Internal hemorrhoids and anal fissures

Many people think that internal hemorrhoids and anal fissures are exactly the same disease, but in fact, the two are not the same disease. Not only are there great differences in pathology, but also in personal physical conditions, we must pay attention to making reasonable distinctions. Generally, patients with external hemorrhoids usually have bloody stools or constipation, but internal hemorrhoids will have bloody stools and spurting bleeding, and anal fissures will cause periodic pain, which will affect normal bowel movements in the future.

Thrombosed external hemorrhoids are the most common type of external hemorrhoids. It is often caused by excessive force during defecation, strenuous activity or forceful coughing, which causes the veins at the edge of the anus to rupture, and blood to seep into the connective tissue and form blood clots, forming round or oval lumps of varying sizes under the skin of the anus, located inside the anal canal or outside the anal edge. The lump is soft at first and becomes hard after a few days. At this time, you can apply the hemorrhoid ointment of traditional Chinese medicine externally. If there is no inflammation, the lump can be completely absorbed and disappear within 3-4 weeks without leaving any trace; if there is repeated inflammation, the connective tissue in the lump will proliferate and it may become connective tissue external hemorrhoids; if infection occurs, an abscess may form.

Rupture, bleeding and thrombosis of the subhemorrhoidal venous plexus are often caused by constipation, excessive straining during defecation, lifting heavy objects, coughing, childbirth, etc.

1. Pain Anal fissure can cause periodic pain due to defecation, which is the main symptom of anal fissure. When defecating, the feces stimulate the nerve endings on the ulcer surface, and you will immediately feel a burning pain in the anus, but the pain will ease a few minutes after defecation. This period is called the pain interval. Later, due to the spasm of the internal sphincter, severe pain will occur again. This period can last from half an hour to several hours, making the patient restless and very difficult to bear. Until the sphincter fatigues, the muscles relax and the pain is relieved. But the pain occurred again when I defecated again. The above is clinically called anal fissure pain cycle. The pain may also radiate to the perineum, buttocks, inner thighs, or sacrum.

2. Constipation This is the cause of anal fissure and also the consequence of anal fissure. After anal fissure, the patient is unwilling to defecate due to anal pain, which will cause constipation over time, and the stool will become drier and harder. Constipation can also aggravate the anal fissure, forming a vicious circle and making it difficult to heal the anal fissure.

3. Blood in stool: When defecating, a small amount of fresh blood is often seen on the surface of the stool or on the toilet paper, or drops of fresh blood. Major bleeding is rare.

4. Others such as anal itching, discharge, diarrhea, etc. Anal itching is caused by the stimulation of secretions from anal fissure ulcers or concurrent anal cryptitis, anal papillitis, etc. (Table 1).

5. Signs: 355 cases of anal fissure were reported abroad with the following different signs: anal canal spasm 78%, sentinel piles 68%, hypertrophic papillae 25%, anal fistula 6%, intersphincteric abscess 4%, hemorrhoids 38%, and anal canal stenosis 2%.