The pathological changes of chronic virus hepatitis includes cloudy swelling of liver cells, gradual increase of portal pressure and alterations of visceral hemodynamics leading to increase of blood flow of the entire gastrointestinal tract. If lower section esophageal varicosities occur, hematemesis may take place; if portal hypertension exists, venous varicosities of the color and rectum may be produced. Polyps of the colon and rectum are likely to occur and development of hemorrhoids or cancerous changes is also promoted. The chief clinical symptom of colonic and rectal venous varicoties and hemorrhoids is often painless hematochezia. Therefore, early stage hepatophilic virus disease patients, complicated with hematochezia, regardless of its amount, should all be given adequate attention. It is extremely important that patients with hematochezia not yet given a definite diagnosis of liver disease, should be investigated to prove or rule out the existence of Hepatophilic virus disease. If virus hepatitis can be treated in time by systemic TCM therapy to attain clinical cure, the relapse of hematochezia can be controlled. One should always keep this in mind.
Clinical statistical data indicates: in patients with cirrhosis of liver, the incidence of colonic and rectal carcinoma is comparatively high, for example, incidence of carcinoma of colon, 6.27%, rectal carcinoma 3.60%. Patients without cirrhosis have an incidence of colonic carcinoma 4.2%, rectal carcinoma 1.30%. The precise cause of this is not clear. Besides that the metabolic dysfunction of cholic acid, lipidic acid and cholesterol may have carcinogenic effect in liver disease, the local changes of venous and lymphatic circulation may also have some effect on carcinogenesis. Therefore, timely treatment of virus hepatitis with TCM therapy may have preventive effect in carcinogenesis of colon and rectum.
(continued of cases study)
| Case 3
Huang (code number 0326), female, age 28 years. Her first visit was on November 1998. She had hemorrhoids since childhood and had relapses which were complicated with repeated inflammation, pain and hemorrhage. Treatment was given but did not attain curative effect. Recently her menstruation delayed, the amount large and with blood clots, its color deep red. She was dreamful, had insomnia, fatigue and also frequent and painful urination. Physical examination: well nourished and developed, liver enlarged to costal margin. Anal examination showed circular hemorrhoids in which a hemorrhoid protruding and everting prominently from 12-6 o’clock, associated with erosion, inflammation and bleeding. The tentative diagnosis was chronic hepatitis combined with hemorrhoids, prolapse of anus, menstrual disorder, anemia and infection of the urinary system. Urine examination found pus cells, leucocytes, B coli, but ultrasonography showed no abnormality of liver and spleen. Through TCM therapy, inflammation of the hemorrhoids and infection of urinary system were cured; the liver returned to normal. After thirty more parcels of TCM drugs, medication was stopped at June 1989. The following ten more years of observation revealed relapse of hepatomegaly for 14 times, with hematochezia and prolapse of hemorrhoids in every episode, but it was controlled every time by TCM treatment. Presently, there remained only one peanut size hemorrhoid and anal prolapse did not occur, but bleeding might happen if dry-heat food was taken.
|
| Case 4
Yin (code number 2268), male, age 51 years. His first visit was on October 2000 when he complained of repeated bleeding from hemorrhoids for over 20 years. He often felt protrusion of a tissue mass after defecation, and he had to wait for an hour before it could retract by itself. He suffered from nasal hypersensitivity symptoms and coughing after exopathy many times. Presently, he suffered from repeated suffocating cough for a week, complicated by bleeding from hemorrhoids and prolapse of rectum. He received medical help from modern doctors as well as TCM physicians with no avail. Physical examination: thin, skin darker in color, senile appearance, percussion tenderness over hepatic region, hepatomegaly of 3 cm, hemorrhoid at 4-6 o’clock of anus with inflammation. After 3 parcels of TCM drugs, the liver returned to normal but the hemorrhoids showed dropping of blood in fair amounts and post-defecation anal prolapse could only return by itself in more than on hour. After seven days of TCM treatment, bowel movements were smooth, being once a day, the stools at first soft but followed by watery consistency. Hematochezia disappeared. Anal prolapse was still present after 3 weeks of medication, but the prolapsed mass decreased significantly; the stools were normal without bleeding. He received totally 4 weeks of TCM treatment and medication was stopped when clinical cure was obtained. Observation to the present did not show relapse of the disease.
|
By WONG Kwok Hung
published on 5th June 2001
(translated by Professor ZHENG Hua En in December 2002)