There is no such 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 bleeding is a consequence of hemorrhoids, and that does not always cause blood.In this case, the concept of "hemorroid nodes" is suitable for the broader concept of "hemorrhoids" - swelling, bloating that occurs during a trash can.
Description of the problem
Hemorrhoids are special anal formations located under 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 formations, hemorrhoids of an internal and external nature are divided.
These plexus themselves fulfill a protection function: protect the rectum against incontinence from liquid excrement and gases, and also completely close the anal canal.According to statistics, 20% of adults suffer from this disease.And it is precisely this disease that is the cause of the campaign to the specialist.
Which contributes to the occurrence and the development of the disease
Hemorrhoids are only normal with a pair of parks.In case of heavy or prolonged physical effort, these ligaments can be torn.In the event of violation of the integrity of the ligaments, hemorrhoids are overwhelmed with blood.The consequence of this is their loss and bleeding.
Vienna, providing normal blood outing from the mucous membrane, pressed.Blood begins to stagnate.
Factors provoking the development of hemorrhoids
The pathology itself does not occur like that alone.It occurred and development is affected by several factors:
- The hereditary factor (in the hemorroidal node and the veins, there are no valves that provide a blood out).
- Increased pressure in the veins.
- Carts in the work of the intestines (constipation, diarrhea), a frequent visit to the toilet.
- Pregnancy, childbirth, improvement in the clinic of the disease.
- A sedentary lifestyle, standing for a long time.
- Some sports and professions.
- Characteristics of nutrition (alcohol, spicy foods).But this contributes more to exacerbation, not to development.
Be careful!Even in the presence of bleeding from the anal canal, one cannot speak of the manifestation of hemorrhoids.To confirm the diagnosis, analyzes and examination of the rectum are necessary:
- Coloscopy.
- Anoscopy.
- Sectoroscopy.
Bleeding and nodes can occur with inflammation of the intestines and in malignant formations.
Hemorrhoids: symptoms and classification
The location of the knots:
- Outside.
- Interior.
- Mixed.
First view- The expansion of the venous cores located under the speed line of the rectum.This species is characterized by edematous manifestations, the presence of discomfort in the rectum.With this type of pathology, intense pain is characterized.
The second view- The expansion of hemorrhoids themselves located under 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, resulting 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.
- Rectum discharge.
Symptoms of chronic hemorrhoids
Intestinal bleeding
This is the most common symptom with this disease that occurred in 10% of patients.According to statistics, the most common event is when the intestinal is empty.The manifestations can be intense and not very, and are episodic in nature.The color of the discharge is scarlet, in the form of "spraying" (occurs with a strangulation), or - at the end of the drain (in the form of drops).If, after the previous emptying in the anus, the blood has remained, the next one in the next one it will come out with a dark or a cluster.
70 to 80% of the hemorrhoid-clinical events.With constipation and diarrhea, alcohol intake, spicy foods and heavy physical effort, bleeding also occurs.The consequence is the presence of anemia.
The manifestation of anal bleeding is not always a sign of this disease.It can occur in other intestine diseases.If this happens in people over 40 to 45, you must certainly consult a doctor.In addition, in the case of people with a predisposition to oncology, a visit to the doctor is necessary.
For which diseases can occurity of bleeding:
- Callon enterticulaus.
- Crohn's disease.
- The malignant neoplasm of the rectum.
- Intestines polyps.
If you notice the release of the anus, consult a proctologist and perform the necessary and important intestine exams.
Venous plexus projection
This symptom is already occurring in the phase of a long evolution of the disease.First of all, it occurs with the devastation of the intestines.In addition, the symptom appears with a strangulation.If the pathology is acute, then fall effortlessly.The independent division defines 2 steps.At 3 steps, they are manually adjusted due to a decrease in the tone of the anal muscles.They fall completely at 4 steps.
Anal pain
Bleeding is not the only reason that comes to a specialist.And they are not necessarily hemorrhoids.Pain syndrome in the anus can occur at an acute stage of the disease.Reasons:
- Constipation.
- Frequent visit to the toilet.
- Anal crack.
- Plromot of nodes.
If the treatment is carried out incorrectly, the anal crack will go to the chronic stage.
Intestinal discharge
The nature of the exit in this disease is aqueous or mucous.Consequently arise from the episodic loss of the nodes.With bleeding, pay attention to mucous secretions.Most often, they are when the nodes or the mucous membrane fall.Other reasons are neoplasms (villi polyps, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with a dysfunction of the colon.They generally occur at the late stage of the disease.
Classification
1 phase- The venous plexus do not fall.The scarlet color of the released blood.
2 phases- The abandoned nodes are adjusted themselves (with or without liberation of blood).
3 phase- The knots fall episodically and improve manually.
4 -phase- The newspaper and the mucosa of the rectum are starting to fall constantly.Manual reduction becomes impossible.
Acute hemorrhoids
It generally occurs with exacerbation in the chronic phase.The most frequent manifestations:
- External knots with the presence of thrombosis.
- Protection of internal thromber plexus.
If thrombosis occurs, the nodes are compacted and increased in size.Severe pain syndrome occurs in the anal opening area.
Treatment of acute hemorrhoids
At the stage of thrombosis, thromboctomy is possible (excision of a thrombus node and elimination of a thrombus).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 demonstrations over time, the duration of the acute stadium is reduced to a week.If 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 the internal and external venous plexus.There is no inflammation.
- The presence of blood clots in the nodes, with the presence of inflammation.
- In the context of the above signs, inflammation of the subcutaneous tissue develops.Complications occur - bleeding, purulent inflammation.
How to treat hemorrhoids at the chronic stage
Hemorrhoids are a serious, unpleasant but reference disease.There are enough treatment methods for its elimination.The treatment system is constantly improved.Each method has no doubt, the advantages and disadvantages.And they are used according to the phase.The following factors affect the use of a particular methodology:
- The course of the disease.
- The nature of the discharge.
- Age of the patient.
- The frequency of bleeding.
The difficulty lies in the fact that many methods are based on the same treatment indications, and the choice of optimal does not become 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 knots with the release of blood or not:
- Compulsory nutrition normalization (with a high percentage of fiber).
- Take medication that reduce inflammation and expansion of venous cores.
- Rectal candles, ointments for external use for exacerbation.
Degree II hemorrhoids
Self-reduction of affected nodes:
- Fixing the hemorrhoidal node with a latex ring.
- Introduction of a sclerosing.
- The ligature of the arteries bringing blood to the inflamed knots.
- Electrocoagulation.
- Excision of external and internal nodes.
Degree III hemorrhoids
Manual reduction:
- The use of latex rings.
- Sclerotherapy.
- Landing arteries.
- Electrocoagulation.
- Excision.
Hemorrhoids of the IV degree
The impossible reduction in nodes: Remove the inflamed nodes with a special device.
The stages of hemorrhoid development
Not all methods are suitable for the treatment of hemorrhoids in one case or another.The final solution affects the correlation of external and internal internal plexus.If pathology is dominant nodes - inside, you can do without surgery.The methods are described above.
Before making a final diagnosis, the patient needs a complete examination.The very first thing to do is to examine the rectum and the big intestine.First of all, this applies to patients over 45, with a hereditary predisposition to oncology, because with hemorrhoids, there can be concomitant diseases:
- The malignant tumor of the rectum.
- Polyps.
In addition, the symptoms (or rather the degree of its severity), the size of the nodes and the episodality affect the choice of a particular treatment method.
With a low severity of the symptoms, a rare loss, it is better to choose a conservative therapy.The very first and important thing that it aims 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, because constipation often occurs with a lack of liquid, which is why the intestines are forced to suck it from the excrement.
To facilitate this condition, the following is important:
- The dominant component of the food is fiber.
- Periodic contribution of laxatives.
- The appointment of phlebropics to the patient.
Conservative therapy is mainly used during an acute exacerbation of the disease.Another treatment is contraindicated.If the disease is in 1st and 2nd phase, other methods are also contraindicated.What is included in conservative treatment:
- Special diet.
- Blades drugs.
- Rectal candles, ointments.
- Phlebropic drugs.
Each patient is prescribed by the regime.The main objective is to normalize a chair.Often, one of the main factors caused is precisely constipation or diarrhea.The diet of this categorically prohibited disease:
- Sharp.
- Salt.
- Roast.
- Alcohol.
The diary involves additional examinations.It is the result of examinations that affects diet and treatment correction.If the patient is subject to constipation, a special diet is recommended to him.The list of products and other shades can be viewed in a special section.For a laxative effect, it is recommended:
- Dried apricots.
- Prunes.
- Dried apricots.
- Fig.
If the diet does not eliminate the stagnant effect in the intestines, 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 the mark of the drug depend on the following factors:
- Individual characteristics of the body.
- Concomitant diseases.
- Age.
- Doctor's decisions.
Until the final treatment has been prescribed, the doctor prescribes the patient 1 tablespoon.L.Eilly oil (2-3 times a day).
Basic in the treatment of pathology
But it should be recalled that no ointments and other drugs will completely save you from the problem.They only temporarily eliminate symptoms, and more.Conservative therapy will be ineffective if the venous plexuses fall regularly: only radical treatment methods will help here.
In addition, when prescribing dose forms of the drug, certain 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, combinations are acceptable.
There is no need to list the entire list of drugs in this pathology because it is very important.The determining 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 drugs that relieve edema are prescribed.It is necessary to use such drugs for a while because they contain anti-inflammatory hormones and non-eteroids.
The use of phlebotrope is a prerequisite for medication.
Ininvasive treatment
Sclerotherapy
This is a method in which a special solution is introduced into the hemorroid - sclerosing nodes area.With good administration, manipulation does not cause pain.Local anesthesia is not used.The duration does not exceed 10 minutes.Hospitalization is not necessary.After the procedure, you can continue to direct the same way of life.In two days in the anus, uncomfortable sensations are possible.This method is used in a chronic pathology (the blood is released, the plexus do not exceed).This method is rarely used, because manipulation is quite complicated, and with the right administration of the drug, the mucosa necrosis is possible.As a rule, the period of calm after manipulation is around 3 to 7 years.
Infrared coagulation
The method by which the radiation acts on the inflamed areas.With him, the hemorroidal fabric begins to die gradually.After manipulations, you can lead the previous lifestyle.Painful sensations are possible for two days.The AI method is used at 1 and 2 steps of pathology, where the size of the sites is small.The calm period is 3 to 7 years old, 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 main thing is that the latex ring is applied to the site area.This is done using a ligator.Due to the pressure of the ring, he begins to die and to reject.The handling of fasting in driving (3-5 minutes), simple, practically painless.After the ligature, you can lead the previous lifestyle.Painful sensations are possible for two days.The ligature method is indicated in phase 1-3 of pathology.There are almost no complications.Sometimes there is blood when the ring leaves.Less from the procedure - only one site is deleted for 1 session, the following handling is only possible after a few weeks.
Arteries landing
The proximal ligature method allows you to find the location of all the arteries providing inflamed areas and bandaging them.In this method, local anesthesia is used.Perform the procedure with an anoscope with a node.Following the dressing of the arteries, the inflamed areas disappear.The duration of the procedure is about half an hour.Pain sensations are almost not observed.Pain is possible within two days and an increase in temperature.You can lead the same lifestyle.This method is used on all phases of pathology.
Benefits:
- Lack of wiping fabrics.
- Reducing the rehabilitation period.
- Treatment 1 time.
- A longer period of calm (5-10 years).
Disadvantages:
- The procedure is longer compared to others.
- Pain.
- High cost.
Surgery
The operation of the Milligan-Morgan
This surgical intervention method implies the excision of external and internal swelling, with their subsequent dressing.Apply to all phases of the disease.Shades:
- General anesthesia.
- The need for 3 to 5 hospitalization by patients hospitalized per day.
- Performance reduction within 10 to 15 days.
- A long recovery period - about 1 month.
- The duration of manipulation is about half an hour.
The advantages are that this is the only radical therapy method.The quiet period is up to 12 years old, repeated relapses are only possible in 15 to 30% of cases.Conscious in painful sensations for 2 to 4 days.We need an pain reliever.The recovery period is long, as well as the occurrence of scars and a decrease in the tone of the anal sphincter.
Teacher Longo
This method involves truncating the mucosa of the rectum.It is made using a special stapler.The sites lose the possibility of breaking and the blood circulation decreases.Shown by pathology in all phases.Shades:
- General anesthesia.
- Hospitalization in hospital for 2 to 4 days.
- The recovery period is 3 to 5 days.
The advantages of the procedure are similar to hemorrhoidctomy, a small gravity of pain;Recovery is fast, there are no complications.Minus in High Cost (due to the use of a stapler).
Conclusion
The methods described in the article are not the only ones by which hemorrhoids are processed.Cryotherapy is also used.But this method is not so widespread, because there is an incontinence of the anus discharge, the exposure depth is not controlled.
The patient himself has the right to decide to see him or not a doctor.Of course, it is worth paying attention to the frequency of bleeding and pain, because the frequent liberation of blood causes anemia.Otherwise, hemorrhoids are not very threatening.But it should be notified that the earlier you consult a doctor, the better.Thus, you will avoid a more radical treatment method and will improve life.
Remember that only a proctologist can help solve this problem.If you notice the following signs:
- Periodic anal bleeding.
- Itching and burning in the anus.
- Sensation of discomfort and pain - immediately contact a proctologist!In no case is I not self-managed!