anal bulge
Introduction
Introduction Anal bulge refers to the feeling of trying to solve the bowel movements. The heavy ones can be expressed as urgency and heavy, that is, there is essentially no arranging, but it is repeated. In this case, it is sometimes typical of local symptoms of peritoneal irritation, especially the accumulation of blood in the rectum to stimulate the rectum.
Cause
Cause
First, anorectal disease:
1, rectal, anal sinus inflammation.
2, rectal prolapse.
3, anorectal malignant tumor.
4, perianal abscess.
Second, gynecological diseases:
1, the posterior position of the uterus.
2, chronic pelvic inflammatory disease.
3, pelvic congestion.
4, rectal endometriosis.
Third, urology diseases:
Chronic prostatitis.
Fourth, orthopedic diseases:
1, lumbar disc herniation.
2, ankle tumor.
In addition, certain mental illnesses can also cause illness.
Examine
an examination
Related inspection
Fecal food residue, fecal occult blood test, faecal angiography, examination, fecal odor, crystallization
Clinically, patients with anal bulge should be examined:
First, physical examination
Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.
Second, laboratory inspection
Repeatedly want to solve the feeling of bowel movements, can be expressed as urgency and heavy, but in fact no way to row, but repeatedly have a good intention, after collecting medical history and related examinations, you can initially make a diagnosis of lesions suspected of having an anal bulge, further The diagnosis has yet to be checked.
Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as: colonoscopy, anorectal visual examination, digital rectal examination.
Diagnosis
Differential diagnosis
Differential diagnosis:
1. Anorectal disease:
1.1, rectal, anal sinus inflammation: inflammation is one of the main causes of anal bulge. The length of the disease varies. It appears to be frequent, with aggravation of swelling during defecation, or radiation to the tail of the appendix causing soreness, or thin feces, or a small amount of mucus. In the rectal examination, if it is proctitis, it can be seen in the lower and middle rectal mucosa congestion and edema, or there are a lot of secretions attached, or ulcers, bleeding; if it is anal sinusitis, the anal sinus mouth of the lesion is congested, or a small amount The purulent discharge overflows and there is a feeling of soreness when pressed.
1.2, rectal prolapse: rectal prolapse refers to the whole rectal intestinal wall or simple mucosal layer folded into the distal intestine or anal canal during the defecation process, does not exceed the outer edge of the anus, and is discharged in the fecal block After the existence of the person. The symptoms of rectal prolapse are time-consuming and laborious, defecation of the anus, increased stools, and rectal emptying are most prominent. Other common symptoms include mucus and blood, abdominal pain, diarrhea, and abnormal urination.
1.3, anorectal malignant tumor: more anal bulge in the middle and late stages of the disease. With frequent intentions, heavy or pus and bloody stools, body weight loss, fatigue and fatigue. Refers to the anal canal or rectum touch hard mass, or tenderness, finger puffs on the pus, and stench.
1.4, perianal abscess: acute onset, and easy to misdiagnose. Because part of the abscess is deep, the lesions often occur in the area innervated by the plant, and the pain is often not obvious, manifesting as bulging, falling pain or rectal irritation.
2, gynecological diseases
2.1, posterior uterus: There are many women due to anal rectum swell to the anorectal clinic. After the specialist examination, there is no nucleus, no inflammation and other diseases, but the patient always feels that the anus is swelled and it is frequent. After the gynecological examination, the uterus is in the posterior position. And the degree of the rear position is proportional to the weight of the bulge. Symptoms can be relieved after calcination through the knee chest.
2.2, chronic pelvic inflammatory disease: chronic pelvic inflammatory disease is the most common cause of pelvic pain, can also be expressed as perineal, anal bulging pain. The pelvic pain caused by it is mainly characterized by persistent dull pain and dull pain. It can be manifested as lower abdominal pain, anal bulge or lumbosacral pain, pain, or fatigue or menstrual pain.
2.3, pelvic congestion: pelvic septicemia is a unique disease caused by chronic pelvic venous stasis, its clinical features are chronic lower abdominal bulge pain, autonomic dysfunction and other symptoms. It is also often manifested as anal pain, which is more common in defecation and premenstrual period, especially in the third degree. Symptoms are light and heavy in the morning, long standing and aggravated, and the side is reduced or disappeared. Although the symptoms are heavier, there are often fewer positive signs. Gynecological examination showed abnormal filling of the labia majora, vaginal and cervical mucosa often purple-blue, cervical hypertrophy, venules filled in the posterior lip of the cervix, posterior uterus, and uterine and accessory areas with obvious tenderness and Fullness, but no obvious thickening and blockiness.
Because the symptoms and signs are very similar to chronic pelvic inflammatory disease, it is easy to be misdiagnosed. Positive patient position test can be identified: when the chest and knee are placed, the symptoms disappear. If the patient is changed to the hips and sits tightly on the heel, and the head and chest are slightly higher than the lower abdomen, symptoms similar to those of the usual ones appear. When the chest and knees are taken, the symptoms disappear.
Patients with pelvic congestion syndrome may be associated with symptoms of autonomic nervous system dysfunction, such as neurasthenia, insomnia, palpitations, shortness of breath, etc., gynecological examinations often do not get positive signs, it is easy to mistaken for neurosis. Laparoscopy and pelvic venography can help differential diagnosis.
2.4, rectal endometriosis: refers to the growth of the endometrium involving the rectal wall, non-cancerous growth in the rectal wall, affected by the cyclical effects of ovarian hormones, resulting in anal bulge, urgency, weight, menstrual blood in the clinic Symptoms of the disease.
3, urology diseases
Anal bulge is a common symptom of chronic prostatitis. Among them, type III prostatitis mainly manifests as pain and discomfort in the pelvic region, often occurring in the perineum, penis, perianal and other parts.
4, orthopedic diseases
4.1, lumbar disc herniation: Part of the lumbar disc herniation patients complained of anal bulge, often easily misdiagnosed. Relevant data pointed out that the anal bulge caused by disc herniation is mainly in the anal canal. The finger sensation is normal during the anal internal examination. The patient complains that the discomfort is not obvious, and the anorgioscopic examination can not find obvious abnormalities. With limited waist activity, when the lumbosacral compression and slamming, the patient has discomfort, and some accompanied by one side of the sciatic nerve compression and showed weakness and pain in the lower limbs.
Lumbar disc herniation occurs in the lumbar and ankle position, and the protrusion often protrudes backward into the spinal canal to stimulate the surrounding tissues such as nerve roots and blood vessels. The innervation of the rectum and surrounding organs mainly comes from the pelvis, and the upper part of the rectum and anal canal is dominated by the visceral nerve. The components of the pelvic plexus pass through the lumbar vertebrae at the roots of the phrenic nerve. Once the phrenic nerve is compressed, the patient presents with an anal bulge discomfort, which is frequent, and the toilet is inconveniently discharged, or only a small amount of normal feces. The patient's symptoms in the morning are not obvious, and the more he gets worse in the afternoon, the more he can't stand for a long time, and the symptoms are relieved when lying down. According to the severity of the compression of the lumbar disc, the patient is often accompanied by waist and hip discomfort, and the bulge radiates to the perineum. Some patients have numbness, fatigue or pain in the lower limbs.
4.2. Ankle tumor: An ankle tumor refers to a group of tumors that occur in the tibia or pelvic soft tissue around the pelvis. Defecation dysfunction is the more common first symptom. The patient often complained that the anus had a sense of bulging, continued to feel, difficulty in urinating and defecation, abnormal feeling in the saddle area, and decreased.
5, mental illness
Anorectal neurosis: patients with this disease often complain of anorectal bulge. However, there are more complicated symptoms, frequent visits, inconsistent complaints or swells, or numbness, or burning, or foreign body sensation, or severe pain. Every time the narrative is difficult to distinguish between the primary and the secondary, the contradictions and emotions are extremely unstable. After excluding organic lesions, the disease can be initially diagnosed.
