Hemorrhoids

7 May 2025

Hemorrhoids are varicose veins in the hemorrhoidal veins of the rectum. The inflammation of the hemorrhoidal node is characterized by thrombosis, a change of shape and the pathological expansion of the hemorrhoidal veins, forming ganglia around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which are aggravated by them from time to time. And more than 70% of people, at least occasionally, experience several hemorrhoid symptoms, such as discomfort in the area of anus, itching and pain during defecation.

Hemorrhoids in women often occur during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very soft methods, since a pregnant woman is not recommended to take some medications for hemorrhoids that are prescribed in the usual order. Hemorrhoids in men are also a fairly frequent phenomenon caused by a series of other causes and factors that will be discussed more thoroughly.

What are the causes of hemorrhoids?

In general, it is accepted that hemorrhoids develop due to an increase in blood flow or their insufficient output flow, which leads to stagnant processes. The causes and factors of hemorrhoid development are:

Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which must be said first. And although hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. The inheritance of certain groups of genes leads to congenital weakness or vascular dysfunction located in the rectum. This is the cause of an improved flow and an insufficient output of blood through the cavernous veins, which leads to the pathological expansion of the latter. A long -term expansion of the cavernous veins leads to the thinning of the walls of the blood vessels, which contributes to the appearance of bleeding with hemorrhoids.
Long data work and weightlifting. In addition to a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First, this applies to people who are forced to remain in standing position for a long time. This category includes teachers, teachers, Swiss, guards, hairdressers and others. The lifting of height is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, mainly related to office workers, drivers and people, leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First, this is greater pressure on the vessels of the rectum in sitting position. With a prolonged seat, the anus area is heated slightly, which leads to stagnant phenomena and vascular expansion. In addition, the lack of physical effort is a true path towards the development of venous insufficiency. Including this applies to the veins located in the rectum.
Chronic constipation and diarrhea. People who suffer from chronic constipation are predisposed to the development of hemorrhoids. Why is this happening? The point is that with constipation, the feces harden, exerting pressure on the veins in the lower intestine. This leads to a deterioration in the supply of blood of cavernoso and the appearance of hemorrhoids. An additional factor in constipation is the habit of pushing strongly during defecation, which creates additional pressure on the vessels in the rectum.

In addition to constipation, it contributes to the development of hemorrhoids and severe diarrhea (diarrhea), which leads to the irritation and inflammation of the mucous membrane of the rectum.

Pregnancy. Hemorrhoids during pregnancy and childbirth are a frequent phenomenon, since the load of the fetus creates pressure on the venous vessels of the rectum. And tense attempts during childbirth only exacerbate the course of hemorrhoids and contribute to the formation of new hemorrhoidal nodes.
Inadequate nutrition, spicy food and alcohol. A significant factor in the appearance of hemorrhoids is malnutrition. In particular, the abuse of spicy food leads to the irritation of the intestinal mucosa, and also stimulates an improved blood flow to the rectum. And insufficient use of fiber (plant foods) worsens intestinal motility. The provocative factor in the development of hemorrhoids is alcohol, which expands the vessels. The reception of alcoholic beverages, even in a small amount, can cause an exacerbation of chronic hemorrhoids.

The main factors that contribute to the development of hemorrhoids:

Obesity.
Hereditary predisposition.
A sedentary lifestyle (hypodinamia) or a work associated with low motor activity.
Activities associated with excessive muscle tension (high physical activity).
Stress.
Violation of blood output in the rectum.
Frequent constipation.
Inflammatory and tumor processes in the intestines and the liver.
Infection.
Smoking.

Internal and external

In the place of appearance of hemorrhoidal nodes, the disease is divided into two main types: internal and external hemorrhoids.

With external hemorrhoids, the nodes are formed in the immediate vicinity of the anus, in relation to this, its sensitive surface often breaks and produces bleeding bright scarlet blood. The pain in external hemorrhoids is quite acute and strong, but in terms of independent diagnosis, this species does not represent any difficulty.

The internal type of hemorrhoids, although it has a much more serious threat to health, is often distinguished by the total lack of pain (especially in the initial stage of the disease). This fact is explained by the fact that the hemorrhoidal nodes are inside, and its surface is the same insoluctive mucous membrane of the rectum, which carries it.

Degree

Usually, distinguish 3 degrees of internal hemorrhoids:

1st grade. Hemorrhoids are found in the anal channel, they cannot be felt (even with a rectal study). Inflammation complaints of the anus and hemorrhage, "Contrajeando" the pain after defecation.
2nd grade. The nodes stand out from the anus when they strive and disappear independently. In principle, the same disorders are observed here as with first -degree hemorrhoids, however, the small ruptures of the mucous membrane are more often, and the inflammation of the anus is stronger.
3rd grade. It is characterized by the loss of hemorrhoidal nodes that do not recover independently. The symptoms can be the same as in 2-, but often the phenomena of fecal and gases develop additionally. When examined by hemorrhoids, it is distinguished from the fall of the anus along the radiant grooves, cyanotic coloration and a tuberous surface.

Hemorrhoid symptoms

The characteristic hemorrhoid signs of all stages of the development of the disease:

discomfort in the anus;
pain during defecation (at the insignificant, then strong);
Bleeding of the anus;
Hemorrhoid formation and growth.

Hemorrhoids are a chronic pathology that progresses for many years. The disease development rate depends on many factors, including nutrition, lifestyle.

For the initial stageDiseases are characterized by a slight increase in veins in the anus. In general, such a sign remains unnoticed. In this case, the patient can be altered by the bloody discharge of the rectum that occurs immediately after defecation. Blood can easily be seen on toilet paper. It is worth remembering that a similar symptom is characteristic of malignant intestinal tumors, so when it happens, you should consult a prostologist. The timely search for a doctor and the appointment of therapy will easily slow down the development of hemorrhoids.

In the second stageThe development of patient disease may periodically experience discomfort in the anus, with itching. He often has the feeling of a foreign body in the anus. Hemorrhoids begin to fall during defecation and still easily adjust in.

For the third stageHemorrhoids are characterized by an increase in existing characteristics. The great venous nodes in the anus make it difficult to empty the intestinal emptying, become the cause of constipation, the act of defecation itself is accompanied by pain and bleeding. Strong bleeding with hemorrhoids is dangerous, over time it can lead to the development of anemia.

For the last stageDiseases are characterized by an increase in the size of hemorrhoids. They cannot be straightened with one hand. The presence of advanced veins in the anus causes serious discomfort, it hurts the patient, going to the bathroom. He is concerned about abundant bleeding during each defecation. The fourth stage of hemorrhoid development can be complicated by unpleasant and dangerous phenomena such as veins thrombosis at the end of the rectum.

Hemorrhoids in pregnant women

Very often hemorrhoids appear during the last quarter of pregnancy and childbirth. The causes of hemorrhoids are an increased uterus drilling of intestinal veins, which leads to deterioration in the blood flow of intestines and perineum. Vienna increases in diameter and changes the shape. Periodic constipation in pregnant women can also cause their appearance.

However, in most women, the symptoms of hemorrhoids pass the postpartum period, therefore, it is believed that the causes can be hormonal changes. It must be treated immediately after detecting the first of its symptoms. It is important to deal with constipation, for example, take drugs to relieve feces (Forlax, Laminaride, Methyl -Velis), observe the hygiene rules (wash the anus after defecation). Hemorrhoids (aurobin, relief, etc. ) are mainly used externally in the form of ointments and candles. Surgical intervention is carried out only in severe cases.

Hemorrhoid prevention must be carried out since the first days of pregnancy: make a competent diet to prevent constipation, not wear tight belts, spend more time in fresh air and walk on foot.

What is the danger?

The progress of the disease without proper treatment will lead to a series of very unpleasant complications.

Hemorrhoid complications:

Anemia (develops with a long course of the disease with abundant hemorrhage).
Inflammatory processes in surrounding tissues, until the development of paraprocitis (inflammation of the fiber around the rectum). Paraproprocitis is considered a very serious complication that requires severe treatment.
The cracks of the anus. The most common cause of severe pain in hemorrhoids. The cracks create favorable conditions for the development and penetration of several infections deeply in soft tissues. This fact can lead to the development of a formidable complication as an abscess (limited purulent inflammation, which is accompanied by general discomfort, temperature and severe pain). This complication needs mandatory surgical intervention.
ItchingA very unpleasant complication, which acts not only as a strong negative psychological moment, undermining the patient's psychocomotional state. The constantly mechanical irritation of the anal region can significantly aggravate the process of the disease course. In addition, constant damage to tissue increases the risk of developing several tumor processes.
The insufficiency of the anal sphincter, the incontinence of gas and feces (often in the elderly).

It follows that hemorrhoids need an early diagnosis and take immediate measures to solve this problem.

How hemorrhoids are seen: photo

Diagnosis

As a general rule, the diagnosis is not associated with special difficulties, the diagnosis occurs as part of a patient survey and an initial outpatient exam. Inspection helps determine:

the degree of loss of the anus of the nodes,
Evaluate the possibility of returning,
The condition of the skin,
as well as relevance and degree of bleeding.

Symptoms for hemorrhoids are similar to other diseases. Therefore, the diagnosis must be careful because there is a risk of prescribing incorrect treatment. Hemorrhoids can be confused with:

Crack anal, which is also accompanied by slight bleeding, pain during defecation;
rectum cancer (malignant intestinal tumors occur with bleeding);
the loss of rectum;
Colitis, polyps and condylomas.

If you notice the first signs of the disease yourself, do not postpone a trip to the doctor for a long time. The early diagnosis will facilitate treatment and help avoid not only complications, but also a surgical intervention.

How to treat hemorrhoids?

Conservative hemorrhoid treatment:

Be sure to normalize the intestinal emptying. The chair must be regular, soft. To normalize feces with hemorrhoids, food is recommended with the content of dietary fibers, including wheat bran, but its number must be gradually increased by 2-3 weeks. (From 5-10 g to 20 g per day), which excludes the appearance of discomfort.
With constipation, you can recommend lactulose up to 30-40 ml per day to achieve a soft chair daily and other media, follow a diet and recommendations for constipation.

The treatment uses local drugs: rectal hemorrhoid and ointment candles.

With pain, candles that contain small doses of narcotic vehicles (for example, Beladonna, etc. ) help. It can prescribe candles, sodium alginate, ictiol, depending on the symptoms and the stage of the disease.
If there is no bleeding, you can prescribe suppositories or phenylefrin hydrochloride ointment, etc. But all medications are prescribed in each case, so only a proctologist can prescribe the correct treatment after examining the patient.
In pain, in addition to candles, cold lotions can be used, but no more than 30 seconds.
To increase the efficiency of local medicines, it is necessary to take oral products that improve the tone of venous vessels and prevent thrombosis: Godmine, troxerutine.
The base of the hemorrhoidal nodes (prolapse) is the basis of its dressing. When the thrombosis of the hemorrhoidal veins, the cold hydrochloride and the lidocaine (1%solution) are used locally and a greater bandage is possible.
With relapse, despite the treatment, hemorrhoid direction is recommended.

Medication treatment methods are exclusively symptomatic, that is, hemorrhoids do not cure radically hemorrhoids. However, they allow you to temporarily face the unpleasant signs of hemorrhoids. If the patient after pharmacological treatment will meet the medical recommendations for relapse prevention, surgical treatment can be avoided.

But not always patients can follow all recommendations.

Small invasive methods

The minimally invasive treatment allows you quickly and without serious injuries to get rid of a problem as delicate as hemorrhoids. Therapeutic methods in most cases only cushion the symptoms of the disease, delay the time it is necessary to use more radical methods. Before the appointment of a particular procedure, the doctor studies the patient's history, performs a comprehensive exam, evaluates all possible risks.

Sclerotherapy- This is a traumatic treatment through special sclerosing substances that are inserted into the node, paste its walls, so it is possible to achieve the cessation of its nutrition and death in the future. The technique is carried out only in 1-3 stages. It does not exclude the risk of relapse of the disease and is effective only with small hemorrhoids.
ElectrocoagulationIt is carried out under the control of the anoscope. The electrode is taken to the knot leg and the fabric is coagulad (soldier), after which they die quickly. In a procedure, it is possible to get rid of 1-2 pathological foci. After paste, the hemorrhoidal node stops eating and growing, and after a while disappears completely.
Ligand with latex rings-No of the most modern methods of minimally invasive treatment of internal hemorrhoids of 1-3 stages. A latex ligation is applied through the anoscope in the node's leg, which leads to tighten the tissues and a violation of blood circulation in them. After 8-14 days, the hemorrhoidal node dies and is removed with the latex ring.
Cryotherapy- Short -term effect on hemorrhoids with liquid nitrogen. After that, the hemorrhoid node dies and disappears. The procedure takes place under local anesthesia, so there are no painful sensations.

Small invasive procedures are contraindicated in:

exacerbation of the inflammatory process in the rectum and anus;
anal cracks, injuries;
hemorrhoid thrombosis.

Small invasive methods to combat hemorrhoids can only be used in 1-3 stages of the disease, necessarily by exacerbation of the inflammatory process. All procedures are carried out after local anesthesia. There is no need to use general anesthesia. In one session, only 1-3 knots can be removed. Sometimes, the treatment takes place in several stages, from intervals in several weeks.

Surgical treatment

Surgical treatment is the most effective treatment for the third and fourth stage.

The hemorrhoid removal operation, proposed in the 30s of the last century, is still applied and continues to modify. In the world, two types of operations are carried out mainly:

Closed hemorrhoidctomy. Apply in stage III and IV of the disease.
Open hemorrhoidctomy. Also in stadium III and IV, but complicated by the anal crack or paraprocitis.

Also in 1993, a new way of treating hemorrhoids was proposed, it was made by the Italian doctor A. Longgo, which consists of the circular elimination of the mucous layer and exit of the rectum using a special device.

Patients are discharged 3-4 days after surgery, disability restoration occurs in 5-7 days. There is also a small percentage of postoperative complications.

Power and diet after surgery

In most cases, patients, after hemorrhoid surgery, can start drinking and eating a few hours after operation.

But observe the dietary table (according to Pevzer 1a), exclude products and dishes that excite stomach secretion and irritate their mucous membrane. Food should be cooked in cleaning, cooking for steam or boiling on water, it is necessary to take a liquid and suede -shaped condition. Exclude: hot and cold, bread and flour products, raw fruits of vegetables, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.

Eating 6 times a day in small portions. The restoration of the normal functioning of the intestine usually occurs on the second day after the operation, therefore, the usual diet can be proceeded. But, of course, all sharp and spicy dishes must be excluded, alcohol must also be forgotten. Fulfilling these recommendations, you can reduce recovery time after surgery and reduce the risk of complications.

Home treatment

You can make some measures independently that help relieve the symptoms of hemorrhoids at home. However, it is worth remembering that they will not help get rid of the disease:

Hot baths help well. You can take a bath or simply sit in a water basin. It is necessary to place the anus area in warm water for 10-15 minutes 2-3 times a day.
Exhaustive hygiene of the anal region. It is necessary to bathe or shower daily, wash the year of the year thoroughly.
Do not use soap in the anus and other means that may cause irritation. Avoid the use of humid flavored wipes, which includes alcohol.
Do not use ordinary toilet paper. It is better to use wet wipes, but without alcohol.
Use cold. To eliminate edema in the anus, you can use cold warming pads, ice packages, cloth moistened in cold water.

In addition, the diet with hemorrhoids pursues two objectives: prevent constipation and irritation in the rectum. Main recommendations:

Drink enough liquid. This will help the chair to be softer, will facilitate its passage through the intestines.
Your diet should include more vegetables, fruits, cereals. They contain vegetable fiber, which helps prevent constipation.
Alcohol, coffee, strong tea should be avoided.
Limit sharp dishes, spices.
It is better to take food in small portions, 4-5 times a day.
Eat approximately at the same time.
Physical activity also helps normalize the work of intestines.

Gym

Gymnastic exercises aim to prevent constipation and strengthen anal sphincter. For example, improving the exit of the blood and the strengthening of the muscle layer of the press, can normalize the work of the intestines, which and prevent constipation:

The exercise of "scissors" is lying on the back with the legs raised, which must be diluted and crossed alternately;
"Bicycle" is a fairly famous exercise that reminds a bike ride a lot, however, lying on his back;
And you can go to bed on the floor (on the back), put together straight legs, lift one or the other leg, if possible, reaching a right angle in the hip joints. O Bend your legs on your knees and extend to the sides, while trying to start the floor basin as much as possible.

Then, a person who feels his "fifth point" is organized in any position and can lead it, so gymnastics to strengthen the anus does not require any device and can be done anywhere, and it is unlikely that those around him notice it.

So, exercises to strengthen the sphincter:

Get up, cross your legs and make rhythmic relaxations and tension of the buttocks;
Choose the toughest chair, feel a little forward (you can do it easily on the desk), try to reduce and relax the sphincter in turn, trying to push the anus to the rectum. It must take 20 minutes in the exercise, which, if desired, can always be found.

Prevention

The best tool against hemorrhoids is prevention. There are predisposing factors that lead to the development of the disease:

Irregular chair, a trend to constipation or diarrhea, the habit of strangling during defecation or for a long time to sit in the toilet with a book;
Hard physical work and, on the contrary, a movement deficiency, long -term stay in a sitting position;
pregnancy and childbirth;
Alcohol abuse

This means that lifestyle correction will help relieve the course of the disease.

It is advisable to reconsider the diet: abandoning simple carbohydrates (cakes, sweets) in favor of complex (vegetables, fruits, vegetables, grain bread), instead of tea and coffee, drinking water, will help normalize a chair.
Avoid alcohol, including beer.
With hemorrhoids, we are not desired by riding, heavy athletics, bicycle sports, but walking or swimming is simply necessary.
It is useful to strengthen the muscles of the abdominal press and the buttocks, to do gymnastics in Kegel.
Sitting in the bathroom for a long time is a bad habit. But use after visiting the toilet bidet or ascending shower to wash, on the contrary, very useful.

If despite all preventive measures of exacerbation they could not be avoided, it is not necessary to panic. It is advisable to change the position sitting at the lie, apply cold compresses to the sore place, moistened in a weak solution of potassium permanganate or organize baths with chamomile (not hot! ), Do not forget the diet and personal hygiene.