Hemorrhoids are varicose veins in the rectum hemorrhoids. Inflammation of the hemorrhoids joint is characterized by thrombosis, a change in shape and pathological enlargement of the hemorrhoids veins, forming joints around the rectum.
According to statistics, about 25% of people suffer from hemorrhoids, which is exacerbated by them from time to time. And more than 70% of people at least occasionally experience different symptoms of hemorrhoids, such as discomfort in the anus area, itching and pain during defecation.
Hemorrhoids in women often occur during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very mild methods, as a pregnant woman is not recommended to take some medicines for hemorrhoids prescribed in ordinary order. Hemorrhoids in men are also a very common phenomenon caused by a number of causes and other factors that will be discussed further.
What are the causes of hemorrhoids?
It is generally acknowledged that the hemorrhoids develops due to an increased blood flow or its inadequate exit, which leads to stagnant processes. The causes and factors of hemorrhoids development 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. Heritage of certain gene groups leads to congenital weakness or vascular dysfunction located in the rectum. This is the cause of an enlarged flow and insufficient blood flow through the cavernous veins, which leads to the pathological enlargement of the latter. A long -term enlargement of the cavernous veins leads to the thinning of the blood vessel walls, which contributes to the appearance of bleeding with hemorrhoids.
Long standing work and weight lifting. As well as a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First of all, this applies to people who are forced to stay in a standing position for a long time. This category includes teachers, lecturers, Swiss, guards, hairdressing and others. Height raising is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, mainly about office employees, executives and persons, leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is the increased pressure on the rectum ships in a sitting position. With an extended location, the anus area heats up slightly, which leads to stale phenomena and vascular expansion. Moreover, the lack of physical exercise is a real path to developing venous insufficiency. Including this applies to veins located in the rectum.
Chronic constipation and diarrhea. People suffering from chronic constipation are predisposed to the development of hemorrhoids. Why is this happening? The thing is that with constipation, the feces harden, exerting pressure on the veins in the lower intestine. This leads to a deterioration in the blood supply of the cave and the appearance of hemorrhoids. An additional factor in constipation is the habit of severe push during defecation, which creates additional pressure on the vessels in the rectum.
As well as constipation, it 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, as retention of the fetus creates pressure on the rectum venous vessels. And tense efforts during childbirth only exacerbate the flow of hemorrhoids and contribute to the formation of new hemorrhoids.
Improper nutrition, abuse of spicy foods and alcohol. A significant factor in the appearance of hemorrhoids is malnutrition. In particular, the abuse of spicy food leads to irritation of the intestinal mucosa, and also stimulates an extended blood flow to the rectum. And insufficient use of fibers (plant foods) exacerbates intestinal mobility. The provocative factor in the development of hemorrhoids is alcohol, which expands vessels. The reception of alcoholic beverages, even in a small amount, can provoke a deterioration of chronic hemorrhoids.
The main factors that contribute to the development of hemorrhoids:
Overweight
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 blood flow to the rectum.
Frequent constipation.
Inflammatory and tumor processes in the intestines and liver.
Infection.
Smoking.
Internal and outer
At the site of the appearance of hemorrhoids, the disease is divided into two main types: internal and external hemorrhoids.
With external hemorrhoids, the joints form in the immediate vicinity of the anus, in this respect, their sensitive surface often breaks down and bright blood bleeding occurs. Pain in external hemorrhoids is quite sharp and severe, but in terms of independent diagnosis, this species does not present any difficulty.
The inner type of hemorrhoids, although it carries a much more serious threat to health, is often distinguished by the complete lack of pain (especially in the initial stage of the disease). This fact is explained by the fact that the hemorrhoids are located deep inside, and their surface is the same unsupported mucous membrane of the rectum, which lives it.
degree
Usually distinguish 3 internal hemorrhoids:
1st degree. Hemorrhoids are located in the anal canal, may not be felt (even with a rectal study). Complaints about inflammation of the anus and bleeding, "shaking" the pain after defecation.
2nd degree. The joints extend from the anus when trying and disappear independently. In principle, the same disorders are observed here as with 1 degree hemorrhoids, however, small mucosal fractures are more often, and inflammation of the anus is stronger.
3rd degree. It is characterized by the so -called loss of hemorrhoids, which do not heal independently. Symptoms can be the same as in 2-, but often the phenomena of fecal and gases develop additional. When examined by hemorrhoids, it is distinguished by the drop of the anus along the radiant grooves, cyanotic staining and a tuberous surface.
Symptoms of hemorrhoids
Signs of hemorrhoids characteristic for all stages of development of the disease:
discomfort in the anus;
pain during defecation (early insignificant, then strong);
bleeding from the anus;
Formation and increased hemorrhoids.
Hemorrhoids are a chronic pathology that progresses for many years. The degree of development of the disease depends on many factors, including food, lifestyle.
For the initial phaseDiseases are characterized by a slight increase in veins in the anus. Usually such a sign remains unnoticed. In this case, the patient may be disturbed by bloody discharge from the rectum that occurs immediately after defecation. Blood can easily be seen on hygienic paper. It is worth remembering that a similar symptom is characteristic of malignant intestinal tumors, so when it happens, you should consult a proctologist. A doctor's timely search and the appointment of therapy will easily slow the development of hemorrhoids.
In the second phaseThe development of the patient's disease may periodically experience discomfort in the anus, itching. Often he has a sensation of a foreign body in the anus. Hemorrhoids begin to fall during defecation and are still easily adjusted internally.
For the third stageHemorrhoids are characterized by an increase in existing features. Large venous joints in the anus make it difficult to empty the intestinal emptying, become the cause of constipation, the act of defecation itself is associated with pain and bleeding. Strong bleeding with hemorrhoids is dangerous, over time it can lead to the development of anemia.
For the last stageDiseases are characterized by an increase in the size of hemorrhoids. They cannot be directed at one hand. The presence of advanced veins in the anus causes severe discomfort, damages the patient, go to the toilet. He is concerned about abundant bleeding during each defecation. The fourth stage of the development of hemorrhoids can be complicated by such unpleasant and dangerous phenomena as vein thrombosis at the end of the rectum.
Hemorrhoids in pregnant women
Very often hemorrhoids appear during the last trimester of pregnancy and childbirth. The causes of hemorrhoids are a luminous uterine of the intestinal veins, which leads to a deterioration of blood flow from the intestines and the perineum. Vienna grows in diameter and changes form. Periodic constipation in pregnant women can also provoke its appearance.
However, in most women, the symptoms of hemorrhoids exceed the postnatal period, so it is believed that the causes can be hormonal changes. It should be treated immediately after the first of its symptoms is detected. It is important to deal with constipation, for example, take medication to ease the excrement (forlax, laminaride, methyl -Velosis), observe hygiene rules (washing the anus after defecation). Hemorrhoids (aurobin, relief, etc. ) are mainly used externally in the form of ointments and candles. Surgical intervention is performed only in severe cases.
Hemorrhoids prevention should be done from the first days of pregnancy - make a competent diet to prevent constipation, not to wear tight belts, to spend more time in fresh air and walking.
What is the risk?
The progression of the disease without proper treatment will lead to a number of very unpleasant complications.
Hemorrhoids complications:
Anemia (develops with a long course of disease with abundant bleeding).
Inflammatory processes in the surrounding tissue, until the development of paraprokutitis (inflammation of the fibers around the rectum). Paraproproctitis is considered a very severe complication that requires serious treatment.
Anus cracks. The most common cause of severe pain in hemorrhoids. Ackes create favorable conditions for the development and penetration of various infections deep into the soft tissue. This fact can lead to the development of scary complications as an abscess (limited purulent inflammation, which is associated with general wrongdoing, fever and severe pain). This complication needs mandatory surgical intervention.
Itching. A very unpleasant complication, which acts not only as a strong negative psychological moment, undermining the patient's psycho -emotional state. Constantly mechanical irritation of the anal region can significantly exacerbate the process of the course of the disease. Moreover, continuous tissue damage increases the risk of developing different tumor processes.
Inadequacy of anal sphincter, incontinence of gas and feces (often in the elderly).
It follows that hemorrhoids need early diagnosis and take immediate measures to solve this problem.
How do hemorrhoids look: Photo
Troubleshooting
As a rule, the diagnosis is not associated with special difficulties, the diagnosis occurs as part of a patient study and an initial outpatient examination. Inspection helps to determine:
the rate of loss from the anus of nodes,
Appreciate the possibility of their return,
Skin condition,
as well as the importance and degree of bleeding.
Symptoms for hemorrhoids are similar to some other diseases. Therefore, the diagnosis should be careful because there is a risk of describing incorrect treatment. Hemorrhoids can be confused with:
anal cracks, which is also associated with slight bleeding, pain during defecation;
Rectum cancer (malignant intestinal tumors occur with bleeding);
loss of rectum;
Colitis, polyps and condoms.
If you notice the first signs of illness in yourself, do not take a trip to your doctor for a long time. Early diagnosis will facilitate treatment and help to avoid not only complications but also surgical intervention.
How to treat hemorrhoids?
Conservative hemorrhoids treatment:
Be sure to normalize the intestinal emptying. The chair should be regular, soft. To normalize stoolin with hemorrhoids, food with dietary fiber content is recommended, including wheat bran, recommended, but their number should be gradually increased within 2-3 weeks. (from 5-10 g to 20 g per day), which excludes the appearance of disturbance.
With constipation, you can recommend lactulosis up to 30-40 ml daily to reach a soft daily chair and other tools, follow a diet and constipation recommendations.
Treatment uses local medicines: rectal candles from hemorrhoids and ointments.
With pain, candles containing small doses of narcotic vehicles (for example, Beladonna, etc. ) help. You can describe candles, sodium algina, ichthyol, depending on the symptoms and stage of the disease.
If there is no bleeding, you can prescribe suppositories or hydrochloride oil phenyfrin, etc. But all medicines are prescribed in each case, so only one proctologist can prescribe the correct treatment after the patient's examination.
In pain, in addition to candles, cold lotions can be used, but no more than 30 seconds.
To increase the efficiency of local drugs, it is necessary to get oral products that improve the tone of venous vessels and prevent thrombosis: diosmina, troxerutin.
The missing hemorrhoidal joints (prolapse) are the basis for their coating. When hemorrhoidal vein thrombosis, cold and lidocaine hydrochloride (1%solution) are used locally, and further bandage is possible.
With relapse, despite treatment, hemorrhoids -inkomy is recommended.
Methods of treatment medication are exclusively symptomatic - that is, hemorrhoids do not radically cure hemorrhoids. However, they allow you to temporarily cope with the unpleasant signs of hemorrhoids. If the patient after treatment of the drug will match medical recommendations for relap prevention, surgical treatment may be avoided.
But not always patients can follow all the recommendations.
Small methods -invasive
Minimally invasive treatment allows you to quickly and without serious injuries to get rid of such a delicate problem as hemorrhoids. Therapeutic methods in most cases only muffle symptoms of the disease delay the moment when it is necessary to use more radical methods. Before appointing a particular procedure, the doctor studies the patient's history, performs a comprehensive examination, evaluates all possible risks.
Sclerotherapy- This is a low -traumatic treatment through special sclerosis substances that enter the knot, glue its walls in order to achieve the interruption of their food and death in the future. The technique is performed only in 1-3 stages. It does not exclude the risk of relapse of the disease and is effective only with small hemorrhoids.
ElectrocoagulationIt is performed under the control of the anoscope. The electrode is brought to the knot foot and the fabric is coagulated (joined), after which they quickly die. In one procedure, it is possible to get rid of 1-2 pathological focus. After gluing, the hemorrhoids joint stops eating and growing, and after a while disappears completely.
Latex rings-On of the most modern methods of minimally invasive treatment of internal hemorrhoids of stages 1-3. A latex ligature is applied through the anoscope on the leg of the joint, which leads to squeezing the tissue and a violation of blood circulation in them. After 8-14 days, the hemorrhoids dies and is removed with the latex ring.
Cryotherapy- short -term effect on hemorrhoids with liquid nitrogen. After that, the hemorrhoids dies and disappear. The procedure takes place under local anesthesia, so there is no painful sensation.
Small invasive procedures are contraindicated in:
irritation of the inflammatory process in the rectum and anus;
anal cracks, injuries;
Hemorrhoids thrombosis.
Small methods of hemorrhoids fighting hemorrhoids can only be used in stages 1-3 of the disease, necessarily out of irritation of the inflammatory process. All procedures are performed after local anesthesia. There is no need to use general anesthesia. In one session, only 1-3 joints can be removed. Sometimes treatment takes place in several stages, from intervals in several weeks.
Surgical treatment
Surgical treatment is the most effective treatment for the third and fourth phases.
Hemorrhoid removal operation, proposed again in the 1930s, is still applied and continues to be modified. In the world, two types of operations are mainly performed:
Closed hemorrhoids. Apply in phase III and IV of the disease.
Open hemorrhoids. Also in Phase III and IV, but complicated by anal cracking or paraprotitis.
Also in 1993, a new way to treat hemorrhoids was proposed, it was done by Italian doctor A. Longgo, which consists of circular removal of the mucous layer and rectum output using a special apparatus.
Patients are discharged 3-4 days after surgery, disability restoration occurs in 5-7 days. There is also a small percentage of post -surgery complications.
Power and diet after surgery
In most cases, patients, after surgery for hemorrhoids, may begin to drink and eat several hours after surgery.
But to observe the dietary table (according to Pevzer 1A), to exclude products and vessels that harass the secretion of the stomach and irritate its mucosa. Food should be cooked in a wiped form, cooked for steam or boiled in water, it is necessary to take in a liquid and strict state. Exclude: hot and cold products, bread and flour, raw fruit, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.
Eating 6 times a day in small portions. Restoration of normal intestinal function usually occurs on the second day after surgery, therefore, can be continued in the usual diet. But, of course, all sharp and spicy dishes must be excluded, alcohol must also be forgotten. By adhering to these recommendations, you can reduce after surgery recovery time and reduce the risk of complications.
Home treatment
You can independently perform some measures that will help alleviate the symptoms of hemorrhoids at home. However, it is worth remembering that they will not help get rid of the disease:
Warm baths help well. You can take a bath or just sit in a water pelvis. It is necessary to place the anus area in warm water for 10-15 minutes 2-3 times a day.
Complete hygiene of the anal region. It is necessary to take a bath or shower daily, wash the anus area completely.
Do not use soap on the anus and other remedies that can cause irritation. Avoid using spicy wet wipes, which includes alcohol.
Do not use ordinary hygiene paper. It is better to use wet but alcohol -free brooms.
Use the cold. To remove edema on the anus, you can use pads for cold heat, ice pack, wet fabric in cold water.
Moreover, the hemorrhoids diet follows two purposes: to prevent constipation and irritation in the rectum. Key Recommendations:
Drink enough juice. This will help make the chair softer, facilitate its passage through the intestines.
Your diet should include more vegetables, fruits, cereals. They contain vegetable fibers, which helps prevent constipation.
Alcohol, coffee, strong tea should be avoided.
Limit sharp dishes, spices.
It is better to get food in small portions, 4-5 times a day.
Eat at the same time.
Physical activity also helps to normalize intestinal work.
Gymnastics
Gymnastics are aimed at preventing constipation and strengthening anal sphincter. For example, by improving blood flow and strengthening the pressure of the press muscle, you can normalize intestinal work, which and prevent constipation:
Exercise of "scissors" is performed by stretching on the back with raised legs, which must be diluted and crucified alternately;
"Bike" is a very famous exercise that remembers a bike ride, however, lying on his back;
And you can lie on the floor (on the back), place your feet straight, raise one or the other leg, if possible, reaching a right angle to the hip joints. Or bend your feet to your knees and spread to the sides as you try to remove the basin from the floor as much as possible.
So a person is arranged for him to feel his "fifth point" in every position and is able to lead it, so the gymnastics for strengthening the anus requires no equipment and can be performed anywhere, and those surrounding it is unlikely to notice it.
So exercises to strengthen the sphincter:
Get up, pass your feet and make rhythmic relaxations and gluteal muscle tension;
Choose the most difficult chair, sit a little forward (you can easily make on the desktop), try to reduce and relax the sphincter on the other hand, trying to push the anus into the rectum. You need to take 20 minutes in the drill, which, if you want, can always be found.
PREVENTION
The best tool against hemorrhoids is prevention. There are predisposing factors that lead to the development of the disease:
Irregular chair, a tendency for constipation or diarrhea, the habit drowning during defecation or for a long time to sit in the toilet with a book;
difficult physical work and, conversely, a lack of movement, long -term stay in a sitting position;
pregnancy and childbirth;
Alcohol abuse.
This means that life style correction will help mitigate the course of the disease.
It is advisable to reconsider the diet: abandon simple carbohydrates (pastries, sweets) in favor of the complex (vegetables, fruits, greens, wheat bread), instead of tea and coffee, drink water, will help to normalize a chair.
Avoid alcohol, including beer.
With hemorrhoids, we are unwanted by horse riding, heavy athletics, bike sports, but walking or swimming is simply necessary.
It is useful to strengthen the abdominal press muscles and buttocks, to make gymnastics in Kegel.
Sitting in the toilet for a long time is a bad habit. But to use after visiting the toilet bids or washing adhesive shade, on the contrary, very useful.
If despite all the preventive measures of irritation it cannot be avoided, it is not necessary to panic. It is advisable to change the sitting position in a lie, apply cold compresses to the injured site, wet in a poor solution of potassium permanganate or adjust chamomile baths (not hot! ), Do not forget about personal diet and hygiene.
