Hemorrhoids

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Hemorrhoids are a condition in which there is blood stasis and abnormal changes in the veins in the rectum or in the area around the anus. Such a delicate pathology has no restrictions on age and sex.

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

The 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 region, rectal hemorrhages and intense pain in the perianal region.

The clinician will be able to make the correct diagnosis based on a physical examination, but in addition some laboratory and instrumental tests may be necessary.

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

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

Etiology

The main reason for the appearance of hemorrhoidal cones is:

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

Furthermore, physicians identify a large number of unfavorable factors that lead to the above processes, which is why they are generally divided into several groups - pathological and physiological.

The first category of hemorrhoid causes includes:

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

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

• lack of physical activity - this occurs in the context of a wide variety of sources - laziness, a serious illness that deprives the patient of the ability to move, as well as specific working conditions in which a person is forced to sit or stand while most of the time working time;
• overweight body weight;
• poor nutrition - includes the abuse of fatty and spicy foods, smoked meats, confectionery, soft drinks, semi-finished products, fast food and other harmful ingredients. It is for this reason that diet therapy is one of the components of hemorrhoid treatment;
• indiscriminate use of medications, including laxatives or oral contraceptives;
• incorrect execution of proctological diagnostic procedures or enemas;
• unconventional sexual preferences, namely anal sex;
• prolonged influence of stressful situations;
• perform heavy physical activities;
• practice of some sports, in particular cycling or motorcycling, equestrian sports and other types of weight lifting;
• excessive consumption of alcohol and tobacco;
• period of pregnancy or work;
• menstruation.

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

Classification

Due to its clinical nature, the disease is:

• acute - is the first manifestation of previously undiagnosed hemorrhoids;
• chronic - characterized by alternating phases of symptom exacerbation and remission.

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

• External hemorrhoids - occurs when the lump appears under the skin of the anus rather than under the mucous membrane of the rectum. It is considered the rarest form of the disease;
• internal hemorrhoids are the most common type of pathology in which vascular cones appear 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, divided by severity:

• mild course - symptoms may be completely absent or expressed to an insignificant degree. Conservative methods prevail in therapy;
• medium-heavy - differs in the addition of pain sensations, which are caused by the enlargement of the nodules and their injury by the stool. Internal swellings fall out during the act of defecating, after which they adjust. It is possible to eliminate the disease with minimally invasive methods;
• severe - characterized by the expression of a hemorrhoid sign as bleeding. The nodules can fall out not only during bowel emptying, but also in any other situation that leads 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 minimally invasive procedures and extensive operations;
• complicated - is expressed by the increase in disease symptoms and, during diagnosis, complications often develop, one of which may be thrombosis. However, it should be noted that not in all cases of untimely hemorrhoid treatment, the formation of consequences occurs.

Symptoms

The first signs of hemorrhoids can be so small that the person doesn't pay attention to them. The initial clinical manifestations are considered:

• mild discomfort in the anus;
• not intense itching in the anal region;
• pain during bowel movements;
• swelling of the entrance to the anal canal.

As the disease progresses, the following hemorrhoid symptoms begin to be expressed:

• burning and intense itching;
• increased pain, which will appear not only during bowel movements but also during intense walking or a prolonged session;
• the appearance of blood and mucus impurities in the stool. It is noteworthy that pathological clots do not mix with feces, but are located on top of them;
• prolapse of the hemorrhoidal nodule, which causes severe pain;
• redness of the skin in the perianal region;
• Rectal bleeding - if in the early stages this hemorrhoid sign could manifest itself only as blood stains on toilet paper or underwear, then, with a complicated course, the bleeding can reach flow intensity. This is what often prompts a person to seek help.

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

Diagnosis

It often happens that when the symptoms of an illness occur, the person does not know which doctor to look for to treat 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 shows signs, it should be immediately shown to the pediatrician, and if it is a pregnant woman, an obstetrician-gynecologist should be consulted first.

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

• a detailed survey of the patient for the first time the signs of hemorrhoids appear - to identify the stage of evolution of the disease;
• familiarization with the medical and life history not only of the patient, but also of their family members - this is often enough to determine the sources of why hemorrhoids appear;
• performing an objective exam that aims to assess the status of the perianal region, as well as a digital exam of the rectum, which will distinguish internal from external hemorrhoids and determine the location of the nodule.

The second step for establishing the correct diagnosis is laboratory tests, that is, general blood tests, biochemical tests and coagulogram.

The final part of the diagnosis is the patient's instrumental exams, which aim to assess the appearance of the hemorrhoids and provide:

• sigmoidoscopy;
• anoscopy;
• colonoscopy;
• contrast agent radiography;
• Ultrasound of Organs abdominal organs.

Only after studying the test results, the clinician devises tactics to cure hemorrhoids in a patient.

Treatment

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

• the use of medicines for local and general effects. In the first case, rectal suppositories, ointments, creams and gels are used, and in the second - pills to improve blood circulation, strengthen the veins and neutralize the concomitant symptoms;
• adherence to an economical diet - shown for external and internal hemorrhoids. All recommendations regarding the menu and cooking methods are provided by the attending physician;
• minimally invasive techniques to remove hemorrhoids;
• open surgery;
• the use of alternative medicine prescriptions. This should include preparing candles and ointments with natural ingredients at home, as well as decoctions of herbs and medicinal plants, which are used for ingestion or as microcrystals and sitz baths.

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

• the introduction of sclerosing substances directly into the nodule;
• ligature with latex rings;
• infrared and electrocoagulation;
• cryodestruction;
• disarterization.

Haemorrhoid removal tactics will be determined by the stage of the pathology.

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

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

Possible complications

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

• adhesion of a secondary infection;
• the spread of the inflammatory process;
• anal sphincter insufficiency;
• profuse hemorrhages that lead to anemia;
• proctitis and paraproctitis;
• the formation of blood clots;
• anal fissures.

Prevention and prognosis

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

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

It is impossible to unequivocally answer the question of hemorrhoid prognosis, since the outcome depends on several factors - the stage and form of disease evolution, age group, time to start hemorrhoid treatment and patient compliance to all the recommendations of the doctors.

Often, people who have been diagnosed with hemorrhoids ask if the disease can go away on its own. The answer from doctors will always be in the negative - the disease will become chronic.