Hemorrhoids

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

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

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

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

Treatment of hemorrhoids directly depends on the severity of the course of the disease, which is why it can be both conservative and surgical.

Since the pathology has several varieties, it is coded with different meanings in the International Classification of Diseases.

Etiology

The main reason for the appearance of hemorrhoidal cones is:

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

In addition, doctors identify a huge number of unfavorable factors leading to the above processes, which is why they are generally divided into several groups: pathological and physiological.

The first category of hemorrhoid causes includes:

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

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

• lack of physical activity - this occurs against the background of a wide variety of sources - laziness, a serious illness that deprives the patient of the ability to move, as well as specific working conditions in which a person is forced to sit or stand for most working hours;
• excess body weight;
• poor diet - this includes the abuse of fatty and spicy foods, smoked meats, confectionery, carbonated drinks, semi-finished products, fast food and other harmful ingredients. It is for this reason that diet therapy is one of the components of hemorrhoid treatment;
• indiscriminate use of drugs, including laxatives or oral contraceptives;
• incorrect execution of proctological diagnostic procedures or enemas;
• unconventional sexual preferences, namely anal sex;
• prolonged influence of stressful situations;
• engage in heavy physical activity;
• engaging in certain sports, especially cycling or motorcycling, equestrian sports and other types of weight lifting;
• excessive drinking and smoking cigarettes;
• period of pregnancy or work;
• Menses.

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

Classification

By its clinical nature, the disease is:

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

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

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

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

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

Symptoms

The first signs of hemorrhoids can be so mild that a person doesn't pay attention to them. Initial clinical manifestations are considered:

• slight discomfort in the anus;
• not intense itching of the anal area;
• pain during bowel movements;
• swelling of the entrance to the anal canal.

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

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

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

Diagnostics

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

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

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

The second stage in establishing the correct diagnosis is laboratory tests, i. e. general blood tests, biochemicals and coagulogram.

The final part of the diagnosis are the instrumental examinations of the patient, which are aimed at assessing the appearance of the hemorrhoids and include:

• sigmoidoscopy;
• anoscopy;
• colonoscopy;
• contrast radiography;
• Ultrasound of the abdominal organs.

Only after studying the results of the examination, the clinician draws up tactics on how to cure hemorrhoids in a patient.

Treatment

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

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

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

• the introduction of sclerosing substances directly into the node;
• ligature with latex rings;
• infrared and electrocoagulation;
• cryodestruction;
• characterization.

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

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

How to treat hemorrhoids in pregnant women and children will be suggested by an obstetrician-gynecologist and a pediatrician.

Possible complications

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

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

Prevention and prognosis

To prevent the appearance of hemorrhoids, the following prevention rules must be observed:

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

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

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