Hemorrhoids

Hemorrhoids are a disease in which there is blood stasis and abnormal changes in the veins of the rectum or in the area around the anus. Such a delicate pathology has no restrictions regarding age and gender.

The underlying factor that leads to the formation of hemorrhoidal cones is stagnation, which, in turn, arises from a large number of other predisposing factors.

Pathology is characterized by characteristic symptoms that a person cannot ignore. The most specific clinical signs of hemorrhoids are itching and burning in the anal area, rectal bleeding, and severe pain in the perianal region.

The doctor will be able to establish the correct diagnosis based on a physical examination, but in addition, some laboratory and instrumental tests may be needed.

The treatment of hemorrhoids directly depends on the severity of the course of the disease, so it can be both conservative and surgical.

Since the pathology has quite a few varieties, it is coded with various meanings in the International Classification of Diseases.

Etiology

The main reason for the appearance of hemorrhoidal cones is:

• violation of the functioning of the vessels of this organ;
• increased arterial blood flow;
• venous plexus blood outflow disorder;
• loss of tone of the rectal veins, which leads to their expansion and the appearance of nodes.

In addition, doctors identify a large number of unfavorable factors that lead to the above processes, therefore they are generally divided into several groups: pathological and physiological.

The first category of hemorrhoid causes includes:

• chronic constipation - hardened stool damages the walls of the rectum and anus;
• severe intoxication of the body - this should include intoxication with alcoholic beverages, toxic and chemical substances, as well as poor-quality food;
• profuse diarrhea of an infectious nature;
• the formation of malignant tumors, less often benign, in the intestine;
• diseases of the pelvic organs, such as prostatitis or cystitis;
• inflammatory diseases of the digestive system;
• hormonal disorders;
• portal hypertension and cirrhosis of the liver, as well as other ailments of this organ. The connection of hemorrhoids with the liver is due to the presence of common veins;
• the pathological influence of pathogenic bacteria leading to the development of infections.

In addition to diseases and disorders, the causes of hemorrhoids may not be associated at all with the presence of one or another ailment in the body. Among the physiological factors, it is worth highlighting:

• lack of physical activity - this occurs against the background of a wide variety of sources: laziness, a serious illness that deprives the patient of the ability to move, as well as the specific working conditions under which a person is forced to sit or stand most of the time. working time;
• excess body weight;
• poor nutrition: this includes the abuse of fatty, spicy foods, smoked meats, sweets, carbonated drinks, semi-finished products, fast food and other harmful ingredients. That is why diet therapy is one of the components of hemorrhoid treatment;
• indiscriminate use of medications, including laxatives or oral contraceptives;
• incorrect performance of proctological diagnostic procedures or enemas;
• unconventional sexual preferences, namely anal sex;
• prolonged influence of stressful situations;
• engage in vigorous physical activity;
• practice some sports, in particular cycling or motorcycling, equestrian sports and other types of weight lifting;
• excessive drinking and smoking of cigarettes;
• period of having a child or job;
• menstruation.

Genetic predisposition plays an important role in the development of the disease. Diagnosing a similar pathology in one of the closest relatives greatly increases the probability of strokes. Knowing this, you can independently prevent the appearance of an ailment, you just need to follow all the rules for the prevention of hemorrhoids.

Classification

By its clinical nature, the disease is:

• acute - this is the first manifestation of hemorrhoids that has not been previously diagnosed;
• chronic: characterized by alternate phases of exacerbation of symptoms and their withdrawal.

Depending on the area of formation of hemorrhoids, cavernous pathology is divided into:

• External hemorrhoids - it is such if the lump appears under the skin of the anus and not under the mucous membrane of the rectum. It is considered the rarest form of the disease;
• internal hemorrhoids are the most common type of pathology in which vascular cones appear directly in the anal canal;
• Mixed hemorrhoids - the second most common type of disease, characterized by the presence of signs of the two forms described above.

In addition, there are types of hemorrhoids, divided by severity:

• mild course - symptoms may be completely absent or expressed to a negligible degree. Conservative methods prevail in therapy;
• medium-heavy - differs in the addition of pain sensations, which are caused by an increase in the nodes and their injury by the stool. The internal bumps fall off during the act of defecation, after which they adjust. It is possible to eliminate the disease with minimally invasive methods;
• severe: characterized by the expression of a sign of hemorrhoids such as bleeding. The nodes can fall out not only during intestinal emptying, but also in any other situation that causes an increase in intra-abdominal pressure. In such cases, they can only be adjusted manually. The tactics of how to get rid of hemorrhoids can include both minimally invasive procedures and extensive operations;
• complicated - it is expressed by an increase in the symptoms of the disease, and during diagnosis, the development of complications is often observed, one of which may be thrombosis. However, it should be borne in mind that not in all cases of premature hemorrhoid treatment, the formation of consequences occurs.

Symptoms

The first signs of hemorrhoids can be so mild that a person does not pay attention to them. The initial clinical manifestations are considered to be:

• mild discomfort in the anus;
• not intense itching of the anal area;
• pain when defecating;
• swelling of the entrance to the anal canal.

As the disease progresses, the following hemorrhoid symptoms will begin to manifest:

• severe burning and itching;
• increased pain, which will appear not only during bowel movements, but also during vigorous walking or prolonged sitting;
• the appearance of blood and mucus impurities in the stool. It is noteworthy that pathological clots will not mix with the feces, but will be located on top of it;
• prolapse of the hemorrhoidal lump, leading to severe pain;
• redness of the skin of the perianal region;
• rectal bleeding - if in the early stages such a sign of hemorrhoids can manifest itself only in the form of a blood stain on toilet paper or underwear, then with a complicated course the bleeding can reach the intensity of the jet. This is what often causes a person to seek help.

In addition to the specific clinical manifestations, the above symptoms of hemorrhoids can be supplemented by an increase in body temperature, which indicates the progression of the inflammatory process.

Diagnostics

It often happens that when symptoms of an ailment occur, a person does not know which doctor to contact for hemorrhoids. A proctologist or surgeon is involved in the diagnosis and treatment of hemorrhoids, but for the first consultation, you can contact a therapist. It should be borne in mind that if a child has signs, it should be immediately shown to a pediatrician, and if she is a pregnant woman, they should first consult an obstetrician-gynecologist.

The first stage of diagnosis includes the work of the doctor, which is aimed at:

• a detailed survey of the patient for the first time the signs of hemorrhoids appear, to identify the stage of the course of the disease;
• familiarization with the medical history and life history not only of the patient, but also of her relatives; This is often enough to determine the sources of why hemorrhoids appear;
• perform an objective examination aimed at evaluating the state of the perianal region, as well as a digital examination of the rectum, which will allow to distinguish internal from external hemorrhoids and determine the location of the lump.

The second stage in establishing the correct diagnosis are laboratory tests, namely, general blood tests, biochemical tests, and coagulogram.

The final part of the diagnosis is the instrumental examinations of the patient, which aim to evaluate how the hemorrhoids look and to anticipate:

• sigmoidoscopy;
• anoscopy;
• colonoscopy;
• X-ray with a contrast agent;
• Ultrasound of the abdominal organs.

Only after studying the results of the examination, the doctor devises tactics on how to cure hemorrhoids in a patient.

Treatment

The treatment regimen for the ailment will depend on the severity of the ailment, but common methods of treating hemorrhoids include:

• the use of drugs for both local and general effects. In the first case, rectal suppositories, ointments, creams and gels are used, and in the second - tablets to improve blood circulation, strengthen the veins and neutralize concomitant symptoms;
• adherence to a moderate diet - proven for both external and internal hemorrhoids. All recommendations on the menu and cooking methods are provided by the attending physician;
• minimally invasive techniques to remove hemorrhoids;
• open surgery;
• the use of alternative medicine recipes. This should include the preparation of candles and ointments from natural ingredients in the home, as well as decoctions of herbs and medicinal plants, which are used for ingestion or as microclysters and sitz baths.

Among the minimally invasive methods for the treatment of hemorrhoids, it is worth noting:

• the introduction of sclerosing substances directly into the ganglion;
• ligation with latex rings;
• infrared and electrocoagulation;
• cryodestruction;
• dearterization.

Tactics for removing hemorrhoids will be determined by the stage of the pathology.

With the ineffectiveness of conservative methods, as well as in cases of a complicated course of the disease, an open surgical operation is indicated - hemorrhoidectomy.

An obstetrician-gynecologist and pediatrician will instruct you on how to treat hemorrhoids in pregnant women and children.

Possible complications

Ignoring pronounced clinical phenomena and late treatment of hemorrhoids often leads to the development of the following consequences:

• adhesion of a secondary infection;
• the spread of the inflammatory process;
• anal sphincter insufficiency;
• profuse bleeding leading to anemia;
• proctitis and paraproctitis;
• the formation of blood clots;
• anal fissures.

Prevention and prognosis

To prevent the occurrence of hemorrhoids, the following prevention rules should be observed:

• lead a healthy and moderately active lifestyle;
• eat properly and balanced;
• strengthen the pelvic and abdominal muscles;
• take medications only as directed by your doctor;
• if possible, avoid physical and emotional stress;
• timely treat constipation and other pathological causes of hemorrhoids;
• make sure body weight is within normal limits;
• have a complete physical exam on a regular basis.

It is impossible to unequivocally answer the question of the prognosis of hemorrhoids, since the result depends on several factors: the stage and form of the course of the disease, the age category, the time of the beginning of hemorrhoid treatment and compliance of the patient with all the recommendations of the doctors.

Often people who have been diagnosed with hemorrhoids ask if they can go away on their own. The answer from doctors will always be negative - the disease will turn into a chronic form.