Zhi-Heng Zhao，Chao-Chao Mu

1Tianjin University of TCM, Tianjin, China.

Abstract Objective: To report a patient with connective tissue external hemorrhoids who showed beneficial efficacy after fire needle was used for cutting off the connective tissue. Methods: Burn the front end of needle on the alcohol lamp until red and cut off the connective tissue external hemorrhoids quickly and accurately. Results: The connective tissue external hemorrhoid was totally removed and the patient showed a complete recovery after one and a half-year follow up.Conclusion: Fire needle can quickly eliminate perianal connective tissue, improve pain and bleeding, promote tissue regeneration and shorten the wound healing time, which may provide us a new idea for the surgical treatment of external hemorrhoids.

Key words: Acupuncture, Fire needle, Connective tissue external hemorrhoids

Background

External hemorrhoids are goitre under the skin around anus.Pain, bleeding and itching are the major complaints in patients with hemorrhoids. Acupuncture has traditionally thought to be able to relieve pain and bleeding. In a clinical report of sixty cases of hemorrhoids, acupuncture at the points of Xialiao (BL34) and Changqiang (GV1) achieved the superior efficacy on mixed hemorrhoids as compared with diosmin tablets [1].

Compared with ordinary acupuncture, the stimulus intensity of fire needle is much larger, which could enhance the local tissue metabolism, improve microcirculation and adjust the blood rheology [2]. Fire needle, also called “big needle” or “burnt needle”, is originated from acupuncture and the original record regarding fire needle is in HuangDiNeiJing. It is the therapy that points are punctured with red-hot needle rapidly, which has the potentials to relieve the sensation of pain, itching and numbness. The first report about the application of fire needle in the treatment of external hemorrhoids was the penetration of hemorrhoids with fire needle [3]. There are also reports about the treatment of hemorrhoids with fire-needle afterward [4-5]. However,the literature about the therapeutic effect of fire needle on cutting off connective tissue external hemorrhoids has not been reported. Here we introduce a surgical use of fire needle for external hemorrhoids.

Case report

In March 2016, a 28-year-old man complained of the hemorrhoids pain and perianal discomfort. He suffered from hemorrhoids five years ago and prescribed the Chinese herbal medicine with supplemental light diet.After treatment, these symptoms were alleviated. Until October 2014, hemorrhoids were recidivated due to excessive intake of chili and other stimulating foods.Though the symptoms including bleeding and pain have persisted for more than two months, the patient didn’t pay attention to it until a size of 1*1.5cm external hemorrhoids appeared around anus (Figure 1A). The patient hoped to choose acupuncture treatment instead of undergoing surgical treatment.

The specific operation of fire needle was as follows: to help the surgeon to burn the needle, assistant held a litten alcohol lamp and approached the anus. One hand of the surgeon hold the connective tissue external hemorrhoids,while the other hand hold needle and burned the front end of needle (diameter 0.6 mm) on the alcohol lamp until red.Quickly and accurately cut the connective tissue from the root of external hemorrhoids. Each needle can be operated 2 to 3 times with burn and cut, until complete remove the connective tissue (Figure 1B, C, D). No bleeding was observed on operative site in general situation. If there is a small amount of bleeding, iron the bleeding point using fire needle slowly and steadily to stop bleeding. After a year and a half follow-up, the patient’s hemorrhoids were not attack again.

Figure 1 Cutting connective tissue external hemorrhoids with fire needle

Discussion

Western medicine regarding to treatment of external hemorrhoids tend to employ the method of surgery, which usually accompanied with serious postsurgical pain. It also leads to a large area of scar, anal incontinence, anal stenosis and other sequelae. Fire needle has an advantage of good efficacy and easy operation, with less pain and complications. This is the first report about the surgical treatment of external hemorrhoids by fire needle. For this case, the patient was treated with fire needle to cut off the connective tissue of external hemorrhoids. Fire needle has been demonstrated to quickly eliminate perianal skin tag,relieve pain and bleeding, and shorten the wound healing time. The burn injury formed by fire needle also helps to shrink blood vessels, numb local nerves and relieve pain[6]. Because of the definitely therapeutic effect, fire needle therapy deserves further popularization and application,which may provide us a new idea for the surgical treatment of external hemorrhoids.