There is no person who has never heard the word "hemorrhoids."It is used by all those who are not lazy, even those who have nothing to do with medicine.
The term "hemorrhoids" itself comes from two Greek words -"Haem"("Blood") and"Rhoos"("bleeding").
The concept is ambiguous, because not all hemorrhages are a consequence of hemorrhoids, and does not always cause blood.In this case, the concept of "hemorrhoidal nodes" is suitable for the broader concept of "hemorrhoids" - swelling, swelling that occurs during garbage.
Problem description
Hemorrhoids are special anal formations located under the rectum.In structure, they are a plexus of venous vessels.They are located inside and outside the mucous membrane.From the location of these formations, hemorrhoids of internal and external nature are divided.
These plexus perform a protective function: protect the rectum from the incontinence of stool and liquid gases, and also completely close the anal channel.According to statistics, 20 % of adults suffer from this disease.And this disease is precisely the cause of the specialist campaign.
That contributes to the occurrence and development of the disease
Hemorrhoids are normal only with a couple of parks.In case of heavy or prolonged physical effort, these ligaments can be torn.In case of violation of ligament integrity, hemorrhoids overflow with blood.The consequence of this is your loss and bleeding.
Vienna, which provides normal blood outlet from the mucosa, is approved.The blood begins to stagnate.
Factors that cause hemorrhoid development
The pathology itself does not arise like that, by itself.It happened and the development is affected by several factors:
- The hereditary factor (in the hemorrhoidal node and the veins there are no valves that provide blood output).
- Increased pressure in the veins.
- Cars in the work of the intestines (constipation, diarrhea), a frequent visit to the bathroom.
- Pregnancy, childbirth, improvement of the disease clinic.
- A sedentary lifestyle, standing position for a long period.
- Some sports and professions.
- Nutrition characteristics (alcohol, spicy food).But this more contributes to exacerbation, not development.
Pay attention!Even in the presence of bleeding of the anal channel, you cannot talk about the manifestation of hemorrhoids.To confirm the diagnosis, rectum analysis and examination is necessary:
- Colonoscopy
- Anoscopy.
- Sectoroscopy
Bleeding and nodes can occur with inflammation of intestines and in malignant formations.
Hemorrhoids: symptoms and classification
The location of the nodes:
- Abroad.
- Inside.
- Mixed.
First view- The expansion of the venous vessels located below the gear line of the rectum.This species is characterized by edematous manifestations, the presence of discomfort in the rectum.With this type of pathology, severe pain is characterized.
The second view- The expansion of hemorrhoids itself located below the line.Hemorrhoids are divided into 1, 2, 3 and 4 degrees (the severity of the disease depends on the severity of the nodes).There are also acute and chronic hemorrhoids, which arise from a disease.
Chronic hemorrhoids
Clinical image:
- Periodically, blood is released from the anus.
- The loss of plexus inside the mucosa.
- Itching and burning in the anus.
- Download of the rectum.
Chronic hemorrhoid symptoms
Intestinal bleeding
This is the most frequent symptom with this disease that occurred in 10 % of patients.According to statistics, the most frequent occurrence is when the intestinal is empty.The manifestations can be intense and not very, and are of an episodic nature.The color of the discharge is scarlet, in the form of "spray" (occurs with strangulation) or, at the end of the emptying (in the form of drops).If, after the previous emptying in the anus, the blood remained, the next one will come out with a dark or a group.
70-80 % of cases clinical manifestations of hemorrhoids.With constipation and diarrhea, alcohol intake, spicy foods and strong physical effort, bleeding is also produced.The consequence of this is the appearance of anemia.
The manifestation of anal bleeding is not always a sign of this disease.It can occur in other intestine diseases.If it occurs in people over 40-45, you should definitely consult a doctor.In addition, in the case of this in people with a predisposition to oncology, a visit to the doctor is required.
For what diseases bleeding can occur:
- Colon diverticulase.
- Crohn's disease.
- The malignant neoplasia of the rectum.
- Polyps of intestines.
If you notice the top of the anus, consult a proctologist and perform the necessary exams of the direct and thick intestine.
Profusion of venous plexus
This symptom already occurs in the phase of a long course of the disease.First, it occurs with the devastation of the intestines.In addition, the symptom appears with strangulation.If the pathology is acute, then it falls effortlessly.Division independently into 2 stages.In 3 stages, they adjust manually due to a decrease in the tone of the anal muscles.They fall completely into 4 stages.
Anal pain
Bleeding is not the only reason that comes to a specialist.And this is not necessarily hemorrhoids.The pain syndrome can occur in an acute stage of the disease.Reasons:
- Constipation.
- Frequent visit to the bathroom.
- Anal crack.
- Nodes plromisis.
If the treatment is carried out incorrectly, the anal crack will enter the chronic stage.
Intestinal secretion
The nature of the discharge in this disease is aqueous or mucosa.It arises as a consequence of the episodic loss of nodes.With bleeding, pay attention to mucous secretions.Very often, they are when the nodes or mucosa fall.Other reasons are neoplasms (hairy polyps, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with colon dysfunction.They occur, as a rule, in the late stage of the disease.
Classification
1 phase- Venous plexus do not fall.The scarlet color of the released blood.
2 phase- The fallen nodes fit themselves (with or without blood release).
3 phase- The nodes fall episodically and improve manually.
4 Phase- The newspaper and the mucous membrane of the rectum begin to fall constantly.The manual reduction becomes impossible.
Acute hemorrhoids
It usually occurs with exacerbation in the chronic phase.The most frequent manifestations:
- External nodes with the appearance of thrombosis.
- Profusion of internal thrombrated plexuses.
If thrombosis occurs, the nodes are compacted and increase in size.A severe pain syndrome occurs in the anal opening area.
Acute hemorrhoid treatment
In the thrombosis stage, thromboectomy is possible (splitting a thrombus node and thrombus elimination).The operation is carried out under local anesthesia.Duration - A few minutes.After the operation, the pain immediately begins to decrease.
When internal hemorrhoidal nodes fall, swollen phenomena and inflammation occur.Surgical intervention is contraindicated due to possible complications.Therapy:
- The use of ointments and candles.
- Pills.
If you notice the manifestations over time, the duration of the acute stage is reduced to a week.If the pathology is not treated for a long time, purulent inflammation can occur.
3 phases of the disease in the acute course
- The appearance of blood clots in internal and external venous plexuses.There is no inflammation.
- The presence of blood clots in the nodes, with the presence of inflammation.
- At the bottom of the previous signs, the inflammation of the subcutaneous tissue develops.Complications occur: bleeding, purulent inflammation.
How to treat hemorrhoids in the chronic stage
Hemorrhoids are a serious, unpleasant, but reference illness.There are enough treatment methods for elimination.The treatment system is constantly improving.Each method has no doubts, pros and cons.And are used depending on the phase.The following factors affect the use of a particular methodology:
- The course of the disease.
- The nature of the discharge.
- Patient age.
- The frequency of bleeding.
The difficulty lies in the fact that many methods are based on the same indications for treatment, and choosing the optimal is not easy.In this case, you must combine the necessary methods.According to the classification, 3 types of treatment are distinguished:
- Conservative.
- Small invasive.
- Operational.
First degree hemorrhoids
The loss of nodes with the release of blood or not:
- Mandatory normalization of nutrition (with a high percentage of fiber).
- Take drugs that reduce inflammation and expansion of venous vessels.
- Rectal candles, ointments for external use for exacerbation.
Degree II hemorrhoids
Auto -Reduction of the affected nodes:
- Hemorroidal node fixation with a latex ring.
- Introduction of a sclerosant.
- The ligation of arteries that bring blood to inflamed nodes.
- Electrocoagulation.
- External and internal nodes split.
Degree III hemorrhoids
Manual reduction:
- The use of latex rings.
- Sclerotherapy.
- Landing of the arteries.
- Electrocoagulation.
- Excision.
Degree IV hemorrhoids
The impossible reduction of nodes: Eliminate inflamed nodes with a special device.
The stages of hemorrhoid development
Not all methods are suitable for hemorrhoid treatment in one case or another.The final solution affects how exactly external and internal plexuses are correlated.If the pathology is prevailing nodes, inside, then it can dispense with surgery.The methods are described above.
Before making a final diagnosis, the patient needs a complete exam.The first thing to do is examine the rectum and the large intestine.First, this applies to patients over 45 years, with an inherited predisposition to oncology, since there may be concomitant diseases with hemorrhoids:
- The malignant tumor of the rectum.
- Polyps.
In addition, symptoms (or rather, the degree of their severity), the size of the nodes and episodality affect the choice of a particular method of treatment.
With a weak gravity of symptoms, rare loss, it is better to choose conservative therapy.The first thing to what is directed is the correction of nutrition, the elimination of constipation and pressure during the emptying of the intestine.The diet must contain a sufficient amount of water, since constipation often occurs with a lack of liquid, so the intestines are forced to suck it with the feces.
To facilitate this condition, the following is important:
- The predominant component in the diet is fiber.
- Periodic laxative intake.
- The appointment of phlebotropes for the patient.
Conservative therapy is mainly used during an acute exacerbation of the disease.Another treatment is contraindicated.If the disease is in the first and second phase, other methods are also contraindicated.What is included in conservative treatment:
- Special diet.
- Sta drugs.
- Rectal candles, ointments.
- Flobotropic medications.
Each patient is prescribed by the diet.The main objective is to normalize a chair.Often, one of the main provocative factors is precisely constipation or diarrhea.Diet for this disease categorically prohibits:
- Sharp.
- Salt.
- Roast.
- Alcohol.
Diario implies additional exams.It is the result of the exams that affect the correction of the diet and treatment.If the patient is prone to constipation, a special diet is recommended.The list of products and other nuances can be seen in a special section.For a laxative effect, it is recommended:
- Dry apracotes.
- Pruning
- Dry apracotes.
- Fig.
If the diet does not eliminate the stagnant effect on the intestines, the use of laxatives begins.Now it will not be difficult to find them: just go to any pharmacy and ask.Do not take them yourself.The dose and the medication mark depend on the following factors:
- Individual characteristics of the body.
- Concomitant diseases.
- Age.
- Doctor decisions.
Until the final treatment has been prescribed, the doctor prescribes the patient 1 tablespoon.l.Vaseline oil (2-3 times a day).
Basic in the treatment of pathology
But it is worth remembering that there are no ointments and other medications will save it completely from the problem.They only temporarily eliminate symptoms, and no more.Conservative therapy will be ineffective if venous plexuses fall regularly: only radical treatment methods will help here.
In addition, by prescribing the dosage forms of the medication, certain factors are taken into account.For example, rectal candles are not suitable for patients with a pronounced pain syndrome.In this case, the ointment is preferable.In some cases, combinations are acceptable.
It is not necessary to list the complete drug list of this pathology, since it is very large.The defining factor is the individual characteristics of the body and the patient's personal complaints.
Which affects the choice of ointments or candles:
- Acute hemorrhoids with thrombosis.
- Inflammation.
At the same time, anesthetics, anti -inflammatory medications that relieve edema are prescribed.It is necessary to use such medications for a certain time, since they contain hormones and non -anti -inflammatory steroids.
The use of phlebotropic is a prerequisite for pharmacological therapy.
Small invasive treatment
Sclerotherapy
This is a method in which a special solution is introduced in the area of hemorrhoidal nodes: sclerosing.With adequate administration, manipulation does not cause pain.Local anesthesia is not used.Duration is not more than 10 minutes.Hospitalization is not necessary.After the procedure, you can continue leading the same way of life.Within two days in the anus, they are possible uncomfortable sensations.This method is used in a pathology in a chronic phase (blood is released, plexus are not protruding).This method is rarely used, since manipulation is quite complicated, and with the correct administration of the drug, mucosa necrosis is possible.As a general rule, the period of calm after manipulation is about 3-7 years.
Infrared coagulation
The method by which if radiation acts in inflamed areas.With him, hemorrhoidal tissue begins to die gradually.After manipulations, you can lead the previous lifestyle.Painful sensations are possible for two days.The ai method is used in 1 and 2 stages of pathology, where the size of the sites is small.The calm period is 3 to 7 years, without serious complications.
Fixing with latex rings
This procedure is the most common among all other methods.Its advantages:
- Low cost.
- A wide range of indications.
- Lack of risk of complications.
The conclusion is that the latex ring applies to the site area.This is done using a biker.Due to ring pressure, it begins to die and reject.Fast manipulation in driving (3-5 minutes), simple, practically painless.After the ligation, you can lead the previous lifestyle.Painful sensations are possible for two days.The ligation method is shown in phase 1-3 of pathology.There are almost no complications.Sometimes there is blood discharge when the ring leaves.Less of the procedure: only 1 site is deleted for 1 session, the following manipulation is possible only after a couple of weeks.
Arteries landing
The proximal ligation method allows you to find the location of all arteries that provide inflamed areas and sell them.In this method, local anesthesia is used.Perform the procedure with an anocopio with a knot.As a result of the dressing of the arteries, the inflamed areas disappear.The duration of the procedure is approximately half an hour.Pain sensations are almost not observed.The pains are possible in two days and an increase in temperature.You can lead the same lifestyle.This method is used in all phases of pathology.
Pros:
- Lack of cleaning tissues.
- Reducing the rehabilitation period.
- Processing 1 time.
- A longer period of calm (5-10 years).
Cons:
- The procedure is longer compared to others.
- Pain.
- High cost.
Surgical intervention
The Milligan-Morgan operation
This method of surgical intervention implies the split of external and internal inflammations, with its posterior dressing.Apply in all phases of the disease.Nuances:
- General anesthesia.
- The need for 3-5 daily hospitalization of hospitalization.
- Reduced yield within 10-15 days.
- A long recovery period: approximately 1 month.
- The duration of manipulation is approximately half an hour.
The advantages are that this is the only and radical therapy method.The quiet period is up to 12 years, only repeated relapses are possible in 15-30 % of cases.Painful consumption sensations for 2-4 days.We need an analgesic.The recovery period is long, as well as the appearance of scars and a decrease in the tone of the anal sphincter.
Long Professor
This method implies truncating the mucous membrane of the rectum.It is carried out using a special stapler.The sites lose the possibility of exceling, and blood flow decreases.Shown by pathology in all phases.Nuances:
- General anesthesia.
- Hospitalization in the hospital for 2-4 days.
- The recovery period is 3-5 days.
The advantages of the procedure are similar to hemorrhoidctomy, the small severity of pain;The recovery is fast, there are no complications.High cost cost (due to the use of a stapler).
Conclusion
The methods described in the article are not the only ones for which hemorrhoids are treated.Cryotherapy is also used.But this method is not so widespread, since there is a discharge incontinence of the anus, the depth of the exposure is not controlled.
The patient himself has the right to decide whether to see him a doctor or not.Of course, it is worth paying attention to the frequency of bleeding and pain, since frequent release of blood causes anemia.Otherwise, hemorrhoids are not very threatening.But it is worth noting that the sooner consults a doctor, the better.Therefore, it will avoid a more radical treatment method and improve life.
Remember that only a proctologist can help solve this problem.If you notice the following signals:
- Newspaper bleeding.
- Itching and burning in the anus.
- Sensation of discomfort and pain: Communicate immediately with a proctologist!In no case do not self -medicate!