Internal hemorrhoids: symptoms, signs, how to treat them in women

What are hemorrhoids

Hemorrhoids (from the Greek haima - “blood”, roe - “flow”) are one of the most common diseases in proctology, which is based on the pathological condition of the cavernous plexuses of the rectum, accompanied by stagnation of blood in them. Hemorrhoids are manifested by periodic bleeding from the nodes, their prolapse from the anal canal and frequent inflammation. Men and women are equally susceptible to hemorrhoids

Classification of hemorrhoids

Internal hemorrhoids. With internal hemorrhoids, there are varicose hemorrhoidal veins, which are located deep in the anal canal, so such hemorrhoids are not visible during a normal examination. In order to see them, you have to resort to special research methods: anoscopy, rectoscopy. Also, such nodes can be identified during digital rectal examination. Such a sign of the disease as prolapse of hemorrhoids can cause bleeding when they are injured during the act of defecation. With significant weakness of the ligamentous apparatus of the rectum, such nodes fall out during defecation or significant straining. In addition, the internal nodes, when they fall out and spasm of the anal sphincter, can be infringed. Most often, the first signs of internal hemorrhoids are bleeding.

External hemorrhoids. In this type of hemorrhoid, the hemorrhoids are marked externally and should not be confused with prolapsed internal hemorrhoids. Most often, external nodes manifest as thrombosis. As a rule, bleeding from external nodes does not occur, since they are not injured during defecation. Such hemorrhoids hurt and cause discomfort during bowel movements. But constant stagnation of blood in them can lead to the formation of blood clots in them. Externally, the external hemorrhoidal node can be of different sizes, from 3 mm or more, which depends on its blood supply. An external hemorrhoid is usually covered by skin, while a prolapsed internal hemorrhoid is usually covered by the mucous membrane of the anal canal.

Combined hemorrhoids. As the name implies, with combined hemorrhoids, the patient has a combination of external and internal hemorrhoids.

The occurrence of hemorrhoids

Normally, all people have external and internal hemorrhoidal venous plexuses under the mucous membrane of the anal canal, which are similar in structure to the cavernous tissue of the genital organs. They play a significant role in retaining intestinal contents, ensuring complete closure of the anal canal when they are filled with blood. As a result of the influence of a number of factors, most adults experience an increase in hemorrhoidal nodes, and hemorrhoids begin to develop.

Factors influencing the development of hemorrhoids: constipation, straining; pregnancy, childbirth; hereditary factors; sedentary lifestyle; prolonged standing or sitting; excessive physical activity; practicing some sports (horse riding, cycling, weightlifting); lifting weights; overweight; hot, spicy food; drinking alcohol; prolonged exposure to heat (sauna, hot bath); prolonged diarrhea (diarrhea).

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.

Timely diagnosis

To avoid hemorrhoids and possible complications, it is necessary to identify the disease at its earliest stages. Internal hemorrhoids can be detected by digital examination of the rectum, feeling for compaction of the hemorrhoidal veins. But such an examination is effective only when the nodes are located low. If the cones are located high up, then only modern equipment can help in diagnosing the disease. Anoscopy and sigmoidoscopy are the most common techniques. In the first case, a special tube with an optical device is used, which allows one to examine the rectal mucosa over a ten-centimeter length. If the hemorrhoids are located even higher, then you cannot do without the help of a sigmoidoscope. The rectum at a distance of 25 cm will be “in full view” to the doctor. If the patient states that during defecation he himself observed the prolapse of nodes, then a diagnosis can be made based on this reliable fact. True, unfortunately, for the patient the stage of the disease in this case is later, and therefore less treatable.

Reasons for the development of hemorrhoids in women

Chronic hemorrhoids in women, as a rule, develop after 30 years of age; with age, the risk of developing the disease increases. Women suffer from dilated hemorrhoidal veins four times less often than men. However, the risk increases in the presence of permissive factors: • chronic constipation; • prolonged sitting on the toilet; • obesity; • sedentary work, sedentary lifestyle; • diseases occurring with chronic cough; • diseases of the pelvic organs.

A typical cause of acute hemorrhoids in women is pregnancy or childbirth. In such cases, adequate conservative treatment leads to the disappearance of the problem. However, if therapy was untimely or careless, the disease becomes chronic.

Is it always necessary to treat acute thrombosis of the external hemorrhoid?

The choice of treatment method for this disease is one of the most controversial issues in general proctology. Like hemorrhoids, acute thrombosis does not turn into cancer, does not cause deadly complications, but can significantly affect the patient’s quality of life; the pain syndrome is often described as “unbearable”, with which it is “simply impossible to live.”

Our Clinic has adopted a patient-centered approach to choosing a treatment method for acute thrombosis of external hemorrhoids: the doctor, together with the patient, determine how severe the symptoms are, how much the patient’s quality of life suffers, taking into account his employment, and choose a treatment method.

Acute thrombosis of the external hemorrhoid can be treated promptly (perform surgery), conservatively (take pills and use topical ointments and/or suppositories) or not treat at all, but choose a wait-and-see approach. Research and practical experience show that surgical treatment allows you to get rid of the manifestations of the disease in a shorter time; conservative treatment also allows you to get rid of the manifestations of the disease, but over a much longer time. The absence of any treatment also ends with recovery, the timing of which differs only slightly from the timing of intensive conservative treatment. The determining factor in the choice of treatment method is the patient’s choice and his assessment of the severity of the pain syndrome, therefore, the patient’s opinion is crucial for the choice of tactics. If the patient assesses the pain as unbearable, or he urgently needs to return to work, fly to another city or country, it is more reasonable to choose surgical treatment in the scope of removing the hemorrhoidal node or evacuating the blood clot from the node. Surgical treatment usually leads to faster relief of unpleasant symptoms. If the pain syndrome allows the patient to live fully in this condition or the patient is not ready for surgical intervention, it is possible to carry out conservative treatment aimed at reducing the pain syndrome and accelerating the process of organizing and resolving the blood clot.

Symptoms of the acute form of the disease

Symptoms of acute hemorrhoids in young women are most often associated with pregnancy or childbirth. The appearance of an enlarged hemorrhoid constipation characteristic of this period .

Acute dilatation of hemorrhoidal veins manifests itself with sharp pain , which becomes unbearable during bowel movements. In addition, the pain syndrome can intensify while walking, as well as with increased intra-abdominal pressure during straining, coughing, laughing, and hiccups.

Another characteristic sign of the acute form of the disease is bleeding from the dilated veins of the rectum. This symptom manifests itself as fresh blood on the surface of the stool.

Often hemorrhoids in women are combined with anal fissure. In such cases, blood stains on toilet paper and underwear appear even more often after defecation.

Complications of hemorrhoids

If the pathology is not diagnosed on time, the risk of complications increases. In advanced stages, conservative treatment does not make sense, so surgical intervention will be required. The rehabilitation period will be many times longer.

Complications of hemorrhoids include thrush and dysbacteriosis. The microflora in a woman’s body is disrupted, and an infection develops that spreads throughout the body.

Complications also include:

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. ).

How to treat acute thrombosis of external hemorrhoids?

Possibilities of surgical treatment

There are two main operations for the treatment of acute thrombosis of an external hemorrhoid: removal of the entire node or just the thrombus from it. The first operation is called economical (partial) hemorrhoidectomy (removal of only the external hemorrhoid), the second is thrombectomy. Both operations are effective in terms of eliminating pain within 2-3 days after their implementation, however, after an operation to evacuate a blood clot, a relapse (reoccurrence of a blood clot) is more common.

Economical (partial) hemorrhoidectomy of a thrombosed node involves incision of the skin around the node, its isolation and removal along with the thrombus. The operation can be performed under local anesthesia.

After removal of a hemorrhoid, a small wound surface is formed, which can cause pain, especially during bowel movements. But usually the pain is much less pronounced than in the presence of a thrombosed node, and only sometimes requires taking tablet painkillers.

Thrombectomy is performed through a skin incision over the thrombus, after which the thrombus is removed and 1-2 sutures may be placed at the incision site. This intervention is almost always performed under local anesthesia.

Conservative treatment

Conservative treatment (tablets and local remedies - ointments and suppositories) is mainly aimed at relieving pain caused by a blood clot, reducing swelling and inflammation of the hemorrhoid, and normalizing the frequency and quality of stool. Pharmacies offer a large number of drugs for the treatment of hemorrhoidal disease, but they are all approximately equal in effectiveness and can be used to treat acute thrombosis of the external hemorrhoid. Local remedies (ointments and suppositories) mainly have an analgesic and anti-inflammatory effect. Topical agents with an anticoagulant effect in the treatment of acute thrombosis are effective only for the temporary prevention of new blood clots or, if the drug contains an analgesic component, for pain relief. Tablets are also used for pain relief (non-steroidal anti-inflammatory drugs, paracetamol) and normalization of venous blood flow in the pelvis (in the rectal area), for example, flavonoids. In addition, conservative treatment is also carried out after surgery to eliminate possible postoperative symptoms. A conservative treatment regimen can only be determined by a specialist, and it is better to select a combination of drugs in each specific case, depending on the characteristics of each patient.

Diagnosis and choice of treatment tactics

Diagnosis of hemorrhoids is carried out by a proctologist using a digital examination. Symptoms such as bleeding, pain, and the sensation of a foreign body in the rectum occur with cancer, as well as with other pathologies of the lower intestine.

Therefore, the general list of examinations may include sigmoidoscopy or colonoscopy, as well as laboratory tests.

At the final stage of diagnosis, treatment tactics are chosen. Acute hemorrhoids are treated conservatively, and in the chronic form of the disease they resort to surgery, giving preference to minimally invasive treatment methods.

The exception is cases when surgery is temporarily contraindicated. For women, this is pregnancy, the postpartum period, as well as situations when it is necessary to stabilize the general condition of the patient. This situation can arise during acute infections or during exacerbation of severe chronic diseases.

We care about your health

Hemorrhoids in women are a fairly common ailment that requires urgent treatment. Its symptoms coincide with a similar disease in men. However, according to statistics, women suffer from this unpleasant disease much more often. This is explained by the lifestyle and structural features of the body of representatives of the fairer sex.

Let's take a closer look at the symptoms and causes of hemorrhoids, treatment of this disease in women and preventive measures.

Symptoms of hemorrhoids in women

The disease does not appear immediately, but develops gradually. Symptoms vary widely and depend on the stage of the disease.

Signs of hemorrhoids in women most often include the following:

• sensation of a foreign body in the anal canal area;
• burning and itching in the anus;
• bleeding from the rectum;
• prolapse of hemorrhoids;
• severe pain in the anus;
• heaviness in the stomach, bloating;
• lack of sensation of complete bowel movement.

With the development of severe inflammation, an exacerbation of the disease occurs, which is accompanied by high fever and blue discoloration of the hemorrhoids.

Causes of female hemorrhoids

Female hemorrhoids can be caused by many factors. Let's look at the most common causes that contribute to the onset of the disease.

• 1. Pregnancy and childbirth. The uterus enlarges during pregnancy and puts strong pressure on the vessels, causing blood stagnation. During childbirth, stagnation increases, pushing is accompanied by increased blood flow to the pelvic veins. This contributes to the development of hemorrhoids.
• 2. Menstrual cycle. During menstruation, a large volume of blood flows to the pelvis, as a result of which the blood vessels become overfilled - there is a risk of hemorrhoids.
• 3. Poor nutrition. The lack of plant fiber in the body and eating disorders can lead to constipation, and this disrupts natural intestinal motility. The result is the development of hemorrhoids. A big risk factor can be a variety of diets that disrupt the diet necessary for the body.
• 4. Profession. Professional activities associated with prolonged sitting or standing positions disrupt the circulation of arterial and venous blood in the pelvic area, which leads to blood stagnation.
• 5. Stress. The occurrence of the disease largely depends on psychological reasons. Women are more likely to be exposed to stress, endure it much more severely and experience severe emotional stress.
• 6. Increased physical activity, lifting weights that do not correspond to the body’s capabilities.
• 7. A sharp decrease in body weight.
• 8. Unconventional sex.

This is not a complete list of the causes of hemorrhoids in women. By adopting a healthy lifestyle and proper nutrition, you can avoid the development of the disease.

Types of hemorrhoids

Hemorrhoids in women can be divided into several types. Each type has its own symptoms and requires specific treatment.

Interior. The disease manifests itself in inflammation of the veins inside the anal canal and develops painlessly. This is explained by the fact that there are no pain receptors in this place.

External. The veins in the anus become damaged, which causes severe pain and itching. In such cases, medical intervention is required.

Combined. It is a combination of internal and external views. The disease may be accompanied by anal fissure, prolapse or thrombosis of hemorrhoids, and this can cause severe bleeding. In such cases, treatment of hemorrhoids in women cannot be delayed - try to see a doctor immediately.

Stages of hemorrhoids in women

In medical circles, there are four stages of hemorrhoids in women.

At the first stage, a slight compaction is felt at the entrance to the rectum. After defecation, itching and burning appear in this place. If you see a doctor right away, the disease can be cured in two to three weeks.

The second stage manifests itself in an increase in hemorrhoidal cones. They become dense and cause pain. When defecating, the lumps may come out and then come back. Discharge in the form of blood or inflammatory fluid appears from the rectum, which is accompanied by unbearable itching and discomfort.

At the third stage, nodes fall out. This happens when visiting the toilet, strenuous physical activity, or lifting heavy objects. Pain haunts a woman constantly: when she sits, walks and even lies.

The fourth , advanced stage is accompanied by severe bleeding during bowel movements, lumps of different sizes on the inside and outside of the anus, the inability to reduce hemorrhoids, and the appearance of blood clots.

The first stage of the disease is treated at home without hospitalization. On the second and third, hospital treatment will be required. The fourth stage of the disease can only be cured with surgery.

Treatment of the disease

Diagnosis and treatment of female hemorrhoids is carried out by a proctologist. He conducts an examination, prescribes therapy and provides advisory assistance.

In the initial stages, ointments, rectal suppositories, and gels help. They relieve pain, irritation, itching and tingling. For oral administration, tablets are prescribed to make it easier to go to the toilet, painkillers, antibiotics (if a bacterial infection is detected), phlebotropic drugs, etc.

For the treatment of female hemorrhoids, special procedures are very effective:

• infrared coagulation - the effect of infrared radiation on hemorrhoids (cures the disease in the initial stages);
• sclerotherapy - the introduction of a sclerosing drug into the inflamed nodes (effective in the treatment of internal hemorrhoids);
• minimally invasive methods - treatment of the disease through latex ligation (when enclosing each node in a ring leads to the falling off of the lump in two to three weeks), ligation of hemorrhoidal arteries (HAL procedure), etc.;
• Hemorrhoidectomy is a surgical operation to remove nodes.

You should not try to diagnose or self-medicate on your own. Hemorrhoids can easily be confused with another serious rectal disease and cause irreparable harm to the body.

Prevention of hemorrhoids in women

To protect yourself from hemorrhoids, follow simple rules for its prevention:

• eat foods rich in plant fiber;
• minimize spicy and spicy foods, alcohol;
• lead an active lifestyle;
• avoid strong strain during bowel movements;
• sit only on hard chairs;
• take breaks during sedentary work;
• Walk more during pregnancy.

Preventing the disease will help avoid unpleasant consequences. A timely visit to a doctor will allow you to cure hemorrhoids quickly and without any complications.

Methods for treating hemorrhoids without surgery

Conservative treatment of painfully enlarged hemorrhoids should be carried out comprehensively, affecting all factors contributing to the development of the disease. It is necessary to normalize the stool, because constipation and diarrhea equally seriously injure the inflamed node.

If the cause of hemorrhoids is an attack of diarrhea, every effort is made to cure the disease that caused the stool disorder. Constipation is fought with a diet that includes a large amount of dietary fiber (prunes, dried apricots, oranges, apples). For persistent constipation, mild laxatives (Duphalac) are prescribed.

In order not to irritate the intestines, spices, salt, vinegar, smoked foods, as well as carbonated drinks and alcohol are excluded from the diet.

The pain increases the spasm of the internal sphincter, which contributes to stagnation of blood in the veins. To relieve pain and spasms, use warm baths with potassium permanganate or herbal decoctions.

Painkillers, antispasmodics, blood thinners, and medications that promote tissue regeneration are prescribed as drug therapy. Preference is given to “local” therapy: ointments are used for external nodes, and suppositories for internal nodes.

Attention! The prescription of drugs depends on the location of the hemorrhoid, the stage of development of the disease, the phase of the process, the presence of concomitant diseases and the general condition of the body. Therefore, we recommend not to self-medicate, but to consult a doctor in a timely manner.

Balanced diet

Diets, colon cleanses and enemas are the main provocateurs of anal problems. But a diet balanced in carbohydrates, proteins and fiber, and adherence to a drinking regime will improve regular bowel movements and relieve constipation.

Consume fermented milk products, which improves intestinal microflora. Eat fruits, vegetables, cereals and bran bread - all these foods improve intestinal motility.

Avoid alcohol and spicy foods. Reduce your consumption of flour, especially baked goods.

Radical treatment of pathology

Minimally invasive methods

Doctors treat chronic hemorrhoids with surgical methods. At the initial stages of the disease, preference is given to minimally invasive techniques, which are carried out on an outpatient basis (without placing the patient in a hospital) and provide for a short rehabilitation period.

An important advantage of low-traumatic operations is a short list of contraindications. The list of methods that are suitable for most patients includes: • sclerotherapy (injection into dilated veins of substances that cause “soldering” of the walls of dilated veins); • infrared coagulation (cauterization of the leg of the node); • ligation of the internal hemorrhoid with latex rings.

Sclerotherapy and infrared coagulation are used at stages I – II of the development of internal hemorrhoids. The effectiveness of these methods at stage I is 85%, and at stage II – about 72%. If the node is ligated with latex rings, the effectiveness exceeds 93%.

Operation hemorrhoidectomy

Hemorrhoidectomy is the removal of enlarged hemorrhoids using surgical methods, that is, using a scalpel.

Such treatment must be carried out in a hospital. The rehabilitation period is much longer and is less well tolerated by patients. Therefore, surgical removal of nodes is carried out only in the last stages of the disease , when minimally invasive techniques are no longer effective.

Hemorrhoidectomy can be combined with disarterization of hemorrhoids under ultrasound control. This method is often used for stage III internal hemorrhoids.

The choice of surgical intervention method depends on the number of enlarged nodes, their location, as well as the presence of complications and concomitant pathologies.

What will happen after the operation?

Typically, patients feel dramatic relief after surgery and note a decrease in pain (Fig. 6). Sometimes continued minimal pain therapy is required. The main task of the patient in the postoperative period is to normalize stool: soft stool causes much less pain during bowel movements than dense stool. As a rule, patients return to their normal lives 2-3 days after surgery, sometimes the very next day.

a) b)

Rice. 6. View of the anus before (a) and immediately after removal of the external hemorrhoid (b). Before the operation, the patient rated the pain level as 8 out of 10, immediately after the operation it was 4 out of 10.

Treatment during pregnancy and after childbirth

Treatment of hemorrhoids in pregnant women and in the early postpartum period does not involve surgical intervention. The fact is that the reasons for the dilation of the veins of the rectum during this period are physiological in nature: • changes in hormonal levels; • increased intra-abdominal pressure; • increase in circulating blood volume; • straining during childbirth.

After childbirth, hormonal levels gradually normalize, which leads to the disappearance of the tendency to constipation. The volume of circulating blood decreases, intra-abdominal pressure decreases, the body's defenses are restored and all conditions for recovery are created.

Therefore, in most cases, a painful node that occurs during pregnancy or after childbirth disappears on its own under the influence of standard methods of conservative treatment.

Attention! When conservatively treating hemorrhoids in pregnant women, as well as in women during lactation, care should be taken. Some active ingredients of topically applied drugs still enter the bloodstream and can harm the child. Therefore, treatment must be done under the supervision of a physician.

Is it necessary to treat stage 1 hemorrhoids?

To treat or not to treat hemorrhoids at stage 1 depends on the symptoms. If there is severe discomfort, itching, and blood appears during bowel movements, then it is necessary to treat. As a rule, treatment begins with the regulation of nutrition. To avoid constipation, you need to follow a diet: eat more fiber (fruits, vegetables, legumes, cereals) and maintain water balance; it is recommended to drink at least 2 liters of clean water per day. Next, conservative treatment of hemorrhoids may be prescribed - topical medications, physiotherapy. If conservative treatment has no effect, minimally invasive non-surgical methods are used.

If you were diagnosed with stage 1 hemorrhoids during a routine examination, or the symptoms are so minor that they do not cause discomfort, there is no bleeding, and you feel well, then there is no need for treatment. After all, as we wrote above, the treatment of stage 1 hemorrhoids is symptomatic. It is necessary to adjust the diet so as not to provoke constipation, and maintain physical activity.

The main problem is that, having discovered such symptoms as blood, pain, discomfort in the rectum, people themselves diagnose themselves with hemorrhoids and begin to self-medicate. This is absolutely not worth doing! Besides hemorrhoids, there are many other diseases with similar symptoms. Because of the fear of visiting a proctologist, you can even reach the fourth stage of hemorrhoids, not to mention more serious diseases. Only a doctor at an appointment can make a correct diagnosis. Believe me, in fact, a proctological examination in modern clinics is absolutely not a problem that you need to worry about. In medical diagnostics, diagnostics are carried out absolutely painlessly, using local anesthesia, in the most comfortable conditions for the patient. As for the treatment itself, several painless procedures may be required.

Take care of yourself, do not advance the disease, because treating hemorrhoids in the early stages is always easier and faster.

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.”

How does acute thrombosis of the external hemorrhoid manifest?

Patients with acute thrombosis of the external hemorrhoid complain of a protrusion, “bump” (neoplasm) and/or pain of varying intensity in the anus. The size of the “bump” can range from several millimeters to several centimeters and is often accompanied by swelling of the surrounding tissues (up to the entire circumference of the anal canal). In some patients, the disease proceeds without pain, but most assess the pain as significant or unbearable.

To assess the degree of pain, a special visual analogue scale is used, in which you can independently determine the severity of pain. After all, this is the key point when choosing a treatment method. Surgical treatment will be most effective when the severity of pain is 7 or more points, while for pain up to 4 points, a conservative method of treatment can be considered optimal.

Rice. Visual analogue scale for pain assessment.

Pain usually worsens during bowel movements and/or sitting. The pain and swelling can be severe, even unbearable for several days. The intensity of pain depends on the size of the blood clot and its location in relation to the anal sphincter muscles. In general, manifestations of the disease can persist for several weeks, in exceptional cases longer. Sometimes spontaneous evacuation of a blood clot from a hemorrhoid occurs. This is preceded by necrosis (destruction) of the skin over the thrombus, and the thrombus seems to “fall out” of the node. Externally, this is accompanied by the sensation of a “bursting” ball and the release of a small amount of blood. Usually, after evacuation of the blood clot, the pain and discomfort in the anus gradually decrease. However, necrosis of the mucous membrane above the thrombus does not always end only with the evacuation of the thrombus; necrosis can continue to spread to the hemorrhoid itself and surrounding tissues, which is why this condition requires consultation with a specialist. After acute thrombosis subsides, the patient is most often left with so-called “skin fringes” - excess skin where the thrombosis was. They do not require medical treatment, but may cause cosmetic discomfort.

Relapse Prevention

If you have already had hemorrhoids removed, there is an increased risk of the disease returning. To protect yourself from relapse, you should follow the recommendations of doctors: 1. Watch your stool (it is advisable to achieve daily morning bowel movements). 2. Be careful with “weight loss” diets (see point 1). 3. If you have a sedentary job, do gymnastics regularly. 4. Treat diseases of the gastrointestinal tract and pelvic organs (gastroenterology, urology, gynecology) in a timely manner. 5. Avoid physical and nervous overload.

Nature has prepared a woman for childbirth, so the venous vessels of the rectum in women are more resistant to stress than in men. If you follow the rules, the disease will not return.

Moderate physical activity

• When working sedentarily, you should get up every hour and take breaks for at least five to ten minutes. It is advisable to move during your lunch break.
• Introduce moderate physical activity: exercise, swimming, running and walking. This is especially true for those who drive.
• Do simple exercises at home. These are pelvic lifts, lying on your back, abdominal exercises, bending.
• In the office, sit on a hard chair, it is safer than a soft chair. Even while working at the computer, you can quietly squeeze and relax your buttocks.

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!

Postpartum hemorrhoids are almost always external hemorrhoids

Many of my patients at the appointment additionally note that they themselves did not give birth, but had a Caesarean section. My dears, the process of childbirth itself does not play any role in the development of hemorrhoidal disease (recently, a woman was seen after two Caesareans - 4.5 and 1.5 years ago with quite large inflamed hemorrhoids)! Hemorrhoids grow during the 9 months of pregnancy due to high levels of progesterone and a large uterus in the second half of pregnancy, compressing the pelvic veins.

During childbirth, existing hemorrhoids “just” become inflamed and worsen due to stress.

Please remember this:

1. Hemorrhoids appear and grow during pregnancy.
2. During childbirth, hemorrhoids become inflamed.

This is precisely why a Caesarean section will not get rid of hemorrhoids, but it can get rid of its inflammation. Although not necessary.

What to consider when choosing a doctor and medical institution

If you are looking for a medical institution where to go for consultation and treatment of acute perianal thrombosis, then you need to pay attention to several factors.

• The institution has a proctological, and not just a general surgical or oncocoloproctological specialization.
• Knowledge of the Clinic staff about all possible methods of treating acute perianal thrombosis
• Possibility of performing minor coloproctological operations in a hospital setting at the Clinic
• Possibility of performing surgical treatment in the Clinic for “special” groups of patients - pregnant women, patients of the older age group

What to do if you have undergone a course of conservative treatment for thrombosis

The abundance of means for the conservative treatment of thrombosis and often the doctor’s disposition to use this technique leads to the fact that most thromboses are treated conservatively. Patients come to our Clinic at different stages of the course of conservative therapy. Often this is a situation where, immediately after the occurrence of a blood clot, conservative therapy was started, some relief of the condition occurred, the pain syndrome decreased, but a “bump” remains in the anus and some pain. Sometimes completely healthy people come in who experienced an episode of acute thrombosis several months or years ago and are now concerned about the presence of skin “fringes,” excess skin in the anus that remain after the acute condition has resolved. They can interfere with the proper hygiene of this area and affect intimate life. What to do in this situation? And again, the main thing for the doctors of our Clinic will be the patient’s opinion. If you want to get rid of the manifestation of acute thrombosis, even if conservative treatment has already been carried out, a lot of time has passed - this can be done surgically.