In our culture, the physical soil and its functions are an issue that is not common in a decent society.Diseases that affect these parts of the body therefore cause suffering not only physical, but also psychological properties.Unfortunately, one of these diseases - hemorrhoids - is not as rare as we want.At least 10-15% of the entire adult population of the earth are subject to it.Most of the time, people between the ages of 30 and 50 suffer from hemorrhoids, and men are four times more common than women.Unfortunately, far from all patients, the signs of the illness started, go to the doctor.False shame prevents many, they prefer themselves, which only worsens their position.But like other diseases, hemorrhoids are the easiest to treat in the early stages.
What are hemorrhoids and the causes of his occurrence
The last part of the digestive tract, the last segment of the large intestine, is called the rectum;It begins somewhere at the third sacred vortex level and ends with the anus.Its blood supply is provided by five arteries (one of them, unpaired, is carried out as a hemorrhoids) and the blood drainage is carried out by a widespread vein of veins that are in the submucosal layer of the rectum.In the lower part of the rectum or in the hemorrhoid zone under the mucous membranes there are cavernous or cave -like bodies that are pierced through the network of the smallest veins.Usually the walls of these vessels should support the connective tissue, but if it is weakened, the blood flow is increased and the drain is disturbed, then the walls of the vessels swell, the cavity -like bodies are filled with blood and protrude, fill the entire cavition and sometimes even showed through the anus.Hemorrhoids are the same blood -swollen and protruding cave -like bodies.Sometimes the occurrence of hemorrhoids cause mechanical causes if the muscle fibers of the rectum's longitudinal muscle fibers are stretched and solved under the influence of a few factors, which causes the shift of hemorrhoid nodes to the anus and their loss.The number of nodes in patients varies very differently - from one to several who can fill the entire anal area.Your 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 uncovered, it is assumed that the following factors contribute to this:
- A sitting lifestyle.People are particularly subject to hemorrhoids for a long time in order to be in a seated or standing position for a long time.When a person sits or stands for a long time, a blood stagnation occurs in the pelvic organs that can disturb the blood drainage through the veins.
- Physical work.However, physical activity is not a panacea;People who work in areas in which longer and constant hard physical work are required also suffer from hemorrhoids.
- Complications for defecation- be it diarrhea or chronic constipation.Both conditions lead to an increase in pressure in the abdominal cavity, which in turn leads to an increase in hemorrhoid nodes and loss.
- Improper nutrition.The increased use of alcohol leads to an arterial influx into the cave -like body of the rectum, which contributes to its expansion.Food, poorly in fiber, causes constipation and the abundance of fatty foods - diarrhea.
- Settlement or overheating of the pelvic area.Both conditions worsen blood circulation and contribute to the stagnation of blood in the pool.
- Pregnancy, birth.In this state, a woman increases the pressure in the abdominal area and the blood drainage through the veins can be disturbed.As a result, hemorrhoids can form.
- obesity.In particular, the occurrence of hemorrhoids are subject to people whose fat is mainly deposited in the stomach.
- Some sexual practicesincluding anal sex.
- Different diseases: Liver diseases (with them the venous blood drainage is affected, 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, intestine.
- Hereditary reasons: Functional lack of connective tissue, impaired nervous regulation of the tone of the venous wall, the pathology of the heart and the blood vessel.
Symptoms of hemorrhoids
Hemorrhoids are gradually and imperceptible;One person has no special inconvenience, unless it can feel symptoms, pain and itching in anus from time to time after defecation.Soft fabrics in the area of the anus can swell.The mucus can be released from the rectum that irritates the anus and cause burning feeling.Sometimes the patient has the feeling that there is a foreign body in the back hole;After defecation, long painful pain is common.These phenomena are reinforced by violating a diet or disorders of the gastrointestinal tract.But mostly people look for a doctor after having grasped blood in feces, toilet paper or underwear in the form of small drops, streaks or in rare cases with intensive 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 with the following diseases:
- Anal tear
- Oncological diseases of the rectum
- The rectal loss
- Colitis, polyps, condylomas
The patient should make sure whether the occurrence of bleeding is due to a change in the intestinal behavior, the occurrence of a chair of a different color or consistency as usual.With such symptoms, a doctor can appear in a different place of the gastrointestinal tract.
How to manifest hemorrhoids
Hemorrhoids passexternalorinternally.In external hemorrhoids, hemorrhoid nodes are expanded, formed from the lower venous plexus and located directly on the anus.Since inflammation is not in the rectum, but if you have desired, you can take this area into account with your own eyes.Bleeding in this form of hemorrhoids lacks practical, but patients are very concerned about pain in the rectal area.External nodes are often inflamed, injured by rough linen and frequently reborn in oncological formations.This type of hemorrhoids relatively rare - no more than 10% of the total number of patients suffer.
The internal hemorrhoid nodes are in the submucosal layer of the rectum.It is possible to see them only in the later stages of the disease with the bare look when the shell of the cave -like body is so deformed that it starts through the anus.The main symptoms of internal hemorrhoids are the presence of blood in the feces (although it is mostly scarlet red, arterial, it is also possible that dark blood with clot pain during defecation. In the later stages of the disease, hemorrhoids fall from the anus; first they are drawn inside, but later the patients have to do it manually.
There are also combined hemorrhoids in which both the cave -like bodies of the rectum and the subcutaneous venous plexus of the anal area are deformed.
Hemorrhoids passsharp(If the symptoms develop quickly, nodes are inflamed, inflammation to adjacent tissues, the patient suffered from pain; necrotic changes due to thrombosis are also possible) and and) and) and) and) and) and) and) and) and) and) and) and) and) and) and) and) and) and) and) and and and and and) and) and) and)possible) and) and possible.)chronic.Then the disease lasts long, months and even years, while regularly tightened - bleeding occurs, knots fall out, trapped and deliver many inconvenience.In remission times, provided that the patient's precautionary measures are practically unpleasant.
Development stages of the disease
Most cases of hemorrhoids are diagnosed in the later stages - either because the patients did not pay attention to the symptoms and attributed them to other reasons or tightened the trip to the doctor due to false shame.There are four stages of hemorrhoids.
- The first stage.The symptoms are impressively expressed and only manifests itself in special cases (for example with intestinal disorders, after severe physical work, long on the spot, on the spot, on the spot, food disorders, overheating or hypothermia).Sometimes the patient feels uncomfortable in the stool, the burning and itching afterwards.During the examination, the doctor determines the presence of blood tag nation and stretching the walls of blood vessels.If hemorrhoids are diagnosed 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 great physical exertion, complicated defecation or hypothermia, traces of blood in the feces, on toilet paper or underwear can be observed, but bleeding is very small and passes quickly.Hemorrhoids are slightly enlarged and can fall out of the anus after the stool, but can return alone.Their appearance is caused by an increase in pressure in the peritoneum with severe stress, be it physical contractions or strong cough.At this stage you can still fall back on conservative treatment.
- The third stage.The anal sphincter experiences dystrophic changes and weakens, whereby the fallen hemorrhoid nodes can only be corrected by hand.The patient is worried about serious itching, bleeding is common and plentiful.Conservative treatment is no longer possible.
- The fourth stage.The knots are enlarged so that it is not possible to correct them.The muscles of the analloch are very weak, the sound of the sphincter is reduced.The smallest physical activity is sufficient for the loss of knots.The nodes themselves can accept the shape of the seal, they are inflamed;Inflammation can also affect the nearby substances.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids are not found too often.Although especially with the patient's hemorrhoids, the type of blood is afraid, it is not noticeable that it is a danger to life.However, anemia is possible with longer constant bleeding.
The mucus flow from the anus causes itching and can lead to eczema.
With the further development of the disease, if hemorrhoids have already moved into the third or fourth level, the patient receives a numerous reduction in the nodes with inconvenience.And you can not only fail after the stool, but also with a heavy cough, sneezing, physical exertion.
In rare cases, the fallen hemorrhoid nodes can be trapped by the muscle of the anal sphincter, which causes severe pain.If the nodes are not adjusted, thrombosis can develop.These are the most difficult complications for hemorrhoids, which requires immediate medical care.In this state, hemorrhoid nodes are swollen, tense, greatly increased and purulent infection is possible in the patient's body.Patients lose their appetite, their temperature increases, they are sick.
Every illness becomes worse if it is not treated.It is no exception of hemorrhoids - if there is no treatment, progress, which can lead to irreversible changes in the veins of the rectum.
Hemorrhoids during pregnancy and birth
The reason for the development of hemorrhoids in pregnant women is to press the veins of the cave -like bodies of the rectum of the rectum, which was increased in the size of the uterus, which causes a disturbed blood outflow, blood vessels and the formation of hemorrhoid nodes.The occurrence of hemorrhoids in pregnant women can also provoke constipation when feces stretch the walls of the rectum and violate the cave -like bodies.As a rule, a woman has been forced to lead a sitting lifestyle in the last few months of pregnancy who also does not contribute to the healing of the body.During birth, the muscles of the perineum are tense, the cave -like bodies of the rectum are stretched and injured.With a strong stretching of the muscles of the perineum, the anal sphincter is weakened and, as a result, the loss of nodes is possible.
Often those who brought women to the world confuse the symptoms of hemorrhoids with the consequences of birth and do not immediately see a doctor, which provokes the development of the disease.
Which doctor who comes into contact with hemorrhoids?
If a person is concerned about the unpleasant sensations in the area of anus, itching and traces of blood, you should consult a professionalist or a collapse doctor.
Diagnosis of the disease
In order to diagnose hemorrhoids, the patient's body is examined sufficiently visually.At the same time, the patient either takes over the knee-socket position or takes a gynecological chair.The doctor examines the patient's anus and pays special attention to the skin condition, the presence of hemorrhoid nodes, their value and their position.
In order to confirm the diagnosis, the doctor can carry out other studies:
- rectum.The doctor examines the tissue of the anal canal, evaluates the condition of the mucous membrane of the rectum as well as the surrounding organs and tissues, determines the position of hemorrhoids, their value and the level of pain and whether there is bleeding.The exact size of the nodes cannot be determined - if you feel, you will usually be reduced in size.In this case, the patient can stand on his side, on the back or on all fours, and the doctor with his index finger examines the rectum from the inside.After a finger examination, the doctor can prescribe anoscopy and spectoroscopy.
- Anoscopy.In anoscopy, a special device is inserted into the rear with which the doctor can examine the surface of the rectum for 10-15 cm.Using the anoscope, the doctor determines exactly where the cave -like bodies are affected, whether there are tumor -shaped processes and inflammatory diseases in the rectum.The anoscope is also used to make tests - biopsy and lines.This process is painless and has practically no contraindications.The exception is the stage of worsening of inflammatory diseases.Then the doctor recommends the inflammation first and only then carries out an exam.
Although anoscopy is a fairly simple process, it requires preliminary preparation.So that nothing prevents the rectum from being examined, the patient should stop it the night before and two hours before him - half a day before the time of the intervention and in the second - a few hours before him - a few hours ahead of him.It is also possible for the doctor to ask the patient to take a laxative the evening before.
In order to rule out the risk of oncological pathology, the doctor can offer the patientSectoronoscopy- Investigation of the Sigmoid and the rectum.In this examination, the doctor can examine the inner surface of the rectum even further up to 25 cm.If it is impossible for any reason to carry out a tomoroscopy (let's say that the patient has pathological disorders of the rectum), they are carried out instead of thisColonoscopy- 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 in which stage he is and how he will develop.On the way, you can identify other diseases that influence the functioning of the nearby systems of the body.Hemorrhoids are often accompanied by diseases of the anal body and colon, which are caused by bleeding from hemorrhoids.Sometimes there is also irritable bowel syndrome.
How to treat hemorrhoids
After a diagnosis, the doctor decides which treatment should prescribe.At all stages of hemorrhoids, however, treatment is carried out right from the start, which enables you to stop the symptoms of the disease - reduce and bleed pain.If hemorrhoids of the first or second stage, it is possible to heal them when using the so -called.Conservative treatment - ie the use of medicinal products that relieve pain, prevent complications and also contribute to postoperative rehabilitation of patients.The best results are achieved by the joint use of medicines both external and internal use.
| group | Scope | Application method | |
|---|---|---|---|
| Non -steroidal anti -inflammatory medication and analgesics | Remove the inflammatory process, reduce the swelling, stunned | Orally | |
| Venotonizing agents | If you improve the blood vessels, reduce the expansion of the veins, prevent thrombosis from | Oral external | |
| Hemostatics | Stop bleeding | Orally in the form of injections | |
| Anoint | Relieve cramp and inflammation, anesthetized | External | |
| anticoagulant | Prevent thrombosis of hemorrhoids | Injections | |
| laxative | Normalize a chair | Orally | |
| Enema | Normalize a chair | External | |
| Candles | Stimulation of 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 offers a different treatment.
If hemorrhoids of the second or third stage and it is impossible to heal them only with drugs, the so -called is.Small invasive methods - in contrast to the operational, they are less traumatic for the patient, patients are spent less time in the hospital and restored faster.This includes:
- Infrared radiation.Using an infrared coagulator, the doctor acts on hemorrhoid nodes with high temperature and chewy 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.The coagulation can also be carried out with laser rays.
- Sclerotherapy.The patient in hemorrhoid nodes introduces a special substance that defines the walls of the vessels.Usually a substance is inserted into sclerotherapy in no more than two knots, so that the patient does not develop pain syndrome.The next session will take place in two weeks.
- Ligation (ligation) of hemorrhoids with latex rings.This method is most often used to treat hemorrhoids in older patients who have complicated treatment of the disease.At the same time, a small ring made of latex is applied to the base of the node, which gradually presses the knot, to its necrosis and rejection.At the same time, no bleeding occurs because the blunt is blocked by the ring;A healthy connective tissue is then formed in its place.The procedure is almost painless, has little trauma, and the ring can be used quickly with anoscope.
- Cryotherapy.With this treatment method, the hemorrhoid node is exposed to low temperatures, after the default of dying, the resulting wound heals over time and the connective tissue forms at the place of the knot.The operation is carried out under local anesthesia.
All minimally invasive treatment methods are only used without aggravating hemorrhoids.If hemorrhoids entered the acute level, it is initially necessary to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
Surgical treatment is indicated at the fourth stage of hemorrhoids.The operation (hemorrhoidctomy) is carried out in the following way: The main groups of hemorrhoid nodes are exposed to excision, ligatures are applied on their reasons, the wounds are sewn.Although it sounds scary, the operation, although it is quite uncomfortable, is very effective and has the slightest number of relapses.According to this case, however, complications are possible: severe pain, bleeding, scars, deforming anal channel, strictures of anus, the supply of wounds, paraprocitis.After operation, it is necessary to observe the regime prescribed by the doctor - to refuse the duration of physical activity and hot baths.
Hemorrhoid treatment at home
There are many folk remedies of hemorrhoids, but not everyone is effective and some can be harmful.It is recommended to only use them when the doctor treats them.
The decoctions of the highlanders of the kidney, the fruits of pour hits and raspberry leaves contribute to reducing inflammation and normalizing the sound of blood vessels.You can also rinse the area of anus and hemorrhoid nodes, especially after defecation, herbal loads that have an anti -inflammatory effect (Calendula, St. John's Wort, Chamomile).You can also make warm baths with 10 to 10 to 15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to avoid the occurrence or deterioration of hemorrhoids and eat properly so that the chair is soft and there is no constipation.This follows:
- There is high fiber fiber- Fruit, vegetables, grain cereals.This turns out the chair and increases its volume, which contributes to avoiding increasing pressure in the abdominal cavity.In small parts, however, your diet should be introduced so that you do not cause increased gas formation.It is recommended to avoid sharp dishes, spices and alcohol.
- Drink many liquids.It is recommended to drink water or other liquids per day from six to eight glasses (alcohol is not included here) so that the stool is softer and the walls of the rectum do not violate.
- Add medication to your diet that contain fiber.Most people do not receive enough fibers a day (25 g are recommended for women for men - 38 g).Some dietary supplements can improve the general condition of the patient with the developed hemorrhoids.However, do not forget that with the introduction of additives with a high content of dietary fibers in the diet of eating water or other liquids (not alcohol) up to eight glasses per day or more should be increased.Otherwise you can cause constipation.
- Do not burden during defecation.Excessive tension and breathing when trying to relieve the great pressure in the veins of the rectum.
- Visit the toilet in good time.If a person eliminates the defecation for any reason, the chair can dry and it becomes more difficult to remove it from the body.However, you should not get involved in laxatives - with constant use you can irritate the anal area and even contribute to the development of inflammatory processes in the rectum.
- Exercise.It is recommended to carry out exercises or to do another physical activity.This improves the condition of the body's vascular system, improves blood flow and reduces pressure on the veins.When sitting or standing, it is advisable to take a short break every few hours, walk on foot, stretch, to do a few exercises.
- Avoid long periods of immobility.Sitting or standing too long can increase the pressure on the veins in the rectal range.