Haemorrhoids

7 May 2025

Hemorrhoids are varicose veins in the rectum hemorrhoidal veins. The inflammation of the hemorrhoidal node is characterized by thrombosis, a change in shape and the pathological expansion of hemorrhoidal veins, forming nodes around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which is aggravated by them from time to time. And more than 70% of people at least occasionally experience various symptoms of hemorrhoids, such as discomfort in the area of the anus, itching and pain during defecation.

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

What are the causes of hemorrhoids?

It is generally accepted that hemorrhoids develops due to an increased blood flow or its insufficient outflow, which leads to stagnant processes. The causes and factors of the development of hemorrhoids are:

Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which must be said in the first place. And although hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. The inheritance of certain groups of genes leads to congenital weakness or vascular dysfunction located in the rectum. This is the cause of an enhanced flow and insufficient outflow of blood through the cavernous veins, which leads to the pathological expansion of the latter. A long -term expansion of cavernous veins leads to thinning of the walls of blood vessels, which contributes to the occurrence of bleeding with hemorrhoids.
Long standing work and weight lifting. As well as a sedentary lifestyle, physical overload also contribute to the development of hemorrhoids. First of all, this applies to people who are forced to stay in a standing position for a long time. This category includes teachers, lecturers, Swiss, guards, hairdressers and others. Height lifting is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, mainly relating to office workers, drivers and persons, leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is increased pressure on the vessels of the rectum in a sitting position. With a prolonged seat, the anus area is slightly heated, which leads to stagnant phenomena and vascular expansion. In addition, the lack of physical exertion is a true road to 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 that with constipation, the feces harden, exerting pressure on the veins in the lower intestine. This leads to a deterioration in the blood supply of cavernous and the appearance of hemorrhoids. An additional factor in constipation is the habit of strongly pushing during defecation, which creates additional pressure on the vessels in the rectum.

As well as constipation, contributes to the development of hemorrhoids and severe diarrhea (diarrhea), which leads to irritation and inflammation of the mucous membrane of the rectum.

Pregnancy. Hemorrhoids during pregnancy and childbirth are a frequent phenomenon, since the bearing of the fetus creates pressure on the venous vessels of the rectum. And tense attempts during childbirth only exacerbate the course of hemorrhoids and contribute to the formation of new hemorrhoidal nodes.
Improper nutrition, abuse of spicy foods and alcohol. A significant factor in the appearance of hemorrhoids is malnutrition. In particular, the abuse of spicy food leads to irritation of the intestinal mucosa, and also stimulate an enhanced flow of blood to the rectum. And the insufficient use of fiber (plant foods) worsens intestinal motility. The provoking factor in the development of hemorrhoids is alcohol, which expands the vessels. Reception of alcoholic beverages, even in a small amount, can provoke an exacerbation of chronic hemorrhoids.

The main factors contributing to the development of hemorrhoids:

Obesity.
Hereditary predisposition.
A sedentary lifestyle (hypodynamia) or work associated with low motor activity.
Activities associated with excessive muscle tension (high physical activity).
Stress.
Violation of the outflow of blood in the rectum.
Frequent constipation.
Inflammatory and tumor processes in the intestines and liver.
Infection.
Smoking.

Internal and outer

At the place of occurrence of hemorrhoidal nodes, the disease is divided into two main types: internal hemorrhoids and external.

With external hemorrhoids, the nodes are formed in the immediate vicinity of the anus, in connection with this, their sensitive surface often breaks through and bleeding bright scarlet blood occurs. Pain in the external hemorrhoids is quite sharp and strong, but in terms of independent diagnosis, this species does not represent any difficulties.

The internal type of hemorrhoids, although it carries a much more serious threat to health, is often distinguished by the complete lack of pain (especially at the initial stage of the disease). This fact is explained by the fact that the hemorrhoidal nodes are located deep inside, and their surface is the same insolurative mucous membrane of the rectum, which lifes it.

Degree

Usually distinguish 3 degrees of internal hemorrhoids:

1st degree. Hemorrhoids are located in the anal canal, may not be felt (even with a rectal study). Complaints of inflammation of the anus and bleeding, "twitching" the pain after defecation.
2nd degree. The nodes protrude from the anus when straining and disappear independently. In principle, the same disorders are observed here as with hemorrhoids of the 1st degree, however, small ruptures of the mucous membrane are more often, and inflammation of the anus is stronger.
3rd degree. It is characterized by the so -called loss of hemorrhoidal nodes, which do not independently recover. Symptoms can be the same as at 2-, but often the phenomena of fecal and gases develop additionally. When examined by hemorrhoids, it is distinguished from the dropping of the anus along the radiant grooves, cyanotic coloring and a tuberous surface.

Symptoms of hemorrhoids

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

discomfort in the anus;
pain during defecation (at first insignificant, then strong);
bleeding from the anus;
Formation and growth of hemorrhoids.

Hemorrhoids are a chronic pathology that progresses for many years. The rate of development 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 remains unnoticed. In this case, the patient can be disturbed by bloody discharge from the rectum that occur immediately after defecation. Blood can easily be seen on toilet paper. It is worth remembering that a similar symptom is characteristic of malignant intestinal tumors, so when it occurs, you should consult a proctologist. Timely seeking 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 can periodically experience discomfort in the anus, itching. Often he has a sensation of a foreign body in the anus. Hemorrhoids begin to fall out during defecation and are still easily adjusted inward.

For the third stageHemorrhoids are characterized by an increase in existing features. Large venous nodes in the anus make it difficult to empty the intestinal emptying, become the cause of 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 an increase in the size of hemorrhoids. They cannot be straightened with a hand. 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 each defecation. The fourth stage of hemorrhoid development can be complicated by such unpleasant and dangerous phenomena as thrombosis of the veins in the end of the rectum.

Hemorrhoids in pregnant women

Very often hemorrhoids appear during the last trimester of pregnancy and childbirth. The causes of hemorrhoids is a piercing the increased uterus of the intestinal veins, which leads to a deterioration in blood flow from the intestines and from the perineum. Vienna increases in diameter and change the shape. Periodic constipation in pregnant women can also provoke 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 must be treated immediately after the first of its symptoms are detected. It is important to deal with constipation, for example, taking drugs to relieve stools (forlax, laminaride, methyl -velosis), observe hygiene rules (washing the anus after defecation). Hemorrhoids (Aurobin, Relief, etc. ) are used mainly externally in the form of ointments and candles. Surgical intervention is carried out only in severe cases.

Hemorrhoid prevention should be carried out from the first days of pregnancy - make a competent diet to prevent constipation, not wear tight belts, spend more time in the fresh air, and walking walks.

What is the danger?

Progressing 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, up to the development of paraproctitis (inflammation of the fiber around the rectum). Paraproproctitis is considered a very severe complication requiring serious treatment.
The cracks of the anus. The most common cause of severe pain in hemorrhoids. 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 formidable complication as an abscess (limited purulent inflammation, which is accompanied by general malaise, temperature and severe pain). This complication needs mandatory surgical intervention.
Itching. A very unpleasant complication, which acts not only as a strong negative psychological moment, undermining the psycho -emotional state of the patient. Constantly mechanical irritation of the anal region, can significantly aggravate the process of the course of the disease. In addition, constant damage to the tissue increases the risk of developing various tumor processes.
The insufficiency of the anal sphincter, the incontinence of gas and feces (often in the elderly).

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

What hemorrhoids look like: photo

Diagnostics

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

the degree of loss from the anus of the nodes,
evaluate the possibility of their turning back,
The condition of the skin,
as well as the relevance and degree of bleeding.

Symptoms for hemorrhoids are similar to some other diseases. Therefore, the diagnosis should be careful because there is a risk of prescribing incorrect treatment. Hemorrhoids can be confused with:

anal crack, which is also accompanied by slight bleeding, pain during defecation;
cancer of the rectum (malignant intestinal tumors occur with bleeding);
the rectum loss;
colitis, polyps and condylomas.

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

How to treat hemorrhoids?

Conservative treatment of hemorrhoids:

Be sure to normalize intestinal emptying. The chair should be regular, soft. To normalize the stool 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 appearance of discomfort.
With constipation, you can recommend lactulose up to 30-40 ml per day to achieve a daily soft chair and other means, follow a diet and recommendations for constipation.

The treatment uses local drugs: rectal candles from hemorrhoids and ointments.

With pain, candles containing small doses of narcotic vehicles (for example, Beladonna, 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 phenylefrin hydrochloride, etc. But all drugs are prescribed in each case, so only a proctologist can prescribe the correct treatment after examining the patient.
In pain, in addition to candles, cold lotions can be used, but no more than 30 seconds.
To increase the efficiency of local drugs, it is necessary to take oral products that improve the tone of the venous vessels and prevent thrombosis: diosmine, troxerutin.
Lutting hemorrhoidal nodes (prolapse) is the basis for their dressing. When thrombosis of hemorrhoidal veins, cold and lidocaine hydrochloride (1% solution) are locally used, and further bandaging is possible.
With relapse, despite treatment, hemorrhoid -ectomy is recommended.

Medication methods of treatment are exclusively symptomatic - that is, hemorrhoids do not radically cure hemorrhoids. However, they allow you to temporarily cope with the unpleasant signs of hemorrhoids. If the patient after drug treatment will comply with medical recommendations for relapse prevention, surgical treatment can be avoided.

But not always patients can follow all the recommendations.

Small -invasive methods

Minimally invasive treatment allows you to quickly and without serious injuries to get rid of such a delicate problem as hemorrhoids. Therapeutic methods in most cases only muffle the symptoms of the disease, delay the moment when it is necessary to use more radical methods. Before the appointment of a particular procedure, the doctor studies the patient’s history, conducts a comprehensive examination, evaluates all possible risks.

Sclerotherapy- This is a low -traumatic treatment through special sclerosing substances that are inserted inside the node, glue its walls, so that it is possible to achieve the cessation of their nutrition and death in the future. The technique is carried out only at 1-3 stages. It does not exclude the risk of relapse of the disease and is effective only with small hemorrhoids.
ElectrocoagulationIt is carried out under the control of the anoscope. The electrode is brought to the knot leg and the fabric is coagulated (welded), after which they quickly die off. In one procedure, it is possible to get rid of 1-2 pathological foci. After gluing, the hemorrhoidal node stops eating and growing, and after a while completely disappears.
Ligating with latex rings-One of the most modern methods of minimally invasive treatment of internal hemorrhoids of 1-3 stages. A latex ligature is applied through the anoscope on the leg of the node, which leads to squeezing the tissues and a violation of blood circulation in them. After 8-14 days, the hemorrhoidal node dies and is removed out with the latex ring.
Cryotherapy- short -term effect on hemorrhoids with liquid nitrogen. After that, the hemorrhoid node dies and disappears. The procedure takes place under 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;
thrombosis of hemorrhoids.

Small-invasive methods of combating hemorrhoids can be used only at 1-3 stages of the disease, necessarily out of exacerbation of the inflammatory process. All procedures are carried out after local anesthesia. There is no need to use general anesthesia. In one session, only 1-3 knots can be removed. Sometimes treatment takes place in several stages, from intervals in several weeks.

Surgical treatment

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

The hemorrhoid removal operation, proposed back in the 30s of the last century, is still applied and continues to be modified. In the world, two types of operations are performed mainly:

Closed hemorrhoidctomy. Apply in the III and IV stage of the disease.
Open hemorrhoidctomy. Also in stage III and IV, but complicated by anal crack or paraproctitis.

Also in 1993, a new way to treat hemorrhoids was proposed, it was done by the Italian doctor A. Longgo, which consists in the circular removal of the mucous and outlet layer of the rectum using a special apparatus.

Patients are discharged 3-4 days after surgery, restoration of disability occurs on 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 begin to drink, and eat a few hours after the operation.

But to observe the dietary table (according to Pevzer 1a), to exclude products and dishes that excite the secretion of the stomach and irritate its mucous membrane. Food must be cooked in a wiped form, cooks for steam or boiled on water, it is necessary to take in a liquid and gruel -shaped condition. Exclude: hot and cold, bread and flour products, raw vegetables fruits, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.

Eating 6 times a day in small portions. The restoration of the normal operation of the intestine usually occurs on the second day after the operation, therefore, it can be proceeded to the usual diet. But, of course, all sharp and spicy dishes should be excluded, alcohol should also be forgotten. Adhering to these recommendations, you can reduce the recovery time after surgery and reduce the risk of complications.

Home treatment

You can independently perform some measures that will help alleviate 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 take a bath or just sit in a basin of water. It is necessary to place the anus area in warm water for 10-15 minutes 2-3 times a day.
Thorough hygiene of the anal region. It is necessary to take a bath or shower daily, wash the anus area thoroughly.
Do not use soap in the anus and other means that can cause irritation. Avoid the use of flavored wet wipes, which includes alcohol.
Do not use ordinary toilet paper. It is better to use wet wipes, but without alcohol.
Use cold. To remove edema in the anus, you can use cold heating pads, ice packs, fabric moistened in cold water.

In addition, the diet with hemorrhoids pursues two goals: to prevent constipation and irritation in the rectum. Main recommendations:

Drink enough fluid. This will help make the chair softer, facilitate its passage through the intestines.
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 at about the same time.
Physical activity also helps to normalize the work of the intestines.

Gymnastics

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

The "scissors" exercise is carried out by lying on the back with lifted legs, which need to be diluted and crossed alternately;
"Bicycle" is a fairly famous exercise that is very reminiscent of a bicycle ride, however, lying on your back;
And you can lie on the floor (on the back), put your legs together straight, raise one or the other leg, if possible, reaching a right angle in the hip joints. Or bend your legs in your knees and spread to the sides, while trying to tear off the basin from the floor as much as possible.

So a person is arranged that he feels his "fifth point" in any position and is able to lead it, so gymnastics for strengthening the anus does not require any devices and can be performed anywhere, and those around him are unlikely to notice it.

So, exercises to strengthen the sphincter:

Get up, cross your legs and make rhythmic relaxations and tension of the gluteal muscles;
Choose the hardest chair, sit down a little forward (you can easily do at the desktop), try to reduce and relax the sphincter in turn, trying to push the anus into the rectum. You should take 20 minutes to the exercise, which, if desired, can always be found.

Prevention

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

irregular chair, a tendency to constipation or diarrhea, the habit of strangleing during defecation or for a long time to sit in the toilet with a book;
hard physical work and, conversely, a deficiency of movement, long -term stay in a sitting position;
pregnancy and childbirth;
Alcohol abuse.

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

It is advisable to reconsider the diet: to abandon simple carbohydrates (pastries, sweets) in favor of complex (vegetables, fruits, greens, grain bread), instead of tea and coffee, drink water, it will help to normalize a chair.
Avoid alcohol, including beer.
With hemorrhoids, we are unwanted by horse riding, heavy athletics, bicycle sports, but walking or swimming is simply 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 ascending shower for washing, on the contrary, very useful.

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