In our culture, the body fund and its functions are a topic that is not customary to discuss in a decent society.Therefore, the diseases that affect these parts of the body cause suffering not only of physical, but also psychological properties.Unfortunately, one of these diseases - hemorrhoids - is not as rare as we would like;At least 10-15% of the entire adult population of the earth is subject to it.Very often, people aged 30 to 50 suffer from hemorrhoids and men are four times more often than women.Alas, far from all patients, feeling the signs of the disease that has started, they go to the doctor.False shame prevents many, they prefer cars -medici, which only worsens their position.But hemorrhoids, like other diseases, are easier to treat in the early stages.
What are the hemorrhoids and causes of its occurrence
The final part of the digestive tract, the last segment of the colon, is called rectum;It starts somewhere at the level of the third sacred vertebra and ends with the anus.Its blood supply is supplied by five arteries (one of these, not coupled, is called hemorrhoid) and the flow of blood is carried out by a large veins of veins located in the underwater layer of the rectum.In the lower part of the rectum, or the hemorrhoidal area, under the mucosa are cavernous or cavernous bodies, drawn from the smallest veins network.Normally, the walls of these vases should support the connective tissue, but if it is weakened, the blood flow has increased and the outflow is disturbed, so the walls of the vessels swell, the cavernous bodies are full of blood and protrude, filling the entire cavity and sometimes they have also shown themselves through the anus.Hemorrhoids are the same swollen blood and protruding cavernous bodies.Sometimes the appearance of hemorrhoids cause mechanical causes when, under the influence of some factors, the muscle fibers of the longitudinal muscle of the rectum are lengthened and loose, which causes the movement of the hemorrhoidal nodes to the anus and their loss from it.The number of knots in patients is very different, from one to different, which can fill the entire anal region.Their dimensions are also very different, from 5 mm to 3 cm.
Although the exact causes of the occurrence and development of hemorrhoids have not yet been revealed, it is believed that the following factors contribute to it:
- A sedentary lifestyle.People are particularly subject to the emergence of hemorrhoids, for a long time to be in a sitting position or standing for a long time.When a person sits or is long, the stagnation of the blood occurs in the pelvic organs, which can disturb the outflow of blood through the veins.
- Physical work.However, physical activity is not a panacea;People who work in areas where prolonged and constant hard physical labor is required also suffer from hemorrhoids.
- Complications for defecation- Whether it's diarrhea or chronic constipation.Both of these states cause an increase in pressure in the abdominal cavity, which, in turn, leads to an increase in hemorrhoidal nodes and their loss.
- Improper nutrition.The increase in the use of alcohol, spicy foods causes a arterial influx to the cavernous bodies of the rectum, which contribute to their expansion.Food, poor fiber, causes constipation and the abundance of fatty foods - diarrhea.
- Hypothermia or overheating of the pelvic area.Both these conditions compromise blood circulation and contribute to the stagnation of the blood in the pelvic area.
- Pregnancy, childbirth.In this condition, the pressure of the woman in the abdominal area increases and the flow of blood in the veins can be compromised.Consequently, hemorrhoids can form.
- Obesity.People whose fat deposits mainly in the abdominal area are particularly vulnerable to hemorrhoids.
- Some sexual practices, including anal sex.
- Various diseases: liver disease (when the venous blood flow is compromised, increases pressure in the veins, which contributes to the development of hemorrhoids);Pelvic organs (bladder, prostate) diseases;neoplasms and/or inflammation of the pelvis and intestine.
- Hereditary causes: functional insufficiency of the connective tissue, altered nerve regulation of the venous wall tone, pathology of the heart and blood vessels.
Symptoms of hemorrhoids
The hemorrhoids appear gradually and imperceptiblely;A person does not feel particular inconveniences, except that from time to time after defecation he can experience discomfort, pain and itching in the anus.The soft fabrics in the anal area can swell.The mucus can escape from the rectum, irritating the anus and causing a burning sensation.Sometimes the patient has the feeling that there is a foreign body in the anus;After defecation, painful and prolonged pain is common.These phenomena are aggravated by poor diet or by gastrointestinal disorders.But in most cases, people consult a doctor after detecting blood in the stool, toilet paper or intimate linen in the form of small drops, stripes or, in rare cases, intense bleeding.
However, bleeding from the anus is not always associated with hemorrhoids (especially if the patient is over 40 years old).Rectal bleeding can also occur in the following diseases:
- Anal crack
- Oncological diseases of the rectum
- The loss of the rectum
- Colitis, polyps, condition
The patient should pay attention to the fact that the bleeding occurrence is due to a change in intestinal behavior, the appearance of a different color or consistency of the usual.With these symptoms, consulting an immediate doctor can occur in another place of the gastrointestinal tract.
How hemorrhoids are manifested
Hemorrhoids happenexternalORinternal.With external hemorrhoids, the hemorrhoidal nodes are expanded, formed by the lower venous plexus and located directly on the anus.Since inflammation is not inside the rectum, but outside of it, if desired, you can consider this area with your eyes.Bleeding in this form of hemorrhoids is practically absent, but patients are very worried about pain in the rectal region.The external knots are often inflamed, injured by rough linen and more often reborn in oncological formations.This type of relatively rare hemorrhoids - no more than 10% of the total number of patients suffers from it.
The internal hemorrhoidal nodes are found in the submucous layer of the rectum, it is possible to see them with the naked gaze only in the subsequent stages of the disease, when the shell of the cavernous bodies is so deformed that it scrutinizes through the anus.The main symptoms of internal hemorrhoids are the presence of blood in the stool (although very often it is scarlet, arterial, it is also possible that dark venous blood with clots), pain during defecation.In the subsequent stages of the disease, hemorrhoids fall from the anus;Initially, they are designed inside, but subsequent patients must do it manually.
There are also combined hemorrhoids, in which both the cavernous bodies of the rectum and the subcutaneous venous plexus of the anal region are deformed.
Hemorrhoids happensharp(When its symptoms develop rapidly, the nodes are inflamed, inflammation passes to nearby tissues, the patient suffers from pain; necrotic changes are possible in the nodes due to thrombosis) e) e)chronic.So the disease lasts long, months and even years, while periodically aggravated - bleeding occurs, the knots fall, pinched and provide many inconveniences.During periods of remission, provided that the precautions are observed practically by the patient does not feel discomfort.
Disease development phase
Most cases of hemorrhoids are diagnosed in the subsequent stages - both because patients have not paid attention to the symptoms, attributing them to other reasons or due to the false shame, has brought the journey from the doctor.There are four phases of hemorrhoids.
- First phase.The symptoms are implicitly expressed, appearing only in particular cases (for example, with intestinal disorders, after hard physical work, long periods standing or sitting still, eating disorders, overheating or hypothermia).Sometimes the patient feels discomfort during defecation, burning and itching later.At the exam, the doctor notes the presence of stagnation of blood and stretching of the walls of the vessels.If it is possible to diagnose hemorrhoids at this stage, the treatment is quick and without problems.
- Second phase.The hemorrhoids increase in size, their walls are thinned and small tears that lead to bleeding can form on them.After an intense physical effort, complicated intestinal movements or hypothermia, a patient can see traces of blood in the stool, on toilet paper or on intimate linen, but the bleeding is very small and disappears quickly.The hemorrhoids are a little enlarged and can fall from the anus after defecation, even if they return on their own.Their appearance is caused by an increase in pressure in the peritoneum during serious stress, whether it is physical work or a strong cough.In this phase it is still possible to resort to conservative treatment.
- The third phase.The anal sphincter undergoes dystrophic changes and weakens, following which the fallen hemorrhoidal nodes can only be corrected by hand.The patient is worried about serious itching, bleeding is frequent and abundant.Conservative treatment is no longer possible.
- The fourth phase.The knots are thus enlarged that it is not possible to correct them.The muscles of the anal hole are very weakened, the sphincter tone is reduced.For loss of nodes, even the smallest physical activity is sufficient.The nodes themselves can take on the shape of seal, are inflamed;Inflammation can also affect neighboring fabrics.
Complications with hemorrhoids
Fortunately, the complications with hemorrhoids are not too often found.Although above all, with the patient's hemorrhoids, the type of blood frightens, it does not stand out so much that it is a danger to life.However, with prolonged constant bleeding, anemia is possible.
The flow of mucus from the anus causes itching and can lead to eczema.
With the further development of the disease, when the hemorrhoids have already moved to the third or fourth stage, the patient is administered a lot of manual reduction in the inconveniences of the nodes.And they can already fall not only after defecation, but also with severe cough, sneezing, physical effort.
In rare cases, the fallen hemorrhoidal nodes can be pinched by the muscle of the anal sphincter, which causes severe pain.If the nodes are not regulated, thrombosis can develop.These are the most difficult complications possible for hemorrhoids, which require immediate medical treatment.In this state, the hemorrhoidal nodes are swollen, thesis, of significantly increased size and purulent infection is possible in the patient's body.Patients lose appetite, the temperature increases, they are sick.
Any disease worsens if it is not treated.It is no exception to hemorrhoids: in the absence of treatment, it progresses, which can lead to irreversible changes in the veins of the rectum.
Hemorrhoids during pregnancy and childbirth
The reason for the development of hemorrhoids in pregnant women is squeezing the veins of the cavernous bodies of the rectum of the rectum, which increased the size of the uterus, which causes outflow of compromised blood, blood vessels and the formation of hemorrhoidal nodes.In addition, the appearance of hemorrhoids in pregnant women can cause constipation when the stool extend the walls of the rectum and will hurt the cavernous bodies.As a rule, in the last months of pregnancy, a woman is forced to conduct a sedentary lifestyle, which does not also contribute to the healing of the body.During childbirth, the perineum muscles are tense, the cavernous bodies of the rectum are elongated and injured.With a serious elongation of the perineum muscles, weakening of the anal sphincter is possible and, consequently, the loss of nodes.
Often those who have given birth to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately see a doctor, thus causing the development of the disease.
Which doctor to contact with suspicion of hemorrhoids?
If a person is worried about the unpleasant sensations in the anus area, the itching and traces of blood, it is necessary to consult a professional or a collapse doctor.
Diagnosis of the disease
In general, to diagnose hemorrhoids, there is enough visual examination of the patient's body.At the same time, the patient takes the position of the knee or occupies a gynecological chair.The doctor examines the patient's anus, paying particular attention to skin conditions, in the presence of hemorrhoidal nodes, their value and position.
To confirm the diagnosis, the doctor can conduct other studies:
- Rectum.The doctor examines the tissues of the anal canal, evaluates the state of the mucosa of the rectum, as well as the surrounding organs and tissues, determines the location of the hemorrhoidal nodes, their value and degree of pain, and whether there is bleeding.True, the exact size of the nodes cannot be set - when they are felt, as a rule, they are small in size.In this case, the patient can lie on his side, on his back or stand on all fours, and the doctor in gloves with his index finger examines the rectum from the inside.Already after an examination of the fingers, the doctor may prescribe anoscopy and spectrooscopy.
- Anoscopy.With anoscopy, a special device is introduced in the back, which allows the doctor to examine the surface of the rectum for 10-15 cm.Using the anoscope, the doctor determines where exactly the cavernous bodies are interested, whether there are tumor -shaped processes and inflammatory diseases in the rectum.The anoscope is also used to test: biopsy and shots.This procedure is painless and practically has no contraindications;The exception is the exacerbation stage of inflammatory diseases.So the doctor recommends before removing inflammation and only then conducting an exam.
Although anoscopy is a fairly simple procedure, it requires preliminary preparation.So that nothing prevents the examination of the rectum, the patient should refrain from eating the night before, as well as making two cleaners - half a day before the moment of the procedure and the second - a couple of hours before.It is also possible that the doctor ask the patient to take a laxative on the eve.
Also, to exclude the risk of developing oncological pathology, the doctor may offer the patient to passSectonoscopy- Examination of the Sigmideo and the Rect.With this examination, the doctor can examine the internal surface of the rectum even higher at 25 cm.If for some reason, it is impossible to perform a stocopy (let's say, the patient has pathological disorders of the rectum), they are performed instead of thisColonoscopy- When the internal surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can obtain a clear picture of the disease, when it is and how it will develop.Along the way, it is possible to identify other diseases that influence the functioning of the systems of the body located nearby.Hemorrhoids are often accompanied by diseases of the anal part of the body and colon, caused by bleeding by hemorrhoids.Sometimes there is also an irritable intestine syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides what treatment to prescribe.But with all stages of hemorrhoids, from the first to the last, treatment is carried out that allows you to stop the symptoms of the disease - to reduce pain, stop bleeding.If the hemorrhoids of the first or second stage, it is possible to cure it when using the so-called.Conservative treatment - i.e. the use of drugs that relieve pain, prevent complications, and also contribute to the postoperative rehabilitation of patients.The best results are given by the joint use of both external and internal drugs.
| Group | Flow | Method of application | |
|---|---|---|---|
| Non -steering anti -inflammatory drugs and analgesics | Remove the inflammatory process, reduce swelling, anesthetize | Orally | |
| Venetonizing agents | Improve blood vessels, reduce the extension of the veins, prevent thrombosis | Orally, externally | |
| Hemostatic | Stop bleeding | Orally, in the form of injections | |
| Ointments | Alleviate spasm and inflammation, anesthetize | Externally | |
| Anticoagulant | Prevent thrombosis of hemorrhoids | Injections | |
| Laxative | Normalize a chair | Orally | |
| Enema | Normalize a chair | External | |
| Candles | Stimulation of the flow of blood, analgesic, anti -inflammatory | External |
If after a week or two there are no positive changes, a second exam should be subjected to a proctologist that will offer different treatment.
If the hemorrhoids of the second or third stadium and it is impossible to take care of them with only drugs, the so called.Small invasive methods - Unlike the operational ones, they are less traumatic for the patient, patients have spent less time in the hospital and are restored faster.This includes:
- Infrared radiation.Using an infrared coagulator, the doctor acts on hemorrhoidal knots with a high temperature, cauterizing blood vessels.This operation does not require anesthesia (except in case of high individual sensitivity of this area in the patient) and has a low trauma.Coagulation can also be carried out using laser rays.
- Sclerotherapy.The patient in hemorrhoidal nodes introduces a special substance that paste the walls of the vessels.Usually, with sclerotherapy, a substance is introduced into no more than two knots so that the patient does not develop pain syndrome.The next session takes place in two weeks.
- Ligation (ligation) of hemorrhoids with latex rings.This method is often used to treat hemorrhoids in elderly patients who have a treatment with the complication of the disease.At the same time, a small latex ring is applied to the base of the knot, which gradually tightens the knot, leads to its necrosis and refusal.At the same time, bleeding does not occur, since the stump is blocked by the ring;Subsequently, a healthy connective tissue is formed in its place.The procedure is almost painless, it has low trauma and the ring can be quickly applied with analoscope.
- Cryotherapy.In this method of treatment, the hemorrhoid node is exposed to low temperatures, after thawing it, the resulting wound heals over time and connective tissue forms at the site of the node.The operation is performed under local anesthesia.
All minimally invasive treatment methods are used only in the absence of exacerbation of hemorrhoids.If the hemorrhoids have entered the acute phase, it is first necessary to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
In the fourth phase of hemorrhoids, surgical treatment is indicated.The operation (hemorrhoidctomy) is performed as follows: the main groups of hemorrhoidal nodes are subjected to excision, the lacatures are applied to their reasons, the edges of the wound are sewn.Although it looks frightening, the operation, although rather unpleasant, is very effective and has the smallest number of relapses.However, after it, complications are possible: severe pain, bleeding, scars, deformive of the anal channel, restrictions of the anus, suppuration of wounds, paraproccitis.After the operation, it is necessary to observe the regime prescribed by the doctor - to refuse for the duration of physical activity and hot baths.
Hemorrhoid treatment at home
There are many popular remedies from hemorrhoids, but not everyone is effective and some can be harmful.It is recommended to use them only when approving the attending physician.
The decoctions of the renal highlanders, the fruits of the rosettes and the raspberry leaves will help reduce inflammation and normalize the tone of the blood vessels.You can also rinse the area of the anus and hemorrhoidal nodes, especially after defecation, decoctions of herbs that have an anti -inflammatory effect (calendula, San Giovanni, chamomile).Also with them you can make hot baths of 10-15 minutes to reduce inflammation and pain.
Prevention of hemorrhoids
The easiest way to avoid the occurrence or exacerbation of hemorrhoids, eat properly so that the chair is soft and there is no constipation.This follows:
- There are high fiber foods- Fruit, vegetables, wheat cereals.This softens the chair and increases its volume, which helps to avoid the increase in pressure in the abdominal cavity.However, in small portions they should be introduced into the diet so as not to cause greater gas formation.It is recommended to avoid sharp dishes, condiments and alcohol.
- Drink many liquids.It is recommended to drink from six to eight glasses of water or other liquids a day (alcohol is not included here) so that the chair is softer and does not damage the walls of the rectum.
- Add drugs containing food fibers to your diet.Most people do not receive quite fiber per day (25 g for women are recommended for men - 38 g).Some nutritional supplements can improve the patient's general conditions with developed hemorrhoids.But do not forget that with the introduction of additives with a high content of food fibers in the diet, the consumption of water or other liquids (non alcohol) to eight glasses per day or more should be increased.Otherwise, they can cause constipation.
- Do not try during defecation.Excessive tension and breathing seal when trying to relieve the great pressure in the veins of the rectum.
- Timely visit the bathroom.If a person for some reason removes defecation, the chair can dry and it will be more difficult to remove it from the body.However, you should not be involved in laxatives - with constant use, they can irritate the anal region and even contribute to the development of inflammatory processes in the rectum.
- Exercise.It is recommended to do exercises or engage in any other physical activity: it will improve the conditions of the body vascular system, improve blood flow and reduce pressure on the veins.With the job sitting or standing, it is advisable to take a short break every couple of hours, walk, stretch, do some exercise.
- Avoid long periods of immobility.Too long sitting or standing can increase pressure on the veins in the rectal region.