The direction is parallel to the longitudinal axis of the anal canal, 0.5 to 1.0 cm long, and is fusiform or elliptical, often causing severe pain in the perianal. More common in young and middle-aged people, the vast majority of anal fissures are located in the posterior midline of the anal canal, but also in the front midline, with few anal fissures on the side. If an anal fissure occurs on the side, it is thought that intestinal inflammatory diseases (such as tuberculosis, ulcerative colitis, Crohn's disease, etc.) or tumors may be considered.
3, habitual constipation:
Habitual constipation refers to long-term, chronic functional constipation, which occurs mostly in the elderly. However, some scholars believe that habitual constipation is not limited to functional constipation. It also includes colon constipation and rectal constipation. Therefore, people with habitual constipation should go to the hospital early to find out the cause of constipation.
4, proctitis:
The proctitis is mild and only the mucous membrane is inflamed. In severe cases, the inflammation involves the submucosa, the muscular layer, and even the tissues around the rectum. Sometimes only a part of the rectal mucosa is involved, and sometimes the rectal mucosa is inflamed, and the mucosa of the colon may also be involved in inflammation.
5, anal itching:
Peritus ani (PA) is a common local pruritus. Sometimes the anus is slightly itchy, such as severe itching, and it becomes pruritus when it is not cured for a long time. It is a common localized neurological dysfunction skin disease. Usually only around the anus, and some can spread to the perineum, vulva or scrotum.
6, perianal eczema:
Perianal eczema refers to the skin around the anus, and a few can affect the perineum. Itching is unbearable. It is often wet, the skin is infiltrated and thick, and it can be cleft. It can occur at any age.
7, chronic enteritis:
Enteritis is intestinal inflammation and colitis caused by bacteria, viruses, fungi, and parasites. Clinical manifestations include abdominal pain, diarrhea, septic flushing or mucus pus and blood. Some patients may have fever and sensation after urgency, so it is also known as infectious diarrhea. Enteritis is divided into acute and chronic according to the length of the disease. The course of chronic enteritis is generally more than two months. Clinically common are chronic bacterial dysentery, chronic amoebic dysentery, schistosomiasis, non-specific ulcerative colitis and limited enteritis.
8, hemorrhoids:
(commonly known as acne) is a common disease located in the anus, which can occur at any age, but with the increase of age, the incidence is gradually increased. In China, cockroaches are the most common anorectal diseases, and they are known as ten men and nine baboons and ten women and ten babies. In the United States, the incidence of ticks is about 5%.
Examine
Anorectal examination
1, anal inspection
Gently separate the patient's buttocks with both hands and observe the anus and surrounding area with or without exudates, external hemorrhoids, fistula, abscess, anal fissure, etc.
2, rectal examination
Also known as anal finger examination. The examiner puts on the glove on the right hand or puts on the fingertip on the right index finger, applies the lubricant, and puts the front end of the right index finger on the anus. After the patient adapts, gently insert it into the anus. First test the tightness of the anal sphincter and then the anal canal. The rectum is examined in turn, and attention should be paid to the presence or absence of tenderness, swelling, undulation, and stenosis around the intestinal wall. On the anterior wall of the rectum, the male can lick the prostate, and the woman can touch the cervix. When the finger is pulled out, observe whether there is blood or mucus on the glove.
3, anoscope examination
The anoscope is coated with lubricating oil, slowly inserted into the anus, and the core is taken out. The light is good. The color of the rectal mucosa is observed from deep to shallow. The rectal flap, with or without ulcers, polyps, tumors, foreign bodies, etc., will slowly exit the anus. Retreat to observe the presence of lesions near the rectum and the tooth line, such as the internal mouth and sputum.
Diagnosis
Diagnosis of anorectal disease
diagnosis
Diagnosis can be performed based on clinical performance and laboratory tests.
Differential diagnosis
There are many types of anorectal diseases, including: hemorrhoids, blood in the stool, diarrhea, constipation, anal fistula, anal fissure, rectal cancer, colitis, perianal abscess, proctitis, colon cancer, acute enteritis, chronic enteritis, intestinal polyps, and twelve fingers. Intestinal, anal sinusitis, anal wetness, anal eczema, anal itching and other infectious viral diseases. These diseases are differentiated.
