Hemorrhoids

What are the causes of hemorrhoids?It is generally accepted that hemorrhoids develop due to an increase in blood flow or insufficient exit, which leads to stagnant processes. The causes and factors for 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 heritage of certain groups of genes leads to congenital weakness or to a vascular dysfunction located in the rectum. This is the cause of an improved flow and an insufficient blood outing through the cavernous veins, which leads to the pathological expansion of the latter. A long -term expansion of the cavernous veins leads to slimming the walls of the blood vessels, which contributes to the occurrence of bleeding with hemorrhoids. Longtime 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 forced to stay in a standing position for a long time. This category includes teachers, teachers, Swiss, guards, hairdressers and others. Another reason for hemorrhoid development and hemorrhoid loss.A sedentary lifestyle. This is a serious negative factor, mainly linked to office employees, engines and people, leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, it is increased pressure on the rectum's vessels in a sitting position. With a prolonged seat, the anus area is slightly heated, which causes stagnant phenomena and vascular expansion. In addition, the lack of physical effort is a real path to the development of venous insufficiency. Including this applies to the veins located in the rectum.Chronic constipation and diarrhea. People with chronic constipation are predisposed to the development of hemorrhoids. Why does it happen? The fact is that with constipation, the excrement harden, exerting pressure on the veins of the lower intestine. This leads to a deterioration in the blood supply of cavernous and the appearance of hemorrhoids. An additional factor of constipation is the habit of growing strongly 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 rectum mucosa.Pregnancy. Hemorrhoids during pregnancy and childbirth are a frequent phenomenon, because the rolling of the fetus creates pressure on the venous vessels of the rectum. And tendency attempts during childbirth only exacerbate the course of hemorrhoids and contribute to the formation of new hemorroid nodes.Incorrect nutrition, abuse of spicy foods and alcohol. Malnutrition is an important factor in the appearance of hemorrhoids. In particular, the abuse of spicy food leads to irritation of the intestinal mucosa and also stimulates an improved blood flow towards the rectum. And insufficient use of fibers (plant foods) aggravates intestinal motility. The factor causing the development of hemorrhoids is alcohol, which widens the ships. The reception of alcoholic beverages, even in small quantities, can cause 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 flow of blood in the rectum.Frequent constipation. Inflammatory and tumor process in the intestines and the liver.Infection.Smoking.

Internal and exteriorInstead of the occurrence of hemorroid nodes, the disease is divided into two main types: internal and external hemorrhoids.With external hemorrhoids, nodes are formed in the immediate vicinity of the anus, on this subject, their sensitive surface often breaks and bleed the brilliant scarlet blood. Pain in external hemorrhoids is quite clear and strong, 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 threat to health, is often distinguished by the total lack of pain (especially at the initial stage of the disease). This fact is explained by the fact that the hemorroid nodes are located deeply inside, and their surface is the same insolutive mucous membrane of the rectum, which life.

DegreeGenerally 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, "contract" pain after defecation.2nd degree. The nodes exceed the anus during the fight and disappear independently. In principle, the same disorders are observed here as for hemorrhoids of the 1st degree, however, the small ruptures of the mucosa are more often, and the inflammation of the anus is stronger. 3rd degree. It is characterized by the loss so called hemorrhoidal nodes, which are not recovered independently. Symptoms can be the same as in 2-, but often fecal and gas phenomena are developing in addition. When examined by hemorrhoids, it differs from the drop in the anus along the radiant grooves, cyanotic coloring and a tuberous surface.

Hemorrhoid symptomsThe signs of hemorrhoids characteristic of all stages of the development of the disease:discomfort in the anus;pain during defecation (first insignificant, then strong);Anus bleeding;Hemorrhoid training and growth.

Hemorrhoids are a chronic pathology that progresses for many years. The development rate of the disease depends on many factors, including nutrition, lifestyle.For the initial stageDiseases are characterized by a slight increase in the veins of the anus. Usually, such a sign remains unnoticed. In this case, the patient can be disturbed by the bloody flows of the rectum which occur immediately after defecation. Blood can easily be seen on hygienic paper. It should be recalled that a similar symptom is characteristic of malignant intestinal tumors, so when it occurs, you must consult a proctologist. A timely research of a doctor and the appointment of therapy will easily slow the development of hemorrhoids.In the second stepThe development of patient's disease can periodically experience discomfort in the anus, itching. Often it has a feeling of a foreign body in the anus. Hemorrhoids are starting to fall during defecation and are always easily adjusted inward. For the third stepHemorrhoids are characterized by an increase in existing characteristics. The large venous nodes of the anus make it difficult to empty intestinal drain, become the cause of constipation, the act of defecation itself is accompanied by pain and bleeding. Strong bleeding with hemorrhoids is dangerous, over time, this can lead to the development of anemia.For the last stepDiseases are characterized by an increase in the size of hemorrhoids. They cannot be straightened with one hand. The presence of advanced veins in the anus causes serious discomfort, it hurts the patient, going to the toilet. He worries abundant bleeding during each defecation. The fourth stage of hemorrhoid development can be complicated by phenomena as unpleasant and dangerous such as veins thrombosis at the end of the rectum.

Hemorrhoids in pregnant womenVery often, hemorrhoids appear during the last trimester of pregnancy and childbirth. The causes of hemorrhoids are a drilling of the increase in the uterus of the intestinal veins, which leads to a deterioration of the blood flow of the intestines and the perineum. Vienna increases in diameter and changes the shape. Periodic constipation in pregnant women can also cause appearance. However, in most women, symptoms of hemorrhoids pass the postpartum period, it is therefore supposed that causes can be hormonal changes. He must be treated immediately after detecting the first of his symptoms. It is important to cope with constipation, for example, taking medication to relieve stool (forlax, laminaride, methyle-velose), observe hygiene rules (wash the anus after defecation). Hemorrhoids (aurobine, relief, etc. ) are used mainly outside in the form of ointments and candles. Surgical intervention is only carried out in serious cases.The prevention of hemorrhoids should be carried out from the first days of pregnancy - make a competent diet to prevent constipation, do not wear tight belts, spend more time in fresh air and walking.

What is the danger?The progression of the disease without appropriate treatment will result in a certain number of very unpleasant complications.Hemorrhoid complications:Anemia (develops with a long course of the disease with abundant bleeding).Inflammatory processes in surrounding tissues, until the development of paraprochet (inflammation of the fiber around the rectum). Paper -owner is considered to be a very serious complication requiring serious treatment.The cracks of the anus. The most common cause of intense pain in hemorrhoids. The cracks create favorable conditions for the development and penetration of various infections deeply in soft tissues. This fact can lead to the development of formidable complications as abccess (limited purulent inflammation, which is accompanied by general discomfort, temperature and intense pain). This complication requires compulsory 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 considerably worsen the process of the disease. In addition, constant fabric damage increases the risk of developing various tumor processes.Insufficient anal sphincter, the incontinence of gas and excrement (often in the elderly).It follows that hemorrhoids require early diagnosis and take immediate measures to solve this problem.

What hemorrhoids look like: photo

DiagnosisAs a rule, the diagnosis is not associated with specific difficulties, the diagnosis occurs within the framework of a survey on patients and an initial ambulatory examination. Inspection helps to determine:the degree of loss of the nodes anus,assess the possibility of going back,The condition of the skin,as well as the relevance and the degree of bleeding.The symptoms of hemorrhoids are similar to certain other diseases. Therefore, the diagnosis must be careful because there is a risk of prescription for incorrect processing. Hemorrhoids can be confused with: Anal crack, which is also accompanied by slight bleeding, pain during defecation;Rectum cancer (malignant intestinal tumors occurs with bleeding);loss of rectum;Colitis, polyps and condylomas.If you notice the first signs of the disease in yourself, do not discourage the doctor for a long time. Early diagnosis will facilitate treatment and help avoid complications, but also surgical intervention.

How to treat hemorrhoids?Conservative treatment of hemorrhoids:Make sure to normalize the intestinal emptying. The chair must be regular, soft. To normalize stool with hemorrhoids, foods with the content of dietary fibers, including wheat sound, are recommended, but their number should be increased gradually in 2 to 3 weeks. (from 5 to 10 g to 20 g per day), which excludes the appearance of discomfort.With constipation, you can recommend lactulosis up to 30 to 40 ml per day to obtain a soft daily chair and other means, follow a diet and constipation recommendations.Treatment uses local drugs: rectal candles of hemorrhoids and ointments.With pain, candles containing small doses of narcotic vehicles (for example, Beladonna, etc. ) help. You can prescribe candles, sodium alginate, ichthyol, according to symptoms and the stage of the disease.If there is no bleeding, you can prescribe suppositories or an ointment of phenylefrine 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 not more than 30 seconds.To increase the effectiveness of local drugs, it is necessary to take oral products that improve the tone of the venous vessels and to prevent thrombosis: diosmine, troxerruitine.Lutting Hemorrhoidal nodes (prolapse) are the basis of their dressing. When hemorrhoidal vein thrombosis, cold and lidocaine hydrochloride (1%solution) is used locally, and additional bandage is possible.With relapse, despite treatment, hemorrhoid unctomy is recommended.The methods of treatment of drugs are exclusively symptomatic-that is to say that hemorrhoids do not radically heal hemorrhoids. However, they allow you to temporarily face the unpleasant signs of hemorrhoids. If the patient after drug treatment complies with medical recommendations for relating to relapse, surgical treatment can be avoided.But not always patients can follow all recommendations.

Small invasive methodsMini-invasive treatment allows you to injure yourself quickly and without serious injuries to get rid of such a delicate problem like hemorrhoids. Therapeutic methods in most cases only suffocate 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, performs a complete examination, assesses all possible risks. Sclerotherapy- This is a low -traumatic treatment thanks to special sclerosing substances that are inserted inside the knot, stick with its walls, so that it is possible to reach the cessation of their nutrition and their death in the future. The technique is only carried out 1-3 steps. It does not exclude the risk of relapse of the disease and is only effective with small hemorrhoids.ElectrocoagulationIt is carried out under the control of the anoscope. The electrode is brought to the node leg and the fabric is coagulated (welded), after which they die quickly. In a procedure, it is possible to get rid of 1 to 2 pathological homes. After having glued, the hemorrhoidal knot stops eating and growing, and after a while disappears completely.Ligature with latex rings-Ne of the most modern methods of mini-invasive treatment of internal hemorrhoids from 1 to 3 stages. A latex ligature is applied through the anoscope on the node's leg, which leads to the pressing of the tissues and a violation of the blood circulation. After 8 to 14 days, the hemorroidal node dies and is withdrawn with the latex ring.Cryotherapy- short -term effect on hemorrhoids with liquid nitrogen. After that, the hemorrhoid knot 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 the anus; anal cracks, wounds;hemorrhoid thrombosis.Small invasive methods of fighting hemorrhoids can only be used 1 to 3 stages of the disease, necessarily by exacerbation of the inflammatory process. All procedures are carried out after local anesthesia. It is not necessary to use general anesthesia. In one session, only 1 to 3 nodes can be deleted. Sometimes the treatment takes place at several stages, from intervals in several weeks.

Surgical treatmentSurgical treatment is the most effective treatment for the third and fourth floors.The hemorrhoid elimination operation, proposed in the 1930s of the last century, is still applied and continues to be modified. Around the world, two types of operations are mainly carried out:Closed hemorrhoidctomy. Apply stage III and IV of the disease.Open hemorrhoidctomy. Also at stage III and IV, but complicated by an anal crack or a paraprotitis.Also in 1993, a new way of treating hemorrhoids was proposed, it was carried out by the Italian doctor A. Longgo, which consists of the circular elimination of the mucous layer and output of the rectum using a special device.Patients are released 3 to 4 days after surgery, disability restoration occurs over 5 to 7 days. A small percentage of postoperative complications is also noted.

Power and diet after surgeryIn most cases, patients, after hemorrhoid surgery, can start drinking and eating a few hours after the operation.But to observe the food table (according to Pevzer 1A), to exclude the products and dishes that excite the secretion of the stomach and irritate its mucous membrane. Food should be cooked in a wiped form, cooked from steam or porridge on water, it is necessary to take a state of liquid and porridge. Exclude: hot and cold products, bread and flour, raw vegetables fruit, cheese, dairy products, sure cream, cottage cheese, spices, sauces, coffee, tea.Eat 6 times a day in small portions. The restoration of the normal operation of the intestine generally occurs the second day after the operation, therefore, it can be transferred to the usual diet. But, of course, all net and spicy dishes must be excluded, alcohol must also be forgotten. Joining these recommendations, you can reduce recovery time after surgery and reduce the risk of complications.

Home treatmentYou can independently perform certain measures that will help alleviate the symptoms of hemorrhoids at home. However, it should be remembered that they will not help get rid of the disease:Hot baths help well. You can take a bath or just sit in a pool of water. It is necessary to place the anus area in lukewarm water for 10 to 15 minutes 2-3 times a day.In -depth hygiene of the anal region. It is necessary to take a bath or shower daily, to carefully wash the anus area. Do not use soap in the anus and other means that can cause irritation. Avoid using flavored damp wipes, which includes alcohol.Do not use ordinary toilet paper. It is best to use wet wipes, but alcohol -free.Use the cold. To eliminate edema in the anus, you can use cold heating pads, ice packs, humidified tissue in cold water.In addition, the diet with hemorrhoids pursues two objectives: to prevent constipation and irritation in the rectum. Main recommendations:Drink enough liquid. This will help make the chair softer, will facilitate its passage through the intestines.Your diet should include more vegetables, fruit, cereals. They contain vegetable fibers, which helps prevent constipation.Alcohol, coffee, strong tea should be avoided.Limit sharp dishes, spices.It is best to take food in small portions, 4-5 times a day.Eat roughly at the same time.Physical activity also helps normalize the work of the intestines.

GymnasticsGymnastics exercises aim to prevent constipation and strengthen anal sphincter. For example, improving the flow 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 on the back with raised legs, which must be diluted and crossed alternately;"Bicycle" is a fairly famous exercise that greatly recalls a bicycle ride, however, lying on the back;And you can lie on the ground (back), gather your straight legs, lift one or the other leg, if possible, reaching a right angle in the hip joints. Or fold your legs in your knees and spread out on the sides, while trying to tear the basin from the ground as much as possible.Thus, a person is arranged that he feels her "fifth point" in any position and is able to direct him, so gymnastics to strengthen the anus does not require any devices and can be done anywhere, and those around him do not notice.Thus, exercises to strengthen the sphincter:Raise yourself, cross your legs and make rhythmic relaxations and the tension of the gluteal muscles;Choose the hardest chair, sit a little forward (you can easily do in the office), try to reduce and relax the sphincter in turn, trying to push the anus in the rectum. You have to take 20 minutes in the exercise, which, if desired, can always be found.

PreventionThe best tool against hemorrhoids is prevention. There are predisposing factors leading to the development of the disease:Irregular chair, tendency to constipation or diarrhea, the habit of widen during defecation or for a long time to sit in the toilet with a book; Hard physical work and, conversely, a moving deficiency, a long -term stay in a sitting position;pregnancy and childbirth;Alcohol abuse.This means that correction of lifestyle will help alleviate the course of the disease.It is advisable to reconsider the diet: abandon simple carbohydrates (pastries, candies) in favor of complexes (vegetables, fruits, green, grain bread), instead of tea and coffee, water, it will help normalize a chair.Avoid alcohol, including beer.With hemorrhoids, we are undesirable 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 make 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 the preventive measures of exacerbation could not be avoided, it is not necessary to panic. It is advisable to change the sitting position in the lie, to apply fresh compresses on the painful point, humidified in a low solution of potassium permanganate or to organize baths with chamomile (not hot! ), Do not forget the diet and personal hygiene.