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Hemorrhoids

anal pain with hemorrhoids

Hemorrhoids are a disease in which there is blood stasis and unusual changes in the veins of the rectum or in the area around the anus. Such delicate pathology has no age or gender restrictions.

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

The pathology is characterized by characteristic symptoms that one 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 area.

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

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

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

Etiology

The main reason for the appearance of hemorrhoidal cones is:

  • dysfunction of the vessels of this body;
  • increased arterial blood flow;
  • impaired blood flow from the venous plexus;
  • loss of tone of the veins of the rectum, which leads to their dilation and the appearance of nodules.

In addition, clinicians identify a huge number of adverse factors leading to the above processes, which is why they are usually divided into several groups - pathological and physiological.

The first category of causes of hemorrhoids includes:

  • chronic constipation - hardened stools injure the walls of the rectum and anus;
  • severe intoxication of the body - this should include poisoning with alcohol, toxic and chemical substances, as well as low-quality food;
  • profuse infectious diarrhea;
  • 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 cirrhosis of the liver, as well as other diseases of this organ. The connection of hemorrhoids with the liver is due to the presence of common veins;
  • the pathological influence of pathogenic bacteria that lead to the development of infections.

In addition to diseases and disorders, the causes of hemorrhoids may not be related to the presence of one or another disease in the body. Among the physiological factors it is worth emphasizing:

  • 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 the greaterpart of the working hours;
  • overweight;
  • malnutrition - this includes the abuse of fatty, spicy foods, smoked meats, confectionery, carbonated beverages, processed foods, fast food and other harmful ingredients. For this reason, dietary therapy is one of the components of the treatment of hemorrhoids;
  • indiscriminate use of drugs, including laxatives or oral contraceptives;
  • improper performance of proctological diagnostic procedures or enemas;
  • non-standard sexual preferences, namely anal sex;
  • prolonged impact of stressful situations;
  • performing heavy physical activity;
  • engaging in certain sports, in particular cycling or motorcycling, equestrian sports and other types of weightlifting;
  • excessive drinking and smoking;
  • period of childbirth or labor;
  • menstruation.

Genetic predisposition plays an important role in the development of the disease. Diagnosing such pathology in one of the closest relatives significantly increases the likelihood of swelling. Knowing this, you can prevent the appearance of the disease on your own, 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, which has not been diagnosed before;
  • chronic - characterized by alternating phases of exacerbation of symptoms and their remission.

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

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

There are also types of hemorrhoids by severity:

  • mild course - symptoms may be completely absent or insignificant. Conservative methods predominate in therapy;
  • moderate - differs in the addition of pain, which are caused by enlargement of the nodes and their injury from the stool. The internal bumps fall during the act of defecation and then adjust. It is possible to eliminate the disease with minimally invasive methods;
  • severe - characterized by the expression of such a sign of hemorrhoids as bleeding. Nodes can fall out not only during bowel movements, but also in any other situation leading to an increase in intra-abdominal pressure. In such cases, they can only be adjusted manually. Tactics on how to get rid of hemorrhoids can include both minimally invasive procedures and extensive surgery;
  • complicated - is expressed by an increase in the symptoms of the disease, and during the diagnosis often develops complications, one of which may be thrombosis. However, it should be noted that not in all cases of untimely treatment of hemorrhoids the formation of consequences occurs.
stages of development of hemorrhoids

Symptoms

The first signs of hemorrhoids can be so insignificant that one does not pay any attention to them. Initial clinical manifestations are considered to be:

  • slight discomfort in the anus;
  • mild itching of the anal area;
  • pain during defecation;
  • swelling at the entrance to the anal canal.

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

  • burning and severe itching;
  • increased pain, which will appear not only during defecation, but also during intense walking or prolonged sitting;
  • the appearance of impurities of blood and mucus in the stool. It is noteworthy that the pathological clots will not mix with the stool, but are located on top of it;
  • prolapse of the hemorrhoidal lump, leading to severe pain;
  • redness of the skin of the perianal area;
  • rectal hemorrhage - if in the early stages such a sign of hemorrhoids can appear only in the form of smearing with blood on toilet paper or underwear, then in a complex course the bleeding can reach the intensity of the flow. This is what often makes a person seek help.

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

Diagnosis

It often happens that when symptoms of a disease appear, one does not know which doctor to go to for hemorrhoids. A proctologist or surgeon is involved in the diagnosis and treatment of hemorrhoids, but you can contact a therapist for the first consultation. It should be borne in mind that if the child has signs, it should immediately see a pediatrician, and if a pregnant woman, then above all they consult an obstetrician-gynecologist.

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

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

The second stage in establishing the correct diagnosis is laboratory tests, namely, general, biochemical blood test and coagulogram.

The last part of the diagnosis are instrumental examinations of the patient, which aim to assess what the hemorrhoids look like and predict:

  • sigmoidoscopy;
  • anoscopy;
  • colonoscopy;
  • contrast-enhanced radiography;
  • Ultrasound of the abdominal organs.
Contrast-enhanced X-ray of the colon to diagnose hemorrhoids

Only after studying the results of the study, the clinician develops tactics on how to cure hemorrhoids in a patient.

Treatment

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

  • the use of drugs for both local and general effects. In the first case, rectal suppositories, ointments, creams and gels are used, and in the second - tablets to improve blood circulation, strengthen 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 to remove hemorrhoids;
  • open surgery;
  • the use of prescriptions for alternative medicine. This should include the preparation of candles and ointments from natural ingredients at home, as well as decoctions of medicinal herbs and plants that are used for ingestion or as microclysters and sedentary baths.

Among the minimally invasive methods of treating hemorrhoids, it is worth emphasizing:

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

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 complicated course of the disease, open surgery is indicated - hemorrhoidectomy.

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

Possible complications

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

  • joining a secondary infection;
  • the spread of the inflammatory process;
  • anal sphincter insufficiency;
  • heavy 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 followed:

  • lead a healthy and moderately active lifestyle;
  • eat properly and balanced;
  • strengthen the pelvic and abdominal muscles;
  • take medication only as directed by your doctor;
  • if possible, avoid physical and emotional stress;
  • timely treatment of constipation and other pathological causes of hemorrhoids;
  • make sure your body weight is within normal limits;
  • undergo a full physical examination regularly.

It is impossible to answer unequivocally the question of the prognosis of hemorrhoids, as the result depends on several factors - stage and form of the disease, age, time of onset of treatment of hemorrhoids and the patient's compliance with all recommendations of clinicians.

Often people who are diagnosed with hemorrhoids ask if it can go away on its own? The answer of doctors will always be negative - the disease will become chronic.