How to remove the flesh ball outside the anus

The anus is a place where problems can easily occur, with hemorrhoids being the most common. The lump outside the anus mentioned here may be a manifestation of external hemorrhoids, or it may be the result of prolapsed internal hemorrhoids. In a word, it is because of hemorrhoids! So, is this internal hemorrhoids or external hemorrhoids? If this lump is an internal hemorrhoid, what should I do? If it is an external hemorrhoid, what should I do? The following content will answer your questions.

Hemorrhoids (commonly known as hemorrhoids) are a common disease located in the anal area. They can occur at any age, but the incidence rate gradually increases with age. In our country, hemorrhoids are the most common anorectal disease.

Classification

Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the location of occurrence. There is a jagged visible line at the junction of the anal canal skin and the rectal mucosa called the anal dentate line. Hemorrhoids above the dentate line are internal hemorrhoids, which are pathological changes or displacements in the supporting structure of the anal cushions, venous plexus and arteriovenous anastomoses, and are covered with rectal mucosa. Due to the contraction of the internal sphincter, the anal cushions are divided into three parts by the Y-shaped groove: the left side, the right front side and the right back side. Therefore, internal hemorrhoids are commonly found on the left side, the right front side and the right back side. Hemorrhoids below the dentate line are external hemorrhoids, which are covered with the anal canal mucosa and can be divided into connective tissue external hemorrhoids, varicose external hemorrhoids and thrombosed external hemorrhoids. Mixed hemorrhoids are those with both internal and external hemorrhoids, which are the fusion of internal hemorrhoids with the corresponding external hemorrhoids through the venous plexus, that is, the anastomosis of the upper and lower venous plexuses. When mixed hemorrhoids protrude from the anus and are in a plum blossom shape, they are called annular hemorrhoids. If they are incarcerated by the sphincter, they form incarcerated hemorrhoids.

Clinical manifestations

1. The main manifestation is blood in the stool, which may be painless, intermittent, fresh blood after defecation, blood dripping during defecation or blood on toilet paper, and aggravated by constipation, drinking or eating irritating foods.

2. Simple internal hemorrhoids are painless but only cause a feeling of heaviness and distension. They may bleed and develop into prolapse. Pain only occurs when combined with thrombosis, incarceration, and infection.

3. Internal hemorrhoids are divided into 4 degrees. ① Grade I bleeding during defecation, the bleeding stops on its own after defecation, and the hemorrhoids do not protrude from the anus; ② Grade II often has blood in the stool; the hemorrhoids protrude from the anus during defecation, and return to the anus automatically after defecation; ③ Grade III hemorrhoids need manual assistance to return to the anus after prolapse; ④ Grade IV hemorrhoids stay outside the anus for a long time and cannot be returned to the anus; Among them, internal hemorrhoids above grade II often form mixed hemorrhoids, which are manifested by the simultaneous presence of symptoms of internal and external hemorrhoids, and may cause pain, discomfort, and itching. The itching is often due to the outflow of sticky secretions when the hemorrhoids prolapse. The last three degrees often become mixed hemorrhoids.

4. External hemorrhoids usually have no special symptoms, but swelling and pain may occur when thrombosis and inflammation occur.

treat

1. Non-surgical treatment

Asymptomatic hemorrhoids do not require treatment; symptomatic hemorrhoids do not require radical treatment; non-surgical treatment is the main treatment.

(1) General treatment is applicable to most hemorrhoids, including the early stages of thrombotic and incarcerated hemorrhoids. Pay attention to your diet, avoid alcohol and spicy foods, increase fiber foods, eat more fruits and vegetables, drink more water, change bad bowel habits, keep bowel movements smooth, take laxatives when necessary, and clean the anus after defecation. For prolapsed hemorrhoids, be careful to gently push the hemorrhoids back with your hands to prevent them from falling out again. Avoid sitting or standing for long periods of time, do appropriate exercise, take a sitz bath in warm water (which may contain potassium permanganate) before going to bed, etc.

(2) Local medication has been widely used, including suppositories, ointments and lotions, most of which contain Chinese herbal ingredients.

(3) Oral medications are generally used to treat varicose veins.

(4) Injection therapy is more effective for grade I and II bleeding internal hemorrhoids. The sclerosant is injected around the venous plexus in the submucosal layer to cause an inflammatory reaction and fibrosis, thereby compressing the varicose veins. The treatment can be repeated after one month to avoid injecting the sclerosant into the mucosal layer and causing necrosis.

(5) Physical therapy: laser therapy, cryotherapy, direct current therapy, copper ion electrochemical therapy, microwave thermocoagulation therapy, and infrared coagulation therapy are less commonly used.

(6) Rubber band ligation is used to tie the root of the hemorrhoids to block their blood supply and cause the hemorrhoids to fall off and necrotize. It is suitable for grade II and III internal hemorrhoids, and is more suitable for giant internal hemorrhoids and fibrotic internal hemorrhoids.

2. Surgery

(1) Indications for surgery: Conservative treatment is ineffective, hemorrhoids are severely prolapsed, large fibrotic internal hemorrhoids are not well treated with injections, and there are anal fissures, anal fistulas, etc.;

(2) Principles of surgery: Surgery is used to reposition the prolapsed anal cushion and preserve the structure of the anal cushion as much as possible, thereby minimizing the impact on the ability to control bowel movements.

(3) Preoperative preparation: When there are ulcers or infections on the surface of internal hemorrhoids, conservative treatment such as laxatives and warm water sitz baths should be performed first, and surgery can be performed after the ulcers have healed; bowel preparation should be performed.

(4) Surgical methods ① Thrombosed external hemorrhoidectomy is suitable for patients whose pain does not ease or the swelling does not shrink after conservative treatment of thrombosed external hemorrhoids. ② Traditional hemorrhoidectomy is external peeling and internal ligation. ③Hemorrhoidectomy (Whitehead procedure) is a classic procedure in textbooks, which can easily lead to anal stenosis and is rarely used in clinical practice. ④PPH surgery: hemorrhoidal rectal mucosal circumcision and stapling with stapler. It was created by Italian doctor Longo and began to be promoted in 1998. It is mainly suitable for prolapsed III-IV grade mixed hemorrhoids, annular hemorrhoids, and some severely bleeding II grade internal hemorrhoids. The mechanism of PPH in treating prolapsed hemorrhoids: circular resection of 2 to 3 cm mucosa and submucosal tissue at the lower end of the rectum to restore the normal anatomical structure, that is, the anal cushions are returned to their original position; the resection of the submucosal tissue blocks the blood supply of the superior hemorrhoidal artery to the hemorrhoidal area, causing the hemorrhoids to shrink after surgery. Compared with traditional hemorrhoidectomy, PPH surgery has shorter operation time, less postoperative pain, faster recovery and fewer complications, but the equipment is more expensive.

(5) Postoperative treatment: Observe whether any complications occur, pay attention to diet, and maintain smooth bowel movements.