Below is an expert explanation. The primary symptoms of internal hemorrhoids are as follows: 1. Rectal bleeding: Early-stage internal hemorrhoids typically present with bleeding during bowel movements. In advanced cases, the mucosal surface thickens due to inflammation or friction, often reducing bleeding.The blood is typically bright red. In mild cases, only streaks of blood appear in the stool or on toilet paper. In more severe cases, dripping or spurting blood may occur, and occasionally, stool may be entirely covered in fresh blood. Heavy or frequent bleeding can lead to secondary anemia.
2. Protruding hemorrhoids: Protrusion is the main symptom of internal hemorrhoids in the middle to late stages.In the middle stage, hemorrhoidal tissue prolapses during bowel movements but retracts spontaneously afterward. In the late stage, manual support or bed rest is required for retraction, and prolapse may occur during routine activities, prolonged standing, exertion, or coughing. Some patients experience incarcerated internal hemorrhoids where prolapsed tissue cannot be manually reduced, or incomplete retraction resulting in persistent partial prolapse.
3. Anal heaviness: Anal heaviness may occur to varying degrees in early, mid, and late-stage internal hemorrhoids. It is milder in early and mid-stage, becoming more pronounced in late-stage, particularly after exertion, prolonged standing, or in the afternoon. This sensation may result from irritation of the rectal mucosa by enlarged hemorrhoidal tissue or inflammation on the hemorrhoidal mucosal surface.
4. Pain: Simple internal hemorrhoids are typically painless. However, incarceration of internal hemorrhoids can cause severe pain, obstructing defecation and flatus. In some cases, it may reflexively cause urinary retention.
5. Mucus discharge, anal moisture, or itching: In moderate to advanced stages, relaxation of the anal sphincter often allows rectal secretions to leak from the anus, causing moisture or itching discomfort in the anal area.
Key symptoms of anal fissures include:
1. Constipation: Primarily rectal constipation. Patients fearing severe pain during bowel movements often delay defecation and reduce frequency. This prolongs stool retention in the rectum, allowing complete water absorption and increasing stool hardness. Defecation then deepens the fissure and intensifies pain.
2. Pain: Inflammation causes anal sphincter spasm and pain. During bowel movements, stool irritates the fissure or becomes lodged in it, causing pain. In chronic anal fissures, exposed nerve endings at the ulcerated surface cause pain from stool friction.The pain of an anal fissure has distinct characteristics: immediate pain occurs when the fissure is irritated during defecation. After bowel movement, there is a brief period of pain relief, followed by persistent pain lasting from several hours to over ten hours due to anal sphincter spasm. The intensity and duration of pain vary among individuals, but the common thread is that it is triggered by defecation.
3. Bleeding: Bleeding from an anal fissure results from constipation and excessive straining during bowel movements, which tear the anal canal. Therefore, bleeding is associated with defecation. The blood is bright red, often appearing on the surface of dry, hard stool or staining toilet paper. Dripping blood is common, while projectile bleeding is rare.
4. Itching: Anal fissures typically produce only minimal bloody discharge. However, if infection occurs or a subcutaneous fistula forms, increased discharge may contaminate undergarments, irritating the anal skin and causing localized itching or even eczema.
Expert Tip: If you experience anal pain, first determine whether it stems from internal hemorrhoids or an anal fissure. This allows for targeted treatment and complete recovery.
Treatment Recommendations for Anal Pain:
1. Establish a regular daily bowel movement routine and increase vegetable intake to maintain smooth bowel movements. For constipation, use mild laxatives such as 20-40 ml of mineral oil once nightly. Avoid strong laxatives.
2. Warm sitz baths improve local blood circulation and maintain hygiene. Fill a deep basin with 40°C warm water or a 1:5000 potassium permanganate solution. Have the patient sit in the basin for 15-20 minutes.
3. For persistent cases or those unresponsive to the above methods, surgical treatment such as anal fissure excision may be performed.
4. Try this herbal formula:
Ingredients: 30g Frankincense, 30g Myrrh, 10g Salvia miltiorrhiza, 5g Borneol, 30g Honey,
Method: Grind the first four ingredients into a fine powder. Add 75% alcohol in sufficient quantity,soak for 5 days, then mix with honey. Simmer until it forms an ointment-like paste. Store in a bottle for future use. Instruct the patient to evacuate completely, then soak in a 1:5000 potassium permanganate solution for 10 minutes. Clean the wound with hydrogen peroxide solution, pat dry with a cotton ball, apply the ointment to the wound, cover with sterile gauze, and secure with adhesive tape. Apply once daily.
5. Tissue-Repairing Ointment,
Formula: Borneol 6g, Calcined Dragon Bone Powder 6g, Cinnabar 7.5g, Calcined Zinc Oxide 64g, Calcined Gypsum 143g, Vaseline 264g, Sesame Oil as needed.
Method: Grind Borneol and a small amount of Calcined Zinc Oxide into a fine powder.Add calcined dragon bone powder, cinnabar, and remaining calcined zinc oxide. Mix thoroughly. Incorporate calcined gypsum, stir well, then pour into petroleum jelly and blend thoroughly. Finally, add sesame oil to desired consistency to form ointment. Apply externally after local disinfection.
Daily Precautions for Anal Pain and Prevention of Perianal Diseases
1.Adjust diet appropriately. This can increase appetite, correct constipation, improve gastrointestinal function, and establish regular bowel habits. Daily meals should include more vegetables, fruits, legumes, and other foods rich in vitamins and fiber. Reduce intake of spicy and irritating foods such as chili peppers, mustard, ginger, and alcohol.
2. Establish a regular bowel routine. Ideally, develop a habit of daily morning bowel movements. Additionally, engage in morning exercises like jogging, calisthenics, or Tai Chi. Do not suppress the urge to defecate, as prolonged holding can lead to habitual constipation. Avoid prolonged squatting on the toilet during bowel movements.
3.Maintain anal hygiene: Keep the anal area clean daily by steaming with warm water and changing underwear frequently.