Hemorrhoids

7 May 2025

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

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

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

What are the causes of hemorrhoids?

It is generally accepted that hemorrhoids develop due to an increase in blood flow or its insufficient outflow, which leads to stagnant processes. The causes and factors of the development of hemorrhoids are:

Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which must be said in the first place. And although hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. The legacy of some groups of genes leads to congenital weakness or vascular dysfunction located in the rectum. This is the cause of an improved flow and an insufficient outflow of blood through the cavernous veins, which leads to the pathological expansion of the latter. A long -term expansion of the cavernous veins leads to a thinning of the walls of the blood vessels, which contributes to the occurrence of bleeding with hemorrhoids.
Long -date work and weight lifting. In addition to a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First of all, this applies to people who are forced to stay in a long position for a long time. This category includes teachers, teachers, Swiss, guards, hairdressers and others. Height lifting is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, mainly relating to employees, drivers and people, leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is greater pressure on the rectum ships in a sitting position. With a prolonged seat, the anus area is slightly heated, which leads to stagnant phenomena and vascular expansion. In addition, the lack of physical effort is a real way to the development of venous insufficiency. Including this applies to the veins located in the rectum.
Chronic and diarrhea constipation. People suffering from chronic constipation are predisposed to the development of hemorrhoids. Why is it happening? The fact is that with constipation, the feces harden, exerting the pressure on the veins in the lower intestine. This leads to a deterioration of the caveman's blood supply and the appearance of hemorrhoids. A further factor in constipation is the habit of pushing heavily during defecation, which creates further pressure on the vessels in the rectum.

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

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

The main factors that contribute to the development of hemorrhoids:

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

Internal and outside

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

With external hemorrhoids, the nodes are formed in the immediate vicinity of the anus, in relation to this, their sensitive surface often breaks and bright scarlet blood is verified. The pain in external hemorrhoids is quite acute and strong, but in terms of independent diagnosis, this species represents no difficulty.

The internal type of hemorrhoids, although it involves a much more serious threat to health, often stands out for the complete lack of pain (especially in the initial phase of the disease). This fact is explained by the fact that the hemorrhoidal nodes are found deep and their surface is the same insolurative mucosa as the rectum, which makes it skip.

Grade

It usually distinguishes 3 degrees of internal hemorrhoids:

1st degree. The hemorrhoids are found in the anal channel, they may not be heard (even with a rectal study). Complaints of inflammation of the anus and bleeding, "contraction" pain after defecation.
2nd degree. The knots protrude from the anus when they strive and disappear independently. In principle, the same ailments are observed here as with the hemorrhoids of the 1st degree, however, the small breaks of the mucosa are more often and the inflammation of the anus is stronger.
3rd degree. It is characterized by the loss so called of hemorrhoidal nodes, which do not recover independently. The symptoms can be the same as 2-, but often the phenomena of fecal and gas develop more. When examined by the hemorrhoids, it stands out from the fall of the anus along the radiant grooves, cyanotic coloring and a tuberous surface.

Symptoms of hemorrhoids

The signs of the hemorrhoids characteristics of all the phases of the development of the disease:

discomfort in the anus;
pain during defecation (initially insignificant, then strong);
bleeding from the anus;
Training and growth of hemorrhoids.

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

For the initial phaseDiseases are characterized by a slight increase in the veins in the anus. Usually such a sign remains unnoticed. In this case, the patient can be disturbed by a bloody discharge from the rectum that occur immediately after defecation. Blood can be easily seen on toilet paper. It is worth remembering that a similar symptom is characteristic of malignant intestinal tumors, so when it occurs, it is necessary to consult a proccologist. The timely research of a doctor and the appointment of therapy will easily slow down the development of hemorrhoids.

In the second phaseThe development of the patient's disease can periodically experience discomfort in the anus, itching. He often has the feeling of a foreign body in the anus. The hemorrhoids begin to fall during defecation and are still easily regulated inwards.

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

For the last phaseDiseases are characterized by an increase in the dimensions of hemorrhoids. They cannot be straightened with one hand. The presence of advanced veins in the anus causes serious discomfort, it hurts the patient, they go to the bathroom. He is worried about abundant bleeding during any defecation. The fourth phase of the development of hemorrhoids can be complicated by such unpleasant and dangerous phenomena as the trumpet of the veins at the end of the rectum.

Hemorrhoids in pregnant women

Very often hemorrhoids appear during the last trimester of pregnancy and childbirth. The causes of hemorrhoids are a pierce the increase in the uterus of the intestinal veins, which leads to a deterioration of the blood flow from the intestine and perineum. Vienna increases in diameter and changes the shape. Periodic constipation in pregnant women can also cause its appearance.

However, in most women, the symptoms of hemorrhoids pass the postpartum period, so it is believed that the causes may be hormonal changes. It must be treated immediately after detecting the first of its symptoms. It is important to face constipation, for example, take drugs to relieve the feces (Forlax, Laminaride, Metil -Velosis), observe the hygiene rules (wash the anus after defecation). The hemorrhoids (aurobine, relief, etc. ) are mainly used externally in the form of ointments and candles. The surgery is carried out only in serious cases.

The prevention of hemorrhoids should be carried out by the first days of pregnancy: to make a competent diet to prevent constipation, do not wear tight belts, spend more time in fresh air and walks.

What is the danger?

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

Hemorrhoid complications:

Anemia (develops with a long cycle of disease with abundant bleeding).
Inflammatory processes in the surrounding tissues, up to the development of paraproccitis (inflammation of the fiber around the rectum). Paraproproccitis is considered a very serious complication that requires severe treatment.
The cracks of the anus. The most common cause of severe pain in hemorrhoids. Crepes create favorable conditions for the development and penetration of various deep infections in soft tissues. This fact can lead to the development of formidable complications as a abscess (limited purulent inflammation, which is accompanied by general malaise, temperature and severe pain). This complication needs compulsory surgery.
Itching. A very unpleasant complication, which acts not only as a strong negative psychological moment, undermining the patient's psycho -emotional state. The constantly mechanical irritation of the anal region can significantly aggravate the process of the course of the disease. In addition, the constant damage to the fabric increases the risk of developing various tumor processes.
The insufficiency of the anal sphincter, the incontinence of gas and feces (often in the elderly).

It follows that hemorrhoids require early diagnosis and adopt immediate measures to solve this problem.

What the hemorrhoids are waiting for: photos

Diagnostics

As a rule, diagnosis is not associated with special difficulties, diagnosis occurs as part of an investigation into patients and an initial outpatient examination. Inspection helps to determine:

the degree of loss from the anus of the nodes,
evaluate the possibility of going back,
The condition of the skin,
as well as relevance and the degree of bleeding.

The symptoms for hemorrhoids are similar to some other diseases. Therefore, the diagnosis should be careful because there is the risk of prescribing incorrect treatment. Hemorrhoids can be confused with:

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

If you notice the first signs of the disease in yourself, do not postpone a journey from the doctor for a long time. Early diagnosis will facilitate treatment and help avoid not only complications, but also surgery.

How to treat hemorrhoids?

Conservative treatment of hemorrhoids:

Make sure to normalize intestinal emptying. The chair should be regular, soft. To normalize the feces with hemorrhoids, food is recommended with the food fiber content, including wheat bran, but their number should be gradually increased within 2-3 weeks. (from 5-10 g to 20 g per day), which excludes the appearance of the discomfort.
With constipation, you can recommend lettulose up to 30-40 ml per day to obtain a soft daily chair and other means, follow a diet and recommendations for constipation.

The treatment uses local drugs: rectal candles from hemorrhoids and ointments.

With pain, candles containing small doses of narcotic vehicles (for example Beladonna, etc. ) help. You can prescribe candles, sodium alginated, Ichthyol, depending on the symptoms and stadium of the disease.
If there is no bleeding, it is possible to prescribe suppositories or ointment of phenylefrine hydrochloride, etc. But in any case all drugs are prescribed, so only a procistologist can prescribe the correct treatment after examining the patient.
In pain, in addition to candles, cold lotions can be used, but no more than 30 seconds.
To increase the efficiency of local drugs, it is necessary to take oral products that improve the tone of venous vessels and prevent thrombosis: Diosmina, Troxerutin.
Luto hemorrhoidal nodes (prolapse) are the basis for their dressing. When thrombosis of the hemorrhoidal veins are used locally the hemorrhoidal veins, further bandages are used locally.
With the impact, despite the treatment, secorroid -ectomy is recommended.

The methods of treatment of drugs are exclusively symptomatic, that is, hemorrhoids do not radically treat hemorrhoids. However, they allow you to temporarily face the unpleasant signs of hemorrhoids. If the patient after pharmacological treatment complies with medical recommendations for recurrence prevention, it is possible to avoid surgical treatment.

But patients cannot always follow all recommendations.

Small methods -vasive

The minimally invasive treatment allows you to quickly and without serious injuries to get rid of such a delicate problem as hemorrhoids. In most cases, therapeutic methods only soften the symptoms of the disease, delay the moment when it is necessary to use more radical methods. Before the appointment of a particular procedure, the doctor studies the patient's history, leads a global examination, evaluates all possible risks.

Sclerotherapy- This is a traumatic low treatment through special sclerosing substances that are inserted inside the node, glue its walls, so that it is possible to obtain the cessation of their diet and death in the future. The technique is performed only in 1-3 phases. It does not exclude the risk of recurrence of the disease and is effective only with small hemorrhoids.
ElectrocoagulationIt is performed under the control of the anoscope. The electrode is brought to the knot leg and the fabric is coagulated (welded), after which they die quickly. In a procedure, it is possible to get rid of 1-2 pathological outbreaks. After gluing, the hemorrhoidal node stops eating and growing and after a while it disappears completely.
Linding with latex rings-Ast of the most modern methods of minimally invasive treatment of internal hemorrhoids of 1-3 phases. A latex binding is applied through the anoscope on the leg of the knot, which leads to squeezing the tissues and a violation of the blood circulation in them. After 8-14 days, the hemorrhoidal node dies and is removed with the latex ring.
Cryotherapy- Short -term effect on hemorrhoids with liquid nitrogen. After that, the hemorrhoid node dies and disappears. The procedure takes place under local anesthesia, so there are no painful sensations.

Small invasive procedures are contraindicated in:

exacerbation of the inflammatory process in the rectum and in the anus;
Anal cracks, injuries;
Thrombosis of hemorrhoids.

Invasive methods of small hemorrhoids can only be used in 1-3 stadiums of the disease, necessarily for exacerbation of the inflammatory process. All procedures are performed after local anesthesia. It is not necessary to use general anesthesia. In a session, only 1-3 knots can be removed. Sometimes the treatment takes place in different stages, from intervals in several weeks.

Surgical treatment

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

The hemorrhoid removal operation, proposed in the 1930s, is still applied and continues to be modified. In the world, two types of operations are mainly performed:

Closed hemorrhoidctomy. Apply in phase III and IV of the disease.
Open hemorrhoidctomy. Also in stadium III and IV, but complicated by anal cracks or paraproccitis.

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

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

Power and diet after surgery

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

But observe the diet table (according to Pevzer 1a), to exclude products and dishes that excite the secretion of the stomach and irritate the mucous membrane. The food must be cooked in dry shape, cook for steam or boiled on the water, it is necessary to take a condition of a liquid and mastery form. Escape: hot and cold products, bread and flour, raw vegetables, cheese, dairy products -Caseari, sour cream, cottage, spices, sauces, coffee, tea.

Eat 6 times a day in small portions. The restoration of the normal functioning of the intestine usually occurs on the second day after the operation, therefore the usual diet can be proceeded. But, of course, all sharp and spicy dishes should be excluded, alcohol should also be forgotten. By adhering to these recommendations, it is possible to reduce recovery times after surgery and reduce the risk of complications.

Domestic treatment

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

The warm bathrooms help well. You can take a bath or simply sit in a water basin. It is necessary to place the anus area in hot water for 10-15 minutes 2-3 times a day.
In -depth hygiene of the anal region. It is necessary to swim or shower every day, carefully wash the anus area.
Do not use soap in the anus and other means that can cause irritation. Avoid the use of flavored wet wipes, which includes alcohol.
Do not use ordinary toilet paper. It is better to use wet wipes, but without alcohol.
Use the cold. To remove the edema in the anus, you can use cold heating bearings, ice packages, tissue moistened in cold water.

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

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

Gymnastics

Gymnastics exercises aim to prevent constipation and strengthen anal sphincter. For example, by improving the outflow of blood and strengthening the muscle layer of the press, it is possible to normalize the work of the intestine, which and prevent constipation:

The exercise of "scissors" is performed lying on the back with the raised legs, which must be diluted and crossed alternately;
"Bicycle" is a fairly famous exercise that is very reminiscent of a bicycle ride, however, lying on the back;
And you can lie down on the floor (on the back), put your legs straight, lift one or the other leg, if possible, reaching a right angle in the hip joints. Or bend your legs on your knees and spread to the sides, trying to snatch the pelvis from the floor as much as possible.

So a person who feels his "fifth point" is organized in any position and is able to guide him, therefore the gymnastics for strengthening the anus does not require any device and can be performed everywhere, and it is unlikely that those around him notes him.

So, exercises to strengthen the sphincter:

Get up, cross your legs and make rhythmic relaxations and tension of the buttock muscles;
Choose the most difficult chair, sit a little forward (you can easily do on the desktop), try to reduce and relax the sphincter in turn, trying to push the anus into the rectum. You should take 20 minutes to the exercise, which, if desired, you can always find.

Prevention

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

Irregular chair, a tendency to constipation or diarrhea, to the habit of strangling during defecation or for a long time to sit in the bathroom with a book;
Hard physical work and, on the contrary, a lack of movement, in the long term remains in a sitting position;
pregnancy and childbirth;
Alcohol abuse.

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

It is recommended to reconsider the diet: abandon simple carbohydrates (pastries, desserts) in favor of complexes (vegetables, fruit, vegetables, grain bread), instead of tea and coffee, drinking water, will help normalize a chair.
Avoid alcohol, including beer.
With hemorrhoids, we are unwanted by horses, heavy athletics, bicycle sports, but it is simply necessary to walk or swim.
It is useful to strengthen the muscles of the abdominal press and buttocks, to make Kegel gymnastics.
Sitting on the bathroom for a long time is a bad habit. But to be used after visiting the cabinet bidet or the ascending shower for washing, on the contrary, very useful.

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