Hemorrhoids - a disease associated with varicose inflammation and swelling of the veins of the rectum in the anus. The affected areas protrude outwards, may form large nodules (protrusions) that interfere with the promotion and output of stool. The disease affects both men and women, it is dangerous for the rupture of veins, as well as a secondary infection.
Classification of hemorrhoids
Depending on the location of the pathological site, 2 types of the disease are distinguished:
- exterior. The veins in 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 less, but unpleasant friction from linen is often created. Complications from external hemorrhoids occur less often, it is easier to treat.
- Interior. The affected veins are located in the rectum above the anus, making it difficult to determine the early stage of the disease. Vessels are covered by 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.
According to the severity of the course, internal hemorrhoids are divided into 3 degrees (stages):
- Initial (1). The knots protrude, bleed, but do not fall off.
- Moderate (2). With muscle tension (during defecation, exercise), swollen veins come out of the anus. When everything relaxes, they return.
- Heavy (3). Nodules fall off, 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 muscles of the rectum. The complete picture depends on the stage of the disease. If nodules (swollen sections separated from the veins) appear, they look like dark pink or purple bumps (rarely almost black), are easily palpable, and appear dense. The shade depends on the filling of the vessels: if blood clots have formed, blood has accumulated and cannot come out, the nodules will turn dark.
internal hemorrhoids
In the first days and weeks, the disease hardly manifests itself. It starts with swelling, which is not felt if you don't start probing the rectum from the inside. There are no pain receptors in this part, so the person does not feel discomfort even during the defecation process.
At an early stage of hemorrhoids, you can discover their existence just by drops of blood that appear after the release of large, hard stools. Due to edema, the walls of the rectum narrow the lumen, the mucosa is more damaged during constipation. Important - with hemorrhoids, almost every bowel movement will cause a small amount of blood to appear.
Other symptoms will follow:
- Pain during bowel movements. Severe swelling will cause muscle spasms so even loose stools will cause discomfort.
- Burning, itching. Due to inflammation in the rectum, a lot of mucus is formed, which irritates the tissues.
- Blood. Appears in large numbers when nodes are formed. Important: with hemorrhoids, it is bright red - not dark.
- release us. They appear in the later stages of hemorrhoids. First they are pulled back, then they need to be "pushed" with a finger.
abroad
The external veins are covered with skin, which has many pain receptors. Already at an early stage of hemorrhoids, a person will feel discomfort if the vessels are swollen. Pain occurs during defecation and when cleaning the anus and with tight contact of linen with the skin. If the inflammation is severe or a blood clot forms in the vein, a large swelling forms. It's easy to grope, touch causes pain.
The skin with external hemorrhoids becomes sensitive, often gathering in folds due to swelling. The process of cleaning the anus after defecation is difficult, so the risk of secondary infections increases. Blood then appears if the hemorrhoids are damaged, but there will be less than with the formation of internal cones.
Causes
The disease is associated with impaired blood flow in the veins of the rectum, which is usually caused by congestion in Organs pelvic organs. Because of them, the pressure in the veins increases, which swell and protrude. In most people, this is 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 stools.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, causes pressure from the growing uterus on the rectum.
- Hormonal fluctuations - cause atony of the muscles of Organs pelvic organs.
- Oncology of the intestine (most often - the colon).
- Deferred operations on the rectum, less often - on Organs pelvic organs.
- Spinal cord injury, curvature of the spine, injuries to the lower back, sacrum, coccyx.
Additional risk factors:
- Sedentary lifestyle - causes stagnation of blood in the pelvis.
- A low-calorie, low-fiber diet causes constipation.
- Lifting weights causes muscle tension.
Diagnosis
The doctor examines the medical history and asks clarifying questions to rule out other causes of bleeding from the anus. Hemorrhoids are similar in symptoms 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 delayed if the swelling is very severe and the patient's touch causes sharp pain. To clarify the diagnosis and a more detailed examination of the anus, examinations are performed by a surgeon or gastroenterologist.
The following methods are applied:
- Anoscopy. Inspection of a section of the rectum up to 10 cm in length from the anus. The procedure is painless, but some patients receive 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 portions of injury.
- MRI. CT is done if an accurate diagnosis cannot be made 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 appears to determine the pathogen. They also do an analysis in situations where bleeding from the rectum is profuse to see the hemoglobin level, 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 harm the inflamed or swollen mucosa. The patient will be offered to move more, do gymnastics to work the muscles of the "lower press" and small pelvis.
How to treat hemorrhoids, which cause discomfort, is determined by the doctor, given the stage of the disease. In the early stages, it is really possible to manage with drugs alone. If there are many lymph nodes, they are thrombosed and do not retract on their own, surgery may be necessary. In any subsequent situation, the patient needs to follow the diet and lifestyle recommendations, as 50% of cases relapse. An exception is surgery: after it, repeated hemorrhoids occur in only 5% of patients.
Diet
The tasks of nutrition are to save a person from constipation, to prevent the development of inflammation. Fiber sources are introduced into the diet: vegetables, herbs, fresh fruits. Grains are handled with care, especially rice - they can thicken stools. In addition, they drink more pure warm water: it does not allow the stool to sinter, it also speeds up the process of cleaning the intestines. Simple carbohydrates and sugar should be discarded so as not to provoke inflammation.
medical therapy
- Laxatives. Preparations that soften stools and relieve constipation, prevent further damage to the mucosa. They are drunk with care so as not to cause loss of intestinal muscle tone and diarrhea.
- Candles with anesthetic. Relieve the pain of internal hemorrhoids.
- vasoconstrictor. This is also a local therapy that reduces swelling.
- Anticoagulants. Stop the bleeding.
- Hormonal preparations. They are used topically (injections) for severe inflammation.
Surgical intervention
In the last stage, hemorrhoids require surgery:
- ligature. An instrument is inserted into the anus, which throws 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 there are many contraindications to it.
- Classic hemorrhoidectomy. The nodules are removed with a scalpel or a special device, 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:
- Hot 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.
- compresses. With grated raw potatoes, aloe juice, chamomile decoction, hawthorn 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 sedentary, get up every 1-2 hours for 5-10 minutes. Walk outdoors, choose the stairs over the elevator, the ability to walk a few meters and not drive a car.
- Watch your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.