In our culture, the body background and its functions are a topic that is unual to discuss in a decent society.Therefore, diseases that affect these parts of the body cause suffering not only from 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 population of the earth is subject to it.Most of the time, people from 30 to 50 suffer from hemorrhoids, and men are four times more often than women.Unfortunately, far from all patients, feeling the signs of the disease that began, go to the doctor.False shame prevents many, they prefer to self -medicate, which only worsens their position.But hemorrhoids, like other diseases, are easier to treat in the early stages.
What are hemorrhoids and the causes of their occurrence
The final part of the digestive tract, the last segment of the colon, is called 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 paired, is called hemorrhoid), and the blood exit is performed by a large branched veins of veins located in the submucosal layer of the rectum.At the bottom of the rectum, or in the hemorrhoidal zone, under the mucous membrane are cavernous or cavernous bodies, pierced by the smaller vein network.Normally, the walls of these vessels should support connective tissue, but if weakened, blood flow is increased and the exit will be disturbed, then the walls of the vessels increase, the cavernous bodies are filled with blood and stand out, filling the entire cavity and sometimes appeared by the anus.Hemorrhoids are the same swollen and protruding cavernous bodies.Sometimes the appearance of hemorrhoids cause mechanical causes when, under the influence of some factors, the muscle fibers of the rectum longitudinal muscle are stretched and loosened, which causes the displacement of hemorrhoids to the anus and its loss of it.The number of us in patients is very different - from one to several, which can fill the entire anal region.Its dimensions are also very different - from 5 mm to 3 cm.
Although the exact causes of the occurrence and development of hemorrhoids have not yet been revealed, it is believed that the following factors contribute to this:
- A sedentary lifestyle.People are particularly subject to the emergence of hemorrhoids for a long time to be sitting or standing for a long time.When a person sits or means a long time, blood stagnation occurs in the pelvic organs, which may disturb blood exit through the veins.
- Physical work.However, physical activity is not a panacea;People who work in areas where prolonged and constant physical work also suffer from hemorrhoids.
- Complications for Defecation- Whether diarrhea or chronic constipation.Both states cause an increase in pressure on the abdominal cavity, which in turn leads to an increase in hemorrhoid nodes and their loss.
- Inadequate nutrition.Increased alcohol use, spicy foods cause an arterial influx to the cavernous bodies of the rectum, which contributes to its expansion.Fiber -poor food causes constipation and the abundance of fatty foods - diarrhea.
- Hypothermia or overheating of the pelvis area.Both conditions worsen blood circulation and contribute to blood stagnation in the pelvis.
- Pregnancy, delivery.In this state, a woman increases the pressure in the abdominal area, and the output of blood through the veins can be disturbed.As a result, hemorrhoids can form.
- Obesity.Especially the occurrence of hemorrhoids is subject to people whose fat is deposited mainly in the abdomen.
- Some sexual practicesincluding anal sex.
- Various diseases: Liver diseases (with them, venous output of blood is impaired, increases pressure on veins, which contributes to the development of hemorrhoids);Pelvic organs (bladder, prostate) diseases;Neoplasms and/or inflammation in the pelvis, intestines.
- Hereditary reasons: Functional deficiency of connective tissue, impaired nerve regulation of venous wall tone, heart pathology and blood vessels.
Hemorrhoid symptoms
Hemorrhoids gradually arise and imperceptibly;A person does not experience a special drawback unless from time to time after defecation may seem discomfort, pain, itching in the anus.Soft tissues in the anus area may swell.The mucus can be released from the rectum, irritating the anus and causing burning sensation.Sometimes the patient has a feeling, as if a foreign body were in the rear hole;After defecation, painful long pains are frequent.These phenomena are improved in violation of a diet or disorders of the gastrointestinal tract.But most of the time, people seek a doctor after detecting blood in feces, toilet paper or underwear under the form of small drops, stripes or, in rare cases, with intense bleeding.
However, anus bleeding is not always associated with hemorrhoids (especially if the patient is over 40).Retal bleeding can also occur in the following diseases:
- Anal crack
- Rectus cancer diseases
- The loss of rectum
- Colitis, polyps, condilomas
The patient should pay attention if the occurrence of bleeding is due to a change in intestinal behavior, the appearance of a stool of a different color or consistency than usual.With these symptoms, consult a doctor immediately that the release may occur at another location of the gastrointestinal tract.
How hemorrhoids manifest themselves
Hemorrhoids happenexternalorinternal.With external hemorrhoids, hemorrhoid nodes are expanded, formed from the lower venous plexus and located directly in the anus.Since inflammation is not inside the rectum, but outside it, if desired, you can consider this area with your own eyes.Bleeding in this form of hemorrhoids is practically absent, but patients are very concerned about pain in the rectal region.External nodes are often inflamed, wounded by rough linen and more often reborn in cancer formations.This type of relatively rare hemorrhoids - no more than 10% of the total number of patients suffer from them.
The internal hemorrhoid nodes are located in the submucosal layer of the rectum, it is possible to see them with the naked look only in the later stages of the disease, when the shell of the cavernous bodies is so deformed that it spies on the anus.The main symptoms of internal hemorrhoids are the presence of blood in the stool (although most of the time scarlet, arterial, it is also possible that dark venous blood with clots), pain during defecation.In the posterior stages of the disease, hemorrhoids fall from the anus;At first they are designed inside, but later patients need it to manually.
There is also a combined hemorrhoid, in which the cavernous bodies of the rectum and the subcutaneous venous plexus of the anal region are deformed.
Hemorrhoids happensharp(When their symptoms develop rapidly, nodes are inflamed, inflammation passes to neighboring tissues, the patient undergoes pain; necrotic changes in the nodes due to thrombosis are also possible) andchronic.So the disease lasts a long time, months and even years, while it occurs periodically - bleeding occurs, the nodes fall, pinch and offer many inconveniences.During periods of remission, provided that the precautions are observed by the patient practically does not seem discomfort.
Stages of disease development
Most cases of hemorrhoids are diagnosed in later stages - because patients did not pay attention to symptoms, giving them to other reasons or due to false shame, squeezed the journey to the doctor.There are four stages of hemorrhoids.
- The first stage.Symptoms are impressively expressed, manifested only in special cases (eg, with intestinal disorders, after heavy physical work, long time or sitting on site, eating disorders, overheating or hypothermia).Sometimes the patient feels discomfort during defecation, burning and itching after him.In the exam, the doctor observes the presence of blood stagnation and stretching the walls of the blood vessels.If hemorrhoids can diagnose at this stage, treatment occurs rapidly and without problems.
- The second stage.Hemorrhoids increase the size, its walls become thinner, small breaks can form in them, which leads to bleeding.In the patient, after great physical exertion, complicated defecation or hypothermia, stools in the stool, toilet paper or underwear can be observed, but bleeding is very small and rapidly passes.Hemorrhoids are slightly increased and may fall from the anus after defecation, however, returning on their own.Its appearance is caused by an increase in peritoneum pressure with severe stress, whether physical work or strong cough.At this stage you can still resort to conservative treatment.
- The third stage.The anal sphincter undergoes changes and weakens as a result of which fallen hemorrhoid nodes can only be corrected manually.The patient is concerned about severe itching, bleeding is frequent and abundant.Conservative treatment is no longer possible.
- The fourth stage.Nodes are so wide that it is not possible to correct them.The anal orifice muscles are very weakened, the tone of the sphincter is reduced.For the loss of us, even the slightest physical activity is sufficient.We themselves can assume the form of seal, they are inflamed;Inflammation can also affect nearby tissues.
Complications with hemorrhoids
Fortunately, hemorrhoid complications are not found very often.Although above all, with the patient's hemorrhoids, the type of blood, does not stand out so much that it is a danger to life.However, with prolonged constant bleeding, anemia is possible.
The mucus flow of the anus causes itching and can lead to eczema.
With the additional development of the disease, when hemorrhoids have already moved to the third or fourth step, the patient receives a lot of manual reduction in nodes.And they may fall not only after defecation, but also with severe cough, sneezing and physical effort.
In rare cases, fallen hemorrhoids may be compressed by the anal sphincter muscle, which causes intense pain.If the nodes are not adjusted, thrombosis may develop.This is the most difficult complications of hemorrhoids, which requires immediate medical care.In this state, hemorrhoid nodes are swollen, tense, increased in size and purulent infection in the patient's body.Patients lose their appetite, temperature increases, are sick.
Any disease becomes worse if it is not treated.It is no exception to hemorrhoids - in the absence of treatment, it progresses, which can lead to irreversible changes in the veins of the rectum.
Hemorrhoids during pregnancy and childbirth
The reason for the development of hemorrhoids in pregnant women is squeezing the veins of the rectus of the rectum, which increased the size of the uterus, causing the impaired blood exit, blood vessels and the formation of hemorrhoids.In addition, the appearance of hemorrhoids in pregnant women can cause constipation when feces stretch the rectus walls and hurt the cavernous bodies.As a rule, in recent months of pregnancy, a woman is forced to lead a sedentary lifestyle, which also does not contribute to the healing of the body.During delivery, the perineum muscles are tense, the cavernous bodies of the rectum are stretched and injured.With severe stretching of the perineum muscles, anal sphincter weakening is possible and, as a result, the loss of us.
Often those who have given rise to women confuse the symptoms of hemorrhoids with the consequences of childbirth and do not immediately consult a doctor, thus causing the development of the disease.
Which doctor contacts the suspicion of hemorrhoids?
If a person is concerned about the unpleasant sensations in the anus area, itching and blood traces, you should consult a professionalist or a collapse doctor.
Disease diagnosis
Usually, to diagnose hemorrhoids, there is sufficient visual examination of the patient's body.At the same time, the patient assumes the knee position or occupies a gynecological chair.The doctor examines the patient's anus, paying special attention to the condition of the skin, the presence of us hemorrhoids, its value and position.
To confirm the diagnosis, the doctor can perform other studies:
- Straight.The doctor examines the tissues of the anal canal, evaluates the state of the mucous membrane of the rectum, as well as the surrounding organs and tissues, determines the location of hemorrhoid nodes, their value and the degree of pain and if there is bleeding.It is true that the exact size of the nodes cannot be defined - when feeling, they are usually reduced in size.In this case, the patient may be sideways, on the back or standing on four, and the glove doctor with the index finger examines the rectum inside.Already after an examination of the fingers, the doctor may prescribe years ofCopy and Spectooroscopy.
- Yearscopy.With the years, a special device is introduced at the rear, allowing the doctor to examine the rectum surface by 10-15 cm.Using the yearscope, the doctor determines where exactly cavernous bodies are affected, if there are tumor processes and inflammatory diseases in the rectum.The yearscope is also used to do tests - biopsy and strokes.This procedure is painless and practically has no indications;The exception is the stage of exacerbation of inflammatory diseases.Then the doctor recommends first removing inflammation and then perform an exam.
Although the years is a very simple procedure, it requires preliminary preparation.So that nothing prevents the rectum examination, the patient should refrain from eating the night before, and two cleaning enemas - mid -day before the time of the procedure and the second - a few hours before him.It is also possible for the doctor to ask the patient to take a laxative the day before.
In addition, to exclude the risk of developing cancer pathology, the doctor can offer the patient to passSectoronocopy- Sigmoid and rectum examination.With this examination, the doctor can examine the inner surface of the rectum even more to 25 cm.If, for some reason, it is impossible to perform a stomoroscopy (say, the patient has pathological disorders of the rectum), they are performed insteadColonoscopy- When the inner surface of the rectum is examined with an endoscope.
Thanks to this approach, the doctor can get a clear image of the disease, which 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.Frequently, hemorrhoids are accompanied by diseases of the anal part of the body and colon, caused by bleeding hemorrhoids.Sometimes there is also an irritable bowel syndrome.
How to treat hemorrhoids
After making a diagnosis, the doctor decides which treatment to prescribe.But with all the stages of hemorrhoids, from the first to the last, the treatment is performed that allows the symptoms of the disease to interrupt - to reduce pain, to stop bleeding.If hemorrhoids of the first or second internship, it is possible to heal it when using the chamber.Conservative treatment - that is, the use of pain relieving drugs, avoid complications and also contribute to the postoperative rehabilitation of patients.The best results are provided by the joint use of external and internal drugs.
| Group | Scope | Application method | |
|---|---|---|---|
| Anti -non -esteroids and painkillers | Remove the inflammatory process, reduce swelling, anesthesia | Orally | |
| Venotonizing Agents | Improve blood vessels, reduce vein extension, prevent thrombosis | Orally, externally | |
| Hemostatics | Stop the bleeding | Orally, in the form of injections | |
| Ointments | Relieve spasm and inflammation, anesthetize | Externally | |
| Anticoagulant | Prevent hemorrhoid thrombosis | Injections | |
| Laxatives | Normalize a chair | Orally | |
| Enemas | Normalize a chair | External | |
| Candle | Stimulation of blood supply, analgesic, anti -inflammatory | External |
If, after a week or two, no positive changes are observed, a second exam must be passing a proctologist who will offer a different treatment.
If hemorrhoids of the second or third internship and it is impossible to heal it with only drugs, the so -called.Small - invasive - unlike operational methods, they are less traumatic for the patient, patients spent less time in the hospital and are restored faster.This includes:
- Infrared radiation.Using an infrared coagustor, the doctor acts on us hemorrhoids with cauterizing blood vessels.This operation does not require anesthesia (except in cases of individual individual sensitivity of this area in the patient) and has low trauma.Coagulation can also be performed using laser rays.
- Sclerotherapy.The patient in us hemorrhoids introduces a special substance that glues the walls of the vessels.Generally, with sclerotherapy, a substance is introduced into no more than two nodes, so that the patient does not develop pain syndrome.The next session is held in two weeks.
- Linking (connection) of hemorrhoids with latex rings.This method is most often used to treat hemorrhoids in elderly patients complicating the treatment of the disease.At the same time, a small ring made of latex is applied to the base of the knot, which gradually tightens the knot, leads to its necrosis and rejection.At the same time, bleeding does not occur, as stump is blocked by the ring;Subsequently, a healthy connective tissue is formed in its place.The procedure is almost painless, has low trauma and the ring can be applied quickly with the years.
- Cryotherapy.In this method of treatment, the hemorrhoid node is exposed to low temperatures, after defrosting it, the resulting wound heals over time and connective tissue forms at the site of the node.The operation is performed under local anesthesia.
All minimally invasive treatment methods are used only in the absence of hemorrhoid exacerbation.If hemorrhoids have entered the acute stage, it is necessary first and foremost to relieve inflammation and reduce bleeding.
Surgical treatment of hemorrhoids
In the fourth stage of hemorrhoids, surgical treatment is indicated.The operation (hemorrhoidctomy) is performed as follows: the main groups of hemorrhoids are subjected to excision, the ligasures are applied to their terrain, the wound edges are sewn.Although it seems scary, the operation, although quite unpleasant, is very effective and has the smallest number of relapses.However, after that, there are possible complications: severe pain, bleeding, scars, deformed anal canal, anus restrictions, wound suppuration, toProctitis.After the operation, it is necessary to observe the regime prescribed by the doctor - to refuse the duration of physical activity and the hot baths.
Hemorrhoid treatment at home
There are many popular hemorrhoid remedies, but not all are effective, and some can be harmful.It is recommended to use them only when approving the assistant doctor.
Renal Highlander's decoctions, the fruits of roses and raspberry leaves will help reduce inflammation and normalize the tone of blood vessels.You can also rinse the area of nodes from anus and hemorrhoids, especially after defecation, herbal decoctions that have an anti -inflammatory effect (calendula, St. John's herb, chamomile).In addition, you can make hot baths by 10 to 15 minutes to reduce inflammation and pain.
Hemorrhoid prevention
The easiest way to prevent the occurrence or exacerbation of hemorrhoids, eating correctly so that the chair is soft and there is no constipation.This follows:
- There are high fiber foods- Fruits, vegetables, grain cereals.This softens the chair and increases its volume, which helps to avoid increasing pressure on the abdominal cavity.However, in small portions should be introduced into your diet so that they do not cause gas formation increased.It is recommended to avoid sharp dishes, spices and alcohol.
- Drink many liquids.It is recommended to drink six to eight glasses of water or other liquids a day (alcohol is not included here) so that the chair is smoother and does not harm the walls of the rectum.
- Add drugs that contain food fibers to your diet.Most people do not receive enough fiber per day (25 g are recommended for women, for men - 38 g).Some nutritional supplements may improve the patient's general condition with developed hemorrhoids.But do not forget that with the introduction of additives with a high dietary fiber content in the diet, water consumption or other liquids (non -alcohol) to eight cups a day or more should be increased.Otherwise, they can cause constipation.
- Do not strive during defecation.Excessive tension and breathing retention when trying to alleviate the great pressure on the veins of the rectum.
- Visit the bathroom timely.If a person, for some reason, removing defecation, the chair may be dry and will be more difficult 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.
- Exercise.It is recommended to exercise or get involved in any other physical activity-This will improve the condition of the vascular system of the body, improve blood flow and reduce the pressure in the veins.With work sitting or permanent, it is advisable to take a short break every two hours, walk, stretch, do some exercises.
- Avoid long periods of immobility.Sitting or standing too much can increase the pressure on the veins in the rectal region.