In our culture, the body background and its functions are an issue that is not usual to discuss in a decent society.Therefore, diseases that affect these body parts cause suffering not only physical properties, but also psychological.Unfortunately, one of these diseases, hemorrhoids, is not as rare as we would like;At least 10-15% of the entire adult population of the Earth is subject to it.Most of the time, people aged 30 to 50 suffer from hemorrhoids, and men are four times more often than women.Unfortunately, far from all patients, feeling the signs of the disease that has begun, go to the doctor.False shame avoids many, prefer to self -medicate, which only worsens their position.But hemorrhoids, like other diseases, are easier to treat in the early stages.
What are hemorrhoids and the causes of their occurrence?
The final part of the digestive tract, the last segment of the colon, is called straight;Start somewhere at the level of the third sacral vertebra and ends with the anus.Its blood supply is provided by five arteries (one of them, not paired, is called hemorrhoidal), and blood exit is carried out by a wide vein of veins located in the submucose layer of the rectum.In the lower part of the rectum, or the hemorrhoidal zone, under the mucous membrane there are cavernous or cavernous bodies, perforated by the network of smaller veins.Normally, the walls of these vessels must withstand the connective tissue, but if it weakens, the blood flow increases and the exit is disturbed, then the walls of the vessels swell, the cavernous bodies are full of blood and stand out, filling the entire cavity and, sometimes, they are even shown through the anus.Hemorrhoids are the same cavernous bodies swollen by the blood and survey.Sometimes, the appearance of hemorrhoids causes mechanical causes when, under the influence of some factors, the muscle fibers of the longitudinal muscle of the rectum stretch and loosen, which causes the displacement of the hemorrhoidal nodes to the anus and their loss of it.The number of nodes in patients is very different, from one to several, which can fill the entire anal region.Its dimensions are also very different, from 5 mm to 3 cm.
Although the exact causes of the occurrence and development of hemorrhoids have not yet been revealed, the following factors are believed to contribute to it:
- A sedentary lifestyle.People are particularly subject to the appearance of hemorrhoids, for a long time to be in a sitting or standing position for a long time.When a person sits or defends a lot of time, the stagnation of the blood occurs in the pelvic organs, which can alter the exit of blood through the veins.
- Physical work.However, physical activity is not a panacea;People who work in areas where prolonged and constant physical work is required also suffer from hemorrhoids.
- Complications for defecation- Either diarrhea or chronic constipation.Both states cause an increase in pressure in the abdominal cavity, which, in turn, leads to an increase in hemorrhoidal nodes and their loss.
- Incorrect nutrition.The greatest use of alcohol, spicy food causes an arterial influx to the cavernous bodies of the rectum, which contributes to its expansion.Food, poor in fiber, cause constipation and abundance of fatty foods: diarrhea.
- Hypothermia or overheating of the pelvis area.Both conditions worsen blood circulation and contribute to the stagnation of blood in the pelvis.
- Pregnancy, childbirth.In this state, a woman increases the pressure in the abdominal area, and blood exit through the veins can be altered.As a result, hemorrhoids can be formed.
- Obesity.Especially the appearance of hemorrhoids is subject to people whose fat is deposited mainly in the abdomen.
- Some sexual practicesincluding anal sex.
- Various diseases: Liver diseases (with them, the venous exit of the blood is affected, increases the pressure in the veins, which contributes to the development of hemorrhoids);pelvic organ diseases (bladder, prostate);Neoplasias and/or inflammation in the pelvis, intestines.
- Hereditary reasons: Functional deficiency of connective tissue, deteriorated nerve regulation of venous wall tone, heart pathology and blood vessels.
Hemorrhoid symptoms
Hemorrhoids arise gradually and imperceptibly;A person does not experience a special inconvenience, unless, from time to time after defecation, he can feel discomfort, pain, itching in the anus.Soft fabrics in the anus area can swell.The mucus can be released from the rectum, irritating the anus and causing an ardor feeling.Sometimes the patient has a sensation, as if a foreign body was in the rear hole;After defecation, long -paining pains are frequent.These phenomena improve a diet or gastrointestinal tract disorders.But most people are looking for a doctor after detecting blood in the stool, in toilet paper or underwear in the form of small drops, stripes or, in rare cases, with intense bleeding.
However, the bleeding of the anus is not always associated with hemorrhoids (especially if the patient is over 40 years old).Rectal bleeding can also occur in the following diseases:
- Anal crack
- Oncological Diseases of the rectum
- The loss of rectum
- Colitis, polyps, condylomas
The patient should pay attention to whether the occurrence of bleeding is due to a change in intestinal behavior, the appearance of a stool of a different color or consistency than usual.With such symptoms, consult a doctor immediately that the bleeding can occur in another place of the gastrointestinal tract.
How hemorrhoids manifest
Hemorrhoids occurexternaleitherinternal.With external hemorrhoids, hemorrhoidal nodes are extended, they are formed from the lower venous plexus and are directly located in the anus.Since inflammation is not inside the rectum, but outside it, if you wish, you can consider this area with your own eyes.Bleeding in this form of hemorrhoids is practically absent, but patients are very concerned about pain in the rectal region.External nodes often become inflamed, injure by harsh linen and more often reborn in oncological formations.This type of relatively rare hemorrhoids: no more than 10% of the total number of patients suffering.
The internal hemorrhoidal nodes are found in the submucose layer of the rectum, it is possible to see them with the bare gaze only in the posterior stages of the disease, when the cover of the cavernous bodies is deformed so that it looks through the anus.The main symptoms of internal hemorrhoids are the presence of blood in feces (although it is often scarlet, arterial, it is also possible that dark venous blood with clots), pain during defecation.In the posterior stages of the disease, hemorrhoids fall from the anus;At first, they are drawn inside, but then patients have to do it manually.
There are also combined hemorrhoids, in which both the cavernous bodies of the rectum and the subcutaneous venous plexus of the anal region are deform.
Hemorrhoids occursharp(When their symptoms develop rapidly, nodes become inflamed, inflammation passes to neighboring tissues, the patient suffers from pain; necrotic changes in nodes due to thrombosis are also possible) andchronic.Then, the disease lasts a long time, months and even years, while the exacerbes periodically produce bleeding, the nodes fall, pinch and offer many inconveniences.During periods of remission, provided that the precautions are observed by the patient do not feel discomfort.
Stages of disease development
Most hemorrhoid cases are diagnosed in the posterior stages, either because patients did not pay attention to the symptoms, attributing them to other reasons, or due to the false shame, they hardened the trip to the doctor.There are four hemorrhoid stages.
- The first stage.The symptoms are expressed in an impressive way, they manifest only in special cases (for example, with intestinal disorders, after a strong physical work, for a long time or sitting in the place, eating disorders, overheating or hypothermia).Sometimes, the patient feels discomfort during defecation, burning and itching later.In the exam, the doctor indicates the presence of blood stagnation and stretching the walls of the blood vessels.If hemorrhoids manage to diagnose at this stage, the treatment is carried out quickly and without problems.
- The second stage.Hemorrhoids increase in size, their walls become thinner, small breaks can be formed in them, which leads to bleeding.In the patient, after a great physical effort, complicated defecation or hypothermia, traces of blood can be observed, in toilet paper or underwear, but bleeding is very small and passes quickly.Hemorrhoids are slightly enlarged and can fall from the anus after defecation, however, return to their account.Its appearance is caused by an increase in pressure in the peritoneum with severe stress, either strong physical work.At this stage, you can still resort to conservative treatment.
- The third stage.The anal sphincter undergoes distributing changes and weakens, as a result of which the fallen hemorrhoidal nodes can only be corrected by hand.The patient is concerned about severe itching, bleeding is frequent and abundant.Conservative treatment is no longer possible.
- The fourth stage.The nodes are so enlarged that it is not possible to correct them.Anal hole muscles are very weakened, the sphincter tone is reduced.For the loss of nodes, even the smallest physical activity is sufficient.The nodes themselves can take the seal form, they are inflamed;Inflammation can also affect nearby fabrics.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids are not found too often.Although, above all, with patient's hemorrhoids, the type of blood scares, it is not so highlighted that it is a danger to life.However, with constant prolonged bleeding, anemia is possible.
The mucus flow of the anus causes itching and can cause eczema.
With the additional development of the disease, when hemorrhoids have already moved to the third or fourth stage, the patient receives a great manual reduction of inconveniences of the nodes.And they can fall not only after defecation, but also with severe cough, sneezing, physical effort.
In rare cases, the fallen hemorrhoidal nodes can pinch by the anal sphincter muscle, which causes severe pain.If the nodes do not fit, thrombosis can be developed.These are the most difficult complications possible for hemorrhoids, which requires immediate medical attention.In this state, the hemorrhoidal nodes are swollen, tense, increase largely in size, and purulent infection in the patient's body is possible.Patients lose their appetite, their temperature increases, they are sick.
Any disease gets worse if it is not.It is no exception to hemorrhoids: in the absence of treatment, it progresses, which can lead to irreversible changes in the veins of the rectum.
Hemorrhoids during pregnancy and childbirth
The reason for the development of hemorrhoids in pregnant women is to tighten the veins of the cavernous bodies of the rectum of the rectum, which increased in the size of the uterus, which causes a deteriorated blood exit, blood vessels and the formation of bleeding nodes.In addition, the appearance of hemorrhoids in pregnant women can cause constipation when stool stretch the walls of the rectum and injure cavernous bodies.As a general rule, in the last months of pregnancy, a woman is forced to lead a sedentary lifestyle, which also does not contribute to the healing of the body.During childbirth, the muscles of the perineum are tense, the cavernous bodies of the rectum are stretched and injured.With the severe stretching of the perineum muscles, a weakening of the anal sphincter is possible and, as a result, the loss of nodes.
Often, those who gave birth to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately see a doctor, thus causing the development of the disease.
What doctor contact with suspicion of hemorrhoids?
If a person is concerned about unpleasant sensations in the anus area, itching, as well as traces of blood, they must consult a professional or a collapse doctor.
Disease diagnosis
In general, to diagnose hemorrhoids, there is enough visual examination of the patient's body.At the same time, the patient takes the knee elbow position or occupies a gynecological chair.The doctor examines the patient's anus, paying special attention to the condition of the skin, the presence of hemorrhoidal nodes, their value and position.
To confirm the diagnosis, the doctor can do other studies:
- Straight.The doctor examines the tissues of the anal channel, evaluates the state of the mucous membrane of the rectum, as well as the surrounding organs and tissues, determines the location of the hemorrhoidal ganglia, their value and the degree of pain, and if there is bleeding.It is true that the exact size of the nodes cannot be established: when they feel, they, as a rule, are reduced in size.In this case, the patient can lay on his side, on his back or stand on all fours, and the doctor in gloves with his index finger examines the rectum from the inside.Already after an examination of the fingers, the doctor can prescribe anoscopy and spectorcopia.
- Anoscopy.With anoscopy, a special device is introduced in the rear, which allows the doctor to examine the rectum surface for 10-15 cm.Using the Anocopio, the doctor determines where exactly the cavernous bodies are affected, if there are processes in the form of tumor and inflammatory diseases in the rectum.Anoscope is also used to take tests: biopsy and strokes.This procedure is painless and practically has no contraindications;The exception is the exacerbation stage of inflammatory diseases.Then, the doctor recommends first eliminating inflammation and only then perform an exam.
Although anoscopy is a fairly simple procedure, it requires preliminary preparation.So nothing prevents the rectum examination, the patient must refrain from eating the night before, as well as making two cleaning enemas, half a day before the procedure and the second, a couple of hours before.It is also possible that the doctor asks the patient to take a laxative on the eve.
In addition, to exclude the risk of developing oncological pathology, the doctor can offer the patient to passSector- Sigmoid and straight exam.With this exam, the doctor can examine the internal surface of the rectum even more than 25 cm.If for some reason, it is impossible to carry out a stomoroscopy (say, the patient has pathological disorders of the rectum), they are carried out instead.Colonoscopy- When the internal surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can get a clear image of the disease, at what stage it is and how it will develop.Along the way, you can identify other diseases that affect the functioning of body systems located nearby.Often, hemorrhoids are accompanied by diseases of the anal part of the body and the colon, caused by the bleeding of hemorrhoids.Sometimes there is also an irritable intestine syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides what treatment to prescribe.But with all the stages of hemorrhoids, from the first to the end, a treatment is carried out that allows you to stop the symptoms of the disease, to reduce pain, stop bleeding.If the hemorrhoids of the first or second stage, it is possible to cure it when using SO.Conservative treatment: that is, the use of medicines that relieve pain, prevent complications and also contribute to the postoperative rehabilitation of patients.The best results are given by the joint use of drugs for external and internal use.
| Cluster | Scope | Application method | |
|---|---|---|---|
| Non -steroid anti -inflammatory medications and analgesics | Eliminate the inflammatory process, reduce swelling, anesthetize | Orally | |
| Venotonizing agents | Improve blood vessels, reduce the extension of the veins, prevent thrombosis | Orally, externally | |
| Hemostatic | Stop bleeding | Orally, in the form of injections | |
| Ointments | Relieve spasm and inflammation, anesthetize | Externally | |
| Anticoagulant | Prevent hemorrhoid thrombosis | Injections | |
| Laxatives | Normalize a chair | Orally | |
| Enemas | Normalize a chair | External | |
| Candles | Stimulation of the blood supply, analgesic, anti -inflammatory | External |
If after one or two weeks there are no positive changes, a second exam must be experiencing a proctologist who will offer a different treatment.
If the hemorrhoids of the second or third stage and it is impossible to cure it only with drugs, what is calculated.Small invasive methods: unlike operators, they are less traumatic for the patient, patients spend less time in the hospital and are restored faster.This includes:
- Infrared radiation.Using an infrared coagulator, the doctor acts on the hemorrhoidal ganglia with a high temperature and caulbond the blood vessels.This operation does not require anesthesia (except in cases of high individual sensitivity of this area in the patient) and has a low trauma.Coagulation can also be carried out using laser rays.
- Sclerotherapy.The patient in the hemorrhoidal ganglia introduces a special substance that hits the walls of the vessels.In general, with sclerotherapy, a substance is introduced in no more than two nodes so that the patient does not develop pain syndrome.The next session takes place in two weeks.
- Ligration (ligation) of hemorrhoids with latex rings.This method is used more frequently to treat hemorrhoids in elderly patients who have a complicated treatment of the disease.At the same time, a small ring made of latex is applied to the base of the node, which gradually adds the node, leads to its necrosis and rejection.At the same time, bleeding does not happen, since the stump is blocked by the ring;Subsequently, a healthy connective tissue is formed instead.The procedure is almost painless, it has low trauma and the ring can be applied quickly with Anocopio.
- Cryotherapy.In this method of treatment, the hemorrhoidal node is exposed to low temperatures, after defrosting it, the resulting wound is cured over time and connective tissue is formed on the node site.The operation is carried out under local anesthesia.
All minimally invasive treatment methods are used only in the absence of hemorrhoid exacerbation.If hemorrhoids entered the acute stage, it is necessary to relieve inflammation and reduce bleeding.
Surgical hemorrhoid treatment
In the fourth stage of hemorrhoids, surgical treatment is indicated.The operation (hemorrhoidctomy) is carried out as follows: the main groups of the hemorrhoidal ganglia are subjected to split, the ligatures are applied to their land, the wound edges are sewn.Although it sounds terrifying, the operation, although quite unpleasant, is very effective and has the least number of relapses.However, after that, they are possible complications: severe pain, bleeding, scars, deforming anal channel, anus restrictions, wounds suppuration, for the -process.After the operation, it is necessary to observe the regime prescribed by the doctor, to reject the duration of physical activity and hot baths.
Hemorrhoid treatment at home
There are many popular hemorrhoid remedies, but not all are effective, and some can be harmful.It is recommended to use them only by approving the treating doctor.
The decoctions of the renal highlander, the fruits of the roses and raspberry leaves will help reduce inflammation and normalize the tone of the blood vessels.It can also rinse the area of the anus and the hemorrhoidal nodes, especially after defecation, decoctions of herbs that have an anti -inflammatory effect (calendula, must of San Juan, chamomile).They can also make warm baths at 10-15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to avoid the occurrence or exacerbation of hemorrhoids, eating correctly so that the chair is soft and there is no constipation.This continues:
- There are high fiber foods- Fruits, vegetables, grain cereals.This softens the chair and increases its volume, which helps to avoid increasing the pressure in the abdominal cavity.However, in small portions they must be introduced in their diet so that they do not cause greater gas formation.It is recommended to avoid sharp dishes, condiments and alcohol.
- Drink many liquids.It is recommended to drink six to eight glasses of water or other liquids per day (alcohol is not included here) so that the chair is softer and does not hurt the walls of the rectum.
- Add medications containing dietary fiber to your diet.Most people do not receive enough fiber per day (25 g are recommended for women, for men - 38 g).Some nutritional supplements can improve the general condition of the patient with developed hemorrhoids.But do not forget that with the introduction of additives with a high content of dietary fibers in the diet, water consumption or other liquids (no alcohol) should be increased to eight glasses per day or more.Otherwise, they can cause constipation.
- Do not stop during defecation.Excessive tension and breathing containment trying to relieve great pressure in the veins of the rectum.
- Timely visit the bathroom.If a person, for some reason, eliminates defecation, the chair can dry and it will be more difficult to eliminate it from the body.However, it should not be involved in laxatives: with constant use, they can irritate the anal region and even contribute to the development of inflammatory processes in the rectum.
- Exercise.It is recommended to exercise or participate in any other physical activity, this will improve the condition of the vascular system of the body, improve blood flow and reduce pressure on the veins.With the work sitting or standing, it is advisable to take a short break every two hours, walk, stretch, do some exercises.
- Avoid long periods of immobility.Too much sitting or standing can increase pressure on the veins in the rectal region.