Hemorrhoids

Hemorrhoids are a disease in which there are blood stasis and abnormal changes in the veins of the rectum or in the area around the anus. Such a subtle pathology has no restrictions regarding age and gender.

The underlying factor that leads to the formation of hemorrhoidal cones is stagnation, which, in turn, arises from a large number of other predisposing factors.

Pathology is characterized by characteristic symptoms that a person cannot ignore. The most specific clinical signs of hemorrhoids are itching and burning in the anal area, rectal hemorrhages and severe pain in the perianal region.

The clinician will be able to make an accurate diagnosis based on a physical examination, but in addition, several laboratory and instrumental examinations may be necessary.

The treatment of hemorrhoids depends directly on the severity of the course of the disease, so it can be both conservative and surgical.

Since the pathology has many varieties, it is coded with some meanings in the International Classification of Diseases.

Etiology

The main reason for the appearance of hemorrhoid cones is:

• violation of the functioning of the vessels of this body;
• increased arterial blood flow;
• disorder of blood flow from the venous plexus;
• loss of tone of the rectal veins, which leads to their expansion and the appearance of nodules.

In addition, clinicians identify a large number of adverse factors that lead to the above processes, so they are usually divided into several groups - pathological and physiological.

The first category of causes of hemorrhoids includes:

• chronic constipation - hardened stools damage the walls of the rectum and anus;
• severe intoxication of the body - this should include poisoning with alcoholic beverages, toxic and chemical substances, as well as low-quality food;
• profuse diarrhea of an infectious nature;
• formation of malignant tumors, rarely benign in the intestine;
• diseases of the pelvic organs, such as prostatitis or cystitis;
• inflammatory diseases of the digestive system;
• hormonal disorders;
• portal hypertension and cirrhosis of the liver, as well as other diseases of this organ. The connection of hemorrhoids with the liver is due to the presence of common veins;
• pathological impact of pathogenic bacteria leading to the development of infections.

In addition to diseases and disorders, the causes of hemorrhoids may not be related at all to the presence of one or another disease in the body. Among the physiological factors, it is worth noting:

• lack of physical activity - this occurs against the background of a variety of sources - laziness, a serious illness that deprives the patient of the ability to move, as well as the specific working conditions under which a person is forced to sit or stay in the partmost of the working time;
• excess body weight;
• poor nutrition - this includes the abuse of fatty, spicy, smoked meats, cakes, carbonated beverages, semi-finished products, fast food and other harmful ingredients. Strong for this reason that diet therapy is one of the ingredients of hemorrhoid treatment;
• indiscriminate use of medications, including laxatives or oral contraceptives;
• incorrect performance of proctological diagnostic procedures or enemas;
• unconventional sexual preferences, namely anal sex;
• prolonged impact of stressful situations;
• performing strenuous physical activity;
• engaging in certain sports, in particular, cycling or motorcycles, horse sports and other types of weight lifting;
• excessive smoking and cigarette smoking;
• the period of childbirth or labor;
• menstruation.

Genetic predisposition plays an important role in the development of the disease. Diagnosing a similar pathology in one of the closest relatives greatly increases the likelihood of lumps. Knowing this, you can independently prevent the onset of a disease, you just need to follow all the rules for preventing hemorrhoids.

Distribution

By its clinical nature, the disease is:

• acute - this is the first manifestation of hemorrhoids that has not been previously diagnosed;
• Chronic - is characterized by alternating stages of symptom exacerbation and withdrawal.

Depending on the area of hemorrhoid formation, cavernous pathology is divided into:

• External hemorrhoids - is such that the lump appears under the skin of the anus, and not under the mucosa of the rectum. It is considered the rarest form of the disease;
• internal hemorrhoids are the most common type of pathology in which there is the appearance of vascular cones directly in the anal canal;
• Mixed hemorrhoids - the second most common type of disease, which is characterized by the presence of signs of the two forms described above.

In addition, there are types of hemorrhoids, separated by severity:

• easy course - symptoms may be completely absent or expressed to an insignificant degree. Conservative methods predominate in therapy;
• medium-severe - varies in the increase of pain sensations, which are caused by an increase in the joints and their damage by feces. Internal shocks fall during the act of defecation, after which they self-regulate. It is impossible to eliminate the disease with minimally invasive methods;
• severe - characterized by the expression of such a sign of hemorrhoids as bleeding. The joints can fall not only during bowel emptying, but also in any other situation leading to an increase in intra-abdominal pressure. In such cases, they can only be adjusted manually. Tactics on how to get rid of hemorrhoids can include both minimally invasive procedures and extensive surgeries;
• complicated - is expressed with an increase in symptoms of the disease, and during diagnosis, the development of complications is often observed, one of which may be thrombosis. However, it should be noted that not in all cases of premature treatment of hemorrhoids, the formation of consequences occurs.

Symptoms

The first signs of hemorrhoids can be so small that a person pays no attention to them. Initial clinical manifestations are considered to be:

• mild discomfort in the anus;
• non-intense itching of the anal area;
• pain during bowel movements;
• swelling of the entrance to the anal canal.

As the disease progresses, the following symptoms of hemorrhoids will begin to manifest:

• severe burning and itching;
• increasing pain, which will appear not only during bowel movements, but also during intense walking or prolonged sitting;
• the appearance of impurities of blood and mucus in the stool. It is worth noting that pathological clots will not mix with the feces, but are located on top of it;
• prolapse of the hemorrhoidal lump, which leads to severe pain;
• redness of the skin of the perianal region;
• rectal hemorrhage - if in the early stages such a sign of hemorrhoids can appear only in the form of blood staining on toilet paper or underwear, then with a complicated flow, the bleeding can reach the intensity of the flow. This is what often makes a person seek help.

In addition to specific clinical manifestations, the above symptoms of hemorrhoids may be complemented by an increase in body temperature, which indicates the progression of the inflammatory process.

Diagnosing

It often happens that when the symptoms of a disease occur, a person does not know which doctor to contact for hemorrhoids. A proctologist or surgeon is involved in diagnosing and treating hemorrhoids, but for the first consultation, you can contact a therapist. It should be borne in mind that if a child has signs, then it should be immediately referred to a pediatrician, and if a woman pregnant, then first of all they consult an obstetrician-gynecologist.

The first stage of diagnosis involves the work of the clinician, which aims to:

• a detailed study of the patient for the first time the signs of hemorrhoids appear - to identify the stage of the course of the disease;
• familiarity with the medical history and life history not only of the patient but also of his relatives - often this is enough to determine the sources why hemorrhoids appear;
• performing an objective examination aimed at assessing the condition of the perianal region, as well as digital examination of the rectum, which will make it possible to distinguish internal from external hemorrhoids and determine the location of the lump.

The second stage in establishing the correct diagnosis are laboratory examinations, respectively, general, biochemical blood test and coagulogram.

The last part of the diagnosis is the instrumental examinations of the patient, which aim at assessing the appearance of hemorrhoids and predict:

• sigmoidoscopy;
• anoscope;
• colonoscopy;
• radiograph using a contrast agent;
• Ultrasound of the abdominal organs.

Only after studying the results of the examination, the clinician devises tactics on how to cure hemorrhoids in a patient.

treatment

The treatment regimen of the disease will depend on the severity of the disease, but common methods of treating hemorrhoids include:

• use of medicines for local and general effects. In the first case, rectal suppositories, oils, lotions and gels are used, and in the second - tablets to improve blood circulation, strengthen veins and neutralize the accompanying symptoms;
• adherence to a frugal diet - indicated for external and internal hemorrhoids. All recommendations regarding the menu and cooking methods are provided by the attending physician;
• minimally invasive techniques for removing hemorrhoids;
• open surgery;
• use of alternative medicine prescriptions. This should include the preparation of candles and oils from natural ingredients at home, as well as decoctions from medicinal herbs and plants, which are used for ingestion or as micro-clusters and sitz baths.

Among the minimally invasive methods of treating hemorrhoids, it is worth noting:

• introduction of sclerosing substances directly into the joints;
• bonding with latex rings;
• infrared and electrocoagulation;
• cryodestruction;
• dearterization.

Hemorrhoid removal tactics will be determined by the pathology stage.

With the ineffectiveness of conservative methods, as well as in cases of a complicated course of the disease, an open surgical operation is indicated - hemorrhoidectomy.

The treatment of hemorrhoids in pregnant women and children will be promoted by an obstetrician-gynecologist and a pediatrician.

Possible complications

Ignoring the pronounced clinical phenomena and late treatment of hemorrhoids often leads to the development of the following consequences:

• acceptance of a secondary infection;
• spread of the inflammatory process;
• anal sphincter insufficiency;
• profuse bleeding leading to anemia;
• proctite and paraproctite;
• blood clot formation;
• anal fissures.

Prevention and prognosis

To prevent the appearance of hemorrhoids, the following rules of prevention must be observed:

• leads a healthy and moderately active lifestyle;
• eat properly and in a balanced way;
• strengthen pelvic and abdominal muscles;
• take medication only as directed by your doctor;
• if possible, avoid physical and emotional stress;
• deal in time with constipation and other pathological causes of hemorrhoids;
• make sure body weight is within normal limits;
• undergo a full physical examination regularly.

It is impossible to answer without a doubt the question of the prognosis of hemorrhoids, as the result depends on several factors - the stage and form of the course of the disease, age category, time of starting treatment of hemorrhoids and the patient's compliance with all recommendations. clinicians.

Often people who have been diagnosed with hemorrhoids wonder if it can go away on its own? The response of doctors will always be negative - the disease will turn into a chronic form.