Hemorrhoids

7 May 2025

Hemorrhoids are varicose veins in the hemorrhoid veins of the rectum. Inflammation of the hemorrhoid node is characterized by thrombosis, a change in shape and the pathological expansion of the hemorrhoid veins, forming us around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which is aggravated by them from time to time. And more than 70% of people at least occasionally experience various symptoms of hemorrhoids, such as discomfort in the anus area, itching and pain during defecation.

Hemorrhoids in women usually occur during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very kind methods, as a pregnant woman is not recommended to take some medicines for hemorrhoids that are prescribed in the usual order. Hemorrhoids in men are also a very frequent phenomenon caused by several other causes and factors that will be discussed even more.

What are the causes of hemorrhoids?

It is generally accepted that hemorrhoids develop due to increased blood flow or insufficient output, which leads to stagnant processes. The causes and factors of the development of hemorrhoids are:

Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which should be said first. And while hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. The inheritance of certain groups of genes leads to congenital weakness or vascular dysfunction located in the rectum. This is the cause of an improved flow and an insufficient exit of blood through the cavernous veins, which leads to the pathological expansion of the latter. A long -term expansion of cavernous veins leads to the thinning of the walls of the blood vessels, which contributes to the occurrence of bleeding with hemorrhoids.
Longtime work and weight lifting. In addition to a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First of all, this applies to people who are forced to remain in standing position for a long time. This category includes teachers, teachers, Swiss, guards, hairdressers and others. The height lifting is another reason for the development of hemorrhoids and the loss of hemorrhoids.
A sedentary lifestyle. This is a serious negative factor, especially related to workers, drivers and people, bringing a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is an increased pressure on the rectum vessels in a sitting position. With a prolonged seat, the anus area is slightly heated, which leads to stagnant phenomena and vascular expansion. In addition, lack of physical effort is a true way to develop venous insufficiency. Including this applies to veins located in the rectum.
Chronic constipation and diarrhea. People who suffer from chronic constipation are predisposed to the development of hemorrhoids. Why is this happening? The fact is that, with constipation, the stools hardens, exerting pressure on the veins in the lower intestine. This leads to a deterioration in the cavernous blood supply and the appearance of hemorrhoids. An additional factor in constipation is the habit of pushing strongly during defecation, which creates additional pressure on the rectum vessels.

Like constipation, it contributes to the development of hemorrhoids and severe diarrhea (diarrhea), which leads to irritation and inflammation of the mucous membrane of the rectum.

Pregnancy. Hemorrhoids during pregnancy and childbirth are a frequent phenomenon, as the fetus bearing creates pressure in the venous vessels of the rectum. And tense attempts during childbirth only exacerbate the course of hemorrhoids and contribute to the formation of new hemorrhoid nodes.
Inadequate nutrition, abuse of spicy foods and alcohol. A significant factor in the appearance of hemorrhoids is malnutrition. In particular, the abuse of spicy foods leads to irritation of the intestinal mucosa and also stimulates an improved blood flow to the rectum. And insufficient use of fiber (plant foods) worsens intestinal motility. The thought -provoking factor in the development of hemorrhoids is alcohol, which expands the vessels. The reception of alcoholic beverages, even in a small amount, can cause an exacerbation of chronic hemorrhoids.

The main factors that contribute to the development of hemorrhoids:

Obesity.
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 exit in the rectum.
Frequent constipation.
Inflammatory and tumor processes in the gut and liver.
Infection.
Smoking.

Internal and external

In the place of occurrence of us hemorrhoids, the disease is divided into two main types: internal and external hemorrhoids.

With external hemorrhoids, nodes are formed in the vicinity of the anus, in connection with it, its sensitive surface usually breaks and bleeds bright scarlet blood. Pain in external hemorrhoids is quite clear and strong, but in terms of independent diagnosis, this species represents no difficulty.

The internal type of hemorrhoids, although it has a much more serious threat to health, is usually distinguished by the complete lack of pain (especially at the early stage of the disease). This fact is explained by the fact that hemorrhoid nodes are located in the background, and their surface is the same insoluctive mucous membrane as the salary.

Degree

Usually distinguishes 3 degrees of internal hemorrhoids:

1st degree. Hemorrhoids are located in the anal canal, cannot be felt (even with a rectal study). Complaints of anus inflammation and bleeding, "writhing" pain after defecation.
2nd degree. The nodes project themselves from the anus by stretching and disappearing independently. In principle, the same disorders are observed here and the hemorrhoids of the 1st degree, however, small ruptures of the mucous membrane are more often, and the inflammation of the anus is stronger.
3rd degree. It is characterized by the loss of hemorrhoids, which do not recover independently. Symptoms may be the same as 2-, but usually fecal phenomena and gases develop additionally. When examined by hemorrhoids, it is distinguished from the fall of the anus along the radiant grooves, cyanotic coloration and a tuberous surface.

Hemorrhoid symptoms

The signs of hemorrhoids characteristic of all stages of disease development:

discomfort in the anus;
pain during defecation (at first insignificant, then strong);
Anus bleeding;
Formation and growth of hemorrhoids.

Hemorrhoids are a chronic pathology that progresses for many years. The rate of disease development depends on many factors, including nutrition, lifestyle.

For the early stageDiseases are characterized by a slight increase in the veins in the anus. Generally, this signal remains unnoticed. In this case, the patient can be disturbed by the bloody discharge of the rectum that occurs immediately after defecation. Blood can be easily seen in toilet paper. It is worth remembering that a similar symptom is characteristic of malignant intestinal tumors; Therefore, when it occurs, you should consult a proctologist. The opportune search for a doctor and the appointment of therapy will easily decrease the development of hemorrhoids.

In the second stageThe development of the patient's disease can periodically suffer discomfort in the anus, itching. Often it has a feeling of a foreign body in the anus. Hemorrhoids begin to fall during defecation and are still easily adjusted inside.

For the third stageHemorrhoids are characterized by an increase in existing resources. Great venous nodes in the anus make it difficult to empty intestinal emptying, the cause of constipation becomes, the act of defecation is accompanied by pain and bleeding. The strong bleeding with hemorrhoids is dangerous, over time can lead to the development of anemia.

For the last stepDiseases are characterized by an increase in hemorrhoid size. They cannot be straightened by hand. The presence of advanced veins in the anus causes severe discomfort, hurts the patient, go to the bathroom. He is concerned about abundant bleeding during each defecation. The fourth stage of hemorrhoid development can be complicated by such unpleasant and dangerous phenomena as thrombosis of the veins at the end of the rectum.

Hemorrhoids in pregnant women

Often, hemorrhoids appear during the last trimester of pregnancy and childbirth. The causes of hemorrhoids are a piercing in increasing the uterus of the intestinal veins, which leads to a deterioration of the blood flow of the intestine and perineum. Vienna increases in the diameter and changes the shape. Periodic constipation in pregnant women can also cause its appearance.

However, in most women, the symptoms of hemorrhoids pass in the postpartum period; Therefore, it is believed that the causes may be hormonal changes. Should be treated immediately after detecting their first symptoms. It is important to deal with constipation, for example, take medications to relieve stools (forlax, laminate, methyl -elosis), 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.

Hemorrhoid prevention should be performed from the early days of pregnancy - make a competent diet to avoid constipation, do not wear tight belts, spend more time to fresh air and walking.

What is the danger?

Progressing the disease without proper treatment will lead to several very unpleasant complications.

Hemorrhoid complications:

Anemia (develops with a long course of the disease with abundant bleeding).
Inflammatory processes in surrounding tissues, until the development of paraproctitis (inflammation of the fiber around the rectum). Paraproproproctitis is considered a very serious complication that requires severe treatment.
The cracks in the anus. The most common cause of intense pain in hemorrhoids. Cracks create favorable conditions for the development and penetration of various infections deep in soft tissues. This fact can lead to the development of formidable complications such as abscess (limited purulent inflammation, which is accompanied by poorly -overall, temperature and intense pain). This complication needs mandatory surgical intervention.
Itch. A very unpleasant complication, which acts not only as a strong negative psychological moment, undermining the patient's psychological -emotional state. Constantly mechanical irritation in the anal region can significantly aggravate the process of the course of the disease. In addition, constant damage to tissue increases the risk of developing various tumor processes.
The insufficiency of the anal sphincter, gas incontinence and feces (usually in the elderly).

It follows that hemorrhoids need early diagnosis and take immediate measures to solve this problem.

How are the hemorrhoids: photo

Diagnosis

As a rule, diagnosis is not associated with special difficulties, diagnosis occurs as part of patient research and initial outpatient examination. Inspection helps to determine:

the degree of loss of the anus of the knots,
Evaluate the possibility of turning back,
The condition of the skin,
as well as the relevance 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 prescribing incorrect treatment. Hemorrhoids can be confused with:

Anal crack, which is also accompanied by slight bleeding, pain during defecation;
rectum cancer (malignant intestinal tumors occur with bleeding);
the loss of the rectum;
Colitis, polyps and condylomas.

If you notice the first signs of the disease itself, do not postpone a doctor trip for a long time. Early diagnosis will facilitate treatment and help avoid not only complications but also surgical intervention.

How to treat hemorrhoids?

Conservative hemorrhoid treatment:

Be sure to normalize intestinal emptying. The chair should be regular, soft. To normalize hemorrhoid feces, foods with food fiber content is recommended, including wheat bran, but its number should be gradually increased by 2-3 weeks. (from 5-10 g to 20 g per day), which excludes the appearance of discomfort.
With constipation, you can recommend lactulose up to 30 to 40 ml per day to get a soft chair daily and other means, follow a diet and recommendations for constipation.

Treatment uses local medications: rectal candles of hemorrhoids and ointments.

With pain, candles containing small doses of narcotic vehicles (for example, belladona, etc. ) help. You can prescribe candles, sodium alginate, ichthiol, depending on the symptoms and stage of the disease.
If there is no bleeding, you can prescribe suppositories or phenylephrine hydrochloride ointment, etc. But all medications are prescribed in each case so that only one proctologist can prescribe the correct treatment after examining the patient.
With pain, besides candles, cold lotions can be used, but no more than 30 seconds.
To increase the efficiency of local medications, it is necessary to take oral products that improve the tone of venous vessels and avoid thrombosis: diosmine, trunk.
Hemorrhoidal Lutting We (prolapse) is the basis for your dressing. When hemorrhoid vein thrombosis, cold and lidocaine hydrochloride (1%) solution is used locally, and additional bandage is possible.
With the relapse, despite treatment, hemorrhoid -thectomy is recommended.

Treatment treatment methods are exclusively symptomatic - that is, hemorrhoids do not radically cure hemorrhoids. However, they allow you to temporarily deal with the unpleasant signs of hemorrhoids. If the patient after drug treatment meets medical recommendations for relapse prevention, surgical treatment may be avoided.

But patients may not always follow all recommendations.

Small Methods -Invasive

Minimally invasive treatment allows you to do serious, serious injury to getting rid of such a delicate problem as hemorrhoids. Therapeutic methods, in most cases, drown out only the symptoms of the disease, delay the moment when more radical methods are needed. Before appointing a specific 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 sclerous substances that are inserted into the node, glue its walls, so that it is possible to cess its nutrition and death in the future. The technique is performed only in 1-3 stages. It does not exclude the risk of disease relapse and is effective only with small hemorrhoids.
ElectrocoagulationIt is performed under the control of the years. The electrode is brought to the node leg and the fabric is coagulated (soldier), after which they quickly die. In one procedure, it is possible to get rid of 1-2 pathological focuses. After gluing, the hemorrhoid node stops eating and growing and, after a while, disappears completely.
Calling with latex rings-The most modern methods of minimally invasive treatment of internal hemorrhoids of 1-3 stages. A latex ligation is applied through the year -leg years, which leads to squeeze tissues and a violation of the blood circulation in them. After 8 to 14 days, the hemorrhoid node is died and is removed with the latex ring.
Cryotherapy- Short -term effect on liquid nitrogen hemorrhoids. After that, the hemorrhoid node dies and disappears. The procedure occurs under local anesthesia; Therefore, there are no painful sensations.

Small invasive procedures are against -Indicated in:

Exacerbation of the inflammatory process in the rectum and anus;
Anal cracks, lesions;
Hemorrhoid thrombosis.

Small invasive methods of combating hemorrhoids can be used only at 1-3 stages of the disease, necessarily outside the exacerbation 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 we can be removed. Sometimes treatment occurs in several steps, from intervals in several weeks.

Surgical treatment

Surgical treatment is the most effective treatment for the third and fourth stage.

The hemorrhoid removal operation, proposed in the 1930s, is still applied and continues to be modified. In the world, two types of operations are performed mainly:

Closed hemorrhoidctomy. Apply to stage III and IV of the disease.
Open hemorrhoidctomy. Also in stage III and IV, but complicated by anal cracks or topoproctitis.

Also in 1993, a new way of treating hemorrhoids was proposed, it was made by the Italian doctor A. Longgo, which consists of circular removal of the mucous layer and exit of the rectum using a special device.

Patients are discharged 3-4 days after surgery, disability restoration occurs within 5 to 7 days. A small percentage of post -operative complications is also observed.

Power and diet after surgery

In most cases, patients, after surgery for hemorrhoids, may begin to drink and eat a few hours after operation.

But observe the food table (according to Pevzer 1a), exclude products and dishes that excite stomach secretion and annoy its mucous membrane. Food should be cooked in the form of cleaning, vapor cooks or boiled in the water, it is necessary to take a condition in the form of liquid and porridge. Delete: hot and cold products, bread and flour, crus vegetables fruits, cheese, dairy, sour cream, cottage cheese, spices, sauces, coffee, tea.

Eat 6 times a day in small portions. Restoration of normal bowel operation usually occurs on the second day after operation; Therefore, it can be pursued for the usual diet. But, of course, all clear and spicy dishes should be excluded, alcohol must also be forgotten. Adding to these recommendations, you can reduce recovery time after surgery and reduce the risk of complications.

Household 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:

Hot baths help well. You can take a shower or just sit in a basin of water. It is necessary to place the anus area in warm water for 10 to 15 minutes 2-3 times a day.
Complete hygiene of the anal region. You need to bathe or shower daily, wash the anus area well.
Do not use soap in the anus and other means that can cause irritation. Avoid the use of flavored wet toalhetes, which includes alcohol.
Do not use common toilet paper. It is best to use wet but without alcohol.
Use cold. To remove edema in the anus, you can use cold heating pillows, ice packs, cold water moistened fabric.

In addition, the hemorrhoid diet pursues two goals: to avoid constipation and irritation in the rectum. Main recommendations:

Drink enough fluid. This will help make the chair smoother, facilitate its passage through the gut.
Your diet should include more vegetables, fruits, cereals. They contain plant fibers, which helps prevent constipation.
Alcohol, coffee, strong tea should be avoided.
Limit clear dishes, spices.
It is better to get food in small portions, 4-5 times a day.
Eating almost at the same time.
Physical activity also helps normalize the work of the intestine.

Gymnastics

Gymnastics exercises aim to prevent constipation and strengthen the anal sphincter. For example, improving the output of the blood and strengthening the muscle layer of the press, you can normalize the work of the intestine, which prevents constipation:

The "scissors" exercise is performed on the back with lifted legs, which need to be diluted and crossed alternately;
"Bicycle" is a very famous exercise that is very reminiscent of a bicycle ride, however, lying on his back;
And you can lie on the floor (on the back), joining the straight legs, raise one leg or the other, if possible, reaching a straight angle on the hip joints. Or bend your legs on your knees and spread to the sides while trying to rip the ground basin as much as possible.

Therefore, a person is organized for feeling his "fifth point" in any position and is able to lead him, so that the gymnastics to strengthen the anus does not require devices and can be performed anywhere, and it is unlikely to perceive them.

Then exercises to strengthen the sphincter:

Get up, cross the legs and make rhythmic relaxation and tension of the glute muscles;
Choose the hardest chair, feel a little forward (you can easily do the desktop), try to reduce and relax the sphincter, in turn, trying to push the anus into the rectum. You should take 20 minutes to exercise, which, if desired, can always be found.

Prevention

The best hemorrhoid tool is prevention. There are predisposing factors that lead to the development of the disease:

Irregular chair, a tendency to constipation or diarrhea, the habit of strangle during defecation or for a long time to sit in the bathroom with a book;
Hard physical work and, conversely, a motion deficiency, long -term stay in a sitting position;
Pregnancy and childbirth;
Alcohol abuse.

This means that lifestyle correction will help relieve the course of the disease.

It is advisable to reconsider the diet: abandon simple carbohydrates (sweets, sweets) in favor of complexes (vegetables, fruits, vegetables, grain bread) instead of tea and coffee, drinking water, will help normalize a chair.
Avoid alcohol, including beer.
With hemorrhoids, we are unwanted by horseback riding, heavy athletics, bicycle sports, but walking or swimming is simply necessary.
It is useful to strengthen the muscles of the press and abdominal buttocks, do gymnastics in Kegel.
Sitting in the bathroom for a long time is a bad habit. But use after visiting the bathroom bidet or upward shower to wash, on the contrary, very useful.

If, despite all preventive exacerbation measures, it was not possible to avoid, it is not necessary to panic. It is advisable to change the position sitting to the lie, apply cold compresses to the painful point, moistened in a weak potassium permanganate solution or organize bathing with chamomile (not hot! ), Do not forget the diet and personal hygiene.