Hemorrhoids

7 May 2025

Hemorrhoids are varicose veins in the rectum hemorrhoid veins. Inflammation of the hemorrhoid node is characterized by thrombosis, change in form and pathological enlargement of the hemorrhoids, forming nodes around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which occasionally worsens from time to time. And more than 70% of people at least occasionally experience various symptoms of hemorrhoids, such as discomfort in the anus, itching and pain during bowel movements.

Hemorrhoids in women are often found during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very gentle methods, as a pregnant woman is not recommended to take some medicines for hemorrhoids that are prescribed in the usual order. Hemorrhoids in men are also quite common, caused by a number of other causes and factors that will be further discussed.

What are the causes of hemorrhoids?

It is generally accepted that hemorrhoids develop due to increased blood flow or its insufficient outflow, leading to stagnant processes. The causes and factors of hemorrhoid development are:

Hereditary predisposition to hemorrhoids. This is the main factor for the appearance of hemorrhoids, which must be said first. And although hemorrhoids are not inherited, the predisposition to this disease can be determined by genetic factors. The legacy of certain groups of genes leads to congenital weakness or vascular dysfunction located in the rectum. This is the reason for increased flow and insufficient blood flow through the cavernous veins, leading to the pathological expansion of the latter. The long -term expansion of the cavernous veins leads to the thinning of the walls of the blood vessels, which contributes to the appearance of bleeding with hemorrhoids.
Long standing 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 remain in a permanent position. This category includes teachers, teachers, Swiss, guards, hairdressers and more. Raising height is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, mainly related to office workers, drivers and persons leading to a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First, it is increased pressure on the vessels of the rectum in a sitting position. With a prolonged seat, the anus area is heated slightly, leading to stagnant phenomena and vascular expansion. In addition, the lack of exercise is a real way for the development of venous insufficiency. Including this applies to veins located in the rectum.
Chronic constipation and diarrhea. People suffering from chronic constipation are predisposed to the development of hemorrhoids. Why is this happening? The thing is, with constipation, the stools harden, putting pressure on the veins in the lower intestine. This leads to a deterioration of the blood supply to cavernous and the appearance of hemorrhoids. An additional factor in constipation is the habit of pressing strongly during bowel movements, which creates additional pressure on the vessels in the rectum.

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

Pregnancy. Hemorrhoids during pregnancy and childbirth are a common phenomenon because carrying the fetus creates pressure on the venous vessels of the rectum. And tense attempts during birth only exacerbate the course of hemorrhoids and contribute to the formation of new hemorrhoid nodes.
Improper nutrition, abuse of spicy foods and alcohol. A significant factor for the onset of hemorrhoids is malnutrition. In particular, the abuse of spicy foods leads to irritation of the intestinal mucosa, and also stimulates increased flow from blood to the rectum. And insufficient use of fiber (plant foods) impairs intestinal mobility. The provocative factor for the development of hemorrhoids is alcohol that expands the vessels. Taking alcoholic beverages, even in a small amount, can cause an exacerbation of chronic hemorrhoids.

The main factors contributing to the development of hemorrhoids:

Obesity.
Hereditary predisposition.
A sedentary lifestyle (hypody) or work associated with low motor activity.
Activities related to excessive muscle tension (high physical activity).
Stress.
Disruption of blood flow into the rectum.
Often constipation.
Inflammatory and tumor processes in the intestine and liver.
Infection.
Smoking.

Internal and external

At the site of the onset of hemorrhoids, the disease is divided into two main types: internal hemorrhoids and external.

In external hemorrhoids, nodes are formed in the immediate vicinity of the anus, in this regard, their sensitive surface is often punctured and bleeding of bright alena blood occurs. Pain in external hemorrhoids is quite acute and intense, but in terms of independent diagnosis, this species does not represent any difficulty.

The internal type of hemorrhoids, although it carries a much more serious health threat, is often distinguished by the complete lack of pain (especially in the early stages of the disease). This fact is explained by the fact that the hemorrhoids are located deep inside, and their surface is the same non -destructive mucosa of the rectum that comes to life.

Degree

Usually distinguish 3 degrees internal hemorrhoids:

1st degree. The hemorrhoids are located in the anal canal, may not be felt (even with a rectal study). Complaints of inflammation of the anus and bleeding, "shaking" pain after defecation.
2nd degree. The nodes protrude from the anus when they are strained and disappear independently. In general, the same disorders are observed here as in first -degree hemorrhoids, but the small tears of the mucous membrane is more common and the inflammation of the anus is more severe.
Grade 3. It is characterized by the so -called loss of hemorrhoids that do not recover independently. Symptoms can be the same as in 2, but often the phenomena of faecal and gases develop further. When examined by hemorrhoids, it differs from the release of the anus on the radiant channels, cyanotic coloration and the tubal surface.

Symptoms of hemorrhoids

The signs of hemorrhoids characteristic of all stages of the development of the disease:

discomfort in the anus;
pain during bowel movements (initially insignificant, then severe);
bleeding from the anus;
Formation and growth of hemorrhoids.

Hemorrhoids are a chronic pathology that has progressed for many years. The ratio of the disease depends on many factors, including nutrition, lifestyle.

For the initial stageDiseases are characterized by a slight increase in veins in the anus. Usually such a sign goes unnoticed. In this case, the patient may be disturbed by bloody ejection from the rectum, which occurs immediately after bowel movements. Blood can easily be seen on toilet paper. It is worth remembering that such a symptom is characteristic of malignant intestinal tumors, so when you appear, you should consult a proctologist. Timely search for a doctor and the appointment of therapy will easily slow down the development of hemorrhoids.

In the second stageThe development of the patient's disease may periodically experience discomfort in the anus, itching. Often he has a sense of foreign body in the anus. The hemorrhoids begin to fall out during bowel movements and are still easily adjustable inwards.

For the third stageHemorrhoids are characterized by an increase in existing characteristics. Large venous nodes in the anus make it difficult to empty the intestinal emptying, cause 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 stageDiseases are characterized by increasing the size of hemorrhoids. They cannot be handled. The presence of advanced veins in the anus causes severe discomfort, it hurts the patient, go to the toilet. He is worried about abundant bleeding during any bowel movement. The fourth stage of the development of hemorrhoids can be complicated by such unpleasant and dangerous phenomena as vein thrombosis at the end of the rectum.

Hemorrhoids in pregnant women

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

However, in most women the symptoms of hemorrhoids pass the postpartum period, therefore it is believed that the causes can be hormonal changes. It should be treated immediately after detecting the first of its symptoms. It is important to deal with constipation, such as taking stool relief (Forlax, laminaride, methyl -recently), to observe the rules of hygiene (washing the anus after defecation). Hemorrhoids (aurobin, relief, etc. ) are mainly used externally in the form of ointments and candles. Surgical intervention is performed only in severe cases.

The prevention of hemorrhoids should be performed from the first days of pregnancy - make a competent diet to prevent constipation, not to wear narrow belts, to spend more time in the fresh air and walking walks.

What is the danger?

The progression of the disease without proper treatment will lead to a number of very unpleasant complications.

Hemorrhoid complications:

Anemia (develops with a long course of the disease with abundant bleeding).

Inflammatory processes in the surrounding tissues, to the development of paraproctitis (inflammation of the fibers around the rectum). Paraproctitis is considered to be a very severe complication requiring serious treatment.

Cracks of the anus. The most common cause of severe pain in hemorrhoids. The cracks create favorable conditions for the development and penetration of various infections deep into the soft tissues. This fact can lead to the development of a huge complication as an abscess (limited purulent inflammation, which is accompanied by general malaise, fever and severe pain). This complication needs mandatory surgery.

Itching. A very unpleasant complication that acts not only as a strong negative psychological moment, undermining the patient's psycho -emotional state. Constant mechanical irritation of the anal area can significantly impair the course of the disease. In addition, constant tissue damage increases the risk of developing various tumor processes.

The insufficiency of the anal sphincter, the incontinence of gas and stool (often in the elderly).

It follows that hemorrhoids need an early diagnosis and take immediate action to solve this problem.

How do hemorrhoids look like: Photo

Diagnostics

As a rule, the diagnosis is not related to special difficulties, the diagnosis occurs as part of a patient study and an initial outpatient examination. Inspection helps to determine:

the degree of loss to the anus of the nodes,

Rate the possibility of going back,

The condition of the skin,

as well as the appropriateness and degree of bleeding.

Symptoms of hemorrhoids are similar to some other diseases. Therefore, the diagnosis should be careful as there is a risk of prescribing improper treatment. Hemorrhoids can go wrong with:

Anal crack, which is also accompanied by mild bleeding, pain during bowel movements;

Rectum cancer (malignant intestinal tumors occur with bleeding);

the loss of the rectum;

colitis, polyps and warts.

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

How to treat hemorrhoids?

Conservative treatment of hemorrhoids:

Be sure to normalize intestinal emptying. The chair should be regular, soft. To normalize stools with hemorrhoids, food with the content of dietary fibers, including wheat bran, is recommended, but their number should be increased gradually within 2-3 weeks. (from 5-10 g to 20 g per day), which excludes the onset of discomfort.

With constipation, you can recommend lactulose up to 30-40 ml per day to achieve a daily soft chair and other remedies, follow a diet and recommendations for constipation.

Treatment uses local medicines: rectal candles of hemorrhoids and ointments.

With pain, candles containing small doses of narcotic vehicles (eg belladona, etc. ) help. You can prescribe candles, sodium alginate, ichthyol, depending on the symptoms and stage of the disease.

If there is no bleeding, you can prescribe suppositories or ointment of phenylephrine hydrochloride, etc. But all medicines are prescribed in any case, so only a proctologist can prescribe proper treatment after examination of the patient.

In pain, in addition to candles, cold lotions can be used, but not more than 30 seconds.

In order to increase the effectiveness of local medicines, it is necessary to take oral products that improve the tone of venous vessels and prevent thrombosis: diosmin, troxerutin.

Hemorrhoids (prolapse) are the basis for their dressing. When hemorrhoid vein thrombosis is used topically, cold and lidocaine hydrochloride (1% solution) are used and an additional dressing is possible.

Recurrence, despite treatment, hemorrhoid is recommended.

Treatment methods are extremely symptomatic - that is, hemorrhoids do not heal radical hemorrhoids. However, they allow you to temporarily deal with the unpleasant signs of hemorrhoids. If the patient will meet medical recommendations for the prevention of relapse after medical recommendations, surgical treatment may be avoided.

But not always patients can follow all recommendations.

Small -invasive methods

Minimally invasive treatment allows you quickly and without serious injuries to get rid of such a delicate problem as hemorrhoids. Therapeutic methods in most cases mute the symptoms of the disease, slow down the moment when more radical methods need to be used. Prior to the appointment of a particular procedure, the doctor studies the patient's history, conducts a comprehensive examination, assesses all possible risks.

Sclerotherapy- This is a low traumatic treatment through special sclerosing substances that are placed inside the node, sticking its walls, so it is possible to end their diet and death in the future. The technique is carried out only in 1-3 stages. It does not exclude the risk of recurrence of the disease and is effective only in small hemorrhoids.

ElectrocoagulationIt is performed under the control of the anoscope. The electrode is alleged to the leg of the knot and the tissue is coagulated (welded), after which they quickly die. In one procedure, it is possible to get rid of 1-2 pathological foci. After sticking, the hemorrhoid node stops eating and growing and after a while completely disappears.

Latex ligation-One of the most up-to-date methods for minimally invasive treatment of internal hemorrhoids in 1-3 stages. A latex ligature is applied through the anoscope on the leg of the node, which leads to the pressure of the tissues and a disorder of the circulation in them. After 8-14 days, the hemorrhoid node dies and is removed with the latex ring.

Cryotherapy- short -term effect on hemorrhoids with liquid nitrogen. Then the hemorrhoid node dies and disappears. The procedure is performed with local anesthesia, so there are no painful sensations.

Small invasive procedures are contraindicated in:

exacerbation of the inflammatory process in the rectum and anus;

anal cracks, injuries;

Hemorrhoid thrombosis.

Small invasive methods for combating hemorrhoids can only be used in 1-3 stages of the disease, necessarily by exacerbation of the inflammatory process. All procedures are performed after local anesthesia. There is no need to use general anesthesia. Only 1-3 knots can be removed in one session. Sometimes treatment is performed in several stages, from intervals in a few weeks.

Surgical treatment

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

The surgery to remove hemorrhoids, proposed in the 1930s, is still being applied and continues to change. Two types of operations are performed in the world:

Closed hemorrhoids. Apply in the III and IV stage of the disease.

Open hemorrhoids. Also in stage III and IV, but complicated by anal crack or paraproctitis.

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

Patients are discarded 3-4 days after surgery, restoration of damage occurs every 5-7 days. A small percentage of postoperative complications is also noted.

Power and diet after surgery

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

But to observe the diet mass (according to Pevzer 1A), to exclude products and dishes that excite the secretion of the stomach and to irritate its mucous membranes. The food should be cooked in wipe form, cooking for steam or boiled on water, it is necessary to take in a state of liquid and box. Turn off: hot and cold, bread and flour, raw vegetables, fruits, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.

Feeding 6 times a day in small portions. The restoration of normal bowel function usually occurs on the second day after surgery, therefore, it can proceed to the usual diet. But, of course, all sharp and spicy dishes must be excluded, alcohol should also be forgotten. By sticking to these recommendations, you can reduce recovery time after surgery and reduce the risk of complications.

Home treatment

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

Warm baths help well. You can bathe or just sit in a live with water. It is necessary to place the area of the anus in warm water for 10-15 minutes 2-3 times a day.

Deep hygiene of the anal area. It is necessary to bathe or bathe every day, wash the area of the anus well.

Do not use soap in the anus and other agents that can cause irritation. Avoid using flavored wet wipes, which includes alcohol.

Do not use plain toilet paper. It is better to use wet wipes, but without alcohol.

Use cold. To remove the swelling in the anus, you can use cold heating pads, ice packs, cloth moistened in cold water.

In addition, the hemorrhoid diet pursues two goals: to prevent constipation and irritation in the rectum. Basic recommendations:

Drink enough liquid. This will help to make a more soft chair, make it easier to pass through the intestine.

Your diet should include more vegetables, fruits, cereals. They contain vegetable fiber, which helps prevent constipation.

Alcohol, coffee, strong tea should be avoided.

Limit sharp dishes, spices.

It is better to take food in small portions 4-5 times a day.

Eat about the same time.

Physical activity also helps to normalize bowel function.

Gymnastics

Gymnastic exercises are aimed at preventing constipation and strengthening the anal sphincter. For example, by improving blood flow and strengthening the muscle layer of the press, you can normalize the work of the intestine, which you prevent constipation:

The scissors exercise is performed by lying on the back with raised legs, which should be diluted and crossed sequentially;

"Bike" is a rather known exercise that is very reminiscent of cycling, but lies on your back;

And you can lie on the floor (on the back), put your feet straight, lift one or the other leg, if possible, reaching a right angle in the hip joints. Or bend your legs in your knees and spread aside as you try to tear the pool from the floor as much as possible.

So one is arranged that he feels his "fifth point" in every position and is able to guide it, so that gymnastics to strengthen the anus does not require any devices and can be performed anywhere, and those around it are unlikely to notice it.

So, exercises to strengthen the sphincter:

Become, cross your legs and do rhythmic relaxation and tension of the gluteal 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 press the anus in the rectum. You should take 20 minutes until the exercise, which, if you wish, can always be found.

Prevention

The best tool for hemorrhoids is prevention. There are predisposing factors leading to the development of the disease:

irregular chair, tendency to constipation or diarrhea, the habit of strangling during bowel movements or for a long time sitting in the toilet with a book;

Hard physical work and, conversely, movement deficits, long -term sitting in a sitting position;

pregnancy and childbirth;

Alcohol abuse.

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

It is advisable to review the diet: to abandon simple carbohydrates (sweets, sweets) in favor of complex (vegetables, fruits, green, cereal) instead of tea and coffee, drink water, will help you normalize a chair.

Avoid alcohol, including beer.

With our hemorrhoids is undesirable with horseback riding, heavy athletics, bicycle sports, but walking or swimming is just necessary.

It is useful to strengthen the muscles of the abdominal press and buttocks, to do gymnastics in Kegel.

Sitting on the toilet for a long time is a bad habit. But to use after visiting the toilet bidet or an ascending shower for washing, on the contrary, very useful.

If, despite all preventative exacerbation, they cannot be avoided, it is not necessary to panic. It is advisable to change the position of the sitting position, to apply cool compresses to the sore spot, moistened in a weak solution of potassium permanganate, or to arrange baths with chamomile (not hot! ), Do not forget about diet and personal hygiene.