February 28, 2020
According to the World Health Organization, hemorrhoids in various forms occur in almost 70% of the world's population
According to the World Health Organization, hemorrhoids in various forms occur in almost 70% of the world's population. This includes anyone who has ever experienced symptoms of this disease. Unfortunately, many people are embarrassed to see a doctor and self-medicate, because they believe that it is not customary to talk about such problems.
What are hemorrhoids?
The rectum is the final point of the human digestive system, and therefore plays a very important role. It is surrounded by a double - external and internal, hemorrhoidal plexus of veins, which ensures a hermetic closure of the anus.
If the blood flows in too much or flows out too slowly, blood stagnation forms in the veins. As a result, the vessels swell, forming hemorrhoids (they are also often called lumps). This causes pain, a sensation of a foreign object in the anus.
Under the influence of constant pressure from large accumulations of blood, the walls of the veins become thinner and collapse. Bleeding occurs, particles of feces and other contaminants get inside the vessels, which leads to the formation of a focus of inflammation. As a result, the pain becomes simply unbearable, the person can neither sit nor lie down, and is afraid to go to the toilet.
Brief classification
Hemorrhoids are a painful enlargement of the cavernous cavities of the venous plexus of the rectum.
These cavities fill with blood when straining, performing the function of a kind of “pillow” that protects tissues from the traumatic effects of solid feces during the act of defecation. Hemorrhoids are a pressing problem for humanity; about 60% of Earth's citizens experience at least one episode of painful enlargement of hemorrhoids throughout their lives. It must be said that this percentage is much higher in countries that are commonly called civilized.
Anatomically, internal hemorrhoids - hemorrhoidal nodes in the distal (terminal) part of the rectum, and external hemorrhoids , when the nodes are located outside in the anal area.
According to the nature of the course, hemorrhoids can be acute , associated with thrombosis of the hemorrhoidal veins, and chronic , caused by constant overflow of distended veins with blood.
Symptoms of hemorrhoids
The disease progresses gradually over several years. The key to successful treatment is contacting a proctologist as soon as you notice the first symptoms of hemorrhoids.
All stages of the disease are characterized by the following symptoms:
- discomfort in the anus;
- pain during bowel movements;
- anal bleeding;
- traces of bright scarlet blood on linen, toilet paper, toilet;
- mucous or watery discharge;
- the formation of hemorrhoidal cones, their gradual increase in size.
In the initial form of the disease, there is a slight enlargement of the veins, but the person usually does not notice it. The only thing that indicates hemorrhoids is traces of bright scarlet blood on toilet paper after visiting the toilet. This is already a serious reason to consult a doctor, since bleeding may be a sign of a malignant tumor in the intestines.
When hemorrhoids enter the second stage, a person from time to time feels pain during bowel movements, itching, burning in the anus, and it seems to him that there is a foreign object inside. Hemorrhoidal cones sometimes fall out, but are easily adjusted by the patient on their own.
In the third stage, the symptoms described above intensify. Venous lumps increase significantly, narrowing the lumen of the anus and making defecation difficult. When visiting the toilet, a person experiences severe pain and bleeding often begins.
As the disease progresses to the fourth stage, the hemorrhoids enlarge so much that they cannot be moved inward by hand. The pain is very severe, each bowel movement is accompanied by bleeding. Blood clots – thrombi – form in the veins.
Hemorrhoids develop in two forms - external and internal. In the first case, the lumps are located close to the anus, so they often rupture and bleed during bowel movements. The pain is sharp and severe. In the second case, hemorrhoids can occur without pronounced symptoms, since the venous nodes are located inside the rectum, the mucous membrane of which is insensitive.
Stages of development of chronic pathology
With chronic hemorrhoids, the pain syndrome is much weaker. Often the only signs of chronic pathology are itching around the anus blood appearing on the surface of the stool from time to time .
The stages of development of internal hemorrhoids differ using the most objective symptom - the degree of stretching of the dilated veins: I. The hemorrhoid is constantly located in the intestinal cavity II. The knot falls out when straining and resets itself back III. The patient has to adjust the knot with his hands IV. One or more hemorrhoids are constantly on the outside and cannot be reduced
At any stage, thrombosis of the dilated veins of the rectum , in which case severe pain syndrome characteristic of an acute attack occurs.
With a long course of the disease, the risk of complications increases ( anemia, neurasthenia, anal fissure, etc. ).
Etiology of hemorrhoids
Varicose hemorrhoidal plexus occurs in men and women at any age. The causes of hemorrhoids are varied.
- Hereditary weakness of the walls of blood vessels, disruption of intestinal innervation.
- Lifting weights, excessive physical activity, as a result of which blood flows intensely to the rectal area.
- Prolonged standing or sedentary work, sedentary lifestyle
- lead to a slowdown in blood flow.
- Chronic constipation and diarrhea - feces irritate the mucous membrane and put too much pressure on the blood vessels.
- The habit of pushing hard during bowel movements leads to increased blood pressure on the walls of the veins.
- Poor nutrition, abuse of fatty spicy foods, alcoholic beverages, stress - negatively affect the regularity of bowel movements.
- Inflammatory and tumor processes in the liver and intestines.
- Smoking - under the influence of nicotine, the lumen of blood vessels narrows, and their walls become thin and fragile.
- Passion for anal sex and anal sex toys.
Hemorrhoids in women often occur after pregnancy (especially if it was multiple) or long, difficult labor, since pushing and the fetus create strong pressure on the blood vessels.
Is it possible to cure chronic hemorrhoids with folk remedies?
Unfortunately, chronic hemorrhoids cannot be cured using conservative methods. “Folk” methods give a short-term effect. Similar results will be obtained with “home” drug treatment.
The unpleasant symptoms of the disease may disappear for a while, but the disease will develop unnoticed by you. In the future, the following complications may develop: • anal fissure; • anemia; • nervous exhaustion; • infectious processes (proctitis, paraproctitis, etc.).
It should also be noted that under the mask of hemorrhoids a deadly disease such as rectal cancer . Therefore, if alarming symptoms appear, you should urgently consult a doctor to find out an accurate diagnosis and begin adequate treatment.
Don’t waste time on self-medication, come to an appointment with a proctologist!
Prevention
The best measures to prevent the development and exacerbation of hemorrhoids, according to proctologists, are proper nutrition, improving bowel function, physical therapy, and careful hygiene.
In order for stool to be regular and have optimal consistency, it is necessary to monitor your diet.
- Consume fermented milk products.
- Eat raw vegetables and fruits rich in fiber.
- Eat small meals 5-6 times a day.
- Don't neglect oatmeal and bran bread.
- Take vitamins A, B, C, E, calcium, magnesium.
- Drink enough water, observing the daily norm of 1.5-2 liters.
- Avoid spicy, fried, fatty, smoked, alcohol.
Take laxatives only when absolutely necessary. Use teas and drinks with a laxative effect with caution, otherwise the intestines will literally “forget how” to work.
To strengthen the walls of blood vessels, take a course of phlebotonic drugs twice a year.
Therapeutic exercise and massage are also very useful because they help improve blood circulation and prevent congestion. If you find yourself in the same position for long periods of time, take regular small breaks to walk around or do at least a few squats. There are also special exercises for the anal sphincter and improving bowel function, but during an exacerbation they should not be done.
It is extremely important to carefully observe hygiene: wash your face every day, change your underwear, clean the anus with a damp cloth (without alcohol or fragrances) after each bowel movement.
What medications are used to treat hemorrhoids?
Drugs are selected depending on the stage of the disease.
- At stage 1 of the disease, suppositories and ointments are effective that can normalize blood circulation, relieve pain, relieve inflammation, relax the walls of the rectum and sphincter: Hepatrombin, Anuzol, Fitor, Proctosedyl, Relief, suppositories with sea buckthorn oil, Proctosan.
- At stage 2, stronger drugs are used: Aescusan, Detralex, Etamzilat, Neuflan, methyluracil ointment.
- At stages 3 and 4, the main effect is provided by surgical intervention. In addition to it, Gepatrombin, Troxevasin, Prednisolone, Mafinide are used.
- To normalize digestion, laxatives or fixatives, bacterial complexes (probiotics, symbiotics), enzymes, and agents to improve peristalsis are used.
- To increase the performance of veins and reduce inflammation in hemorrhoids, phlebotropic drugs, for example, Glivenol, are used.
Hemorrhoids, like other diseases, do not accept self-medication. All medications must be prescribed by a doctor. Even if the medicine helps your relatives and friends very well, it is quite possible that it will harm you personally.
Drug and minimally invasive treatment
Treatment of hemorrhoids at the initial stage can be carried out at home, since no special measures are required yet. The doctor usually prescribes the following:
- a course of vascular-strengthening drugs;
- suppositories for hemorrhoids to relieve pain, itching and other unpleasant sensations, as well as to fight inflammation and reduce lumps, heal, stop bleeding;
- therapeutic diet and special physical training after the exacerbation is relieved;
- To relieve pain and itching, it is recommended to use cold compresses, ice packs, warm chamomile baths,
During the second and third stages, when conservative methods are ineffective, minimally invasive procedures are prescribed such as:
- Sclerotherapy - substances are injected into the node that seem to glue its walls together. As a result, the tissues stop receiving nutrition and die.
- Infrared photocoagulation, electrocoagulation - the essence of the method is that the leg of the node is cauterized, and its tissues are deprived of nutrition, stick together and die.
- Ligation with latex rings is used for internal hemorrhoids of stages 1-3. Using an anoscope, a ring is placed on the leg of the node, which compresses the small vessels feeding the node. After about two weeks, the dead node is brought out along with the ligature.
- Cryotherapy is a short-term exposure of the node to liquid nitrogen. The goal is the same - to stop the blood supply to the tissues of the node. After that it disappears on its own.
The listed remedies for hemorrhoids are effective for small bumps, but they cannot be used for thrombosis, anal fissures, acute inflammation, and injuries.
Reviews from patients about the operation
We analyzed patient reviews about the rehabilitation period after hemorrhoid removal. The analysis showed that the severity of pain, difficulty with defecation and bleeding after surgery depends on the size and number of nodes removed.
Patients who have consulted a doctor with a single small node speak of surgical intervention as a completely tolerable procedure, with a short rehabilitation period.
When it comes to several large nodes, treatment will be lengthy. If the doctor recommends a minimally invasive method, you will have to remove one node per week, so the healing process will take several weeks. A surgical operation will remove all pathological elements at once, but in this case the rehabilitation period may also take several weeks.
Therefore, we recommend that you consult a doctor in a timely manner in order to intervene at an early stage of the disease. Additional information about preparing for surgery and rules of behavior during the rehabilitation period can be read in the article “Treatment of hemorrhoids in men.”
Traditional methods and their dangers
In the process of searching for ways to cure hemorrhoids without surgery, patients inevitably encounter various traditional methods. You need to treat them very carefully. Consider whether you are ready to apply apple cider vinegar, lemon or onion juice to inflamed hemorrhoids, or insert cloves of garlic into the anus. Before using herbal teas or decoctions, make sure you are not allergic to them. The use of herbs, oils, meals and tinctures can help relieve inflammation, but will not cure varicose veins. As a result, the disease will be masked and will only get worse.
To cure hemorrhoids, be sure to consult a doctor.
What are the dangers of external hemorrhoids - complications
The external form of hemorrhoids is not dangerous in terms of the sudden occurrence of rectal bleeding, but if the disease is not treated, it can have a number of unpleasant consequences. Most often, the lack of treatment for external hemorrhoids is complicated by inflammation of the tissues surrounding the node changed by the disease. This complication can be recognized by redness of the skin near the anus, swelling and increased body temperature. In the absence of therapy, inflammation is complicated by tissue necrosis and suppuration - purulent paraproctitis is diagnosed.
The second dangerous complication of external hemorrhoids is thrombosis of the hemorrhoid. Symptoms of this complication are bursting pain in the anus at rest and acute pain with straining and defecation. When thrombosis occurs, the node becomes bluish and swells. Often the swelling spreads to the buttocks and perineum.
Conservative method - medications for external hemorrhoids
The conservative or medicinal method is used mainly in the stage of exacerbation of external hemorrhoids, and is a set of measures designed to reduce symptoms, relieve inflammation and prevent the formation of blood clots. A number of dosage forms are used:
- tablets for oral administration with antithrombotic (phlebotropic), analgesic and anti-inflammatory effects;
- external and local agents in the form of creams and ointments with analgesic and anti-inflammatory effects;
- rectal suppositories (used mainly in the presence of anal fissures).
All medications for external hemorrhoids are prescribed by a doctor in accordance with the existing symptoms and taking into account the characteristics of the patient’s body. The most effective are gels and ointments with heparin, antibiotics, anesthetics and glucocorticosteroids - Proctosedyl, Posterisan, Aurobin and Hepatrombin. Applications with Heparin ointment and Vishnevsky ointment are also used.
Oral drugs with venoprotective and venotonic properties have also proven themselves: Detralex, Phlebodia 600, Venarus, Ginkor Forte, Axlezan A and Pilex. In case of exacerbation of hemorrhoids, it is possible to take non-steroidal anti-inflammatory drugs: Ibuprofen, Diclofenac, Indomethacin.
Causes
The immediate cause of the appearance of external hemorrhoids is overstrain of the walls of the hemorrhoidal veins, caused by high physical activity (most often weight lifting) and, accordingly, excess blood flow. Sometimes external hemorrhoids are provoked by pushing during constipation or severe diarrhea.
As a rule, protrusion of the node occurs with significant thinning of the blood vessels, which can be caused by the following factors: