In our culture, the bodily bottom and its functions are a topic that is not customary to discuss in a decent society.Therefore, diseases that affect these parts of the body cause the suffering of 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 entire adult population of the Earth is subject to it.Most often, people from 30 to 50 years old suffer from hemorrhoids, and men are four times more often 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 -medicate, which only worsens their position.But hemorrhoids, like other diseases, are easiest to treat in the early stages.
What is hemorrhoids and the causes of its occurrence
The final part of the digestive tract, the last segment of the colon, is called the rectum;It begins 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, unpaired, is called hemorrhoidal), and the outflow of blood is carried out by a wide -branched veins of veins located in the submucosal layer of the rectum.In the lower part of the rectum, or the hemorrhoidal zone, under the mucous membrane are cavernous, or cavernous, bodies, pierced by the network of the smallest veins.Normally, the walls of these vessels should support the connective tissue, but if it is weakened, the blood flow is increased, and the outflow is disturbed, then the walls of the vessels swell, the cavernous bodies are filled with blood and stick out, filling the entire cavity and sometimes even showed out through the anus.Hemorrhoids are the same blood swollen and protruding cavernous bodies.Sometimes the appearance of hemorrhoids cause mechanical causes when, under the influence of some factors, the muscle fibers of the longitudinal muscle of the rectum are stretched and loosened, which causes the displacement of hemorrhoidal nodes to the anus and their loss from it.The number of nodes in patients is very different - from one to several, which can fill the entire anal region.Their dimensions are also very different - from 5 mm to 3 cm.
Although the exact causes of the occurrence and development of hemorrhoids have not yet been revealed, it is believed that the following factors contribute to it:
- A sedentary lifestyle.People are particularly subject to the emergence of hemorrhoids, for a long time to be in a sitting or standing position for a long time.When a person sits or stands for a long time, stagnation of blood occurs in the pelvic organs, which can disturb the outflow of blood through the veins.
- Physical work.However, physical activity is not a panacea;People working in areas where prolonged and constant hard physical labor is required also suffer from hemorrhoids.
- Complications for defecation- Be it diarrhea or chronic constipation.Both of these states cause an increase in pressure in the abdominal cavity, which, in turn, leads to an increase in hemorrhoidal nodes and their loss.
- Improper nutrition.Increased use of alcohol, spicy food causes an arterial influx to the cavernous bodies of the rectum, which contributes to their expansion.Food, poor in fiber, causes constipation, and the abundance of fatty foods - diarrhea.
- Hypothermia or overheating of the pelvis area.Both of these conditions worsen blood circulation and contribute to stagnation of blood in the pelvis.
- Pregnancy, childbirth.In this state, a woman increases pressure in the abdominal area, and the outflow of blood through the veins may be disturbed.As a result, hemorrhoids may form.
- Obesity.Especially the occurrence of hemorrhoids are subject to people whose fat is mainly deposited in the abdomen.
- Some sexual practicesincluding anal sex.
- Various diseases: liver diseases (with them, venous outflow of blood is impaired, pressure increases 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 nervous regulation of the tone of the venous wall, pathology of the heart and blood vessels.
Symptoms of hemorrhoids
Hemorrhoids arise gradually and imperceptibly;A person does not experience special inconvenience, unless from time to time after defecation can feel discomfort, pain, itching in the anus.Soft fabrics in the area of the anus can swell.Mucus can be released from the rectum, irritating the anus and causing burning sensation.Sometimes the patient has a feeling, as if a foreign body is in the rear hole;After defecation, long aching pains are frequent.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 feces, on 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 rectum loss
- colitis, polyps, condylomas
The patient should pay attention to whether the occurrence of bleeding is due to a change in the intestinal behavior, the appearance of a stool of a different color or consistency than usual.With such symptoms, consult a doctor immediately-bleeding may occur in another place of the gastrointestinal tract.
How hemorrhoids manifest itself
Hemorrhoids happenexternalorinternal.With external hemorrhoids, hemorrhoidal nodes are expanded, formed from the lower venous plexus and located directly at the anus.Since inflammation is not inside the rectum, but outside it, if desired, you can consider 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 region.External nodes are often inflamed, injured by rough linen and 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 hemorrhoidal nodes are located in the submucosal layer of the rectum, it is possible to see them with the naked gaze only in the later stages of the disease, when the shell of the cavernous bodies is so deformed that it peers out through the anus.The main symptoms of internal hemorrhoids are the presence of blood in the feces (although most often it is scarlet, arterial, it is also possible that dark venous blood with clots), pain during defecation.In the later stages of the disease, hemorrhoids fall out of the anus;At first, they are drawn inside, but later patients have to do it manually.
There is also a combined hemorrhoids, in which both the cavernous bodies of the rectum and the subcutaneous venous plexus of the anal region are deformed.
Hemorrhoids happensharp(when its symptoms develop rapidly, nodes are inflamed, inflammation passes to neighboring tissues, the patient suffers from pain; necrotic changes in the nodes due to thrombosis are also possible) andchronic.Then the disease lasts a long time, months and even years, while periodically exacerbates - bleeding occurs, nodes fall out, pinched and deliver many inconvenience.During periods of remission, provided that the precautions are observed by the patient practically does not feel discomfort.
Stages of development of the disease
Most cases of hemorrhoids are diagnosed in the later stages - either because patients did not pay attention to the symptoms, attributing them to other reasons, or due to false shame, tightened the trip to the doctor.There are four stages of hemorrhoids.
- The first stage.The symptoms are impressively expressed, manifest only in special cases (for example, with intestinal disorders, after heavy physical labor, long standing or sitting on the spot, food disorders, overheating or hypothermia).Sometimes the patient feels discomfort during defecation, burning and itching after it.On examination, the doctor notes the presence of stagnation of blood and stretching the walls of blood vessels.If hemorrhoids manage to diagnose at this stage, the treatment takes place quickly and without problems.
- The second stage.Hemorrhoids increase in size, their walls become thinner, small breaks can form on them, which leads to bleeding.In the patient, after large physical exertion, complicated defecation or hypothermia, traces of blood in feces, on toilet paper or underwear can be observed, but the bleeding is very small and quickly passes.Hemorrhoids are slightly enlarged and can fall out of the anus after defecation, however, getting back on their own.Their appearance is caused by an increase in the pressure in the peritoneum with severe stress, whether it is physical labor or strong cough.At this stage, you can still resort to conservative treatment.
- The third stage.The anal sphincter undergoes dystrophic changes and weakens, as a result of which the fallen hemorrhoidal 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 stage.The nodes are so enlarged that it is not possible to correct them.The muscles of the anal hole are very weakened, the tone of the sphincter is reduced.For the loss of nodes, even the smallest physical activity is enough.The nodes themselves can take the form of seal, they are inflamed;Inflammation can also affect the nearby fabrics.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids are not found 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 further development of the disease, when hemorrhoids have already moved to the third or fourth stage, the patient is given a lot of inconvenience manual reduction of the nodes.And they can already fall out not only after defecation, but also with severe coughing, sneezing, physical exertion.
In rare cases, the fallen hemorrhoidal nodes can be pinched by the muscle of the anal sphincter, which causes severe pain.If the nodes are not adjusted, thrombosis may develop.This is the hardest possible complications for hemorrhoids, which requires immediate medical care.In this state, hemorrhoidal nodes are swollen, tense, greatly increased in size, and purulent infection in the patient’s body is possible.Patients lose their appetite, their temperature rises, they are sick.
Any disease becomes worse if it is not treated.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 squeezing the veins of cavernous bodies of the rectum of the rectum, which increased in the size of the uterus, which causes impaired blood outflow, blood vessels and the formation of hemorrhoidal nodes.Also, the appearance of hemorrhoids in pregnant women can provoke constipation when feces stretch the walls of the rectum and injure the cavernous bodies.As a rule, in recent months of pregnancy, a woman is forced to lead a sedentary lifestyle, which also does not contribute to the healing of the body.During childbirth, the muscles of the perineum are tensed, the cavernous bodies of the rectum are stretched and injured.With severe stretching of the muscles of the perineum, a weakening of the anal sphincter is possible and, as a result, the loss of nodes.
Often those who gave birth to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately see a doctor, thereby 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 area of the anus, itching, as well as traces of blood, you should consult a professionalist or a collapse doctor.
Diagnosis of the disease
Typically, to diagnose hemorrhoids, there is enough visual examination of the patient’s body.At the same time, the patient either takes the knee-elbow position or occupies a gynecological chair.The doctor examines the patient's anus, paying special attention to the condition of the skin, the presence of hemorrhoidal nodes, their value and position.
To confirm the diagnosis, the doctor can conduct other studies:
- Rectum.The doctor examines the tissues of the anal canal, assesses the state of the mucous membrane of the rectum, as well as the surrounding organs and tissues, determines the location of hemorrhoidal nodes, their value and the degree of pain, and whether there is bleeding.True, the exact size of the nodes cannot be set - when feeling, they, as a rule, are reduced in size.In this case, the patient can lie on his side, on his back or stand on all fours, and the doctor in gloves with his index finger examines the rectum from the inside.Already after a finger examination, the doctor can prescribe anoscopy and spectoroscopy.
- Anoscopy.With anoscopy, a special device is introduced into the rear, which allows the doctor to examine the surface of the rectum for 10-15 cm. Using the anoscope, the doctor determines where exactly the cavernous bodies are affected, whether there are tumor-shaped processes and inflammatory diseases in the rectum.The anoscope is also used to take tests - biopsy and strokes.This procedure is painless and has practically no contraindications;The exception is the stage of exacerbation of inflammatory diseases.Then the doctor recommends first remove the inflammation and only then conduct an examination.
Although anoscopy is a fairly simple procedure, it requires preliminary preparation.So that nothing prevents the examination of the rectum, the patient should refrain from eating the night before, as well as make two cleansing enemas - one half a day before the time of the procedure and the second - a couple of hours before it.It is also possible that the doctor will ask the patient to take a laxative on the eve.
Also, to exclude the risk of developing oncological pathology, the doctor may offer the patient to passSectoronoscopy- examination of the sigmoid and rectum.With this examination, the doctor can examine the inner surface of the rectum even further-up to 25 cm. If for some reason, it is impossible to carry out a stomoroscopy (let’s say, the patient has pathological disorders of the rectum), they are carried out instead of itColonoscopy- 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's systems located nearby.Often hemorrhoids are accompanied by diseases of the anal part of the body and colon, caused by bleeding from hemorrhoids.Sometimes there is also an irritable bowel syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides which treatment to prescribe.But with all stages of hemorrhoids, from the first to the last, treatment is carried out that allows you to stop the symptoms of the disease - to reduce pain, stop bleeding.If hemorrhoids of the first or second stage, it is possible to cure it when using the so -called.Conservative treatment - that is, the use of drugs that relieve pain, prevent complications, and also contribute to postoperative rehabilitation of patients.The best results are given by the joint use of drugs of both external and internal use.
| Group | Scope | Method of application | |
|---|---|---|---|
| Non -steroidal anti -inflammatory drugs and analgesics | Remove the inflammatory process, reduce swelling, anesthetize | Orally | |
| Venotonizing agents | Improve blood vessels, reduce the extension of veins, prevent thrombosis | Orally, externally | |
| Hemostatics | Stop bleeding | Orally, in the form of injections | |
| Ointments | Relieve spasm and inflammation, anesthetize | Externally | |
| Anticoagulant | Prevent thrombosis of hemorrhoids | Injections | |
| Laxatives | Normalize a chair | Orally | |
| Enemas | Normalize a chair | External | |
| Candles | Stimulation of blood supply, analgesic, anti -inflammatory | External |
If after a week or two no positive changes are observed, a second examination should be undergoing a proctologist who will offer a different treatment.
If hemorrhoids of the second or third stage and it is impossible to cure it with only drugs, the so -called.Small -invasive methods - unlike operating ones, they are less traumatic for the patient, patients are spent less time in the hospital and are restored faster.This includes:
- Infrared radiation.Using an infrared coagulator, the doctor acts on hemorrhoidal nodes with a high temperature, cauterizing blood vessels.This operation 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 carried out using laser rays.
- Sclerotherapy.The patient in hemorrhoidal nodes introduce a special substance that glues the walls of the vessels.Usually, with sclerotherapy, a substance is introduced into no more than two nodes so that the patient does not develop pain syndrome.The next session is held in two weeks.
- Ligating (ligation) of hemorrhoids with latex rings.This method is most often used to treat hemorrhoids in elderly patients who have complicating treatment of the disease.At the same time, a small ring made of latex is applied to the base of the node, which gradually squeezes the node, leads to its necrosis and rejection.At the same time, bleeding does not occur, since the stump is blocked by the ring;Subsequently, a healthy connective tissue is formed in its place.The procedure is almost painless, has low trauma, and the ring can be quickly applied with anoscope.
- Cryotherapy.In this method of treatment, the hemorrhoidal node is exposed to low temperatures, after thawing it dies, the resulting wound heals over time and the connective tissue forms at the site of the node.The operation is carried out under local anesthesia.
All minimally invasive methods of treatment are used only in the absence of exacerbation of hemorrhoids.If hemorrhoids entered the acute stage, it is necessary first of all to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
At the fourth stage of hemorrhoids, surgical treatment is indicated.The operation (hemorrhoidctomy) is carried out in the following way: the main groups of hemorrhoidal nodes are subjected to excision, ligatures are applied to their grounds, the edges of the wound are sewn.Although it sounds scary, the operation, although quite unpleasant, is very effective and has the smallest number of relapses.However, after it, complications are possible: severe pain, bleeding, scars, deforming anal canal, strictures of the anus, suppuration of wounds, paraproctitis.After the operation, it is necessary to observe the regime prescribed by the doctor - to refuse for the duration of physical activity and hot baths.
Hemorrhoid treatment at home
There are many folk remedies from hemorrhoids, but not all of them are effective, and some can be harmful.It is recommended to use them only when approving the attending physician.
The decoctions of the highlander of the renal, the fruits of rosehips and raspberry leaves will help reduce inflammation and normalize the tone of blood vessels.You can also rinse the area of the anus and hemorrhoidal nodes, especially after defecation, decoctions of herbs that have an anti -inflammatory effect (calendula, St. John's wort, chamomile).Also with them you can make warm baths by 10-15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to avoid the occurrence or exacerbation of hemorrhoids, eating correctly so that the chair is soft, and there is no constipation.This follows:
- There are high fiber foods- Fruits, vegetables, grain cereals.This softens the chair and increases its volume, which helps to avoid increasing pressure in the abdominal cavity.However, in small portions should be introduced into your diet so that they do not cause increased gas formation.It is recommended to avoid sharp dishes, seasonings and alcohol.
- Drink a lot of liquids.It is recommended to drink from six to eight glasses of water or other liquids per day (alcohol is not included here) so that the chair is softer and does not injure the walls of the rectum.
- Add drugs containing dietary fiber to your diet.Most people do not receive enough fiber per day (25 g are recommended for women, for men - 38 g).Some nutritional supplements can improve the general condition of the patient with the developed hemorrhoids.But do not forget that with the introduction of additives with a high content of dietary fibers into the diet, the consumption of water or other liquids (not alcohol) to eight glasses per day or more should be increased.Otherwise, they can cause constipation.
- Do not strain during defecation.Excessive tension and holding of breathing when trying to relieves the great pressure in the veins of the rectum.
- Timely visit the toilet.If a person for some reason removes defecation, the chair can become dry and it will be more difficult to remove it 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.
- Exercise.It is recommended to do exercises or engage in any other physical activity-this will improve the condition of the vascular system of the body, improve blood flow and reduce pressure on the veins.With sitting or standing work, it is advisable to take a short break every couple of hours, walk, stretch, do a few exercises.
- Avoid long periods of immobility.Too long sitting or standing can increase the pressure on the veins in the rectal region.