Anal sinusitis

　　The rectum gradually narrows and becomes thinner from the middle to the lower end. With the contraction of the intestinal lumen at the anal opening, the mucosa of the intestinal wall folds up like the cuff of a person's clothes, forming many longitudinal ridges, which are called rectal columns or anal columns in medicine. The two columns are connected by a semilunar fold between the bases, which is called the anal valve. Between the two rectal columns and the anal valves, a funnel-shaped depression facing upwards is formed, which is the anal sinus, also known as the anal crypt.

　　The anal sinus bottom has anal glands and anal gland ducts that can secrete fluid. They can secrete sticky fluid normally, lubricate feces, and protect the rectum and anal canal. Since the anal sinus is like a funnel, opening upwards, feces and other impurities easily accumulate in the sinus, and are also easily scratched and broken by hard feces. After bacteria invade, it will cause infection inside the anal sinus and spread along the anal gland ducts and anal glands, so anal sinusitis is also the source of various anal and rectal diseases, such as anal and rectal abscesses, anal fistulas, anal fissures, hemorrhoids, anal papillitis, etc. The occurrence of anal canal epithelial cancer is also related to the stimulation of chronic anal sinus inflammation.

　　The two major complications of anal sinusitis are: 1. Anal papillitis; 2. Anal papilloma enlargement.

　　Common complications after anal sinusitis surgery - In addition to urinary retention, the following complications are common after anal sinusitis surgery:

　　① Bleeding: There is generally no severe bleeding after surgery. If it is simple bleeding, it can be stopped by packing with gauze, and epinephrine can be locally added if necessary; or Yunnan Baiyao can be sprinkled on the wound surface or gelatin sponge can be used for pressure止血.

　　② Infection: There are many opportunities for anal pollution, but due to rich blood supply, the actual infection of the incision is not common. Frequent sitting in a bath after surgery and reasonable cleaning of the wound can accelerate the normal healing of the wound.

　　③ Fecal impaction: Due to anal sinusitis after surgery, defecation can stimulate and cause anal pain, so patients intentionally control defecation, causing feces to form an impaction in the rectum. The treatment method is very simple, it can be treated with a 38℃ saline enema.

　　Typical symptoms of anal sinusitis

　　1. Urgency to defecate - A sense of anal prolapse with the urge to defecate, but unable to defecate or defecate very little when going to the toilet.

　　2. Pain - Uncomfortable feeling and hidden pain at the anal opening, which worsens during defecation.

　　3. There may be a small amount of mucus and blood in the feces.

　　4. When the anal papillae are hypertrophied, they can prolapse outside the anus.

　　5. Digital rectal examination: Sphincter tension, tenderness of anal sinus and anal papillae.

　　6. Anoscopic examination: Anal sinus and anal papillae congestion and swelling.

　　1. Pay attention to dietary hygiene, lifestyle, and dietary adjustment, eat more vegetables and fruits, drink more water, avoid eating chili, and prohibit drinking alcohol: Reasonable living, avoid alcohol and spicy foods, etc., to reduce the stimulation to the intestines and anus.

　　2. Keep the bowels open, prevent constipation. Constipation can be appropriately treated with bowel softeners, or use glycerin suppositories.

　　3. Take appropriate oral anti-inflammatory drugs.

　　4. Local application of hemorrhoid suppositories.

　　5. Drug enema.

　　6. Keep the anal area clean, take a saltwater bath twice a day, keep the perianal area clean, which can effectively inhibit the growth of many bacteria, and also effectively control the regeneration and infection of bacteria.

　　7. Develop good defecation habits: Regulate bowel movements and develop the habit of defecating once a day. Not only can it effectively prevent anal canalitis, but it can also prevent constipation and reduce damage to the anal canal and other parts caused by forced defecation due to constipation.

　　The examination of anal sinusitis is as follows:

　　①Visual examination: The appearance and shape of the anus are mostly normal in most patients. Severe cases may show local swelling, moist and bluish anal perianal skin, and mucous exudation, but the anal perianal skin folds are not significantly thickened or thickened.

　　②Rectal examination: The temperature inside the rectum is increased, and hard nodules, protuberances, or depressions can be felt near the dentate line, with tenderness or palpation. Sometimes the anal internal sphincter is tense, and there is a sense of constriction in the anal canal.

　　③Anoscopic and probe examination: Under the anoscope, the anal sinus area of the patient can be seen to be congested, swollen, red or dark red. When pressing the surrounding tissue of this anal sinus, there is tenderness or mucous or purulent secretion may be discharged from the inflammatory sinus orifice. It often accompanies hypertrophied anal papillae, which are yellowish or pale red. Some anal valves are thickened and congested. When examined with an anal sinus hook or probe, it can be smoothly inserted into the deeper part of the anal sinus, while it is not easy to insert into the normal anal sinus orifice.

　　④Comprehensive physical examination: Although the location of anal sinusitis is local, it cannot be ignored. Only a comprehensive examination can ensure accuracy. It should be checked for active tuberculosis, and if tuberculosis is present, both local and systemic treatment should be carried out. The experts of the Anorectal Department of Ziyang Water Conservancy Hospital remind that patients with diabetes have low resistance and are prone to develop anal sinusitis. Local lesions should be treated on the basis of treating diabetes. Routine blood, urine, and stool tests are necessary, as well as electrocardiogram, liver function, blood urea nitrogen, and other tests to avoid delays in treating the main disease.

　　Patients with anal sinusitis should pay attention to avoiding greasy foods in their daily diet, and should eat less food with internal damp-heat. They should also quit the habits of smoking, drinking alcohol, and excessive tea consumption. They should eat more light, easy-to-digest, and nutritious foods, such as winter melon, luffa, mung beans, carrots, tomatoes, and so on. In addition, it is also necessary to pay attention to the following: Improper diet can lead to dry stools, and hard stools can tear the anal valves, causing damage to the anal skin and mucosa, making it easy for bacteria to multiply and cause anal gland infection. Therefore, it is appropriate to eat more high-fiber foods such as sweet potatoes, corn, and celery in daily life. Avoid spicy and刺激性 foods, eat more vegetables and fruits, coarse grains, and drink more water.

　　For elderly patients with anal sinusitis, if they do not have diabetes, they can take honey regularly, so as to prevent constipation through dietary adjustment, keep the stool smooth, and benefit the recovery of the disease. For patients with anal sinusitis after surgery, especially those with chronic wound healing, it is also necessary to pay attention to increasing nutrition and eating more foods rich in protein such as lean meat, mushrooms, jujube, eggplant, yam, etc.

　　Below are the specific practices of anal sinusitis in food therapy:

　　(1) Job's tears porridge

　　Composition: Job's tears 100 grams, appropriate amount of sugar.

　　Preparation: Wash and soak Job's tears in cold water for 20 minutes, boil with high heat, then simmer with low heat until soft, add a little sugar.

　　Function: Strengthen the spleen, drain dampness, and remove pus.

　　Dosage and administration: Take 1-2 small bowls once a day.

　　(2) Cold celery salad

　　Composition: Fresh celery 300 grams, a little sesame oil.

　　Preparation: Fresh celery without roots, wash and cut into 6 cm long pieces, boil in hot water. Add a little sesame oil and seasonings and eat.

　　Function: Clear heat and promote defecation.

　　Patients with anal sinusitis that is unresponsive to drug treatment, or those with abscesses inside the anal sinus, or those with papillary hypertrophy and latent fistulas should be treated surgically, with the treatment methods including anal sinus incision and anal sinus resection.

　　(1) Anal sinus incision

　　Applicable to patients with simple cryptitis, or those who have formed abscesses, or those with latent fistulas.

　　Operation method: First, disinfect the anal area, then take the patient in the lithotomy position or lateral position under local anesthesia or waist俞穴 anesthesia, expose the lesion under the anal scope, make a longitudinal incision along the anal sinus to ensure smooth drainage. Apply pressure hemostasis with huanglian baihuang powder gauze or shengji yuhonggao oil gauze on the incision. The patient should take a sitz bath after defecation every day after surgery, and apply shengji yuhonggao medicine externally.

　　(2) Anal sinus resection

　　Applicable to patients with anal sinusitis complicated by papillary hypertrophy.

　　Operation method: First, disinfect the anal area, then take the patient in the lithotomy position or lateral position under local anesthesia or waist俞穴 anesthesia, expose the lesion under the double leaf anal scope, make a longitudinal incision about 1 cm long on the anal sinus and anal valve, deep enough to cut the internal anal sphincter, remove the infected anal glands and their ducts, ligate the bleeding points, clamp one side of the incision of the anal canal and mucosa with a curved hemostat, and ligate it together with the proliferative anal papilla. Then, treat the opposite incision in the same way. Postoperative treatment is the same as above.