There is no such person who has never heard the word “hemorrhoids”.It is used by everyone who is not lazy, even those who have nothing to do with medicine.
The term "hemorrhoids" itself comes from two Greek words -"Haem"("Blood") and"Rhoos"("bleeding").
The concept is ambiguous, because not every bleeding is a consequence of hemorrhoids, and it does not always cause blood.In this case, the concept of “hemorrhoidal nodes” is suitable for the wider concept of “hemorrhoids” - swelling, bloating that occur during a trash.
Description of the problem
Hemorrhoids are special anal formations located under the rectum.In structure, they are a plexus of venous vessels.They are located inside and outside the mucous membrane.From the location of these formations, hemorrhoids of internal and external nature are divided.
These plexuses themselves perform a protective function: protect the rectum from incontinence of liquid feces and gases, and also completely close the anal canal.According to statistics, 20 % of adults suffer from this disease.And it is precisely this disease that is the cause of the campaign to the specialist.
Which contributes to the occurrence and development of the disease
Hemorrhoids are normal only with a pair of parks.In case of heavy or prolonged physical exertion, these ligaments can be torn.In case of violation of the integrity of the ligaments, hemorrhoids are overflowed with blood.The consequence of this is their loss and bleeding.
Vienna, providing normal blood outflow from the mucosa, become squeezed.Blood begins to stagnate.
Factors provoking the development of hemorrhoids
The pathology itself does not arise just like that, on its own.Its occurred and development is affected by several factors:
- The hereditary factor (in the hemorrhoidal node and veins there are no valves that provide outflow of blood).
- Increased pressure in the veins.
- Carts in the work of the intestines (constipation, diarrhea), a frequent visit to the toilet.
- Pregnancy, delivery, enhancing the clinic of the disease.
- A sedentary lifestyle, standing position for a long period.
- Some sports and professions.
- Features of nutrition (alcohol, spicy food).But this more contributes to exacerbation, not development.
Pay attention!Even in the presence of bleeding from the anal canal, one cannot talk about the manifestation of hemorrhoids.To confirm the diagnosis, analyzes and examination of the rectum is necessary:
- Colonoscopy.
- Anoscopy.
- Sectoroscopy.
Bleeding and nodes can occur with inflammation of the intestines and in malignant formations.
Hemorrhoids: symptoms and classification
The location of the nodes:
- Outer.
- Interior.
- Mixed.
First view- the expansion of the venous vessels located below the gear line of the rectum.This species is characterized by edematous manifestations, the presence of discomfort in the rectum.With this type of pathology, severe pain is characterized.
The second view- the expansion of the hemorrhoids themselves located below the line.Hemorrhoids are divided into 1, 2, 3 and 4 degree (the severity of the disease depends on the severity of the nodes).There are also acute and chronic hemorrhoids, arising from one disease.
Chronic hemorrhoids
Clinical picture:
- Periodically, blood is released from the anus.
- The loss of plexuses inside the mucosa.
- Itching and burning in the anus.
- Discharge from the rectum.
Symptoms of chronic hemorrhoids
Intestinal bleeding
This is the most frequent symptom with this disease occurred in 10 % of patients.According to statistics, the most frequent occurrence is when the intestinal is empty.Manifestations can be intense and not very, and are episodic in nature.The color of the discharge is scarlet, in the form of “spray” (occurs with a strangle), or - at the end of emptying (in the form of drops).If, after the previous emptying in the anus, blood remained, the next at the next it will come out with a dark or cluster.
70-80 % of cases-clinical manifestations of hemorrhoids.With constipation and diarrhea, intake of alcohol, spicy foods and heavy physical exertion, bleeding also occurs.The consequence of this is the occurrence of anemia.
The manifestation of anal bleeding is not always a sign of this disease.It can occur in other diseases of the intestine.If it occurs in people over 40-45 years old, then you must definitely consult a doctor.Also, in case of it in people with a predisposition to oncology, a visit to the doctor is required.
For what diseases can bleeding occur:
- Diverticullase of the colon.
- Crohn's disease.
- The malignant neoplasm of the rectum.
- Polyps of the intestines.
If you notice discharge from the anus, consult a proctologist and conduct the necessary examinations of the direct and large intestine.
Protrusion of venous plexuses
This symptom occurs already in the phase of a long course of the disease.First, it occurs with the devastation of the intestines.Further, the symptom appears with a strangle.If the pathology is acute, then falling out without effort.Splitting independently sets at 2 stages.At 3 stages, they are adjusted manually due to a decrease in the tone of the anal muscles.They completely fall out at 4 stages.
Anal pain
Bleeding is not the only reason that comes to a specialist.And this is not necessarily hemorrhoids.The pain syndrome in the anus can occur in an acute stage of the disease.Reasons:
- Constipation.
- Frequent visit to the toilet.
- Anal crack.
- Plrombosis of the nodes.
If the treatment is carried out incorrectly, the anal crack will go into the chronic stage.
Intestinal discharge
The nature of the discharge in this disease is watery or mucous.Arise as a consequence of the episodic loss of nodes.With bleeding, pay attention to the mucous secretions.Most often, they are when the nodes or mucosa falls out.Other reasons are neoplasms (villous polyps, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with dysfunction of the colon.They occur, as a rule, at the late stage of the disease.
Classification
1 phase- Venous plexuses do not fall out.The scarlet color of the released blood.
2 phase- The dropped nodes are adjusted themselves (with or without blood release).
3 phase- The nodes fall out episodically, and get better manually.
4 phase- The newspaper and the mucous membrane of the rectum begin to fall out constantly.Manual reduction becomes impossible.
Acute hemorrhoids
It occurs usually with exacerbation in the chronic phase.The most frequent manifestations:
- External nodes with the occurrence of thrombosis.
- Protrusion of internal thrombed plexuses.
If thrombosis occurs, the nodes are compacted and increased in size.A severe pain syndrome occurs in the anal opening area.
Treatment of acute hemorrhoids
At the stage of thrombosis, thromboectomy is possible (excision of a thrombus node and removal of a thrombus).The operation is carried out under local anesthesia.Duration - a few minutes.After the operation, the pain immediately begins to decrease.
When internal hemorrhoidal nodes fall out, swollen phenomena and inflammation occur.Surgical intervention is contraindicated due to possible complications.Therapy:
- The use of ointments and candles.
- Pills.
If you notice manifestations in time, the duration of the acute stage is reduced to a week.If the pathology is not treated for a long time, purulent inflammation may occur.
3 phases of the disease in the acute course
- The appearance of blood clots in internal and external venous plexuses.There is no inflammation.
- The presence of blood clots in nodes, with the presence of inflammation.
- Against the background of the above signs, inflammation of the subcutaneous tissue develops.Complications occur - bleeding, purulent inflammation.
How to treat hemorrhoids in the chronic stage
Hemorrhoids are a severe, unpleasant, but reference disease.There are enough treatment methods for its elimination.The treatment system is constantly being improved.Each method has no doubt, pros and cons.And they are used depending on the phase.The following factors affect the use of a particular methodology:
- The course of the disease.
- The nature of the discharge.
- Age of the patient.
- The frequency of bleeding.
The difficulty lies in the fact that many methods are based on the same indications for treatment, and choosing the optimal becomes not easy.In this case, you have to combine the necessary methods.According to the classification, 3 types of treatment are distinguished:
- Conservative.
- Small invasive.
- Operational.
Hemorrhoids of the first degree
The loss of nodes with the release of blood or not:
- Mandatory normalization of nutrition (with a high percentage of fiber).
- Taking drugs that reduce inflammation and expansion of venous vessels.
- Rectal candles, ointments for external use for exacerbation.
Hemorrhoids of the II degree
Self -reduction of the affected nodes:
- Fixation of the hemorrhoidal node with a latex ring.
- Introduction of a sclerosant.
- The ligation of arteries bringing blood to inflamed nodes.
- Electrocoagulation.
- Excision of external and internal nodes.
Hemorrhoids of the III degree
Manual reduction:
- The use of latex rings.
- Sclerotherapy.
- Landing of the arteries.
- Electrocoagulation.
- Excision.
Hemorrhoids of the IV degree
The impossible reduction of the nodes: Removing inflamed nodes with a special device.
The stages of the development of hemorrhoids
Not every method is suitable for the treatment of hemorrhoids in one case or another.The final solution affects how exactly external and internal plexuses correlate.If the pathology is prevailing nodes - inside, then you can do without surgery.The methods are described above.
Before making a final diagnosis, the patient needs a complete examination.The very first thing to do is examine the rectum and the large intestine.First of all, this applies to patients over 45 years old, with a hereditary predisposition to oncology, since with hemorrhoids there can be concomitant diseases:
- The malignant tumor of the rectum.
- Polyps.
Also, symptoms (or rather, the degree of its severity), the size of the nodes, and episodality affect the choice of a particular method of treatment.
With a weak severity of symptoms, rare loss, it is better to choose conservative therapy.The very first and important thing that it is aimed at is the correction of nutrition, the elimination of constipation and pressure during the emptying of the intestine.The diet should contain a sufficient amount of water, since constipation often occurs with a lack of liquid, which is why the intestines are forced to suck it from feces.
To facilitate this condition, the following is important:
- The prevailing component in the diet is fiber.
- Periodic intake of laxatives.
- The appointment of phlebotropes to the patient.
Conservative therapy is mainly used during an acute exacerbation of the disease.Other treatment is contraindicated.If the disease is in the 1st and 2nd phase, other methods are also contraindicated.What is included in conservative treatment:
- Special diet.
- Slasping drugs.
- Rectal candles, ointments.
- Phlebotropic drugs.
Each patient is prescribed by the diet.The main goal is to normalize a chair.Often, one of the main provoking factors is precisely constipation or diarrhea.The diet for this disease categorically prohibits:
- Sharp.
- Salt.
- Roast.
- Alcohol.
Diarye implies additional examinations.It is the result of examinations that affects the correction of diet and treatment.If the patient is prone to constipation, then a special diet is recommended to him.The list of products and other nuances can be viewed in a special section.For a laxative effect, it is recommended:
- Dried apricots.
- Prunes.
- Dried apricots.
- Fig.
If the diet does not eliminate the stagnant effect in the intestines, the use of laxatives begins.Now it will not be difficult to find them: just go to any pharmacy and ask.Do not take them yourself.The dosage and brand of the drug depend on the following factors:
- Individual characteristics of the body.
- Concomitant diseases.
- Age.
- Decisions of the doctor.
Until the final treatment has been prescribed, the doctor prescribes the patient 1 tbsp.l.Vaseline oil (2-3 times a day).
Basic in the treatment of pathology
But it is worth remembering that no ointments and other medicines will completely save you from the problem.They only temporarily eliminate the symptoms, and no more.Conservative therapy will be ineffective if venous plexuses fall regularly: only radical treatment methods will help here.
Also, when prescribing dosage forms of the drug, certain factors are taken into account.For example, rectal candles are not suitable for patients with a pronounced pain syndrome.In this case, the ointment is preferable.In some cases, combinations are acceptable.
There is no need to list the entire list of drugs from this pathology, since it is very large.The defining factor is the individual characteristics of the body and the patient’s personal complaints.
What affects the choice of ointments or candles:
- Acute hemorrhoids with thrombosis.
- Inflammation.
At the same time, anesthetics, anti -inflammatory drugs that relieve edema are prescribed.It is necessary to use such drugs for a certain time, since they contain hormones and anti -inflammatory non -steroids.
The use of phlebotropic is a prerequisite for drug therapy.
Small -invasive treatment
Sclerotherapy
This is a method in which a special solution is introduced into the area of hemorrhoidal nodes - sclerosant.With proper administration, the manipulation does not cause pain.Local anesthesia is not used.Duration is no more than 10 minutes.Hospitalization is not needed.After the procedure, you can continue to lead the same way of life.Within two days in the anus, uncomfortable sensations are possible.This method is used in a pathology in a chronic phase (blood is released, plexuses are not protruding).This method is rarely used, since the manipulation is quite complicated, and with the correct administration of the drug, mucosa necrosis is possible.As a rule, the period of calm after manipulation is about 3-7 years.
Infrared coagulation
The method by which IF radiation acts on inflamed areas.With it, hemorrhoidal tissue begins to gradually die.After manipulations, you can lead the previous lifestyle.Painful sensations are possible for two days.The AI method is used at 1 and 2 stages of pathology, where the size of the sites is small.The calm period is 3-7 years, without serious complications.
Fixation with latex rings
This procedure is the most common among all other methods.Her pluses:
- Low cost.
- A wide range of indications.
- Lack of risk of complications.
The bottom line is that the latex ring is applied to the area of the site.This is done using a ligator.Due to the pressure of the ring, he begins to die and reject.The manipulation of fast in conducting (3-5 minutes), simple, practically painless.After ligation, you can lead the previous lifestyle.Painful sensations are possible for two days.The ligation method is shown in the 1-3 phase of pathology.There are almost no complications.Sometimes there are blood discharge when the ring leaves.Minus of the procedure - only 1 site is removed for 1 session, the following manipulation is possible only after a couple of weeks.
Landing of the arteries
The method of proximal ligation allows you to find the localization of all arteries supplying inflamed areas and bandage them.In this method, local anesthesia is used.Carry out the procedure with an anoscope with a knot.As a result of the dressing of arteries, inflamed areas disappear.The duration of the procedure is about half an hour.Pain sensations are almost not observed.Pains are possible within two days, and an increase in temperature.You can lead the same lifestyle.This method is used on all phases of pathology.
Pros:
- Lack of wiping tissues.
- Reducing the rehabilitation period.
- Processing 1 time.
- A longer period of calm (5-10 years).
Cons:
- The procedure is longer compared to others.
- Pain.
- High cost.
Surgical intervention
The operation of the Milligan-Morgan
This method of surgical intervention involves the excision of external and internal swellings, with their subsequent dressing.Apply on all phases of the disease.Nuances:
- General anesthesia.
- The need for 3-5 daily inpatient hospitalization.
- Reduced performance within 10-15 days.
- A long recovery period - about 1 month.
- The duration of manipulation is about half an hour.
The advantages are that this is the only and radical method of therapy.The calm period is up to 12 years, repeated relapses are possible only in 15-30 % of cases.Cons-in painful sensations for 2-4 days.We need an analgesics.The recovery period is long, as well as the occurrence of scars and a decrease in the tone of the anal sphincter.
Professor Longo
This method involves truncating the mucous membrane of the rectum.It is carried out using a special stapler.The sites lose the possibility of protruding, and blood flow decreases.Showed by pathology in all phases.Nuances:
- General anesthesia.
- Hospitalization in the hospital for 2-4 days.
- The recovery period is 3-5 days.
The advantages of the procedure are similar to hemorrhoidctomy, small severity of pain;Recovery is fast, there are no complications.Minus-in high cost (due to the use of a stapler).
Conclusion
The methods described in the article are not the only ones by which hemorrhoids are treated.Cryotherapy is also used.But this method is not so widespread, since there is an incontinence of discharge from the anus, the depth of exposure is not controlled.
The patient himself has the right to decide whether to see him a doctor or not.Of course, it is worth paying attention to the frequency of bleeding and pain, since the frequent release of blood causes anemia.Otherwise, hemorrhoids are not very life -threatening.But it is worth warning that the sooner you consult a doctor, the better.Thus, you will avoid a more radical treatment method and improve life.
Remember that only a proctologist can help in solving this problem.If you notice the following signs:
- Periodic anal bleeding.
- Itching and burning in the anus.
- Sensation of discomfort and pain - immediately contact a proctologist!In no case do not self -medicate!