There is no such person who has never heard the word "hemorrhoids".It is used by anyone who is not lazy, even those who have nothing to do with medicine.
The term "hemorrhoids" comes from two Greek words -"Haem"("Blood") and"Rowes"("bleeding").
The concept is ambiguous because not every bleeding is a consequence of hemorrhoids and does not always cause blood.In this case, the concept of "hemorrhoids" is suitable for the width concept of "hemorrhoids" - swelling, bloating that occurs during garbage.
Description of the problem
Hemorrhoids are special anal formations located below the rectum.In the structure, they are a plexus of venous vessels.They are located inside and outside the mucosa.From the location of these entities are separated hemorrhoids of inner and outer nature.
These plexuses themselves perform a protective function: protect the rectum from incontinence of liquid stools and gases, and also completely close the anal canal.According to statistics, 20 % of adults suffer from this disease.And it is this disease that is the cause of the specialist campaign.
That contributes to the onset and development of the disease
The hemorrhoids are only normal with a pair of parks.In the case of heavy or prolonged exercise, these connections can be torn.In the event of a violation of the integrity of the connections, the hemorrhoids are overflowing with blood.The consequence of this is their loss and bleeding.
Vienna, providing normal blood flow from the mucosa, is squeezed.The blood begins to stagnate.
Factors provoking the development of hemorrhoids
The pathology itself does not just arise like this alone.Its occurrence and development is influenced by several factors:
- The hereditary factor (there are no valves in the hemorrhoid node and the veins that provide blood leakage).
- Increased vein pressure.
- Carts in bowel work (constipation, diarrhea), frequent visit to the toilet.
- Pregnancy, childbirth, strengthening the clinic of the disease.
- A sedentary lifestyle standing for a long period.
- Some sports and professions.
- Feeding Characteristics (alcohol, spicy food).But this contributes more to exacerbation, not development.
Pay attention!Even in the presence of bleeding from the anal canal, it is impossible to speak of the manifestation of hemorrhoids.To confirm the diagnosis, analyzes and examination of the rectum are required:
- Colonoscopy.
- Anoscopy.
- Sectroscopy.
Bleeding and nodes can occur with inflammation of the intestine and in malignancies.
Hemorrhoids: Symptoms and Classification
The location of the nodes:
- External.
- Interior.
- Mixed.
First view- Expansion of venous vessels located below the dental line of the rectum.This species is characterized by edematous manifestations, the presence of discomfort in the rectum.This type of pathology is characterized by severe pain.
The second view- The expansion of the hemorrhoids themselves located below the line.The 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 resulting from a disease.
Chronic hemorrhoids
Clinical picture:
- The blood is periodically released from the anus.
- The loss of plexuses inside the mucosa.
- Itching and burning in the anus.
- Ejection from the rectum.
Symptoms of chronic hemorrhoids
Intestinal bleeding
This is the most common symptom with this disease, occurring in 10 % of patients.According to statistics, the most common occurrence is when the intestinal is empty.The manifestations can be intense and not much and are episodic.The color of the release is Allen, in the form of "spray" (occurs with strangle) or - at the end of emptying (in the form of drops).If after the previous emptying in the anus remains blood, the next one will come out with a dark or cluster.
70-80 % of cases-clinical manifestations of hemorrhoids.With constipation and diarrhea, alcohol intake, spicy foods and heavy physical activity, bleeding occurs.The consequence of this is the onset of anemia.
The manifestation of anal bleeding is not always a sign of this disease.This can occur in other bowel diseases.If it happens in people over 40-45 years of age, then you should definitely consult a doctor.Also, in the case of people with a predisposition to oncology, a doctor is required.
For what diseases bleeding can occur:
- Colon diverticulosis.
- Crohn's disease.
- The malignant neoplasm of the rectum.
- Intestinal polyps.
If you notice ejection from the anus, consult a proctologist and perform the necessary examinations on the direct and large intestine.
Plexus
This symptom is already found in the long course of the disease.First, it happens with the devastation of the intestine.In addition, the symptom occurs with strangle.If the pathology is acute, then you are effortless.Separation of independently sets in 2 stages.At 3 stages, they are manually adjusted due to a decrease in the tone of the anal muscles.They are completely in 4 stages.
Anal pain
Bleeding is not the only reason that reaches a specialist.And this is not necessarily hemorrhoids.Anus pain syndrome can occur in the acute stage of the disease.Reasons:
- Constipation.
- A frequent visit to the toilet.
- Anal crack.
- Pelrombosis of the nodes.
If the treatment is performed incorrectly, the anal crack will enter the chronic stage.
Ejection
The nature of the discharge in this disease is watery or mucous.They occur as a result of episodic loss of nodes.With bleeding, pay attention to mucous secretions.Most often they are when the nodes or mucous membranes fall out.Other reasons are the neoplasms (you played polyps, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with colon dysfunction.They appear as a rule in the late stage of the disease.
Classification
1 phase- Venous plexuses do not fall out.Scarlet color of the released blood.
2 phase- The lowered nodes are regulated themselves (with or without blood release).
3 phase- Nodes fall episodically and improve manually.
4 phase- The newspaper and mucosa of the rectum begin to fall constantly.Manual reduction becomes impossible.
Acute hemorrhoids
It is commonly found with exacerbation in the chronic phase.The most common manifestations:
- External nodes with the appearance of thrombosis.
- Protruding on internal thrombus plexuses.
If thrombosis occurs, the nodes are compacted and increase in size.In the anal area of opening, a syndrome of severe pain syndrome occurs.
Acute hemorrhoids
At the stage of thrombosis, thrombooctomy (cutting of a thrombus node and the removal of a thrombus) is possible.The surgery is performed under local anesthesia.Duration - a few minutes.After surgery, the pain immediately begins to decrease.
When internal hemorrhoids fall out, swollen phenomena and inflammation occur.Surgical intervention is contraindicated due to possible complications.Therapy:
- The use of ointments and candles.
- Pills.
If you notice manifestations on time, the duration of the acute stage is reduced to a week.If the pathology is not treated for a long time, purulent inflammation may occur.
3 phases of the disease in acute course
- The appearance of blood clots in internal and external venous plexuses.There is no inflammation.
- The presence of blood clots in nodes, with inflammation.
- Against the background of the above signs, inflammation of the subcutaneous tissue develops.Complications occur - bleeding, purulent inflammation.
How to treat hemorrhoids in the chronic stage
Hemorrhoids are a severe, unpleasant but reference disease.There are enough methods of treatment to eliminate it.The treatment system is constantly improving.Every method has no doubt, pros and cons.And they are used depending on the phase.The following factors influence the use of a particular methodology:
- The course of the disease.
- The nature of the ejection.
- Age of the patient.
- The frequency of bleeding.
The difficulty is in the fact that many methods are based on the same indications for treatment and the choice of optimal becomes not easy.In this case, you must combine the necessary methods.According to the classification, there are 3 types of treatment:
- 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).
- Taking medicines that reduce inflammation and expansion of venous vessels.
- Rectal candles, ointments for external use for exacerbation.
Grade II hemorrhoids
Self -government of the affected nodes:
- Fixing the hemorrhoid node with latex ring.
- Introduction of sclerosant.
- Legation of arteries that bring blood to inflamed nodes.
- Electrocoagulation.
- Cutting of external and internal nodes.
Grade III hemorrhoids
Manual reduction:
- The use of latex rings.
- Sclerotherapy.
- Landing of the arteries.
- Electrocoagulation.
- Cutting.
Grade IV Hemorrhoids
The impossible reduction of nodes: Removing inflamed nodes with a special device.
The stages of the development of hemorrhoids
Not every method is suitable for the treatment of hemorrhoids in one case or another.The end solution affects exactly how the external and internal plexuses correlate.If the pathology is predominant nodes - inside, then you can do without surgery.The methods are described above.
Before making a final diagnosis, the patient needs a full examination.The first thing you need to do is examine the rectum and colon.First, this applies to patients over 45 years of age, with a hereditary predisposition to oncology, since hemorrhoids may have concomitant diseases:
- The malignant rectum tumor.
- Polyps.
Also, the symptoms (or more recently its severity), the size of the nodes and the episodicity affect the choice of a particular treatment method.
With a slight severity of symptoms, a rare loss is better to choose conservative therapy.The first and important thing to target is adjusting nutrition, removing constipation and pressure during bowel emptying.The diet should contain sufficient water, as constipation often occurs with a lack of fluid, which is why the intestine is forced to suck it from the stool.
To facilitate this condition, the following is important:
- The predominant component in the diet is fiber.
- Periodic intake of laxatives.
- The appointment of the patient's phlebotropes.
Conservative therapy is mainly used during acute exacerbation of the disease.Another treatment is contraindicated.If the disease is in the 1st and 2nd phase, other methods are also contraindicated.What is included in conservative treatment:
- Special diet.
- Drugs.
- Rectal candles, ointments.
- Phlebotropic drugs.
Each patient is prescribed by the diet.The main goal is to normalize a chair.Often one of the main provocative factors is exactly constipation or diarrhea.The diet for this disease strongly prohibits:
- Sharp.
- Salt.
- Roasted.
- Alcohol.
The diary implies further examinations.This is the result of examinations that affect the correction of diet and treatment.If the patient is prone to constipation, then a special diet is recommended for him.The list of products and other nuances can be considered in a special section.For a laxative effect is recommended:
- Dried apricots.
- Smalls.
- Dried apricots.
- FIG.
If the diet does not eliminate the stagnant effect in the intestine, the use of laxatives begins.Now it won't be difficult to find them: just go to any pharmacy and ask.Do not take them yourself.The dosage and brand of the drug depend on the following factors:
- Individual body characteristics.
- Concomitant diseases.
- Age.
- The doctor's solutions.
Until the final treatment is prescribed, the doctor prescribes the patient 1 Tbsp.l.Vasen oil (2-3 times a day).
Main in the treatment of pathology
But it's worth remembering that no ointments and other medicines will save you the problem completely.They only temporarily eliminate the symptoms and no more.Conservative therapy will be ineffective if venous plexuses fall regularly: only radical treatments will help here.
Also, when prescribing dosage forms of the drug, some factors are taken into account.For example, rectal candles are not suitable for patients with pronounced pain syndrome.In this case, the ointment is preferable.In some cases, the combinations are acceptable.
It is not necessary to list the entire list of medicines from this pathology as it is very large.The determining factor is the individual characteristics of the body and the patient's personal complaints.
What affects the choice of ointments or candles:
- Acute hemorrhoids with thrombosis.
- Inflammation.
At the same time, anesthetics are prescribed, anti -inflammatory drugs are prescribed that relieve edema.It is necessary to use such medicines for a certain time as they contain hormones and anti -inflammatory non -intestinaloids.
The use of phlebotrop is a prerequisite for drug therapy.
Small -invasive treatment
Sclerotherapy
This is a method in which a special solution is introduced in the area of hemorrhoids - sclerosant.With proper administration, the manipulation does not cause pain.Local anesthesia is not used.The duration is no more than 10 minutes.Hospitalization is not necessary.After the procedure, you can continue to lead the same lifestyle.Within two days, uncomfortable sensations are possible in the anus.This method is used in pathology in the chronic phase (blood is released, plexuses are not protruding).This method is rarely used because manipulation is quite complicated and mucosal necrosis is possible with the proper administration of the drug.As a rule, the period of calm after manipulation is about 3-7 years.
Infrared coagulation
The method by which radiation acts on inflamed areas.With it, hemorrhoid tissue begins to gradually die.After manipulation, 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 3-7 years, without serious complications.
Fixing with latex rings
This procedure is the most common among all other methods.Her pluses:
- Low price.
- A wide range of indications.
- Lack of risk of complications.
The bottom line is that the latex ring is applied to the site area.This is done with the help of a ligator.Due to the pressure of the ring, he begins to die and reject.Manipulating fast at conducting (3-5 minutes), simple, practically painless.After ligation, you can lead the previous lifestyle.Painful sensations are possible for two days.The ligation method is shown in the pathology phase 1-3.There are almost no complications.Sometimes there is a blood discharge when the ring leaves.Minus of the procedure - only 1 site is removed for 1 session, the following manipulation is only possible after a few weeks.
Landing of the arteries
The proximal ligation method allows you to find the location of all arteries delivering inflamed areas and turning them.This method uses local anesthesia.Perform the procedure with an anoscope with a knot.As a result of the dressing of the arteries, the inflamed areas disappear.The duration of the procedure is about half an hour.The sensations of pain are hardly observed.Pain is possible within two days and fever.You can lead the same lifestyle.This method is used in all phases of pathology.
Pros:
- Lack of wiping fabrics.
- Reduction of rehabilitation period.
- Processing 1 time.
- Longer period of calm (5-10 years).
Cons:
- The procedure is longer than others.
- Pain.
- High price.
Surgery
Milligan-Morgan's work
This method of surgery involves the cutting of external and internal edema, with their subsequent dressing.Apply to all phases of the disease.Shades:
- General anesthesia.
- The need for 3-5 daily stationary hospitalization.
- Reduced efficiency within 10-15 days.
- Long recovery period - about 1 month.
- The duration of the manipulation is about half an hour.
The advantages are that this is the only and radical method of therapy.The movement period is up to 12 years, repeated recurrences are only possible in 15-30 % of cases.Consuming painful sensations for 2-4 days.We need analgesics.The recovery period is long, as well as the appearance of scars and a decrease in the tone of the anal sphincter.
Professor Longo
This method involves cutting the mucous membrane of the rectum.It is performed with the help of a special staple.Sites lose the possibility of shaking, and blood flow decreases.Shown through pathology in all phases.Shades:
- General anesthesia.
- Hospitalization at the hospital for 2-4 days.
- The recovery period is 3-5 days.
The advantages of the procedure are similar to hemorrhoidtomy, low severity of pain;Recovery is quick, there are no complications.Minus high costs (due to the use of staples).
Conclusion
The methods described in the article are not the only ones by which hemorrhoids are treated.Cryotherapy is also used.But this method is not as widespread as there is incontinence of disposal from the anus, the depth of the exposure is not controlled.
The patient himself has the right to decide whether to see him or not.Of course, it is worth paying attention to the frequency of bleeding and pain, as frequent release of blood causes anemia.Otherwise, hemorrhoids are not very enhancing life.But it is worth warning that the earlier you consult a doctor, the better.This will avoid a more radical method of treatment and improve life.
Remember that only a proctologist can help solve this problem.If you notice the following characters:
- Periodic anal bleeding.
- Itching and burning in the anus.
- Feeling of discomfort and pain - contact a protologist immediately!By no means be self -self!