Hemorrhoids are a disease associated with varicose inflammation and swelling of the rectal vessels in the anus. Affected areas protrude, forming large nodules (obstructions) that prevent the passage of feces. The disease affects men and women, is dangerous for rupture of blood vessels, the addition of a secondary infection.
Classification of hemorrhoids
Depending on the location of the pathology, there are 2 types of disease:
- Foreign. The blood vessels in the anus, which are covered with skin, become inflamed. Therefore, it is more difficult to damage the affected areas, there is a stronger "protection". There is less discomfort during defecation, but unpleasant friction from the canvas often occurs. Complications of external hemorrhoids are less common and easier to treat.
- Internal. The affected vessels are located in the rectum above the anus and it is difficult to determine the initial stage of the disease. Vessels are covered with a thin epithelium, so they are more susceptible to mechanical damage. The internal form of the disease is often chronic, more dangerous with complications, more difficult to treat.
According to the severity of the course, internal hemorrhoids are divided into 3 degrees (stages):
- Initial (1). Knots come out, bleed, but do not fall.
- Medium (2). With muscle tension (during defecation, exercise), swollen veins come out of the anus. They come back when everything is relaxed.
- Heavy (3). Knots shed, and even when there is no muscle tension, they do not pull back.
Symptoms
The main symptoms of hemorrhoids are bleeding from the anus, pain with tension in the muscles of the rectum. The full picture depends on the stage of the disease. If nodules are visible (separate the swollen parts of the veins), they look like dark pink or purple (rarely almost black) colored crusts, are easily felt, and feel tight. The shadow depends on the filling of the arteries: if blood clots form, blood collects and cannot come out, the nodules will be dark.
internal hemorrhoids
In the first days and weeks, the disease almost does not manifest itself. If you don't start examining the rectum from the inside, it starts with an imperceptible edema. There are no pain receptors in that part, so the person does not feel such discomfort even during defecation.
In the early stages of hemorrhoids, its presence can be detected only by blood droplets visible after the release of large and hard stools. Due to edema, the walls of the rectum narrow the lumen, and 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 soft stools will cause discomfort.
- Burning, itching. Inflammation of the rectum produces a lot of mucus that irritates the tissues.
- blood. When knots form, a large number appear. Important: with hemorrhoids, it is bright red - not dark.
- leave the nodes. Appears in the later stages of hemorrhoids. First they pull back, then you have to "push" with your finger.
Foreign
The external veins are covered with skin that contains many pain receptors. Already in the early stages of hemorrhoids, if the veins swell, a person will experience discomfort. Pain occurs during defecation and when wiping the anus and close contact of the canvas with the skin. If the inflammation is severe or a blood clot forms in a vein, a large bump will form. It is easy to touch, touching causes pain.
The skin with external hemorrhoids is sensitive, often accumulating in the folds due to swelling. The process of cleaning the anus after defecation is difficult, so the risk of secondary infection increases. Later, if the hemorrhoids are damaged, blood will be visible, but it will be less compared to the formation of internal cones.
Reasons
The disease is associated with impaired blood flow in the vessels of the rectum, which is often caused by obstruction in the pelvic organs. According to them, the pressure in the arteries increases, which swells and comes out. In most people, this is due to poor lifestyle and nutrition, but doctors do not rule out the effects of heredity, genetic vascular abnormalities and increased blood clotting.
Possible causes of hemorrhoids:
- Frequent constipation - causes tension in the vessels of the anus, damage to the mucous membrane during the promotion of solid stools.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, pressure from the growing uterus in the rectum.
- Hormonal fluctuations - cause atony of the muscles of the pelvic organs.
- Intestinal oncology (more often - colon).
- In the rectum, less often - delayed operations on the pelvic organs.
- Spinal cord injury, curvature of the spine, lower back, sacrum, coccyx injuries.
Additional risk factors:
- Sedentary lifestyle - causes blood stasis in the pelvis.
- A low-calorie, fiber-deficient diet causes constipation.
- Lifting weights causes muscle tension.
Diagnostics
The doctor examines the patient's medical history and asks clarifying questions to rule out other causes of bleeding from the anus. Hemorrhoids are similar to symptoms of tumors of the digestive system, polyps, anal fissures, prolapse of the mucous membrane.
After a rectal examination, the doctor feels the lower part of the rectum with a finger. In the early stages of internal hemorrhoids, this may not work, and if the swelling is very severe in the later stage and the patient's touch causes severe pain, the procedure will be postponed. Examinations are performed by a surgeon or gastroenterologist to clarify the diagnosis and a more detailed examination of the anus.
The following methods are used:
- Anoscopy. Examination of a part of the rectum from the anus to 10 cm in length. The procedure is painless, but some patients are given 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 damage to the upper extremities.
- MRT. If an accurate diagnosis cannot be made based on other procedures, a CT scan is performed.
Laboratory research
Blood tests are rarely prescribed, depending on the clinical picture of the disease. This is necessary when a secondary infection occurs to identify the pathogen. They also analyze the level of hemoglobin, the number and activity of red blood cells in cases of excessive bleeding from the rectum. The basic diagnosis does not require laboratory procedures.
Treatment
If there are no symptoms of the disease, no special therapy is required. Your doctor will advise you to change your lifestyle and diet so that hemorrhoids do not develop, the stools become softer and do not damage the inflamed or swollen mucous membranes. The patient will be asked to do more exercise, "lower press" and gymnastics aimed at using the small pelvic muscles.
How to treat hemorrhoids that cause discomfort is determined by the doctor, taking into account the stage of the disease. In the initial stage, it is really possible to administer only drugs. If there are many nodules, they become thrombotic and may require surgery if they do not recede spontaneously. In any case after the patient follows the recommendations of diet and lifestyle, because 50% of cases relapse. The exception is surgery: after that, recurrent hemorrhoids occur in only 5% of patients.
Diet
The tasks of nutrition are to save a person from constipation and prevent the development of inflammation. Sources of fiber are included in the diet: vegetables, herbs, fresh fruits. Cereals, especially rice, should be treated with caution - they can cause thickening of the stool. In addition, they drink cleaner warm water: it does not allow the feces to sinter, but also accelerates the process of cleansing the intestines. Simple carbohydrates and sugar should be discarded to avoid triggering inflammation.
Medical therapy
- Laxatives. Drugs that soften stools and eliminate constipation prevent new damage to the mucosa. They are carefully drunk to avoid loss of intestinal muscle tone and diarrhea.
- Candles with anesthesia. Eliminate pain from internal hemorrhoids.
- Vasoconstrictor. This is a topical therapy that reduces swelling.
- Anticoagulants. Stop the bleeding.
- Hormonal preparations. They are used topically (needles) for severe inflammation.
Surgical intervention
Hemorrhoids in the final stage require surgery:
- Do not connect. An instrument is inserted into the anus, which throws a latex ring over the knot and squeezes it. The affected area disappears after 3-4 days.
- laser surgery. The procedure with minimal trauma is almost painless, but there are many contraindications.
- Classical hemorrhoidectomy. The nodules are removed with a scalpel or a special device, then "sew" the edges of the mucosa. If necessary, the doctor removes blood clots in the process.
Alternative medicine
The initial stage of external hemorrhoids includes symptomatic therapy:
- Hot baths. They are made with calendula, chamomile, sage. These herbs relieve inflammation and muscle spasms. They sit in the bath for 20 minutes 2-3 times a day.
- Compresses. With grated raw potatoes, aloe juice, chamomile decoction, sea buckthorn oil. They remain on the gauze for 30-60 minutes.
Prevention
Follow these simple rules to avoid the question of how to treat hemorrhoids:
- Take more action. Get up in a sitting position every 1-2 hours for 5-10 minutes. Take a walk in the fresh air, choose stairs instead of elevators, the ability to walk a few meters and do not drive.
- Look at your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.