Anal cryptitis

　　The anal sinus opening is upward, which is prone to accumulate feces and cause infection, leading to spasms of the anal sphincter and poor drainage of the anal sinus. The infection is difficult to control, causing inflammation and hypertrophy of anal papillae. Feeling discomfort in the anal area, and pain during defecation due to the pressure of feces on the anal crypt, can cause anal pain, which is usually not severe and disappears within a few minutes.

　　In addition to general symptoms, it can also cause other diseases. This disease may be accompanied by hypertrophy of anal papillae and prolapse from the anus, causing anal dampness and itching. Therefore, once found, it needs to be treated actively, and preventive measures should also be taken in daily life.

　　Feeling discomfort in the anal area, and pain during defecation due to the pressure of feces on the anal crypt, can cause anal pain, which is usually not severe and disappears within a few minutes. If the anal sphincter is stimulated and contracted, the pain may worsen, often accompanied by short-term paroxysmal piercing pain during non-defecation, and may extend to the buttocks and posterior thigh. In the acute stage, constipation is common, and the stool often contains a little mucus, which usually flows out before the stool and sometimes mixed with blood.

　　Maintain smooth defecation and anal cleanliness, and treat chronic intestinal inflammation, constipation, and diarrhea in a timely manner. Seek medical attention in cases of hemorrhoids and leakage. This disease seriously affects the daily life of patients, so it should be actively prevented.

　　1. Inquire in detail about any discomfort, itching, or burning pain in the anal area, and the presence of mucus or blood in stools.

　　2. Check for congestion, edema, and hypertrophy of papillae, and purulent secretion in the anal crypt area with an anoscope.

　　In traditional Chinese medicine, it is believed that the occurrence of anal sinusitis is most closely related to damp-heat. Therefore, attention should be paid to avoiding greasy foods in daily diet, and foods that generate internal damp-heat should be eaten less. At the same time, the habits of smoking, drinking, and tea should be given up.

　　Eat more light, easy-to-digest, and nutritious foods such as winter melon, luffa, mung beans, carrots, tomatoes, etc. In addition, improper diet can lead to dry stools, and hard stools can tear the anal valves, damage the anal skin and mucosa, making it easy for bacteria to reproduce 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.

　　Elderly people without diabetes can take honey regularly, which can prevent constipation through dietary regulation, maintain smooth bowel movements, and benefit from the recovery of diseases. Patients with postoperative anal sinusitis, especially those with chronic non-healing wounds, should also pay attention to increasing nutrition and eating foods rich in protein such as lean meat, mushrooms, jujube, eggplant, yam, etc.

　　Firstly, Traditional Chinese Medicine Treatment

　　1. Internal Treatment

　　Damp-heat flowing downward, anal prolapse or itching discomfort, or burning pain, pain worsens during defecation, anal dampness; jaundice, dry mouth and bitter taste, yellow greasy fur, slippery and rapid pulse.

　　Dialectical analysis: The pathogenic factors of damp-heat are retained in the intestines and stomach, and flow downward to the anal cavity. The Qi and blood are not smooth, resulting in anal prolapse, dampness and itching, and even pain; the stool is difficult to pass, and the Qi and blood become more stagnant, resulting in increased pain; jaundice, dry mouth and bitter taste, yellow greasy fur, slippery and rapid pulse are all signs of damp-heat.

　　Treatment method: Clear heat and drain dampness.

　　Prescription: Add or subtract the Pain Relieving Miracle Decoction.

　　2. External Treatment

　　Fumigation and washing method: boil the Suanlang decoction, first fumigate and then wash.

　　After fumigation and washing with Suanlang decoction, insert the hemorrhoid plug into the anal cavity, or apply Huanglian powder ointment to the anal cavity.

　　Secondly, Western Medicine Treatment

　　1. Non-surgical Treatment

　　Soften the stool, take a sitz bath with a 1:5000 potassium permanganate solution after defecation and every evening, and locally apply anti-inflammatory and analgesic suppositories such as metronidazole suppository, compound Yuhong suppository, etc. The composition of compound Yuhong suppository per 1000 grains is as follows: 6.0g of purple草根, 12.0g of Suanlang, 30.0g of rosin, 6.0g of bael, 170.0g of sesame oil, 25.0g of sulfonamide powder, 5.0g of diclofenac, 2.5g of cortisone.

　　2. Surgical Treatment

　　For chronic or recurrent cases, anal flap resection can be performed under local anesthesia to facilitate drainage. If there is hypertrophy of anal papilla, it should be removed at the same time, and then continue non-surgical treatment. The anal canal can be dilated with fingers within 5-7 days.

　　For those with abscess in the anal sinus, or accompanied by hypertrophy of anal papilla, hidden fistula (internal blind fistula), surgical treatment is recommended.

　　(1) Incision and Drainage Method

　　Indications: Simple anal cryptitis with abscess; or with hidden fistula.

　　Operation method: Take the lithotomy position or lateral position, locally disinfect the perianal area, locally anesthetize the anal area, expose the lesion under the double-leaf anal scope, make a longitudinal incision along the anal sinus to ensure unobstructed drainage, and compress the incision with vaseline gauze. Take a sitz bath after defecation after surgery, and apply Huanglian powder ointment or Maylong hemorrhoid ointment or other hemorrhoid ointment externally.

　　(2) Excision Method

　　Indications: The disease is accompanied by hypertrophy of anal papilla.

　　The preparation method is the same as above. Expose the lesion under the double-leaf anal scope, and remove the anal sinus, anal orifice, and anal papilla together. Apply vaseline gauze to compress the wound. Change the medicine once a day after surgery.