In our culture, body end and its functions are a topic that is not common to discuss in a good society.Therefore, the diseases that affect these parts of the body cause not only the suffering of physical but also psychological properties.Unfortunately, one of these diseases - hemorrhoids - is not as rare as we would like;At least 10-15% of the entire adult soil population is subject to it.Most often, people from 30 to 50 years of age suffer from hemorrhoids, and men are four times more often than women.Sadly, far from all patients, feeling the signs of the disease that has begun, go to the doctor.False shame prevents many, they prefer to self -resemble, which only exacerbates their position.But hemorrhoids, like other diseases, are easier to treat in the early stages.
What is hemorrhoids and the causes of its appearance
The last part of the digestive tract, the last segment of the colon, is called the rectum;It starts somewhere at the level of the third sacral vertebra and ends with the anus.Its blood supply is provided by five arteries (one of them, not paid, called hemorrhoids), and blood flow is performed by a wide veins of veins located in the submucosal layer of the rectum.At the lower part of the rectum, or hemorrhoids, under the mucosa are cavernous, or cavernous bodies, drilled by the smaller vein network.Normally, the walls of these vessels should support the connective tissue, but if weakened, the blood flow is increased, and the flow is disturbed, then the walls of the vessel swell, the cave bodies are filled with blood and climb, filling the entire cavity and sometimes even indicated through the anus.Hemorrhoids are the same swollen blood bodies and prolonged cavernous.Sometimes the appearance of hemorrhoids causes mechanical causes when, under the influence of several factors, the longitudinal muscle muscle fibers of the rectum are extended and released, which causes the hemorrhoids to displace the anus and loss them.The number of joints in patients is very different - from one to some, 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 emergence and development of hemorrhoids have not yet been detected, it is believed that the following factors contribute to it:
- A sedentary lifestyle.People are particularly subject to the appearance of hemorrhoids, for a long time to be in a sitting position or standing for a long time.When a person sits or stays for a long time, blood stagnation occurs in the pelvic organs, which may disturb the blood flow through the veins.
- Physical work.However, physical activity is not a drug;People who work in areas where prolonged and persistent difficult physical work is required also suffer from hemorrhoids.
- Complications for defecation- whether diarrhea or chronic constipation.Both of these countries cause an increase in pressure in the abdominal cavity, which, in turn, leads to an increase in hemorrhoids and their loss.
- Improper food.Increased alcohol use, spicy nutrition causes an arterial flow in the rectum cave bodies, which contributes to their expansion.Food, weak in fiber, causes constipation and abundance of fatty foods - diarrhea.
- Hypothermia or overheating of the pelvic area.Both of these conditions exacerbate blood circulation and contribute to blood stagnation in the pelvis.
- Pregnancy, childbirth.In this condition, a woman increases the pressure in the abdominal area, and the blood flow through the veins may be disturbed.As a result, hemorrhoids can form.
- Overweight.Especially the appearance of hemorrhoids is subjected to humans whose fat is mainly deposited in the abdomen.
- Some sexual practicesincluding anal sex.
- Various illnesses: Liver disease (with them, venous blood flow is damaged, pressure increases in veins, which contributes to the development of hemorrhoids);diseases of the pelvic organs (bladder, prostate);Neoplasms and/or inflammation in the pelvis, intestine.
- Heritage reasons: Functional lack of connective tissue, damaged nerve regulation of the venous wall tone, heart pathology and blood vessels.
Symptoms of hemorrhoids
Hemorrhoids gradually and significantly arise;A person does not experience special concerns unless occasionally after defecation may feel discomfort, pain, itching in the anus.Soft fabrics in the anus area can swell.The mucosa can be released from the rectum, irritating the anus and causing burning sensations.Sometimes the patient has a feeling, as if a foreign body was in the posterior hole;After defecation, long painful pain is frequent.These phenomena have improved in violation of a diet or disorders of the gastrointestinal tract.But most often people seek a doctor after discovering blood in the feces, on hygiene or interior paper in the form of small spots, lines or, in rare cases, with strong bleeding.
However, anus bleeding is not always associated with hemorrhoids (especially if the patient is more than 40 years old).Rectum bleeding can also occur in the following diseases:
- Cracks
- oncological disease
- The loss of the rectum
- colitis, polyps, air conditioning
The patient should pay attention if the appearance of bleeding is due to a change in intestinal behavior, the appearance of an excrement of a different color or consistency than usual.With such symptoms, consult a physician can immediately occur at another location of the gastrointestinal tract.
How do hemorrhoids manifest
Hemorrhoids occurouterORindoor.With external hemorrhoids, the hemorrhoids are enlarged, formed by the lower venous plexus and placed directly on the anus.Since inflammation is not within the rectum, but outside it, if you want, you can consider this area with your eyes.Bleeding in this form of hemorrhoids is practically absent, but patients are very concerned about pain in the rectum region.External joints are often inflamed, damaged by rough linen and most often reborn in oncological formations.This type of relatively rare hemorrhoids - no more than 10% of the total number of patients suffer from them.
The inner hemorrhoids are located in the submucosal layer of the rectum, it is possible to see them with the bare gaze only in the later stages of the disease, when the cavernous bodies shell is so deformed that it looks through the anus.The main symptoms of internal hemorrhoids are the presence of blood in the feces (although most often it is red, arterial, it is also possible that dark venous blood with clots), pain during decation.In later stages of the disease, hemorrhoids fall from the anus;At first, they withdraw inside, but later patients should do it by hand.
There is also a combined hemorrhoids, in which both bodies of the rectum cave and the subcutaneous venous plexus of the anal region are deformed.
Hemorrhoids occursharp(When its symptoms develop rapidly, the joints are inflamed, inflammation passes into neighboring tissues, the patient suffers from pain; necrotic changes in the joints due to thrombosis are also possible) andCHRONIC.Then the disease lasts a long time, months and even years, while periodically deteriorating - bleeding occurs, the joints fall, drink and give a lot of concern.During periods of pardon, provided that the precautions are observed by the patient practically do not feel discomfort.
Stages of development of the disease
Most cases of hemorrhoids are diagnosed in later stages - or because patients did not pay attention to symptoms, attributing them to other reasons, or because of false shame, tightened the journey to the doctor.There are four stages of hemorrhoids.
- First stage.Symptoms are expressed impressive, manifested only in exceptional cases (for example, with intestinal disorders, after severe physical work, long or sitting in place, food disorders, overheating or hypothermia).Sometimes the patient feels discomfort during defecation, burning and itching behind him.On examination, the doctor observes the presence of blood stalks and the extension of the blood vessel walls.If hemorrhoids manage to diagnose at this stage, treatment develops quickly and smoothly.
- The second phase.Hemorrhoids grow in size, their walls become thinner, can form in them, which leads to bleeding.In the patient, after severe physical exercise, complex defects or hypothermia, blood traces can be observed in the feces, hygiene or internal paper can be observed, but the bleeding is very small and passes quickly.Hemorrhoids are slightly enlarged and may fall from the anus after defecation, however, returning itself.Their appearance is caused by an increase in pressure on the peritoneum with severe stress, whether it is physical work or strong cough.At this stage, you can still run into conservative treatment.
- The third stage.The anal sphincter undergoes dystrophic changes and weakens, as a result of which fallen hemorrhoids can only be corrected by hand.The patient is concerned about severe itching, bleeding is frequent and abundant.Conservative treatment is no longer possible.
- Fourth stage.The joints are so enlarged that it is not possible to correct them.The anal hole muscles are heavily weakened, the sphincter tone decreases.For the loss of joints, even the smallest physical activity is sufficient.The joints themselves can take the shape of the seal, they are inflamed;Inflammation can also affect nearby fabrics.
Complications with hemorrhoids
Fortunately, complications with hemorrhoids are not very often found.Although, above all, with the patient's hemorrhoids, the blood type fears, it does not stand as much as a risk to life.However, with constant prolonged bleeding, anemia is possible.
The flow of mucus from the anus causes itching and can lead to eczema.
With the further development of the disease, when hemorrhoids have already been moved to the third or fourth phases, the patient is given many manual decreases of joint disturbances.And they can already fall out not only after defecation, but also with severe cough, sneezing, physical effort.
In rare cases, fallen hemorrhoids can be adhered by the anal sphincter muscles, which causes severe pain.If the joints are not regulated, thrombosis can develop.This is the most difficult complications possible for hemorrhoids, which requires immediate medical care.In this condition, hemorrhoids are swollen, tense, highly increased in size and purulent infection in the patient's body is possible.Patients lose their appetite, their temperature rises, they are sick.
It will get worse if not treated.It is no exception to hemorrhoids - in the absence of treatment, it progresses, which can lead to irreversible changes in the rectum veins.
Hemorrhoids during pregnancy and childbirth
The reason for the development of hemorrhoids in pregnant women is to squeeze the veins of the cavernous rectum of the rectum, which increased in the size of the uterus, which causes damaged blood flow, blood vessels and the formation of hemorrhoidal joints.Also, the appearance of hemorrhoids in pregnant women can provoke constipation when the feces extend the rectum walls and damage the cave bodies.As a rule, in the last months of pregnancy, a woman is forced to lead a sedentary lifestyle, which also does not contribute to the healing of the body.During the birth of children, the perineum muscles are tense, the rectum cave bodies extend and injure.With severe extension of the perineum muscles, a weakening of the anal sphincter is possible and, as a result, loss of joints.
Often those who gave birth to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately see a doctor, thereby provoking the development of the disease.
Which doctor to contact the suspicion of hemorrhoids?
If a person is concerned about unpleasant sensations in the area of anus, itching, and blood traces, you should consult a professional or collapse doctor.
Diagnosis of the disease
Typically, to diagnose hemorrhoids, there is sufficient visual examination of the patient's body.At the same time, the patient either takes the position of the knee elbow or occupies a gynecological chair.The doctor examines the patient's anus, paying particular attention to the condition of the skin, the presence of hemorrhoids, their value and position.
To confirm the diagnosis, the doctor may perform other studies:
- Rectum.The doctor examines the anal canal tissues, evaluates the condition of the rectum membrane mucosa, as well as the surrounding organs and tissues, determines the location of the hemorrhoids, their value and the degree of pain, and if there is bleeding.True, the exact size of the joints cannot be set - when they feel, they, as a rule, decrease in size.In this case, the patient may lie on his side, on his back or stand on all four sides, and the doctor on the handles with his index finger examines the rectum from the inside.Already after an examination of the finger, the doctor may prescribe anoscopy and spectator.
- Anoscopy.With the anoscopy, a special device is inserted into the back, which allows the physician to examine the rectum surface for 10-15 cm.Using the anoscope, the doctor determines where the cavernous bodies are exactly affected, whether there are tumor processes and inflammatory diseases in the rectum.Anoscopy is also used to take tests - biopsy and stroke.This procedure is painless and practically no contraindications;The exception is the stage of deterioration of inflammatory diseases.Then the doctor first recommends to remove the inflammation and only then do an examination.
Although anoscopy is a very simple procedure, it requires preparations.So nothing prevents the rectum being examined, the patient should adhere to eating the night before, as well as making two cleaning enemas - half a day before the procedure and the second - a few hours before it.It is also possible for the doctor to ask the patient to take a laxative on the doorstep.
Also, to rule out the risk of developing oncological pathology, the doctor may provide the patient to passSectoronoscopy- examination of sigmoid and rectum.With this examination, the doctor can examine the inner surface of the rectum up to 25 cm further.If for some reason, it is impossible to perform a stomachoscopy (let's say, the patient has pathological rectum disorders), they are performed in his placeColonoscopy- When the inner surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can take a clear view 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 body systems located nearby.Often hemorrhoids are associated with diseases of the anal part of the body and colon, caused by bleeding by hemorrhoids.Sometimes there is also an irritated bowel syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides which treatment to prescribe.But with all stages of hemorrhoids, from the first to the last, treatment is done that allows you to stop the symptoms of the disease - reduce the pain, stop bleeding.If the first or second phase hemorrhoids, it is possible to cure it when using the so -called.Conservative treatment - that is, the use of pain that relieves pain, prevent complications and also contribute to post -surgery rehabilitation of patients.The best results are given by the common use of external and internal use drugs.
| assort | extension | Application method | |
|---|---|---|---|
| Drugs and analgesics non -inflammatory non -steroidal | Remove the inflammatory process, reduce swelling, anesthesia | Orally | |
| Venotonizing agents | Improve blood vessels, reduce vein extension, prevent thrombosis | Orally, from the outside | |
| Hemostatic | Stop bleeding | Orally, in the form of injections | |
| meals | Relieve spasm and inflammation, anesthesia | From outside | |
| anticoagulants | Prevent hemorrhoids thrombosis | Injections | |
| Nudity | Normalize a chair | Orally | |
| Enemas | Normalize a chair | Outer | |
| Candle | Stimulation of blood supply, analgesic, anti -inflammatory | Outer |
If no positive changes are noticed after a week or two, a second examination should be undergoing a proctologist who will provide a different treatment.
If the second or third phase hemorrhoids and it is impossible to cure it only with medication, the so -called.Small methods - invasive - unlike those operating, they are less traumatic for the patient, patients spend less time in the hospital and reset faster.This includes:
- Infrared.Using an infrared coagulator, the doctor acts on the hemorrhoids with a high temperature, cauterizing 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.Coagulation can also be performed using laser rays.
- Sclerotherapy.The patient in the hemorrhoidal joints presents a special substance that glues the vessel walls.Usually, with sclerotherapy, a substance is inserted into no more than two joints so that the patient does not develop pain syndrome.The next session is held within two weeks.
- Latex rings wetland (connection) of hemorrhoids.This method is most often used to treat hemorrhoids in elderly patients who have complicating treatment of the disease.At the same time, a small ring made of latex is applied to the base of the joint, which gradually squeezes the joint, leads to the necrosis and its rejection.At the same time, bleeding does not occur, as the trunk is blocked by the ring;Then, a healthy connective tissue is formed in its place.The procedure is almost painless, there are low trauma, and the ring can be applied quickly with anoscope.
- Cryotherapy.In this method of treatment, the hemorrhoidal joint is exposed to low temperatures, as its melting dies, the resulting wound cures over time and connective tissue forms at the node site.The operation is performed under local anesthesia.
All minimum invasive treatment methods are used only in the absence of irritation of hemorrhoids.If hemorrhoids enter the acute phase, it is necessary to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
In the fourth stage of hemorrhoids, surgical treatment is indicated.Surgery (hemorrhoidctomy) is performed in the following way: the main groups of hemorrhoids undergo excision, the ligatures are applied to their bases, the ends of the wound are sewn.Although it sounds scary, surgery, though quite uncomfortable, is very effective and has the smallest number of relaps.However, after it, complications are possible: severe pain, bleeding, wounds, anal canal deformity, anus tightening, suppression of wounds, paraproctitis.After surgery, it is necessary to observe the regimen prescribed by the doctor - refuse for the duration of physical activity and hot baths.
Home hemorrhoids treatment
There are many popular remedies from hemorrhoids, but not everyone is effective, and some can be harmful.It is only recommended to use them when approveing the attending doctor.
Renal Highlanders, rose fruits and raspberry leaves will help reduce inflammation and normalize vascular tone.You can also rinse the area of the anus and hemorrhoids, especially after defecation, decoction of plants that have an anti -inflammatory effect (Calendula, St. John's Wort, Chamomile).Also with them you can make warm baths with 10-15 minutes to reduce inflammation and pain.
Hemorrhoids prevention
The easiest way to avoid the appearance or deterioration of hemorrhoids, eating properly so that the chair is soft, and no constipation.This follows:
- There are high fiber foods- Fruits, vegetables, grains of wheat.This softens the chair and increases its volume, which helps to avoid increased pressure in the abdominal cavity.However, small portions should be included in your diet so that they do not cause increased gas formation.It is recommended to avoid sharp dishes, spices and alcohol.
- Drink plenty of liquids.It is recommended to drink from six to eight glasses of water or other liquids a day (alcohol is not included here) so that the chair is softer and not damage the rectum walls.
- Add medicines containing dietary fiber to your diet.Most people do not get enough fiber a day (recommended 25 g for women, for men - 38 g).Some nutrients can improve the patient's general condition with developed hemorrhoids.But remember that with the introduction of additives with a high dietary fiber content in the diet, water consumption or other liquids (not alcohol) in eight cups a day or more should be increased.Otherwise, they can cause constipation.
- Do not strain while defecting.Excessive tension and respiratory maintenance when trying to relieve high pressure on the rectum veins.
- Visit the toilet in time.If a person for some reason removes defecation, the chair can dry out and it will be harder to remove 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.
- drill.It is recommended to do exercises or get involved in any other physical activity-this will improve the condition of the body's vascular system, improve blood flow and reduce pressure in the veins.With sitting or standing work, it is advisable to take a short break every two hours, walk, stretch, do some exercises.
- Avoid long periods of immobility.Very long landing or stay can increase pressure on the veins in the rectum region.