In our culture, the body bottom and its functions are a topic that is not common to discuss in a decent society.Therefore, diseases that affect these parts of the body cause suffering not only 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 whole adult population on Earth is the subject of it.Most often, people from 30 to 50 years of age suffer from hemorrhoids, and men are four times more than women.Alas, far from all patients, feeling the signs of the disease that has begun, go to the doctor.False shame prevents many, they prefer to self -make, which only worsens their position.But hemorrhoids, like other diseases, are easier to treat in the early stages.
What is hemorrhoids and the causes of its occurrence
The last part of the digestive tract, the last segment of the colon, is called the rectum;It starts somewhere at the level of the third sacral vertebra and ends with the anus.Its blood supply is provided by five arteries (one of them, unavailable, is called hemorrhoid), and blood flow is carried out from wide veins of veins located in the submucosal layer of the rectum.At the bottom of the rectum or hemorrhoid area below the mucosa are cavernous or cavernous bodies drilled by the net of the smallest veins.Usually the walls of these vessels should maintain the connective tissue, but if it is weakened, the blood flow increases and the leakage is disturbed, then the walls of the vessels swell, the cavernous bodies are filled with blood and glue, filling the entire cavity and sometimes even appears through the anus.Hemorrhoids are the same blood and protruding cavernous bodies.Sometimes the appearance of hemorrhoids causes mechanical causes when, under the influence of some factors, the muscle fibers of the longitudinal muscle of the rectum are stretched and loosen, which causes the hemorrhoid nodes to displace to the anus and their loss.The number of nodes in patients is very different - from one to several that can fill the entire anal region.Their dimensions are also very different - from 5 mm to 3 cm.
Although the exact causes of hemorrhoids have not yet been discovered, the following factors are thought to contribute to it:
- SedentarySPeople are especially the object of the onset of hemorrhoids, for a long time being in a sitting or upright position for a long time.When a person sits or stands for a long time, a stagnation of blood occurs in the pelvic organs, which can disrupt blood flow through the veins.
- PhysicalSHowever, physical activity is not a panacea;People working in areas where prolonged and constant heavy physical labor is required also suffer from hemorrhoids.
- Complications for defecation- be it diarrhea or chronic constipation.Both conditions cause an increase in abdominal pressure, which in turn leads to an increase in hemorrhoids and their loss.
- MalnutritionSIncreased use of alcohol, spicy foods causes arterial flow of the cavernous bodies of the rectum, which contributes to their expansion.Food, bad in fiber, causes constipation and the abundance of fatty foods - diarrhea.
- Hypothermia or overheating of the pelvic areaSBoth conditions worsen blood circulation and contribute to the stagnation of the blood in the pelvis.
- Pregnancy, childbirthSIn this condition, a woman increases the pressure in the abdomen and blood flow through the veins can be disturbed.As a result, hemorrhoids may form.
- ObesitySEspecially the appearance of hemorrhoids is the subject of people whose fat is deposited mainly in the abdomen.
- Some sexual practicesIncluding anal sex.
- Various diseases: Liver diseases (with them a venous outflow of the blood is impaired, the increase in the pressure in the veins, which contributes to the development of hemorrhoids);Diseases of the pelvic organs (bladder, prostate);Neoplasms and/or inflammation in the pelvis, intestines.
- Hereditary reasons: Functional deficiency of connective tissue, impaired nerve regulation of the tone of the venous wall, pathology of the heart and blood vessels.
Symptoms of hemorrhoids
Hemorrhoids occur gradually and imperceptible;One does not experience special inconveniences unless from time to time after bowel movements can feel discomfort, pain, itching in the anus.Soft tissues in the anus can swell.The mucus can be released from the rectum, irritating the anus and causing a burning sensation.Sometimes the patient has a feeling, as if a foreign body is in the back hole;After defecation, long pain is common.These phenomena are enhanced in violation of a diet or disorders of the gastrointestinal tract.But most often, people seek a doctor after detecting blood in stools, toilet paper or underwear in the form of small drops, stripes or in rare cases with intense bleeding.
However, bleeding from the anus is not always associated with hemorrhoids (especially if the patient is more than 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, warts
The patient should note whether the onset of bleeding is due to a change in intestinal behavior, the appearance of stool of different colors or consistency than usual.For such symptoms, consult a doctor, immediately suppressed, may occur elsewhere on the gastrointestinal tract.
How do hemorrhoids manifest
Hemorrhoids happenExternalorInternalSWith external hemorrhoids, the hemorrhoids are expanded, formed by the lower venous plexus and are located directly on the anus.Because inflammation is not inside the rectum, but outside, if you wish, you can look at this area with your own eyes.Bleeding in this form of hemorrhoids is practically absent, but patients are very concerned about pain in the rectal area.The outer nodes are often inflamed, wounded by coarse underwear and are more often reborn into oncological formations.This type of hemorrhoids relatively rare - no more than 10% of the total number of patients suffer from them.
The internal hemorrhoids are located in the submucosal layer of the rectum, it is possible to see them with the naked look only in the short stages of the disease, when the coat of the cavernous bodies is so deformed that it peeps through the anus.The main symptoms of internal hemorrhoids are the presence of blood in the stool (although the most common is Alena, arterial, dark venous blood with clots is also possible), pain during defecation.In the short stages of the disease, hemorrhoids fall out of the anus;At first they are pulled inside, but later patients should 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 happenacute(When its symptoms develop rapidly, nodes are inflamed, inflammation goes to adjacent tissues, the patient suffers from pain; necrotic changes in nodes due to thrombosis are also possible) andchronicSThen the disease lasts for a long time, months and even years, until periodically exacerbates - bleeding occurs, nodes fall, pinch and deliver a lot of discomfort.During periods of remission, provided that the precautions are monitored by the patient practically do not experience discomfort.
Stages of disease development
Most cases of hemorrhoids are diagnosed in the short stages - or because patients have not paid attention to the symptoms, attributing them to other reasons, or because of false shame, they have tightened the journey to the doctor.There are four stages of hemorrhoids.
- The first stageSSymptoms are impressive, manifesting only in special cases (for example, with intestinal disorders, after high physical labor, long standing or sitting on site, eating disorders, overheating or hypothermia).Sometimes the patient experiences discomfort during bowel movements, burning and itching after it.On examination, the doctor notes the presence of blood stagnation and stretching the walls of the blood vessels.If hemorrhoids manage to diagnose at this stage, treatment is carried out quickly and without problems.
- The second stageSThe hemorrhoids increase in size, their walls become larger, small fractures can form on them, leading to bleeding.In the patient, after high physical exertion, complex bowel movements or hypothermia, traces of blood may be observed on stool, toilet paper or underwear, but the bleeding is very small and passes quickly.The hemorrhoids are slightly enlarged and can fall out of the anus after defecation, but return themselves.Their appearance is caused by an increase in the pressure in the peritoneum with severe stress, whether it is physical labor or a strong cough.At this stage, you can still resort to conservative treatment.
- The third stageSThe anal sphincter undergoes dystrophic changes and weakens, resulting in the fallen hemorrhoid nodes can only be corrected by hand.The patient is worried about severe itching, bleeding is frequent and abundant.Conservative treatment is no longer possible.
- The fourth stageSThe nodes are so extended that it is not possible to correct them.The muscles of the anal opening are very weakened, the tone of the sphincter is reduced.For the loss of nodes, even the smallest physical activity is sufficient.The nodes themselves can take the form of printing, they are inflamed;Inflammation can also affect nearby tissues.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids do not occur too often.Although most of all, with the patient's hemorrhoids, the type of blood scares, 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 more increasing development of the disease, when the hemorrhoids have already moved to the third or fourth stage, the patient is given a great reduction in the leadership of the nodes.And they can now fall not only after bowel movements, but also with severe coughing, sneezing, exercise.
In rare cases, fallen hemorrhoids can be pressed by the muscle of the anal sphincter, which causes severe pain.If the nodes are not corrected, thrombosis may develop.These are the most difficult complications for hemorrhoids, which requires immediate medical attention.In this condition, the hemorrhoids are swollen, tense, significantly increased in size and purulent infections are possible in the patient's body.Patients lose their appetite, their temperature rises, they are sick.
Any disease worsens if left untreated.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 the drainage of the veins of the cavernous bodies of the rectum rectum, which increases in the size of the uterus, which causes impaired blood flow, blood vessels and the formation of hemorrhoids.Also, the appearance of hemorrhoids in pregnant women can provoke constipation when the stools stretch the walls of the rectum and injure the cavernous bodies.As a rule, in the last months of pregnancy, a woman has been forced to lead a sedentary lifestyle that also does not contribute to the healing of the body.During the birth, the muscles of the perineum are tense, the cavernous bodies of the rectum are stretched and wounded.With severe stretching of the muscles of the perineum, the anal sphincter is possible and as a result the loss of nodes.
Often those who have given birth to women confuse the symptoms of hemorrhoids with the consequences of birth and do not immediately see a doctor, thus provoking the development of the disease.
Which doctor to contact with suspicion of hemorrhoids?
If a person is concerned about the unpleasant sensations in the anus, itching, as well as traces of blood, you should consult a professional or doctor.
Diagnosis
Usually, hemorrhoids have sufficient visual examination of the patient's body to diagnose hemorrhoids.At the same time, the patient either occupies the knee position or occupies a gynecological chair.The doctor examines the patient's anus, paying special attention to the skin condition, the presence of hemorrhoid nodes, their value and position.
To confirm the diagnosis, the doctor may conduct other studies:
- RectumSThe doctor examines the tissues of the anal canal, evaluates the condition of the mucosa of the rectum, as well as the surrounding organs and tissues, determines the location of the hemorrhoids, their value and the degree of pain and whether there is bleeding.It is true that the exact size of the nodes cannot be set - when they feel, they are generally reduced in size.In this case, the patient may lie on his side, on his back, or to stand fours, and the doctor in gloves with his index finger examines the rectum inside.Already after examination of the finger, the doctor may prescribe anoscopy and spectoscopy.
- AnoscopySWith anoscopy, a special device is introduced into the back, allowing the doctor to examine the rectum surface for 10-15 cm.Using the anoscope, the doctor determines exactly where the cavernous bodies are affected, whether there are processes in the form of a tumor and inflammatory diseases in the rectum.The anoscope is also used for testing - biopsy and strokes.This procedure is painless and there are virtually no contraindications;An exception is the stage of exacerbation of inflammatory diseases.Then the doctor recommends that you first remove the inflammation and only then have an examination.
Although anoscopy is a very simple procedure, it requires prior preparation.So that nothing prevents the rectum from examining, the patient should refrain from eating the night before, as well as making two cleansing enemas - half a day before the procedure and the second - a few hours before it.It is also possible for the doctor to ask the patient to take a laxative on the eve.
In addition, to rule out the risk of developing oncological pathology, the doctor may suggest the patient passSextonoscopy- Sightseeing of sigmoid and rectum.With this examination, the doctor can examine the internal surface of the rectum further up to 25 cm.If for some reason it is impossible to perform a stomoroscopy (say, the patient has pathological disorders of the rectum), they are performed insteadColonoscopy- When the inner surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can get a clear picture of the disease, at what stage it is and how it will develop.Along the way, you can identify other diseases that affect the functioning of the body systems located nearby.Often hemorrhoids are accompanied by diseases of the anal body and colon caused by bleeding from hemorrhoids.Sometimes there is also irritable bowel syndrome.
How to treat hemorrhoids
After diagnosing, the doctor decides which treatment to prescribe.But with all stages of hemorrhoids, from the first to the last, treatment is performed, which allows you to stop the symptoms of the disease - to reduce pain, to stop bleeding.If the hemorrhoids of the first or second stage, it is possible to cure it when you use SO -Called.Conservative treatment - that is, the use of medicines that relieve pain, prevent complications and also contribute to postoperative rehabilitation of patients.The best results are given by the joint use of medicines from both external and internal use.
| Group | Scope | Application method | |
|---|---|---|---|
| Non -steroidal anti -inflammatory drugs and analgesics | Remove the inflammatory process, reduce swelling, anesthesia | Orally | |
| Venonizing agents | Improvement of blood vessels, reducing the lengthening of veins, preventing thrombosis | Orally, externally | |
| Hemostatics | Stop bleeding | Orally, in the form of injections | |
| Ointment | Relieve spasm and inflammation, anesthetize | Externally | |
| Anticoagulant | Prevent hemorrhoid thrombosis | Injection | |
| Laxatives | Normalize a chair | Orally | |
| Enemas | Normalize a chair | External | |
| Candles | Stimulating blood supply, analgesic, anti -inflammatory | External |
If no positive changes are observed after a week or two, a second examination should be subjected to a proctologist who will offer different treatment.
If the hemorrhoids of the second or third stage and it is impossible to cure it only with medicines, the so -called.Small -invasive methods -unlike the operatives, they are less traumatic for the patient, patients are spending less time in the hospital and recovering more quickly.This includes:
- Infrared radiationSUsing an infrared coagulator, the doctor acts on high fever hemorrhoids, cauting up blood vessels.This surgery does not require anesthesia (except in cases of high individual sensitivity of this area in the patient) and has low trauma.Coagulation can also be performed with the help of laser rays.
- SclerotherapySThe patient in hemorrhoids introduces a special substance that adheres to 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 is held after two weeks.
- Ligation (ligation) of hemorrhoids with latex ringsSThis method is most commonly used to treat hemorrhoids in adult patients who complicate the treatment of the disease.At the same time, a small latex ring is applied to the base of the knot, which gradually presses the knot, leads to its necrosis and rejection.At the same time, bleeding does not happen as the stump is blocked by the ring;Subsequently, healthy connective tissue is formed in its place.The procedure is almost painless, there is a low trauma and the ring can be quickly administered with an anoscope.
- CryotherapySIn this method of treatment, the hemorrhoid node is exposed to low temperatures after its thawing dies, the resulting wound heals over time and the connective tissue is formed at the site of the node.The surgery is performed under local anesthesia.
All minimally invasive treatments are used only in the absence of exacerbation of hemorrhoids.If the hemorrhoids enter the acute stage, it is first necessary to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
The fourth stage of hemorrhoids shows surgical treatment.The surgery (hemorrhoids) is performed as follows: the main groups of hemorrhoid nodes are subjected to excision, the ligatures are applied to their grounds, the ends of the wound are sewn.Although it sounds scary, the surgery, although quite unpleasant, is very effective and has the smallest number of relapses.However, after that, complications are possible: severe pain, bleeding, scars, deformation of the anal canal, anus strictures, wound maintenance, paraproctitis.After surgery, it is necessary to monitor the regimen prescribed by the doctor - to refuse the duration of physical activity and hot baths.
Hemorrhoid treatment at home
There are many folk drugs from hemorrhoids, but not all of them are effective and some can be harmful.It is recommended to use them only when approved by the attending physician.
The decline of the high mountain renal, the fruits of the pink and raspberry leaves will help reduce inflammation and normalize the tone of blood vessels.You can also rinse the area of the anus and hemorrhoids, especially after bowel movements, the herbs that have an anti -inflammatory effect (calendula, St. John's case, chamomile).You can also make warm baths with 10-15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to avoid the appearance or exacerbation of hemorrhoids, eating properly so that the chair is soft and has no constipation.This follows:
- There are foods with high fiber- fruits, vegetables, cereals.This softens the chair and increases its volume, which helps to avoid an increase in abdominal pressure.However, small portions should be introduced into your diet so that they do not cause increased gas formation.It is recommended to avoid sharp dishes, spices and alcohol.
- Drink lots of liquidsSIt is recommended to drink six to eight glasses of water or other liquids a day (alcohol is not included here) so that the chair is smaller and does not injure the walls of the rectum.
- Add medicines containing dietary fiber to your dietSMost people do not receive enough fiber per day (25 g are recommended for women, for men - 38 g).Some nutritional supplements can improve the patient's general condition with developed hemorrhoids.But remember that with the introduction of high -dietary fiber supplements into the diet, consumption of water or other liquids (not alcohol) to eight glasses a day or more should be increased.Otherwise, they can cause constipation.
- Do not strain yourself during bowel movementsSExcessive tension and retention of breathing when you are trying to relieve the high pressure in the veins of the rectum.
- Timely visit the toiletSIf a person for some reason eliminates the bowel movement, the chair can become dry and it will be more difficult to remove from the body.However, you should not get involved in laxatives - with constant use, they can irritate the anal region and even contribute to the development of inflammatory processes in the rectum.
- ExerciseSIt is recommended that you do exercises or get involved in any other physical activity-this will improve the condition of the body system, improve blood flow and reduce the pressure on the veins.When sitting or standing, it is advisable to take a short break every few hours, walk, stretch, do several exercises.
- Avoid long periods of immobilitySToo long sitting or standing can increase the pressure on the veins in the rectal area.