Mr. Zhang from Liaocheng has suffered from fatigue and anorexia for 5-6 years. The test result is anemia. Because of severe anemia, he was hospitalized for two blood transfusions. He usually takes iron supplements and has symptoms of anemia. It was temporarily improved, but anemia appeared again after a few months. The county hospital has checked many times, but no problems have been detected. Not long ago, Mr. Zhang came to the Gastroenterology Department of Shandong Maternal and Child Health Hospital again because of anemia.
Professor Gao Yu, director of the Digestive Endoscopy Center, received him. By analyzing Mr. Zhang’s long-term history of blood in the stool, he preliminarily judged that Mr. Zhang may have hemorrhoids that caused the bleeding after the stool, which caused the blood in the stool. There are many reasons, especially colorectal tumors, inflammatory bowel disease, etc., it is recommended to do a painless colonoscopy.
If internal hemorrhoids, polyps, or even early-stage colorectal tumors are found, they can be treated with minimally invasive colonoscopy, all at one time.
What are hemorrhoids?
As the saying goes, “ten people nine hemorrhoids”, “hemorrhoids” is the most common benign rectal anal disease, with an incidence rate of about 80.6%. Hemorrhoids, or hemorrhoids, are soft venous masses formed by the dilation and flexion of the submucosal venous plexus at the end of the rectum and the anal canal. Fatigue, standing for a long time, sitting for a long time, constipation, drinking alcohol, and eating spicy food are the main causes of hemorrhoids.
Classification and Grading of Hemorrhoids
Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. The pathological changes or displacement of the supporting structures of the anal cushion, venous plexus and arteriovenous anastomosis branches are internal hemorrhoids; the subcutaneous veins distal to the dentate line are internal hemorrhoids. The pathological expansion or thrombosis of the plexus is external hemorrhoids; the internal hemorrhoids merge with each other through the abundant venous plexus anastomotic branches and the external hemorrhoids in the corresponding parts to form mixed hemorrhoids.
Internal hemorrhoids are classified into the following 4 grades:
What it’s like to have a hemorrhoid attack
Simply put, it is miserable. The main symptoms are blood in the stool, prolapse of hemorrhoids, pain, itching, abnormal defecation, infection, etc.
Patients’ chief complaints can be “brain tonic” as follows:
4. Is surgery necessary for hemorrhoids?
Mr. Zhang heard about possible hemorrhoids and immediately thought of surgery. I often hear people say: Hemorrhoids won’t kill you, but after surgery, you will die. Do I have to have surgery if I have hemorrhoids?
Not necessarily. The current concept is that “hemorrhoids” cannot be radically cured. The principle of clinical treatment of hemorrhoids is: asymptomatic internal hemorrhoids do not require treatment, and the purpose of treatment is to eliminate or alleviate the symptoms of internal hemorrhoids.
Therefore, conservative drug treatment is usually the first choice for I-III degree internal hemorrhoids with bleeding tendency or II/III degree internal hemorrhoids with prolapse. Choose minimally invasive endoscopic treatment (sclerotherapy of internal hemorrhoids and band ligation of internal hemorrhoids). For external hemorrhoids, mixed hemorrhoids, and IV degree internal hemorrhoids with severe symptoms and ineffective conservative treatment, surgical treatment is required.
Enteroscopy can also treat internal hemorrhoids
Yes, that’s true.
Traditional sclerotherapy and band ligation are performed under the anoscope, and complications such as postoperative pain, erosion, ulcers, and abnormal defecation often occur due to inaccurate injection or banding. . Compared with the rectal anoscope, we currently use a more flexible electronic colonoscope, which can observe the internal hemorrhoids 360 degrees without dead ends when the mirror body is inverted. Endoscopic treatment. Compared with traditional surgery, the advantage of endoscopic minimally invasive treatment of internal hemorrhoids is that as long as a painless colonoscopy is performed, the treatment can be completed in a while, and you can go home after a good night’s sleep. The whole process is pain-free, and the postoperative care is simple and fast. Can eat and get out of bed, can complete colonoscopy at the same time, and is currently the least expensive method of various hemorrhoid surgeries
How is the effect of minimally invasive treatment of internal hemorrhoids in Shandong Maternal and Child Health Hospital
Minimally invasive treatment of internal hemorrhoids is important for endoscopicTreatment of internal hemorrhoids, Mr. Zhang expressed a little doubt.
Actually, you can rest assured. The Gastrointestinal Endoscopy Center of Shandong Maternal and Child Health Hospital is the first unit in Shandong Province to introduce and successfully carry out endoscopic internal hemorrhoid sclerotherapy and endoscopic internal hemorrhoid bandage treatment, and it is also the first digestive endoscopy center to develop this technology in China. one.
Not only that, the Gastrointestinal Endoscopy Center of Shandong Maternal and Child Health Hospital is a sub-center of the national “multi-center prospective clinical research project on the treatment of internal hemorrhoids with foam sclerotherapy under endoscopy”, and it is the national “multi-center prospective clinical research project”. The sub-center of the standardized multi-center clinical research on the treatment of internal hemorrhoids with cinnamon alcohol has promoted the development of the minimally invasive treatment technology of internal hemorrhoids under the endoscope in our province, and improved the medical experience of patients with “hemorrhoids”.
At present, the Digestive Endoscopy Center has carried out minimally invasive endoscopic treatment of internal hemorrhoids (including endoscopic hemorrhoid sclerotherapy and endoscopic hemorrhoid vein ligation) for more than 900 cases. Treating patients with less pain, quick relief of symptoms, safe and effective, in addition to mild postoperative pain, bleeding, and perianal discomfort, the incidence of complications is less than 1%, and more and more patients can complete the treatment in outpatient clinics, and Some costs may be reimbursed by health insurance.
What if there are other diseases
Mr. Zhang is still a little worried. Now there is a high incidence of intestinal polyps and tumors. What should I do if I have other problems besides internal hemorrhoids?
In fact, another advantage of choosing colonoscopy for the treatment of internal hemorrhoids is the routine colon examination. Once a patient is found to be complicated by intestinal polyps and early-stage tumors, if there are no contraindications, it can be done at the same time. Perform endoscopic treatment.
Can painless stomach and colonoscopy be done together
Wait a minute, Mr. Zhang has another question! Over the past few years, Mr. Zhang has an irregular diet, and his stomach is often uncomfortable. However, in many hospitals, painless gastroscopy and colonoscopy need to be done twice, which is too troublesome.
This also has a solution.
Shandong Maternal and Child Health Hospital Digestive Endoscopy Center routinely conducts painless gastrointestinal endoscopy. For patients without special cardiopulmonary diseases, painless gastric and colonoscopy diagnosis and treatment can be completed at one time after completing anesthesia evaluation. . The Gastrointestinal Endoscopy Center opens Saturday morning gastrointestinal endoscopy outpatient examinations, which greatly facilitates patients who are unable to see a doctor on weekdays.
Original author: Liu Zhu
Review: Jia Li, Gao Yu