Hemorrhoids - a disease associated with varicose inflammation and swelling of the veins of the rectum in the anus. The affected areas protrude outward, they can form large nodules (lumps) that interfere with the promotion and exit of feces. The disease affects men and women, it is dangerous due to the rupture of the veins, as well as a secondary infection.
Hemorrhoid classification
Depending on the location of the pathological site, 2 types of the disease are distinguished:
- Exterior. The veins of the anus, which are covered with skin, become inflamed. Due to this, it is more difficult to damage the affected areas, they have a stronger "protection". Discomfort during defecation is minor, but unpleasant friction with clothing is often created. Complications of external hemorrhoids occur less often, it is easier to treat.
- Inside. The affected veins are located in the rectum above the anus, making it difficult to determine the initial stage of the disease. The vessels are covered with a thin epithelium, therefore they are more vulnerable to mechanical damage. The internal form of the disease often becomes chronic, it is more dangerous with complications, it is more difficult to treat.
Depending on the severity of the course, internal hemorrhoids are divided into 3 degrees (stages):
- Initial (1). The nodes protrude, bleed, but do not fall out.
- Moderate (2). With muscle tension (during defecation, exercise), swollen veins come out of the anus. When everything relaxes, they return.
- heavy (3). The nodes fall out, even when there is no muscle tension, they do not retract.
Symptoms
The main signs of hemorrhoids are bleeding from the anus, pain with tension in the rectal muscles. The full picture depends on the stage of the disease. If nodules (separate swollen sections of veins) do appear, they look like dark pink or purple (rarely almost black) bumps, are easily palpable, and feel dense. The tone depends on the filling of the vessels: if blood clots have formed, the blood has accumulated and cannot flow out, the nodes will be dark.
internal hemorrhoids
In the first days and weeks, the disease almost does not manifest itself. It begins with edema, which is not felt if you do not start probing the rectum from the inside. There are no pain receptors in that part, so a person does not experience discomfort, even during the defecation process.
At an early stage of hemorrhoids, you can find out about their existence only by drops of blood that appear after the release of large, hard feces. Due to edema, the walls of the rectum narrow the lumen, the mucosa is further damaged during constipation. Important: with hemorrhoids, almost every bowel movement will cause the appearance of a small amount of blood.
Other symptoms will follow:
- Pain during bowel movements. Severe bloating will cause muscle spasms, so even loose stools will cause discomfort.
- burning, itchingDue to inflammation in the rectum, a lot of mucus is formed that irritates the tissues.
- Blood. It appears in large numbers when the nodes are formed. Important: with hemorrhoids, it is bright red, not dark.
- drop nodes. They appear in the later stages of hemorrhoids. First, they are removed themselves, then they must be "pushed" with one finger.
Exterior
The external veins are covered with skin, which has many pain receptors. Already at an early stage of hemorrhoids, a person will experience discomfort if the vessels are swollen. Pain occurs during defecation, and when cleaning the anus, and with close contact of clothing with the skin. If the swelling is severe or a blood clot forms in the vein, a large bulge forms. It is easy to handle, touch causes pain.
Skin with external hemorrhoids becomes tender, often collecting in folds due to swelling. The process of cleaning the anus after defecation is difficult, which increases the risk of secondary infections. So blood appears if the hemorrhoids are damaged, but there will be less than with the formation of internal cones.
Causes
The disease is associated with poor blood flow in the veins of the rectum, which is often caused by congestion in the pelvic organs. Due to them, pressure increases in the veins, which swell and protrude. In most people, this occurs due to improper lifestyle and nutrition, but doctors do not exclude the influence of heredity, genetic vascular abnormalities, and increased blood clotting.
Possible reasons why hemorrhoids appear:
- Frequent constipation - leads to tension of the veins of the anus, damage to the mucosa during the promotion of solid stool.
- Diarrhea - acute and chronic.
- Pregnancy: causes swelling, causes pressure of the growing uterus on the rectum.
- Hormonal fluctuations - provoke atony of the muscles of the pelvic organs.
- Oncology of the intestine (most often - the colon).
- Postponed operations on the rectum, less often - on the pelvic organs.
- Spinal cord injury, curvature of the spine, lower back injuries, sacrum, coccyx.
Additional risk factors:
- Sedentary lifestyle - causes stagnation of blood in the pelvis.
- A diet low in calories and deficient in fiber causes constipation.
- Lifting weights causes muscle tension.
Diagnosis
The doctor reviews the medical history and asks clarifying questions to rule out other causes of bleeding from the anus. Hemorrhoids have symptoms similar to tumors in the digestive tract, polyps, anal fissures, mucosal prolapse.
After the doctor performs a rectal exam, feeling the lower part of the rectum with a finger. At an early stage of internal hemorrhoids, this may not give results, and at a later stage, the procedure will be postponed if the swelling is very severe and the patient's touch causes acute pain. To clarify the diagnosis and a more detailed examination of the anus, examinations are carried out by a surgeon or a gastroenterologist.
The following methods apply:
- Anoscopy. Inspection of a section of the rectum up to 10 cm long from the anus. The procedure is painless, but some patients are given local anesthesia (gel, spray).
- Sigmoidoscopy, colonoscopy. A tube is inserted into the patient's colon to rule out other causes of bleeding (tumors) and suspected upper portion injuries.
- MRI Tomography is performed if it is not possible to make an accurate diagnosis based on other procedures.
laboratory research
Blood tests are rarely prescribed, it depends on the clinical picture of the disease. This is necessary if a secondary infection has appeared to determine the pathogen. They also do an analysis in situations where bleeding from the rectum is profuse to see the level of hemoglobin, the number and activity of red blood cells. The main diagnosis does not require laboratory procedures.
Treatment
If there are no symptoms of the disease, no special therapy is needed. The doctor will advise you to change your lifestyle and diet so that hemorrhoids do not develop, stools become softer and do not damage the inflamed or swollen mucosa. The patient will be offered to move more, do gymnastics aimed at exercising the muscles of the "lower press" and the small pelvis.
The doctor determines how to treat hemorrhoids, which cause discomfort, given the stage of the disease. In the early stages, it is actually possible to manage with medication alone. If there are many nodes, they are thrombosed and do not retract on their own, surgery may be required. In any subsequent situation, the patient needs to follow the diet and lifestyle recommendations, because 50% of cases relapse. An exception is surgery - after it, repeated hemorrhoids occur only in 5% of patients.
Diet
The tasks of nutrition are to save a person from constipation, to prevent inflammation from developing. Fiber sources are introduced into the diet: vegetables, herbs, fresh fruits. Grains are handled with care, especially rice, as they can thicken stool. In addition, they drink purer warm water - it does not allow feces to sinter, it also speeds up the process of cleansing the intestines. Simple carbohydrates and sugar should be discarded so as not to cause inflammation.
medical therapy
- laxativesPreparations that soften stool and relieve constipation, prevent further damage to the mucosa. They are drunk carefully so as not to cause loss of intestinal muscle tone and diarrhea.
- Candles with anesthesia. Relieves pain from internal hemorrhoids.
- vasoconstrictor. This is also a local therapy that reduces swelling.
- Anticoagulants. Stop bleeding.
- hormonal preparations. They are used topically (injections) for severe inflammation.
Surgical intervention
At the last stage, hemorrhoids require surgery:
- Ligature. An instrument is inserted into the anus, which drops a latex ring over the knot and tightens it. The affected area disappears after 3-4 days.
- laser surgery. The procedure with minimal trauma, is almost painless, but has many contraindications.
- Classic hemorrhoidectomy. The nodes are removed with a scalpel or a special apparatus, which then "sews" the edges of the mucosa. If necessary, the doctor removes blood clots in the process.
Alternative medicine
The initial stage of external hemorrhoids involves symptomatic therapy:
- warm baths. They are made with calendula, chamomile, sage. These herbs relieve inflammation, muscle spasm. They sit in baths for 20 minutes up to 2-3 times a day.
- compressesWith grated raw potatoes, aloe juice, chamomile decoction, sea buckthorn oil. They are left on gauze for 30-60 minutes.
Prevention
To avoid the question of how to cure hemorrhoids, follow simple rules:
- Move more. When you are sedentary, get up every 1-2 hours for 5-10 minutes. Walk in the fresh air, choose the stairs instead of the elevator, the ability to walk a few meters on foot, and not drive a car.
- Watch your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.