In our culture, the body background and its functions are a subject that is not usual to discuss in a decent society.Consequently, diseases that affect these parts of the body cause suffering not only of physical, but also psychological properties.Unfortunately, one of these diseases - hemorrhoids - is not as rare as we would like;At least 10 to 15% of the entire adult population of the Earth is subject.Most often, people aged 30 to 50 suffer from hemorrhoids and men are four times more often than women.Alas, far from all patients, feeling the signs of the disease that started, go to the doctor.False shame prevents a lot, they prefer to self-mediat, which only makes their position worsen.But hemorrhoids, like other diseases, are the easiest to treat in the early stages.
What is hemorrhoids and causes of its occurrence
The last part of the digestive tract, the last segment of the colon, is called rectum;It starts somewhere at the level of the third sacred vertebra and ends with the anus.Its blood supply is supplied by five arteries (one of them, unpaid, is called hemorrhoidal), and the flow of blood is made by a large branch of veins located in the submucosal layer of the rectum.In the lower part of the rectum, or the hemorrhoidal area, under the mucosa are cavernous, or cavernous bodies, pierced by the network of smaller veins.Normally, the walls of these vessels should support the connective tissue, but if it is weakened, the blood flow is increased and the exit is disturbed, then the walls of the vessels swell, the cavernous bodies are filled with blood and exceed, filling the whole cavity and sometimes shown through the anus.The hemorrhoids are the same swollen blood and the protruding cavernous bodies.Sometimes the appearance of hemorrhoids causes mechanical causes when, under the influence of certain factors, the muscle fibers of the longitudinal muscle of the rectum are stretched and loosened, which causes the displacement of the hemorroid nodes to the anus and their loss.The number of nodes in patients is very different - from one to more, 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 the development of hemorrhoids have not yet been revealed, it is believed that the following factors contribute:
- 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, the stagnation of blood occurs in the pelvic organs, which can disturb the flow of blood through the veins.
- Physical work.However, physical activity is not a panacea;People working in areas where prolonged and hard hard work is also necessary from hemorrhoids.
- Defecation complications- Whether diarrhea or chronic constipation.These two states cause an increase in pressure in the abdominal cavity, which, in turn, leads to an increase in the hemorrhoidal nodes and their loss.
- Incorrect nutrition.Increased consumption of alcohol, spicy foods causes an arterial influx to the cavernous bodies of the rectum, which contributes to their expansion.Foods, poor in fiber, cause constipation and abundance of fatty food - diarrhea.
- Hypothermia or overheating of the basin region.These two conditions aggravate blood circulation and contribute to the stagnation of blood in the basin.
- Pregnancy, childbirth.In this state, a woman increases pressure in the abdominal area, and the flow of blood through the veins can be disturbed.As a result, hemorrhoids can form.
- Obesity.In particular, the occurrence of hemorrhoids is subject to people whose fat is mainly deposited in the abdomen.
- Some sexual practicesincluding anal sex.
- Various diseases: Liver diseases (with them, venous blood outlets are altered, pressure increases in the veins, which contributes to the development of hemorrhoids);Pelvic organ diseases (bladder, prostate);Neoplasms and / or inflammation in the basin, intestines.
- Hereditary reasons: Functional deficiency of connective tissue, altered nerve regulation of the tone of the venous wall, pathology of the heart and blood vessels.
Hemorrhoid symptoms
The hemorrhoids arise gradually and imperceptibly;A person does not undergo any particular drawbacks, unless from time to time after defecation may feel discomfort, pain, itching in the anus.Soft fabrics in the anus area can swell.The mucus can be released from the rectum, irritating the anus and causing a burning sensation.Sometimes the patient has a sensation, as if a foreign body was in the rear hole;After defecation, long painful pains are frequent.These phenomena are improved in violation of a diet or disorders of the gastrointestinal tract.But most often, people are looking for a doctor after detecting blood in excrement, on hygienic paper or underwear in the form of small drops, scratches or, in rare cases, with intense bleeding.
However, the bleeding of the anus is not always associated with hemorrhoids (especially if the patient is over 40).Rectal bleeding can also occur in the following diseases:
- Anal crack
- Oncological diseases of the rectum
- Loss of rectum
- colitis, polyps, condylomas
The patient must pay attention to the question of whether the occurrence of bleeding is due to a change in intestinal behavior, the appearance of a stool of a color or a consistency different from that of the habit.With such symptoms, consult a doctor immediately bleeding in another place in the gastrointestinal tract.
How hemorrhoids manifest
Hemorrhoids occurexternalOrinternal.With external hemorrhoids, the hemorroid nodes are extended, formed from the lower venous plexus and located directly to the anus.Since inflammation is not inside the rectum, but outside, if you wish, you can consider this area with your own eyes.Bleeding in this form of hemorrhoids are practically absent, but patients are very concerned about pain in the rectal region.The external nodes are often ignited, injured by a raw linen and reborn more often in oncological formations.This relatively rare type of hemorrhoids - no more than 10% of the total number of patients suffers from it.
The internal hemorrhoidal nodes are located in the submucosal layer of the rectum, it is possible to see them with the naked gaze only at the later stages of the disease, when the shell of the cavernous bodies is so distorted that it looks through the anus.The main symptoms of internal hemorrhoids are the presence of blood in excrement (although most often it is scarlet, arterial, it is also possible that dark venous blood with clots), pain during defecation.In the last stages of the disease, hemorrhoids fall from the anus;At first, they are drawn inside, but later patients should do so manually.
There are also combined hemorrhoids, in which the cavernous bodies of the rectum and the subcutaneous venous plexus of the anal region are distorted.
Hemorrhoids occursharp(When his symptoms develop quickly, the nodes are ignited, inflammation passes to neighboring tissues, the patient suffers from pain; necrotic changes in nodes due to thrombosis are also possible) andchronic.Then, the disease lasts a long time, months and even years, while periodically exacerbating - bleeding occurs, the knots fall, pinched and deliver many drawbacks.During periods of remission, provided that the precautions are observed by the patient does not feel no discomfort.
Steps of the development of the disease
Most cases of hemorrhoids are diagnosed in the last stages - either because patients have not paid attention to symptoms, attributing them to other reasons, or for a false shame, tightened the trip to the doctor.There are four stages of hemorrhoids.
- The first step.Symptoms are expressed impressively, only manifest themselves in special cases (for example, with intestinal disorders, after heavy physical work, long -standing or sitting on site, eating disorders, overheating or hypothermia).Sometimes the patient feels discomfort during defecation, burn and itching afterwards.On examination, the doctor notes the presence of blood stagnation and stretching the walls of blood vessels.If hemorrhoids manage to diagnose at this stage, treatment takes place quickly and without problems.
- The second step.Hemorrhoids increase in size, their walls become thinner, small ruptures can form on it, which causes bleeding.In the patient, after a great physical effort, a defecation or complicated hypothermia, traces of blood in the excrement, on hygienic paper or underwear can be observed, but the bleeding is very small and passes quickly.Hemorrhoids are slightly enlarged and can fall from the anus after defecation, however, recovering from themselves.Their appearance is caused by an increase in pressure from the peritoneum with serious stress, whether physical work or a strong cough.At this stage, you can always use conservative treatment.
- The third step.The anal sphincter undergoes dystrophic changes and weakens, as a result of which the hemorrhoidal nodes fallen 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 step.The nodes are so widened 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 knots, even the smallest physical activity is enough.The nodes themselves can take the form of a seal, they are ignited;Inflammation can also affect nearby tissues.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids are not found too often.Although above all, with the patient's hemorrhoids, the type of fear of blood, it does not stand out so much that it is a danger to life.However, with prolonged constant bleeding, anemia is possible.
The anus mucus flow causes itching and can cause eczema.
With the subsequent development of the disease, when hemorrhoids have already passed to the third or fourth stage, the patient receives a lot of manual reduction in the inconvenience of nodes.And they can already fall not only after defecation, but also with severe cough, sneeze, physical effort.
In rare cases, the fallen hemorroid nodes can be pinched by the muscle of the anal sphincter, which causes intense pain.If the nodes are not adjusted, thrombosis can develop.These are the most difficult complications possible for hemorrhoids, which require immediate medical care.In this state, the hemorrhoidal nodes are swollen, tense, considerably increased and purulent infection in the patient's body is possible.Patients lose their appetite, their temperature increases, they are sick.
Any disease worsens if it is not treated.This is no exception to hemorrhoids - in the absence of treatment, it progresses, which can cause irreversible changes in the veins of the rectum.
Hemorrhoids during pregnancy and childbirth
The reason for the development of hemorrhoids in pregnant women is to tighten the veins of the cavernous bodies of the rectum of the rectum, which increased in the size of the uterus, which causes an alteration of the blood outing, blood vessels and the formation of hemorrhoidal nodes.In addition, the appearance of hemorrhoids in pregnant women can cause constipation when excrement stretch the walls of the rectum and injure the cavernous bodies.In general, in recent months of pregnancy, a woman is forced to lead a sedentary lifestyle, which does not contribute to the healing of the body either.During childbirth, the muscles of the perineum are tense, the cavernous bodies of the rectum are stretched and injured.With a severe stretch of the perineum muscles, a weakening of the anal sphincter is possible and, therefore, the loss of nodes.
Often, those who have given birth to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately see a doctor, thus causing the development of the disease.
Which doctor contact with suspicions of hemorrhoids?
If a person is concerned about unpleasant sensations in the anus field, itching, as well as traces of blood, you should consult a professionalist or a collapse doctor.
Diagnosis of the disease
As a rule, to diagnose hemorrhoids, there is enough visual examination of the patient's body.At the same time, the patient takes the position of the knee-elbow or occupies a gynecological chair.The doctor examines the patient's anus, paying particular attention to the skin of the skin, the presence of hemorrhoidal knots, its value and its 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 rectum mucosa, as well as the surrounding organs and tissues, determines the location of the hemorrhoidal nodes, their value and the degree of pain, and if there is bleeding.Admittedly, the exact size of the nodes cannot be defined - when they feel, they, as a rule, are reduced in size.In this case, the patient can lie on the side, on the back or stand up on all fours, and the doctor in gloves with his index examines the rectum from the inside.Already after an examination of the finger, the doctor can prescribe anoscopy and SPECToscopy.
- Anoscopy.With anoscopy, a special device is introduced to the rear, which allows the doctor to examine the surface of the rectum for 10 to 15 cm.Using the anoscope, the doctor determines where exactly the cavernous bodies are affected, that there are tumor -shaped processes and inflammatory diseases in the rectum.The anoscope is also used to take tests - biopsy and lines.This procedure is painless and has practically no contraindication;The exception is the stage of exacerbation of inflammatory diseases.Then the doctor first recommends deleting inflammation and carrying out an exam.
Although anoscopy is a fairly simple procedure, it requires preliminary preparation.For nothing to prevent the rectum exam, the patient should refrain from eating the previous night, as well as two cleansing enemas - half a day before the procedure time and the second - a few hours before him.It is also possible that the doctor asks the patient to take a laxative the day before.
In addition, to exclude the risk of developing an oncological pathology, the doctor can offer the patient to passSectoroscopy- examination of the sigmoid and the rectum.With this examination, the doctor can examine the interior surface of the rectum even more at 25 cm.If for any reason, it is impossible to make a stomoroscopy (let's say, the patient has pathological disorders of the rectum), they are made insteadColonoscopy- When the inner surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can have a clear image 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 nearby body systems.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 colon syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides which treatment to prescribe.But with all the stages of hemorrhoids, from the first to the last, a treatment is carried out which 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.Conservative treatment-That is to say the use of drugs that relieve pain, prevent complications and also contribute to the postoperative rehabilitation of patients.The best results are given by the joint use of drugs both to external and internal use.
| Band | Scope | Application method | |
|---|---|---|---|
| Non-steroidal anti-inflammatory drugs and anti-inflammatory drugs | Remove the inflammatory process, reduce swelling, anesthetize | Orally | |
| Venotonizing agents | Improve blood vessels, reduce the extension of the veins, prevent thrombosis | Orally, external | |
| Hemostatic | Stop bleeding | Orally, in the form of injections | |
| Wave | Relieve spasms and inflammation, anesthesia | Outside | |
| Anticoagulant | Prevent the thrombosis of hemorrhoids | Injections | |
| Laxatives | Normalize a chair | Orally | |
| Enemies | Normalize a chair | External | |
| Candles | Stimulation of blood, analgesic, anti-inflammatory supply | External |
If after a week or two, no positive change is observed, a second exam should undergo a proctologist who will offer different treatment.
If hemorrhoids from the second or third step and it is impossible to cure it with only drugs, SO.Small invasive methods - Unlike those operational, they are less traumatic for the patient, patients have spent less time in the hospital and are restored more quickly.This includes:
- Infrared radiation.Using an infrared coagulator, the doctor acts on hemorroid nodes with a high temperature, cauterizing blood vessels.This operation does not require anesthesia (except in case of high individual sensitivity of this area in the patient) and has a low trauma.Coagulation can also be made using laser rays.
- Sclerotherapy.The patient of the hemorrhoidal nodes introduces a special substance that sticks the walls of the vessels.Usually, with sclerotherapy, a substance is introduced into more than two nodes so that the patient does not develop pain syndrome.The next session takes place in two weeks.
- Ligature (ligature) of hemorrhoids with latex rings.This method is most often used to treat hemorrhoids in elderly patients who have complicated treatment for the disease.At the same time, a small latex ring is applied to the base of the node, which gradually tightens the knot, leads to its necrosis and its rejection.At the same time, bleeding does not occur, because the stump is blocked by the ring;Subsequently, a healthy connective tissue is formed in its place.The procedure is almost painless, has a low trauma and the ring can be quickly applied with the anoscope.
- Cryotherapy.In this processing method, the hemorrhoidal node is exposed to low temperatures, after the dies of defrosting, the resulting wound heals over time and the connective tissue forms the node site.The operation is carried out under local anesthesia.
All poorly invasive treatment methods are used only in the absence of hemorrhoid exacerbation.If hemorrhoids have entered the acute stage, it is first necessary to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
In the fourth stadium of hemorrhoids, surgical treatment is indicated.The operation (hemorrhoidctomy) is carried out as follows: the main groups of hemorroid nodes are subject to excision, the ligatures are applied to their land, the edges of the wound are sewn.Although it seems scary, the operation, although quite unpleasant, is very effective and has the smallest number of relapses.However, after that, complications are possible: severe pain, bleeding, scars, a distorting anal channel, anus restrictions, suppuration of injuries, a paraprotitis.After the 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 popular hemorrhoid remedies, but not all are effective, and some can be harmful.It is recommended to use them only when the attending physician approval.
The decoctions of the renal highlander, the fruits of the Rosais and raspberry leaves will help reduce inflammation and normalize the tone of the blood vessels.You can also rinse the anus zone and hemorroid nodes, in particular after defecation, decorations of herbs which have an anti-inflammatory effect (calendula, must of St. John's, chamomile).In addition, with them, you can make hot baths from 10 to 15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to avoid the occurrence or exacerbation of hemorrhoids, eating properly so that the chair is soft and that there is no constipation.This follows:
- There are fiber -rich foods- Fruits, vegetables, cereal cereals.This softens the chair and increases its volume, which helps to avoid increasing pressure in the abdominal cavity.However, in small portions, it is necessary to introduce into your diet so that they do not cause an increase in gas formation.It is recommended to avoid sharp dishes, seasonings and alcohol.
- Drink a lot of liquids.It is recommended to drink 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 medications containing dietary fiber to your diet.Most people do not receive enough fibers per day (25 g are recommended for women, for men - 38 g).Certain nutritional supplements can improve the patient's general condition with developed hemorrhoids.But do not forget that with the introduction of additives with a high content of dietary fiber in the diet, water consumption or other liquids (no alcohol) on eight glasses per day or more should be increased.Otherwise, they can cause constipation.
- Do not fight during defecation.Excessive tension and maintenance of breathing when trying to relieve the high pressure in the veins of the rectum.
- Visit the toilet in a timely time.If a person for any reason removes defecation, the chair can become dry and it will be more difficult to eliminate 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 state of the vascular system of the body, will improve blood flow and reduce pressure on the veins.With sitting or standing work, it is advisable to take a short break every two hours, to walk, to stretch, to do some exercises.
- Avoid long periods of immobility.Too long seat or position may increase the pressure on the veins of the rectal region.