In reality, you may often encounter some friends or family members who say that your anus is very itchy. Most of this situation is caused by anal eczema. Anal eczema itself is a large area of eczema around the anus caused by long-term moisture around the anus. Although this symptom is very common in anorectal , it is also a disease that is difficult to eradicate and easy to recur. So how should patients with anal eczema be treated?
I met a local patient some time ago, Mr. Li, 30 years old, an ordinary employee of a company, who was first diagnosed on June 10, 2022. The main symptom when I came to the doctor was repeated itching of the anus, which had lasted for more than 3 years and worsened this year.
The patient previously underwent surgery for perianal abscess, but after the surgery, he continued to feel discomfort in his anus and often experienced itching. At the beginning of May this year, the symptoms worsened. The anus was moist and itchy, and sometimes the itching was unbearable. I also have 2 to 4 stools per day, which are often shapeless, but there is no abdominal pain or bloating. Eating, sleeping, and urinating are all normal. I looked at his tongue coating and found that the tongue was red, the coating was white and greasy, and the pulse was wet.
Anoscopy revealed that there was slight congestion and edema on the patient's lower rectal mucosa, as well as a large amount of white intestinal mucus. Moreover, the patient's anus was moist, and a vertical row of scars could be seen in the 5 to 6 o'clock direction of the anus. The perianal skin base is flushed and soaked, with scattered scratches and carpet cracks.
Based on the patient’s condition, it is a typical case of perianal eczema secondary to anal surgery. If the skin or mucous membrane is preserved during the operation and then develops hemorrhoids, resulting in the anus not being closed tightly, or the damage during the operation is deep and extensive, and the scar formation is large, affecting the sphincter contraction function, it can lead to perianal eczema.
treats patients as a whole, using the ideas of strengthening the spleen and replenishing qi, removing dampness and relieving itching. Shenling Atractylodes Powder Addition and subtraction of adventitious symptoms.
Prescription: Codonopsis pilosula, Astragalus , Poria , Nutmeg , dried tangerine peel, Atractylodes, Evodia , Gallus gallus gallus domestica, Coix seed , White fresh bark , Cnidium monnieri , Zhigancao .
And take a sitz bath with Chinese medicine boiled in water for 10 minutes every day.
Prescription: Scutellaria baicalensis, Phellodendron , coptis, atractylodes, Sophora flavescens , white fresh bark, Cnidium monnieri, Borneol , Licorice .
and told the patient to adjust his diet, which should be light and nutritious, avoid drinking alcohol, spicy and greasy food, and pay attention to the cleanliness of the anus.
10 After a follow-up visit, the patient found that there was no moisture in the anus and the itching was reduced and tolerable. The stool is 1 to 2 times a day, and the stool is soft. Continue the original treatment, including 10 doses each of oral Chinese medicine and sitz bath medicine.
After one month of follow-up, the patient had no itching in the anus and had 1 to 2 bowel movements per day, which was normal.
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