Hemorrhoids: photos, symptoms and treatment. Basic methods of treating and diagnosing hemorrhoids How hemorrhoids begin to appear
![Hemorrhoids: photos, symptoms and treatment. Basic methods of treating and diagnosing hemorrhoids How hemorrhoids begin to appear](https://i1.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy4.jpg)
Haemorrhoids- this is a disease that has been known since the times of the great healers of antiquity such as Hippocrates and Avicenna. To this day, it still brings suffering to millions of people around the world. About 5% of the world's population have experienced the bitterness of this disease at least once. The prevalence in the population of developed countries ranges from 6% to 10%, and in some countries the percentage is even higher. Almost 80% are representatives of the stronger sex; women suffer less often, about 20%. The largest percentage of patients diagnosed with hemorrhoids are people of working age from 21 to 40 years.
It is believed that this diagnosis was introduced into medicine by Hippocrates himself. From the ancient Greek language, “hemorrhoids” are interpreted as bleeding. Even in those distant times, this disease was already widely known, studied and described in many medical treatises. For example: ancient Chinese healers described 24 types of hemorrhoids and used different treatment methods. Centuries passed, medicine was constantly developing and looking for new opportunities to alleviate the suffering of thousands of people. So what does modern medicine say about hemorrhoids, and what are the most effective treatment methods for sufferers today?
Anatomy of the rectum - where do hemorrhoids come from?
First, let's get acquainted with modern knowledge in the field of anatomy. In order to defeat the enemy, you need to study him well. So with a disease, in order to overcome it, you need to know everything about it.And so under the term "haemorrhoids " understand phlebeurysm in the anus, which manifests itself as periodic bleeding, inflammation and pain.
The location and functions of this section of the gastrointestinal tract determine the peculiarity of its anatomical structure. The anus is the final section of the rectum, which, together with the sigmoid and colon (ascending, transverse, descending) colon, forms the large intestine.
To understand the cause of hemorrhoids, it is necessary to take a closer look at the blood supply to this part of the intestine. This department has a number of characteristic features. The rectum is penetrated by a dense network venous plexuses.
There are internal and external plexuses, which are rather tortuous in nature, they are full-blooded and blood flows through them rather slowly. All this creates excellent conditions for their excessive expansion in certain areas, forming hemorrhoids.
Such veins have one important feature: small arteries open into them. This relationship explains the presence of scarlet blood, instead of dark blue blood (typical of the venous bed), when bleeding from hemorrhoids.
Thus, the anatomical feature of these plexuses allows a number of reasons to trigger the mechanism of occurrence of such a disease as hemorrhoids. So what are the most common reasons for the development of this pathology?
Causes of hemorrhoids?
The basis for the occurrence of hemorrhoids is vascular dysfunction, increased arterial blood flow and decreased blood flow from the venous plexuses, which in turn leads to their expansion and the formation of hemorrhoids. In fact, modern scientists have not yet reached the true reason, but this theory is considered the most reliable.There are a number of unfavorable factors that contribute to the development of the disease, we list the main ones:
- genetic predisposition
- constipation
- working for long periods of time in a standing or sitting position
- hard physical labor
- pregnancy and childbirth
- sedentary lifestyle
- various intoxications (alcohol abuse, etc.).
- errors in nutrition (lots of hot, spicy foods).
- infectious agents (causing: inflammation of hemorrhoidal veins, colitis)
Signs of hemorrhoids in women and men
![](https://i1.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy4.jpg)
Unpleasant sensations in the anus
The sensation of a foreign body and discomfort are usually precursors or occur as the first symptoms of hemorrhoids and appear at the very beginning of the disease.
Bleeding from hemorrhoids
It is the main symptom, occurs during the act of defecation or immediately after it, scarlet blood is not mixed with feces, and is usually located on top of the feces. The intensity varies from a few drops to copious streams. Prolonged and heavy bleeding can lead to the development of anemia (decreased hemoglobin and blood cells in the blood).
Pain from hemorrhoids
A symptom that occurs after the development of certain complications, such as inflammation of the hemorrhoids, their strangulation, or the development of an anal fissure. Pain accompanies the act of defecation and lasts for some time after it.
Itching with hemorrhoids
Itching is possible as a result of irritation of the skin of the perineum and the area around the anus with a high probability of developing eczema (a non-contagious inflammatory skin disease). Constant scratching can lead to infection and the development of various purulent diseases. Long-term mechanical irritation and tissue damage increase the risk of developing tumor processes.
These symptoms may appear in waves. During periods of calm, a person suffering from hemorrhoids has virtually no complaints and feels quite comfortable. But when exposed to unfavorable factors, such as alcohol, heavy physical labor, or others, the disease again manifests itself with its unpleasant symptoms. The signs of hemorrhoids in women and men are no different.
Types of hemorrhoids – internal, external, stages of hemorrhoids
According to the clinical course, the following will be distinguished: acute and chronic hemorrhoids. But essentially these are phases of the same process.Types of hemorrhoids
They also distinguish 3 types of hemorrhoids, according to the location of hemorrhoids:![](https://i2.wp.com/polismed.com/upfiles/other/artgen/1/sm_435922001349688541.jpg)
- Internal hemorrhoids, the nodes are located under the mucous membrane of the rectum, above the dentate (rectal-anal) line, at the site of the internal venous plexus.
- External hemorrhoids, the nodes are located under the skin, below the rectal-anal line.
- Combined hemorrhoids combination of external and internal hemorrhoids.
Degrees of hemorrhoids
During the development of hemorrhoids, there are a number of stages. Stages reflect the degree of complication of a given disease.There are 4 consecutive stages:
- In the first stage the nodes protrude into the intestinal lumen (but do not fall out); during defecation, blood is released from the anal canal.
- In the second stage nodes fall out during defecation and straighten on their own.
- In the third stage the nodes fall out even with slight physical exertion, they do not reset on their own, they must be reset by hand.
- In the fourth stage nodes that have fallen outside the anal canal are not reduced.
Why are hemorrhoids dangerous?
Progression of the disease without proper treatment will lead to a number of very unpleasant complications.Complications of hemorrhoids:
- Anemia(develops with a long course of the disease with heavy bleeding).
- Inflammatory processes in the surrounding tissues, up to the development of paraproctitis (inflammation of the tissue around the rectum). Paraproctitis is considered a very serious complication requiring serious treatment.
- Anal fissures. The most common cause of severe pain with hemorrhoids. Cracks create favorable conditions for the development and penetration of various infections deep into the soft tissues. This fact can lead to the development of a serious complication such as an abscess (limited purulent inflammation, which is accompanied by general malaise, fever and severe pain). This complication requires mandatory surgical intervention.
- Itching. A very unpleasant complication that acts not only as a strong negative psychological moment, undermining the psycho-emotional state of the patient. Constant mechanical irritation of the anal area can significantly aggravate the course of the disease. In addition, constant tissue damage increases the risk of developing various tumor processes.
- Anal sphincter insufficiency, incontinence of gases and feces (often in older people).
It follows from this that hemorrhoids need early diagnosis and immediate measures to be taken to solve this problem.
Diagnosis of hemorrhoids
![](https://i1.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy8.jpg)
Finger examination - a valuable diagnostic method, only after this study the proctologist prescribes and performs anoscopy and rectoscopy. This study is both indicative in nature to assess the possibility of carrying out the most complex diagnostic maneuvers, and targeted at detailing local signs of pathology.
Anoscopy- a method of instrumental examination of the rectum using an anoscope (special instrument), to a depth of 12-14 cm from the anus. The procedure is absolutely safe.
Rectoscopy(Sigmoidoscopy) is one of the leading methods of instrumental research in which the entire rectum and part of the sigmoid colon are examined, thus the rectoscope penetrates to a depth of 25-35 cm from the anus. A rectoscope is a special tube-shaped device equipped with an optical system and lighting elements. Depending on the indications and presumptive diagnosis, a flexible or rigid (rigid) rectoscope is selected. When using a flexible rectoscope, it becomes possible to examine the overlying parts of the intestine (up to the cecum). Modern rectoscopes have a high level of visualization of the surface of the mucous membrane, which makes it possible to diagnose many abnormalities at a very early stage.
Irrigoscopy- an x-ray examination method in which the large intestine is filled with a contrast agent (barium mixture) and x-rays are taken. This study has great diagnostic value, as it allows one to clarify or exclude a large number of diseases of the large intestine.
Any instrumental diagnostic methods must be supplemented with laboratory tests. For a pathology such as hemorrhoids, especially with frequent and heavy bleeding, it is necessary to conduct a general blood test to identify anemia, which is characterized by a decrease in hemoglobin and red blood cells in the blood.
Prevention of hemorrhoids
Movement![](https://i0.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy11.jpg)
Daily walks are 25-45 minutes.
Taking breaks during long-term work, especially while sitting, preferably every 45 minutes, for 10-15 minutes, get up and walk around or do a set of light physical exercises, this will not only be an excellent prevention of hemorrhoids, but will also significantly improve your ability to work.
Sports that do not require significant effort, jogging, swimming, etc.
Work and rest schedule
Lifting weights is not for you. Excessive effort leads to an increase in intravascular pressure, which is one of the main factors in the occurrence of hemorrhoids. So it's time to take the help of friends and your loved ones.
It is necessary to beware of hypothermia, as this leads to impaired circulation, and therefore to new exacerbations.
Rejection of bad habits
It is necessary to limit yourself in drinking alcohol and smoking. These factors greatly reduce protective and restorative functions, which will complicate healing and even worsen the situation. Often, alcohol consumption becomes the main factor that causes exacerbation of hemorrhoids.
Anal hygiene
An important condition in the prevention of hemorrhoids is personal hygiene. Which should be observed day after day, it is advisable to wash the anus area well after each act of defecation. It is also useful to carry out this procedure before bedtime.
Treatment of hemorrhoids: treating hemorrhoids at home
![](https://i2.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy7.jpg)
Diet and proper nutrition for hemorrhoids
In case of hemorrhoids, nutrition has some features, namely: exclusion from the diet of hot, spicy, fried, smoked foods, as well as strong alcoholic drinks, since all this contributes to the dilation of the vessels of the venous network and disruption of local blood flow. Water-salt balance is also important. Excessive fluid and salt intake leads to an increase in total blood volume. And the excess volume of circulating blood increases the pressure in the venous system, which leads to prolapse of hemorrhoids.It is very important to avoid constipation, a key factor in the occurrence of hemorrhoids. Constipation greatly increases intracavitary pressure and pressure in the hemorrhoidal plexuses, which triggers the unfortunate mechanism for the development of hemorrhoids. Therefore, it is recommended to eat foods containing fiber and coarse fibers, such as: black bread, raw vegetables and fruits, prunes, oatmeal, buckwheat and barley.
Often, one regime and diet is not enough to defeat the disease, then medicine comes to the rescue with the entire arsenal of modern medicines and treatment methods.
The clinical course of the disease (acute or chronic) is of decisive importance in the treatment of hemorrhoids.
Tablets for hemorrhoids
As systemic treatment drugs are used that strengthen the walls of blood vessels, improve blood circulation and enhance lymph outflow. This all leads to a decrease in inflammation and pain. This group of drugs includes: detralex, glivenol, rutoside, etc.Detralex - a remedy for hemorrhoids
It is considered one of the most effective drugs today in the treatment of hemorrhoids. They belong to the group of drugs that have a protective effect on blood vessels. Detralex has the following effects: reduces the distensibility of veins, thereby increasing their tone, strengthens the wall of blood vessels and reduces their fragility. With long-term use, blood circulation in the vessels improves and lymph outflow increases. Thus, the drug has a direct beneficial effect on the main link in the development of hemorrhoids. Side effects of the drug are extremely rare. Prescribed 2 tablets per day with meals. During the period of exacerbation of hemorrhoids, 6 tablets per day for 4 days, then 4 tablets per day for three days.Suppositories and ointments for hemorrhoids
For local treatment, suppositories for hemorrhoids are used, as well as ointments for hemorrhoids, such drugs are used as: suppositories (ointment) relief, ointment (suppositories) ultra-proct, ointment aurobin, etc. These drugs relieve inflammation, swelling, itching, and They also have a hemostatic effect and promote rapid restoration of damaged tissue.Relief suppositories for hemorrhoids
An excellent medicine for hemorrhoids, time-tested. The composition includes shark liver oil and phenylephrine (a substance that has the property of constricting blood vessels). The components of the drug perfectly relieve all the symptoms of hemorrhoids, eliminating inflammation, swelling, itching, pain, and improving the ability of tissue restoration. Thus, the drug significantly increases the degree of comfort with such an unpleasant disease. Side effects occur very rarely; redness and itching in the anal area may occur. Suppositories are used up to 4 times a day (in the morning, at night and after each bowel movement).For detailed information about Relief candles, read the article:
Relief
Suppositories for hemorrhoids during pregnancy
During pregnancy, any use of medications should be justified as much as possible. And the drugs of choice must be absolutely harmless to the health of the mother and child. When treating hemorrhoids in pregnant women, it is advisable to use suppositories on a natural basis, for example suppositories with sea buckthorn or propolis.Candles for hemorrhoids with sea buckthorn
Sea buckthorn oil, contained in candles, is a unique biological substance that includes a whole range of valuable biologically active components. Sea buckthorn has a pronounced anti-inflammatory effect, effectively relieves redness, swelling, and pain. In addition, it has antibacterial properties, protecting the body from possible infectious processes and eliminating those present.Sea buckthorn oil perfectly strengthens the immune system, increases the body's protective properties, and improves the body's ability to heal wounds. Whatever the harmless drug, using it during pregnancy always has some risks; in this case, you just need to consult a specialist doctor. Your health and the health of your child is in your hands.
Suppositories for hemorrhoids with propolis
Propolis is simply a gift from nature to humans. It has a huge number of healing properties. And this helps in the treatment of hemorrhoids in an excellent way. Propolis perfectly harmonizes all processes in the body. Suppositories with propolis have a local anti-inflammatory effect, relieve pain, itching, and have a resorption effect, restoring normal blood circulation. Propolis increases the body's protective properties, strengthens the immune system, and has antibacterial activity. Promotes rapid healing and self-healing of damaged tissue. Adverse reactions occur extremely rarely. If you are allergic to propolis, suppositories are contraindicated. Thus, suppositories with propolis will become a harmless and very effective assistant in the treatment of hemorrhoids.Gepatrombin G ointment
The drug is a combination of three active substances heparin, prednisolone and polydaconol. Heparin has a pronounced antithrombotic effect, thins the blood, and prevents the formation of blood clots. Thus, it improves blood circulation through the vessels, reducing congestion in hemorrhoids. Prednisolone is a hormone that has a pronounced anti-inflammatory effect and relieves swelling, itching and pain. Polidocanol has an analgesic effect and promotes the collapse of the node. Overall, this ointment is a very effective remedy, but it contains a hormonal drug, which, if used for a long time or excessively, can cause many unwanted effects. It is prescribed at the beginning, 2-4 times a day, after the disappearance of pain, 1 time a day for 7 days. It is better to discuss the use of such a drug with your doctor.Heparin ointment for hemorrhoids
A good remedy for symptoms of complicated hemorrhoids. Reduces inflammation, prevents the formation of new blood clots and promotes the resorption of old ones. Heparin contained in the ointment acts directly on the mechanisms of blood clots, blocking the production of a component necessary for the formation of a thrombotic plug, as well as reducing the activity of the cells responsible for the formation of a blood clot (platelets). The ointment significantly reduces the severity of pain. Side effects are not pronounced, redness and allergic reactions are possible. The ointment should not be applied to open wounds with purulent processes. Since this will lead to the spread of the purulent process through the bloodstream.Troxevasin ointment for hemorrhoids
This ointment has many of the necessary effects that are needed in the treatment of hemorrhoids. Increases the tone of veins, their protective properties, and has a good anti-inflammatory effect. The ointment relieves swelling, eliminating pain. Reduces destruction processes, improves restoration processes inside the walls of blood vessels. The drug is non-toxic, widely used and has a good therapeutic effect. Possible side effects include the development of an allergic reaction to the drug. The ointment is applied externally, 2 times a day, morning and evening.All of the above conservative treatment drugs have temporary effect. Since if a normal lifestyle is disrupted (errors in diet, excessive physical activity), in most cases they again lead to an exacerbation of hemorrhoids.
Hemorrhoid removal surgery
![](https://i0.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy14.jpg)
At the moment, there are a sufficient number of effective methods for treating hemorrhoids in the world. Preference is given minimally invasive methods treatments that can be performed even on an outpatient basis.
A typical hemorrhoidectomy (surgical method) is performed in only 20% of patients, the rest receive minimally invasive therapy.
Minimally invasive methods include:
- infrared photocoagulation
- sclerotherapy
- ligation with latex rings
- electrocoagulation
- disarterization of hemorrhoids.
Thus, treatment tactics will be determined stage chronic course of the disease. Total there are 4 stages.
- For first stage indicated: conservative treatment with vasoconstrictor drugs, infrared photocoagulation and sclerotherapy.
- Second stage: infrared photocoagulation, sclerotherapy, ligation with latex rings.
- Third stage: ligation with latex rings and disarterization of hemorrhoids.
- Fourth stage: surgery.
Information about each hemorrhoid removal method
Infrared photocoagulation
Using a device that emits a heat flow of energy, the doctor removes the hemorrhoid, blocking the blood flow to it.Sclerotherapy
The method is based on the use of drugs that have the ability to glue blood vessels. They are injected directly into the hemorrhoidal node, this leads to the closure of the lumen inside the node, and therefore to the elimination of the symptoms of the disease. At the first stage, the effectiveness of the method is 85%, at the second 70%.Ligation of hemorrhoids
![](https://i0.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy13.jpg)
Disarterization of hemorrhoids
Simple and affordable method , which allows you to reduce the blood flow entering the hemorrhoids, and thereby eliminate unwanted symptoms. This is achieved by ligating the arterial vessels above their entry into the hemorrhoids. This procedure is performed under ultrasound guidance, which significantly reduces the risk of error. In 80% of patients in the second and third stages, there is complete disappearance of clinical symptoms.
Surgical treatment of hemorrhoids
Surgical treatment is the most effective method of treating hemorrhoids in the third and fourth stages.Surgery to remove hemorrhoids
Surgery to remove hemorrhoids ,
proposed back in the 30s of the last century, is still used and continues to be modified. There are mainly two types of operations performed in the world:
- Closed hemorrhoidectomy. Used in stages III and IV of the disease.
- Open hemorrhoidectomy. Also in stages III and IV, but complicated by anal fissure or paraproctitis.
Patients are discharged 3-4 days after surgery, restoration of work capacity occurs on 5-7 days. There is also a small percentage of postoperative complications.
Preparing for hemorrhoid surgery
![](https://i0.wp.com/polismed.com/upfiles/other/images-art-2/gemorroi/Gemoroy12.jpg)
Direct preparation for a successful surgical operation consists of creating the most comfortable conditions for the doctor’s work and preventing postoperative complications in the patient (bandaging the lower extremities to prevent the formation of blood clots). The surgical field is prepared, for this purpose the hair from the perineum is shaved, a thorough toilet of the perineum is performed, and the intestines are cleansed. In the morning of the day of surgery, cleansing enemas must be given until the colon is completely cleansed.
Diet before hemorrhoid surgery
As before any surgical intervention, a diet must be followed before surgery to remove hemorrhoids. It consists of eating well-balanced foods rich in vitamins and minerals. Food on the eve of surgery should be easily digestible and not burden the digestive tract. It is recommended to include more carbohydrate foods (sugar, honey, jam, etc.) in your diet. Strictly exclude foods that cause bloating and flatulence (legumes, smoked meats, flour), you should also exclude hot, spicy, and very salty foods. Drinking alcoholic beverages is strictly prohibited. You should not fast before surgery, as the body needs energy reserves for normal functioning during surgery and in the postoperative period. On the day of the operation, in the morning it is even recommended to drink a cup of tea with sugar or eat a spoonful of honey.Nutrition and diet after hemorrhoid surgery
In most cases, patients after surgery for hemorrhoids can start drinking and eating within a few hours after surgery. But follow the dietary table (according to Pevzner 1a), exclude foods and dishes that stimulate the secretion of the stomach and irritate its mucous membrane. Food must be prepared in pureed form, food must be steamed or boiled in water, and must be taken in a liquid and mushy state. Exclude: hot and cold, bread and flour products, raw vegetables, fruits, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea. Eating 6 times a day in small portions. Restoration of normal bowel function usually occurs on the second day after surgery, therefore, you can return to your normal diet. But, of course, you should exclude all hot and spicy foods, and you should also forget about alcohol. By following these recommendations, you can reduce your recovery time after surgery and reduce the risk of complications.Modern medicine is currently using more and more low-traumatic operations, using the latest medical equipment, such as an ultrasonic scalpel, the Liga Sure device, etc. These techniques can reduce the intensity and duration of postoperative pain, as well as reduce the time after surgical rehabilitation.
Long-term results of surgical treatment of hemorrhoids practically do not depend on the method of its implementation; after any of the above operations, a good result is recorded in 98-99%.
From all of the above, we can conclude that hemorrhoids are a fairly serious disease and require maximum attention. To do this, a person who has encountered this problem in his life must make every possible effort to solve it. Namely, consult a specialist doctor as early as possible and not self-medicate, as well as change your lifestyle and attitude towards yourself and the world around you.
FAQ
Can I drink if I have hemorrhoids?
Alcohol and hemorrhoids are not compatible concepts. Alcohol is a very strong provoking factor for this disease. Most exacerbations and new cases of acute hemorrhoids are caused by alcohol abuse. Firstly, alcohol mercilessly hits the most important vital centers (brain, heart, liver, kidneys), thereby reducing the body's resistance and its ability to recover from various diseases. Secondly, it directly triggers the mechanisms that lead to the development of hemorrhoids. Namely, when drinking alcohol:- dilation of blood vessels in all parts of the body, including in the venous plexus of the rectum, which leads to excessive blood flow and overflow of hemorrhoidal veins.
- Normal circulation through the vessels is disrupted due to the harmful effects of alcohol on the nervous system.
- destruction and gluing of red blood cells occurs directly in the lumen of the vessels, which disrupts the normal flow of blood, promoting stagnation and the formation of blood clots.
- the protective properties of blood vessels are significantly reduced
Is it possible to drink beer if you have hemorrhoids?
Beer for hemorrhoids, like other alcoholic drinks, should not be consumed. In addition to the main unfavorable mechanisms that cause hemorrhoids, such as vasodilation and increased blood flow to the hemorrhoidal veins, beer increases blood pressure. This occurs as a result of the fact that beer is usually consumed in large quantities, and this leads to an increase in the volume of circulating blood, which leads to an increase in pressure in the vascular system. Vasodilation, increased blood flow, high vascular pressure are formidable factors that contribute to the exacerbation and occurrence of new cases of hemorrhoids.Is it possible to have sex with hemorrhoids?
Having sex with hemorrhoids should have some restrictions. Firstly, sex should be vaginal (traditional), so vaginal sex with hemorrhoids is not contraindicated. Secondly, without excessive effort, which will lead to an increase in intra-abdominal pressure. That is, use the most comfortable and convenient poses. Do not get carried away by long duration and frequency of sexual intercourse. Preferably sexual intercourse with hemorrhoids end with an orgasm, since during sex there is a significant rush of blood to the pelvic organs, and accordingly to the hemorrhoidal veins, while orgasm contributes to a faster and more effective restoration of normal blood circulation. Anal sex with hemorrhoids not recommended and in most cases contraindicated. Mechanical irritation leads to various damage to the mucous membrane and blood vessels, which provokes new exacerbations of hemorrhoids. There is also a high probability of developing unpleasant complications, such as anal fissure, proctitis, paraproctitis. But in order to protect yourself and feel calm, you must definitely consult with a medical specialist who will most correctly and competently determine the extent of what is permitted in your case.Is it possible to exercise if you have hemorrhoids?
It is important to understand that any excessive physical activity for hemorrhoids is highly undesirable. Especially that physical activity that leads to an increase in intra-abdominal pressure, and this is lifting weights, pumping the press, squatting, etc. Excessive pressure is also distributed to the area of the venous plexuses of the rectum, which contributes to their expansion and the active flow of blood to them, and this is the main mechanism development of hemorrhoids. Everything is good in moderation, sport is also necessary and even useful if it is performed according to the rules, without overwork and excessive effort.Is it possible to run with hemorrhoids?
If you have hemorrhoids, it is useful to jog for 30-40 minutes without overexerting yourself. This will improve blood circulation, eliminate congestion and strengthen blood vessels. Running has a beneficial effect on all systems of the body, it will strengthen the immune system and increase vitality, which is so necessary when treating the disease.Is it possible to swim with hemorrhoids?
You need to swim. This is a great activity for strengthening your entire body. It helps to normalize and harmonize many processes in the body, including improving the movement of blood through the vessels of the lower extremities and pelvic vessels. This will significantly relieve the veins of the hemorrhoidal plexuses, thereby eliminating the main mechanism for the development of hemorrhoids. Swimming perfectly relieves physical and mental stress, allowing all body systems to work harmoniously and effectively. Swimming is an excellent assistant in the treatment of many diseases, including hemorrhoids.Is it possible to take a bath if you have hemorrhoids?
You can take a bath with hemorrhoids, but only on condition that there is no bleeding. It is also necessary that the water be warm and never hot or cold. Herbal baths have a particularly good effect, they relieve pain and spasms, have a calming effect, bringing quick relief. Herbs used: horse chestnut, chamomile, sage, celandine, etc. It is important not to take baths for a long time, it is recommended no more than 15-20 minutes. Everything is good in moderation.Is it possible to take a steam bath and go to the sauna if you have hemorrhoids?
Baths and steam rooms are excellent for preventing hemorrhoids. But if you have a disease, visiting the bathhouse and steam room should be avoided. Fluctuations in high temperatures will lead to excessive expansion and overflow of the venous structures of the rectum, which will contribute to the swelling and prolapse of hemorrhoids. Those who love baths and take a good steam bath, those suffering from hemorrhoids should take seriously their own health. See a doctor as soon as possible and remove all obstacles that prevent you from doing what you love. With proper and conscientious treatment, you will certainly soon return to your normal lifestyle.According to medical statistics, 20% of the planet's inhabitants (mostly adult men of working age) suffer from hemorrhoids. Since not everyone sees this as a problem requiring medical attention, the number of such patients is much higher. What this disease is, how to recognize it, how dangerous it is and how to get rid of hemorrhoids is useful for everyone to know.
Hemorrhoids are varicose veins in the rectum. The disease is localized in the anorectal area (in the anus). It is based on degenerative-dystrophic changes in the venous plexuses of the mucous surface of the rectum, characterized by the formation of hemorrhoids. Over time, these protrusions enlarge, become inflamed, become injured, bleed, move towards the entrance hole and fall out.
Pinching of nodes and the formation of blood clots due to blood stagnation are also possible. All of these consequences do not just bring discomfort to the patient - they can pose a real threat to his ability to work and even life. The tendency of the corpora cavernosa to stagnate blood, which coagulates, forming inflamed nodes, can be congenital or acquired.
Causes of hemorrhoids
Doctors distinguish between vascular and mechanical prerequisites for the development of the disease. In the first case, the cause is excessive accumulation of blood due to impaired venous outflow, which provokes hypertrophy of the cavernous bodies and the formation of hemorrhoids. Vascular changes are provoked by a sedentary lifestyle, eating habits that contribute to chronic constipation, inadequate physical activity, alcohol abuse, and pregnancy.
Mechanical prerequisites arise under the influence of unfavorable conditions that provoke stretching and dystrophic disorders of the muscle tissue of the rectum. This contributes to the displacement of hemorrhoids and their advancement towards the anus until they fall out of it.
Hemorrhoids are a disease multifactorial, one of the reasons for its appearance is genetic predisposition. Other prerequisites include:
- Physical inactivity, sedentary or standing work (drivers, teachers, salespeople, hairdressers, office workers);
- Disturbances in the rhythm of defecation;
- Excessive physical activity (loaders, builders, athletes);
- Unbalanced diet with a predominance of salty, spicy, fatty, canned foods;
- Obesity, mainly of the abdominal type (fat is concentrated in the abdominal area);
- Violation of drinking regime;
- Alcohol abuse;
- Pregnancy and natural labor;
- Constant hypothermia of the pelvic organs;
- Cardiovascular failure;
- inflammation in the genitourinary system.
Based on localization features, internal, external and combined types of the disease are distinguished.
Internal is varicose veins above the rectal sphincter. For this reason, it is impossible to see the changes on your own. You can think about the presence of the disease if there is periodic painless bleeding from the rectal canal (traces can be seen on toilet paper or feces), discomfort during bowel movements, or a feeling of incomplete bowel movement.
When external, they are localized below the anal sphincter, the patient has the opportunity to see and feel them. In this case, there may be no blood, but intense pain in the anus due to the slightest carelessness is present.
The name “combined hemorrhoids” speaks for itself: the problem is present both inside, on the hemorrhoidal veins of the rectum, and outside, on the saphenous veins of the anus. This type combines the symptoms of the two previous types.
Clinical picture of the disease
If not treated in a timely manner, it quickly acquires a chronic form, characterized by alternating phases of exacerbation and remission. If the disease is left to chance, it will progress, causing irreversible changes in the venous system of the anorectal zone of the intestine.
The disease creeps up unnoticed and gradually. When the first signs appear, only a few turn to a proctologist – those who have no complexes about the “inconvenient disease”. Exacerbations in the initial stage are short-term, without pronounced symptoms. Itching, heaviness in the anus, bleeding, and pain occur during constipation, pregnancy, physical overload, alcohol abuse and spicy food, and in other critical situations. Frequent bleeding quickly leads to anemia.
People go to the doctor out of fear before bleeding (after all, the option of oncology is not excluded!), as well as during serious exacerbations, when there is no strength to endure, and the disease completely throws you out of your usual rut. In such situations, hemorrhoids are diagnosed in the later stages, when medical methods are no longer sufficient.
Without adequate therapy, serious complications can develop: thrombosis and tissue necrosis, purulent paraproctitis, oncological problems.
From 1961 to the present day, without much change, hemorrhoids have been classified into four stages:
- Hemorrhoidal thickenings are slightly hypertrophied and can protrude into the lumen of the anus. When defecating, patients can sometimes complain of traces of scarlet pure blood from burst vessels.
- The nodes have increased significantly, and during defecation they fall out of the anus, then spontaneously retract back.
- they fall out both when visiting the toilet and during physical activity, coughing, and sneezing. They can no longer be adjusted on their own; you need to help with your hands.
- The knots fall out constantly, and it is possible to set them back only for a short time. The stage is characterized by painful symptoms: strangulation, thrombosis, infection, dangerous to health and life.
Symptoms of hemorrhoids
Often the disease is asymptomatic, and this is its insidiousness, since it seriously worries already in the later stages, when conservative therapy is powerless. How to do it in time so as not to end up on the operating table?
![](https://i0.wp.com/prigemorroe.ru/wp-content/uploads/2018/06/sledy-krovi-na-tualetnoy-bumage.jpg)
Why are hemorrhoids dangerous?
Varicose veins of the rectum can be tolerated for the time being, but at the first complications you will have to regret it.
Bleeding from bursting vessels is usually insignificant, with pure scarlet blood, in rare cases - profuse, dark in color, with clots. It all depends on at what stage of the disease the symptom appears. It is expressed, as a rule, during defecation. There is no pain, the condition is normal, but with regular bleeding, anemia is possible.
The symptom appears from the second stage. Initially, this is associated with going to the toilet, then with any muscle strain or straining (laughter, coughing, sneezing). Over time, the cones can no longer be straightened without the help of hands.
Infringement of nodes. With inflammatory or reflex spasm of the anal sphincter, pinching of the cones is possible. Patients complain of acute pain and prolapse of nodes. In the absence of timely and adequate assistance, vascular thrombosis is possible.
Plexus is the most severe complication of hemorrhoids. There are not just local disturbances in blood flow, but also a deterioration in the general condition of the patient. When examining the problem area, hemorrhoidal cones look tense, swollen, and increased in size. The color is dark red, signs of tissue necrosis may be observed. The patient's general health is unsatisfactory: severe pain, dyspeptic disorders, fever, poor appetite, weakness.
Methods for diagnosing hemorrhoids
The absence of pronounced symptoms, especially at the initial stage of the disease, complicates diagnosis. The simplest and most accessible method used by proctologists is palpation. The examination is carried out after relief of acute pain. The patient is placed on his side in the fetal position. The doctor inserts a gloved index finger, lubricated with Vaseline, into the anus and feels all the bulges adjacent to the sphincter: their size, location, pain, density.
In addition to the condition of the rectal tissues, the performance of the sphincter, the relief of the mucous surface with all damage (nodules, cracks), and the likelihood of bleeding are assessed. The method allows you to determine the Hilton line dividing . The proctologist assesses the tone of the sphincter: if it is weakened, the risk of prolapse of the nodes is high. Unfortunately, this available method allows us to assess the situation only partially: the lumps are felt mainly at the entrance to the rectum.
For further examination, instrumental techniques are used:
- Anoscopy. A mirror and lighting are installed on a special device. The device allows you to view rectal canals up to 12 cm in depth.
- Sigmoidoscopy. Examination of the mucous surface with an endoscope helps to see cavernous formations at a distance of up to 30 cm. An additional device will take a biopsy sample if there is a suspicion of the presence of tumors in the rectum.
- Ultrasound examination. Ultrasound is performed using a special sensor, which allows you to assess in detail the condition of the intestines and anus.
- If necessary, they may also refer you for an x-ray examination of the pelvic organs.
Before the examination, the patient must prepare the intestines. You can clean it during bowel movements, but it doesn’t hurt to also do a cleansing enema. If the lower intestine is full, diagnosis is useless. They complete preparations for a visit to the clinic with hygiene procedures.
In addition to these methods, hemorrhoids are also tested in the laboratory: a blood test is taken to detect anemia, a cocogram is assessed that demonstrates the functionality of the intestines, a test is performed for hidden internal bleeding, and feces are examined.
Differential diagnosis must exclude an oncological factor, since malignant neoplasms can also bleed and cause a feeling of heaviness in the anus. In the first stages of the development of the disease, the clinical picture of the pathologies is identical.
If you suspect hemorrhoids, do not put off visiting a proctologist for too long: only early diagnosis will tell you how to get rid of hemorrhoids forever without complications and invasive surgeries.
Modern methods of treating hemorrhoids
Assessing the patient’s overall health condition and the examination results, the proctologist draws up a treatment regimen. In traditional medicine, two approaches to eliminating pathology are used: conservative and surgical.
Drug therapy is advisable in the early stages of disease development. Medicines are used to treat both acute and chronic stages. Surgical treatment, especially invasive operations, is used only for strict indications. For example, hemorrhoidectomy is prescribed to only 15% of all hemorrhoid sufferers. Most often this happens in the fourth stage, when large nodes fall out, dilated veins are pinched, blood clots form, and infection occurs.
Selection of treatment agents hemorrhoids are the responsibility of the attending physician. So many medications have been developed for varicose hemorrhoidal veins that it is not easy for an experienced doctor to assess their safety and effectiveness. And on the advice of friends - it’s just a crime.
At the first and second stages of the disease, complex treatment of hemorrhoids is used; drugs from the following groups are usually prescribed:
- Venotonics. The products are designed to strengthen weak veins - the main cause of hemorrhoids. Phlebodia 600, Detralex, Venarus will help increase their elasticity, improve blood flow, and relieve congestion. At the local level, Troxevasin gel is used.
- Non-hormonal anti-inflammatory drugs. To relieve symptoms and relieve inflammation, suppositories and ointments are used locally. Among medications of the NSAID class, hemorrhoids are treated with Relief, Indometacion, Levomekol, and Vishnevsky ointment. Among hormonal analogues - hydrocortisone-based drugs: Ultraproctom, Relief Ultra, Proctosedyl M. The second option is higher in effectiveness, but such medications also have more unforeseen phenomena.
- Antiseptics. Drugs of this class are prescribed for infection of the process. A bioactive natural complex (calendula, sea buckthorn, propolis), supplemented with active chemical compounds (zinc, bismuth) is designed to inhibit the spread of colonies of pathogenic microbes. At the local level, they are disinfected with suppositories based on sea buckthorn, ichthyol or Anuzol, Neo-Anuzol, Anestezol. It's not worth tolerating. Even at home, the doctor will suggest pain relief with Nise, Ibuklin, Pentalgin. Suppositories with novocaine, belladonna or Anestezol, Relief Advance, Ginkor Procto, Neo-Anuzol, Procto-Glivenol also help. External cones can be treated with Bezornil ointment.
- Wound healing medications. Suppositories with methyluracil, sea buckthorn oil, propolis and shark liver oil stimulate the regeneration processes of damaged tissues.
- Hemostatics. Medicines are intended to stop bleeding. Vikasol is prescribed in tablet form, and suppositories with adrenaline are prescribed. Advance, Relief, Relief Procto-Glivenol, and Natalsid are also suitable for narrowing the venous network and restoring damaged muscle fibers.
- Anticoagulants. If there is a threat of blood clots, the blood is thinned with heparin-based ointments and suppositories.
If there are disturbances in the rhythm of bowel movements, the doctor may also prescribe laxatives: Guttalax, Duphalac, Normaze, Portalac. They will help improve intestinal function, eliminate blood stagnation in the veins, and reduce pressure on hemorrhoids due to a crowded intestine.
In the final stages of hemorrhoids, medications can only prolong the period of remission - only operations - invasive and minimally invasive - can permanently get rid of varicose hemorrhoidal veins. Among the latter, the most popular are:
- Photocoagulation is the effect of a narrowly directed laser beam on the nodes (it accelerates the rate of protein coagulation in the veins).
- Sclerosis – placement of sclerosants in the nodes. They literally glue the vessels together, impairing the nutrition of the cavernous formations. Gradually the node dies and heals.
- Ligation – constriction of the hemorrhoidal pedicle with a latex ring.
- Cryodestruction is freezing of problem veins with liquid nitrogen.
- Long's operation - pinching the base of the node with a disposable instrument such as a stapler to worsen its blood supply.
Minimally invasive surgeries take just minutes. Due to their low morbidity, they are performed without anesthesia, on an outpatient basis. There is no serious interference in the functioning of the body, therefore the rehabilitation period is short.
If the above methods are not enough and the disease is advanced, hemorrhoidectomy is indicated. - a serious operation. It is done in a hospital hospital under general anesthesia. The surgeon uses an electric knife as a scalpel. It not only cuts the tissue accurately, but also cauterizes the wound, preventing bleeding. After disinfection of the mucous membrane, a rectal speculum is inserted into the anus. A clamp is used to remove the knot from the intestine, and its base is sutured with catgut thread. The lump is excised and the stem is firmly tightened. The edges are stitched, the wound is disinfected and turunda soaked in ointment is inserted into the intestine for 6 hours.
After excision of the nodes, the wound is sutured or left open: sometimes it heals faster without unnecessary stitches. The operation is traumatic, since many tissues are affected, so the patient is observed in the hospital for several days, and in general the recovery period will be long - up to six months or more.
In addition to classical hemorrhoidectomy, the “gold standard,” a modified version is also used, which requires a highly qualified surgeon. During Long's operation, part of the rectum is removed (it is located above the dentate line). In this case, the node is not excised, but is pulled up due to excision of part of the mucosa. The edges of the wound are secured with titanium staples.
In the altered nodes, nutrition deteriorates, they dry out, and are replaced by connective tissue. The operation takes on average 20 minutes, and the patient stays in the hospital for up to three days. The procedure is less painful than the classic version, and therefore the recovery period takes an average of a week. There are no wounds, no stitches, the anatomy of the anal canal is preserved, and therefore the risk of complications is lower.
Possibilities of traditional medicine
The benefits of herbal infusions and other traditional medicine recommended for the treatment of hemorrhoids are also recognized by proctologists. But you can use compresses, baths, tampons, suppositories and ointments only after consultation with your doctor, since their task is auxiliary. In combination with medications, they will help consolidate the effect of treatment or alleviate the patient’s condition during the recovery period after surgery. Medicinal herbs also have contraindications; you should check their compatibility with medications and conduct allergy tests.
Oak bark, calendula and chamomile flowers, onion peels, wild strawberry leaves, sage and St. John's wort herbs will help relieve the symptoms of hemorrhoids. Medicinal infusions and decoctions of these and other components are used for irrigation in microenemas, for compresses and baths, and for making homemade ointments and suppositories. It is useful to take tea made from rose hips and raspberry leaves orally, and drink diluted beet juice for hemorrhoids.
The rectal mucosa can be irrigated with diluted liquid honey and potato juice. Rectal suppositories are made from these ingredients, as well as aloe leaves. Herbal decoctions and other liquid ingredients should be frozen in paper molds made in the shape of a cone. Candles are cut from potatoes. To facilitate insertion, they can be lubricated with Vaseline, or even better, with sea buckthorn oil, which provides an additional therapeutic effect. The suppositories are administered lying on your side, with your legs bent. It is advisable to remain in this position for another half hour. So that the medicine is completely absorbed.
You can make a homemade salve using olive oil and beeswax. The outer lumps are lubricated by hand; for the inner lumps, you need to purchase a special tip at the pharmacy. Before the procedure, you need to cleanse the intestines and wash your hands and the problem area with soap.
Itching in the anus that occurs after the release of exudate from inflammation can be soothed with lotions with crushed fresh rowan berries, a decoction of knotweed, or simply compresses with cold water.
Therapeutic nutrition for hemorrhoids
Diet for hemorrhoids is the foundation without which the success of any type of treatment is impossible. It is based on fractional (5-6 times a day) meals with foods that do not irritate the intestinal mucosa, do not disrupt the rhythm of bowel movements, and do not increase gas formation. To avoid constipation, it is also important to control your drinking regime - up to 2.5 liters of clean water per day. A doctor will help you adjust your norm.
Methods of heat treatment of products should be gentle. Both raw coarse fibers, such as radish or cabbage salad, and spicy fried or smoked foods that irritate the inflamed intestines are unhealthy. Boiled, stewed or baked vegetables, pureed semi-liquid soups, viscous porridges, casseroles, as well as fermented milk products (except cottage cheese) should form the basis of the diet. Fresh vegetables and fruits and cereals will help maintain the level of fiber, which improves intestinal motility. Eggs, lean boiled meat and steamed fish are healthy.
On the banned list products - white bread, strong tea and coffee, chocolate and all legumes, hot spices, radishes, radishes, white cabbage, rice, jelly, potatoes. The consumption of alcoholic beverages, including beer, is completely excluded.
Food should help the medications, create an environment in the intestines that is favorable for the mucous membrane, enhancing the effect of the medications.
Prevention measures
How to prevent the progression of hemorrhoids or at least prolong the period of remission in its chronic form? An ounce of prevention is worth a pound of cure, ancient healers said. And therefore the best medicine in this case is prevention. Judging by the reviews on thematic forums, many are interested in the question: is it possible to die from hemorrhoids? To avoid the operating table and serious complications, analyze your eating behavior and lifestyle:
- Do you always control timely bowel movements? After all, its contents create additional pressure on the veins, injure the mucous membrane, and when defecation is delayed, some of the toxins are again absorbed into the blood, poisoning the body.
- Do you know your water allowance? If not, discuss your drinking regimen with your doctor. Lack of fluid provokes a tendency to constipation, which increases the load on the rectum.
- Are there enough vegetables and fruits and fermented milk products in your diet? Do you abuse alcohol, fatty, salty and spicy foods? Improper nutrition nullifies all the efforts of doctors and creates the preconditions for a new exacerbation.
- Do you control your muscle loads, do you not lift excessive weights (whether at work or in the gym)? Heavy physical work is one of the risk factors for hemorrhoids.
- Do you follow a sleep, rest, and physical activity schedule? When working sedentary or standing, you need to take breaks for gymnastics. Swimming and walking in the fresh air at a calm pace are beneficial.
- Are you watching your weight? Obesity is another reason for the development of hemorrhoids.
- Do you follow the rules of personal hygiene? After each visit to the toilet, you should wash the perineum with soap, first with warm water, and then with cold water, to contract the muscles and blood vessels.
Obviously, lifestyle modification is the first step to eliminating hemorrhoidal varicose veins.
The most common problem people come to a proctologist with is hemorrhoids. And all patients are concerned about how to quickly cure hemorrhoids and preferably forever. Go through a full examination, take courses of venotonics a couple of times a year for preventive purposes, change your eating habits and lifestyle - this will increase your chances of a full recovery.
Hemorrhoids (hemorrhoidal disease) characterized by enlargement of hemorrhoidal veins followed by inflammation and prolapse. All anatomical and physiological components of the anal zone take part in the pathological process. With hemorrhoids, microcirculation is disrupted, which entails dystrophic disorders of all structures of the anal canal.
Symptoms of hemorrhoids include anemia resulting from systematic bleeding, as well as asthenic-depressive syndrome, which is characteristic of most patients with hemorrhoids.
How are hemorrhoids formed?
Anal venous dilations in the submucosal hemorrhoidal plexuses, which are called ampullae of Duret, are a normal phenomenon. There is a concept of “physiological hemorrhoids”, which implies the important role of such formations in sealing the anus, due to which gases and loose stools are retained. Sometimes these hemorrhoidal formations increase in volume, but do not manifest themselves symptomatically. In proctology, the term “hemorrhoids” refers to the enlargement of such nodes with periodic bleeding, their prolapse and systematic inflammation. Hemorrhoids are a fairly common disease of the rectum. Out of 1000 people, 118-120 suffer from its presence.
Internal and external hemorrhoidal plexuses
Cavernous cavities filled with blood, the diameter of which ranges from 2-15 mm, are internal hemorrhoidal plexuses. Their location is the submucosal layer of the intestinal wall. External hemorrhoids are a collection of small saphenous veins that provide blood flow from the external anal zone.
Etiology of hemorrhoids
Hemorrhoids occur as a result of a sedentary lifestyle, alcohol abuse, and poor diet. Under such conditions, the nodes increase in size and begin to move towards the exit. At the same time, the processes of dystrophy in the ligamentous-muscular system increase and they begin to fall out of the anus.
Pathogenesis of hemorrhoids
The determining factors for hemorrhoids are hemodynamics and dystrophy. Dysfunction of blood vessels leads to their overflow. And dystrophic processes in the common longitudinal muscle lead to a gradual and irreversible displacement of hemorrhoids in the distal direction.
Classification of hemorrhoids
Acute hemorrhoids
- Stage I – thrombosis of internal and external nodes without inflammation.
- Stage II – inflammatory process in the nodes.
- Stage III – thrombosis and inflammation of the nodes is complemented by necrosis and the transition of the inflammatory process to the subcutaneous tissue and perianal skin.
Chronic hemorrhoids
This form of hemorrhoids is characterized by the presence of 4 stages:
- Stage I – discharge of scarlet blood during bowel movements without prolapse of nodes.
- Stage II – prolapse of nodes and their independent reduction (without or with bleeding).
- Stage III – periodic prolapse of hemorrhoids, in which they can be set manually (without or with bleeding).
- Stage IV – constant loss of nodes along with the mucous membrane. It is impossible to straighten them even with your hands (without or with bleeding).
This classification is generally accepted, but it is not exhaustive, since it is based on one symptom - prolapse of hemorrhoids from the anal canal. The clinical classification of hemorrhoids takes into account the main symptom from their complex:
- bleeding hemorrhoids;
- its loss;
- painful form;
- weeping hemorrhoids.
The prevailing symptom indicates the localization of the pathological process.
Complications of hemorrhoids
One of the main symptoms of the disease is bleeding. If it lasts more than 40 minutes, then we should talk about a complication. This situation is fraught with the development of anemia with a drop in hemoglobin levels to 40-50 g/m. Inflammation in the surrounding tissue after thrombosis is also a complication.
Neurotic disorders
At the first contact between the proctologist and the patient, it is important to take into account that in patients with a labile nervous system, irrational and inadequate treatment of hemorrhoids over a long period often leads to depressive neurotic disorders, which are not always related to psychiatry.
Diagnosis and differential diagnosis of hemorrhoids
To recognize hemorrhoids, a first outpatient examination of the patient and a survey is sufficient. During the inspection, pay attention to the following signs:
- condition of the skin of the paranal area;
- degree of node prolapse;
- the possibility of their independent reduction;
- degree and intensity of bleeding.
Hemorrhoids look like protrusions in the intestinal lumen, which are covered with mucous membrane and have a dark cherry color. Palpation allows you to determine the presence of seals, anal papillae and polyps, as well as assess the functional state of the obturator apparatus. Determine the presence of Valsalva's symptom: prolapse of nodes when straining.
- Sigmoidoscopy is a mandatory examination for hemorrhoids, allowing to exclude malignant tumors. If there are blood impurities, irrigoscopy or fibrocolonoscopy is prescribed.
Treatment of hemorrhoids
For hemorrhoid treatment three different approaches are used.
We all know what varicose veins are. Such vascular pathology is difficult to hide, it clearly catches the eye, but hemorrhoids can be seen. To put it simply, this is the same dilation of the veins, only localized in the area of the anus and lower part of the rectum hidden from public view.
Enlarged hemorrhoids with internal and external hemorrhoids With hemorrhoids, the so-called hemorrhoids expand. A hemorrhoidal node is an anastomosis: a direct connection of fairly large vessels, but not through a network of capillaries, but directly. The basis of hemorrhoids is cavernous formations, arranged in the form of 3-4 pillows. There are internal hemorrhoids, localized under the mucous membrane of the anus, and external, located subcutaneously. When you strain, excess pressure forms in the abdominal cavity, and the blood, accordingly, has to go somewhere. It flows into these anastomoses, that is, hemorrhoids.
Statistics on the incidence of hemorrhoids in different sources vary from 44 to 86%. The last figure seems rather inflated, but this is only at first glance: how many people do you think will want to advertise their, let’s say, delicate illness? By the way, it’s completely in vain. Hemorrhoids are an absolutely “normal” disease, so to speak, and certainly not a reason for false modesty.
Reasons for the development of hemorrhoids
There are two main causes of hemorrhoids: vascular, when dysfunction develops between the inflow and outflow of blood from the cavernous bodies, and mechanical. In the second case, under the influence of unfavorable factors, the longitudinal muscle of the submucosal layer of the rectum, which holds the hemorrhoids in place, is stretched, and they begin, in the literal sense of the word, to “fall out” out. What factors influence the development of hemorrhoids?
- constipation and its treatment (abuse of enemas, laxatives);
- taking oral contraceptives;
- Surprisingly, excessive hygiene of the anus also contributes to hemorrhoids (the reason is irritation of the anal mucosa);
- improper diet (tea, coffee, alcohol, fiber deficiency);
- anal sex;
- sports (riding a motorcycle, cycling, lifting weights);
- occupation that requires prolonged sitting (risk groups – drivers, pilots, programmers).
![](https://i1.wp.com/webmedinfo.ru/wp-content/uploads/2012/09/gemorroidalnaya-shishka.jpg)
I will allow myself a small lyrical digression within the framework of this chapter. Another reason for the development of hemorrhoids is the presence in the toilet of a tablet, smartphone or various types of printed materials: books, magazines, newspapers, necessary for some in order to “brighten up” a long vigil in the toilet and combine business with pleasure. So: there is nothing useful here. The fact is that prolonged sitting on the toilet waiting for the “second wave” of bowel movements, straining the abdominal muscles with a relaxed sphincter and an empty rectum (since after the first bowel movement, feces have not yet arrived there from the large intestine) leads to a large influx blood to hemorrhoids. Now I have described the so-called two-stage bowel movement, which, according to statistics, up to 90% of people suffering from hemorrhoids are prone to. There is a very wise saying, which, if somewhat literary for publication, sounds like this: “If you don’t want to perform an act of defecation at the moment, don’t torture your anus.” This, by the way, is a most valuable means of preventing hemorrhoids (meaning reducing the time spent on the toilet, excuse me for such physiological details).
Symptoms of hemorrhoids
Clinically, the disease is silent and unnoticeable at first. The first symptom of hemorrhoids is discomfort in the anus, expressed in the sensation of a foreign body in it. This symptom is incoming, usually appearing with intestinal disorders (constipation or diarrhea), diet disorders, and alcohol abuse. The main symptom of hemorrhoids is scarlet bloody discharge after defecation (they can be seen, for example, on toilet paper or in the feces themselves). Other symptoms of hemorrhoids:
- prolapse of hemorrhoids. In the initial stage, they correct themselves, then they require “manual” intervention;
- constant pain (especially during bowel movements), itching in the anus.
As with any disease, hemorrhoids are characterized by acute and chronic variants, with the latter being more typical. During chronic hemorrhoids, there are 4 stages, each of which has its own distinctive features, associated mainly with the condition of the hemorrhoids. At the first stage, hemorrhoids do not fall out, only bloody discharge from the anus is noted. At the second and third stages, the nodes already begin to fall out during defecation, and if at the second stage they are set independently, then at the third this manipulation has to be done manually. At the fourth stage, prolapse of nodes is already observed during sneezing, coughing, and physical exertion. It becomes almost impossible to straighten them.
![](https://i0.wp.com/webmedinfo.ru/wp-content/uploads/2012/09/stadii-gemorroya.jpg)
Hemorrhoids in women
Hemorrhoids are not aware of gender prejudice: although for some reason it is considered a male disease, it is by no means alien to victims among the fair half of humanity. I deliberately omitted pregnancy and childbirth from listing the causes of hemorrhoids in order to talk about this separately. In the second half of pregnancy, the uterus increases significantly in size and begins to put pressure on the rectum, which makes it difficult to empty the intestines, which in turn leads to constipation - one of the reasons for the development of hemorrhoids.In addition to the rectum, blood vessels are also compressed, which means that the outflow of blood from the pelvic organs is hampered, which also provokes hemorrhoids during pregnancy. Severe straining during childbirth also leads to hemorrhoids. There is one more circumstance favorable to hemorrhoids, characteristic only of the female sex: menstruation, during which there is a rush of blood, including to the hemorrhoids, which leads to an exacerbation of hemorrhoids.
Diagnosis of hemorrhoids
It's not particularly difficult. The main thing is sleight of hand, because... hemorrhoids are diagnosed by rectal examination and palpation (feeling). At the same time, compaction of the hemorrhoidal nodes, weakening of the sphincter tone are clearly visible, and when straining, prolapse of the nodes is noted.
How to treat hemorrhoids?
The first thing you should do is contact a doctor who treats hemorrhoids - a proctologist. But, if you want to get a free appointment with a proctologist, you will initially need to visit a surgeon who will listen to your complaints and then issue a referral to the desired proctologist. Below are the dates for recommendations for the prevention and treatment of hemorrhoids, you can use them while you wait for your appointment with a doctor.
At the initial stages of the disease, doctors recommend conservative treatment, i.e. treatment of hemorrhoids at home. Diet is very important in the prevention and treatment of hemorrhoids. Even so: extremely important. Of course, everyone has individual dietary habits, but there are certain groups of foods that cause irritation of the colon and rectum in the vast majority of people. These are onions, garlic, marinades, canned food, mustard, smoking and, of course, alcohol. The diet should be rich in lactic acid products, vegetables, brown bread, fibrous and fiber-rich foods (read: foods that prevent constipation). Eat cauliflower, honey, fish, rice more often and don’t forget to drink more!
Try to walk more and do special exercises - this helps prevent blood stagnation in the pelvis and helps strengthen the muscles of the anal sphincter of the rectum.
After defecation, you must wash yourself with ice water for several minutes, and it is best to do a contrast shower, i.e. direct a stream of cold water to the anus, apply it to the maximum, then take a five-minute break and repeat the procedure. This is useful not only in treatment, but also in the prevention of pathology.
![](https://i0.wp.com/webmedinfo.ru/wp-content/uploads/2012/09/Gepatrombin-g.jpg)
Treating hemorrhoids at home is not complete without the use of medications taken orally, i.e. tablets. To increase the tone of the walls of blood vessels, reduce their distensibility and venous stagnation, proctologists recommend taking Detralex or, due to the high cost of the French drug, its Russian analogue Venarus.
If all of the above does not have the desired effect, then the next stage of treatment is hospitalization of the patient followed by surgery, primarily hemorrhoidectomy, i.e. excision of hemorrhoids, both external and internal, with restoration of the anal mucosa. Recovery after such an operation takes 3 to 4 weeks.
There are also a number of minimally invasive methods for treating hemorrhoids, which are successfully used in combination with surgical treatment. This is sclerotherapy (introduction of special drugs into the hemorrhoidal node that promote the formation of connective tissue in it), infrared photocoagulation (sclerosation of the hemorrhoidal node under the influence of an infrared probe), ligation (ligation) of the hemorrhoidal node using a latex ring, which leads to its death.
Prevention of hemorrhoids
In principle, everything about prevention has already been said above. This includes the fight against digestive disorders, dietary restrictions, controlled physical activity (needed to prevent stagnation of blood in the pelvis, but excessive stress that contributes to straining is contraindicated), proper anal hygiene.
Hemorrhoids are one of the common diseases affecting not only middle-aged and older people, but also young people. Hemorrhoids often appear during pregnancy and after childbirth. Its occurrence is associated with pathological changes in hemorrhoidal veins, which form nodes around the rectum. Symptoms usually include a feeling of heaviness in the anus, itching and burning.
Causes and factors for the development of hemorrhoids
The main reason for the development of hemorrhoids is impaired blood circulation in the hemorrhoidal venous plexuses, which in turn triggers a malnutrition of the muscular system, ligaments and fascia that secure the hemorrhoidal veins inside the anus.
Occupational factors contributing to the appearance and development of the disease include occupations associated with a predominant sitting position (drivers, administrative workers, etc.).
Among other things, even certain types of sports, such as powerlifting, cycling, and rowing, can lead to circulatory problems in the pelvic floor. Pregnancy and childbirth in women also often contribute to the appearance of hemorrhoids.
Despite the fact that the exact causes of hemorrhoids have not been clarified, there are factors that are a trigger in the development of the pathology:
- Physical inactivity, lifestyle with low mobility. People who have to spend most of their time at work sitting or even standing are faced with the occurrence of blood stagnation in the pelvic floor organs.
- Constant heavy physical activity. People who experience excessive muscle tension in their daily work are more likely than others to suffer from hemorrhoids.
- Frequent exacerbations of conditions associated with impaired excretion of feces. This can be either excessive fluid or constipation. All this leads to increased pressure in the pelvic organs and, as a result, contributes to the appearance, enlargement and even prolapse of hemorrhoids.
- Diet disorder. Excessive love for spicy foods and strong drinks directly contributes to an increase in arterial flow to the pelvic organs, which in turn leads to an increase in their size. This leads to increased pressure on the hemorrhoidal veins. The predominance of fried foods leads to diarrhea, and a diet low in fiber contributes to the development of constipation.
- Excessive exposure to cold and heat in the pelvic area can also impair blood circulation and provoke stagnation of blood in the pelvis.
- In women, pregnancy and childbirth cause increased pressure in the pelvic area, which can interfere with the flow and flow of blood, increasing the risk of hemorrhoids.
- Excessive fullness. People with fat deposits in the abdominal area are especially prone to developing hemorrhoids.
- Anal sex without lubrication and foreplay also contributes to the development of the disease.
- Psychosomatic reasons. People who are constantly exposed to stress often suffer from hemorrhoids.
Many diseases can also lead to impaired blood circulation in the pelvic area. These include:
- diseases of the liver, genitourinary system;
- oncological formations;
- inflammatory processes in the gastrointestinal tract and pelvic organs.
Please note that hereditary factors play an important role, such as cardiovascular pathologies, parasympathetic disorders, functional deficiency of muscle and connective tissue.
Symptoms of hemorrhoids
The disease progresses gradually and unnoticed. Defecation is often accompanied by pain, and mucus and blood discharge are present in the stool. Also added to these manifestations are burning, itching, inflammation and swelling of the soft tissues of the anus. When moving, and in advanced stages, and in a calm state, an unpleasant sensation of a foreign body appears in the rectum. There may be severe or painful sensations in the lower abdomen.
There are several stages in the development of hemorrhoids:
Stage | Characteristic |
I | Characterized by enlargement of hemorrhoids. The clinical picture is complemented by itching and spotting during bowel movements. Manifestations at this stage are not permanent and may periodically appear and disappear. |
II | The symptoms are of the same nature as in the first stage, but they are accompanied by prolapse of hemorrhoids and moderate bleeding from the anus. |
III | Prolapse of nodes with minor tension in the muscles of the abdominal wall. The cause of increased intra-abdominal pressure can be both coughing and wearing a tight belt. At this stage, the loss of nodes can only be corrected mechanically. Bloody discharge becomes even more abundant, heaviness appears in the area of the anus, and the soft tissues of the anus swell. |
IV | Regular prolapse of hemorrhoids, which practically cannot be returned to their normal state without surgical intervention. Frequent bleeding, severe pain, inflammation of the tissues around the anus are characteristic of the fourth stage. |
At the stage of acute hemorrhoids, a worsening process occurs that previously occurred chronically. The disease is complicated by thrombosis, which is why surgical or combined treatment is recommended for patients. Treatment without the intervention of a specialist at this stage can have a very detrimental effect on the patient’s health.
Please note that due to constant bleeding there is a risk of developing anemia.
Diagnosis of hemorrhoids
Quite often, when diagnosing hemorrhoids, proctologists find concomitant diseases of the intestines or pelvic organs. These conditions contribute to the development of hemorrhoids.
When visiting a specialist with a complaint of hemorrhoids, a face-to-face examination and digital rectal examination of the rectum are performed. By examining the anal area, the doctor determines whether there are prolapsed hemorrhoids and assesses the condition of the skin around the anus.
Digital examination is necessary for diagnosing diseases of the rectum, pelvis and abdominal organs. To conduct such an examination, the patient must stand on all fours or lie on his side. This analysis helps the proctologist clarify the location of the nodes, their number, and also assess elasticity and pain. In addition, this method can also reveal the presence of an anal fissure.
There are also examinations that are performed using special devices. They allow for a more complete examination and examination of the rectum.
It is important to cleanse your intestines before visiting a doctor. You can use an enema for this.
Anoscopy
An anoscope is used for anoscopy. With its help it is possible to examine the outermost 5 cm of the anal canal.
Rectomanoscopy
To perform rectomanoscopy, the doctor inserts a special device in the form of a tube into the rectum. The tube pumps air into the rectum, thereby straightening the walls of the canal. In this way you can see the true picture of the disease from the inside.
With the help of anoscopy, it is possible to see not only the anal area, but also the lower part of the rectum. While with the help of sigmoidoscopy it is possible to examine the entire rectum.
Please note that these procedures are not performed at the stage of acute hemorrhoids. The use of instruments is possible only in remission.
Treatment of hemorrhoids
Highly qualified specialists allow the use of only modern methods of treating the disease.
There are two fundamentally different types of treatment - conservative, that is, medication, and surgical. Therapy begins from simple to complex, that is, from conservative to surgical. More often, for a complete recovery, you have to resort to surgery. Methods such as photocoagulation, latex and suture ligation, mucosal resection using the Longo method, hemorrhoidectomy, sclerotherapy are the main ones.
Before starting to prescribe medications, the doctor must find out the true cause of the disease. If the reason for the development of hemorrhoids is sedentary work, then the proctologist will prescribe exercise therapy classes, advise you to get up every hour and do a short warm-up while working. A smart watch can help the patient with this, as it will remind him of this.
One of the common causes of hemorrhoids is poor diet. As soon as the patient begins to adhere to a diet and adjusts his diet, the disease will noticeably recede, and if he takes medications, it will go away altogether.
The main effects that a drug against hemorrhoids should have are:
- anesthetic;
- anti-inflammatory;
- thrombolytic.
The main medications that a doctor will definitely prescribe include:
- heparin;
- prednisolone;
- polidocanol;
- hepatrombin G.
If conservative treatment does not produce results, and the disease continues to progress, it is necessary to move on to the previously mentioned surgical treatment methods.
Photocoagulation
First of all, this is the effect on hemorrhoids using focused infrared radiation. If complex treatment was carried out at stages 3 and 4, then this method will help stop bleeding at all stages of the disease.
Advantages: high efficiency, speed of implementation, painless procedure, short rehabilitation.
Sclerotherapy
Characterized by the introduction of a special drug – sclerosant. This substance narrows the lumen of the veins, gluing their walls. Then the bleeding stops, but it is worth remembering that this method is effective only in the first three stages. At the fourth stage, it is necessary to choose a different treatment tactic.
Please note that in acute hemorrhoids, sclerotherapy is contraindicated.
Latex ligation
During the intervention, the surgeon compresses the base of the node with special latex rings. The result can be obtained within two weeks. The node dies completely, as the processes of delivery of nutrients to it are disrupted. The patient does not require hospitalization or anesthesia, and rehabilitation is quick and painless.
Resection of the mucosa using the Longo method
Like the previous method, it is used mainly in the third stage of hemorrhoids. The surgeon resects part of the intestine mainly above the hemorrhoid. As a result, a defect forms in the wall of the rectum, which is sutured. Blood loss and complications with this intervention are minimal.
Hemoroidectomy
This type of surgery is the gold standard of treatment. It is very similar to the previous method, but it is more invasive and has a number of contraindications and complications. After removing the node, a wound is also formed, which is sutured. The rehabilitation period is longer than with other methods, but it can be used at the fourth stage of hemorrhoids.