Hemorrhoids - a disease associated with inflammation of the varicose veins and swelling of the veins of the rectum in the anus. The affected area protrudes outwards, can form large nodes (bumps) that interfere with the promotion and excretion of feces. The disease affects both men and women, dangerous to rupture veins, the addition of secondary infections.
Classification of hemorrhoids
Depending on the location of the pathological site, 2 types of disease are distinguished:
- Outside. The veins in the anus, which are covered with skin, become inflamed. Because of this, it is harder to damage the affected area, they have a stronger "protection". Discomfort during defecation is less, but unpleasant friction from the linen is often made. Complications of external hemorrhoids occur less frequently, being easier to treat.
- Inner. The affected vein is located in the rectum above the anus, making it difficult to determine the early stages of the disease. Vessels are covered with thin epithelium, therefore they are more prone 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):
- Beginning (1). Nodes protruding, bleeding, but not falling off.
- Simple (2). With muscle tension (during defecation, exercise), swollen veins come out of the anus. When everything is relaxed, they return.
- Weight (3). Falling nodes, although there is no muscle tension, they do not retract on their own.
symptoms
The main signs of hemorrhoids are bleeding from the anus, pain with tension in the rectal muscles. The full picture depends on the stage of the disease. If a node appears (isolate the swollen part of the vein), it looks like a dark pink or purple lump (rarely nearly black), is easily felt, and feels dense. Shading depends on the filling of the vessel: if a blood clot has formed, the blood has accumulated and cannot come out, the node will be dark.
internal hemorrhoids
In the first day and week, the disease is almost invisible. It starts with edema, which is not felt if you do not start investigating the rectum from the inside. There are no pain receptors in that part, so a person does not experience discomfort, even during the process of defecation.
In the early stages of hemorrhoids, you can find out about its existence only by the droplets of blood that appear after the release of large and hard stools. Due to edema, the rectal wall narrows the lumen, the mucosa is more damaged during constipation. Important - with hemorrhoids, almost every bowel movement will cause a small amount of blood to come out.
Other symptoms will follow:
- Pain during defecation. Severe swelling will cause muscle cramps, so even soft stools will cause discomfort.
- Burning, itching. Due to inflammation in the rectum, a lot of mucus is formed, which irritates the tissues.
- blood. It appears in large numbers when nodes are formed. Important: with hemorrhoids, it is bright red - not dark.
- drop nod. Appears in the last stages of hemorrhoids. First, they are retracted on their own, then they have to be "pushed" with the fingers.
Outside
The outer veins are covered with skin, which has many pain receptors. Already in the early stages of hemorrhoids, a person will experience discomfort if the ducts swell. Pain occurs during defecation, and when wiping the anus, and with tight contact of the linen with the skin. If severe inflammation or blood clots form in the veins, large lumps form. It is easy to grope, touch causes pain.
Skin with external hemorrhoids becomes sensitive, often gathering in folds due to swelling. The process of cleaning the anus after defecation is difficult, so the risk of secondary infections increases. Blood then appears if the hemorrhoids are damaged, but there will be less than with the formation of an internal cone.
cause
The disease is associated with impaired blood flow in the veins of the rectum, which is often caused by congestion in the pelvic organs. Because of them, the pressure in the veins increases, which swells and protrudes. In most people, this occurs due to improper lifestyle and nutrition, but doctors do not rule out the influence of heredity, genetic vascular anomalies, and increased blood clotting.
Possible reasons why hemorrhoids appear:
- Frequent constipation - leads to tension of the anal veins, damage to the mucosa during the promotion of solid stools.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, causing pressure from the uterus that is growing on the rectum.
- Hormonal fluctuations - trigger atony of the muscles of the pelvic organs.
- Intestinal oncology (more often - colon).
- Delayed surgery on the rectum, less often - on the pelvic organs.
- Spinal cord injuries, curvature of the spine, lower back injuries, sacrum, coccyx.
Additional risk factors:
- Sedentary lifestyle - causes blood clots in the pelvis.
- Low calorie diet, lack of fiber causes constipation.
- Lifting weights causes muscle tension.
Diagnostics
The doctor examines the medical history and asks explanatory questions to rule out other causes of bleeding from the anus. Hemorrhoids are similar in symptoms to tumors in the gastrointestinal tract, polyps, anal fissures, mucosal prolapse.
After the doctor performs an examination of the rectum, feel the lower part of the rectum with a finger. In the early stages of internal hemorrhoids, this may not yield results, and at a later stage, the procedure will be delayed if the swelling is very severe and the patient’s touch causes acute pain. To clarify the diagnosis and more detailed anal examination, the examination is performed by a surgeon or gastroenterologist.
The following methods are used:
- Anoscopy. Examination of the rectum up to 10 cm long from the anus. The procedure is not painful, but some patients are given local anesthesia (gels, sprays).
- Sigmoidoscopy, colonoscopy. A tube is inserted into the patient’s colon to rule out the cause of the bleeding (tumor) and the suspected lesion at the top.
- MRI. Tomography is performed if it is not possible to make an accurate diagnosis based on other procedures.
Laboratory research
Blood tests are rarely prescribed, it depends on the clinical picture of the disease. This is necessary if a secondary infection has emerged to determine the pathogen. They also perform analysis in situations where bleeding from the rectum is abundant to see hemoglobin levels, red blood cell count and activity. Primary diagnosis does not require laboratory procedures.
Treatment
If there are no symptoms of the disease, special therapy is not required. The doctor will advise you to change your lifestyle and diet so that the hemorrhoids do not develop, the stools become softer and do not injure the inflamed or swollen mucosa. Patients will be offered to move more, to do gymnastics aimed at training the "lower pressure" muscles and the small pelvis.
How to treat hemorrhoids, which cause discomfort, is determined by the doctor, given the stage of the disease. In the early stages, it is really possible to manage only with medications. If there are many nodes, they develop thrombosis and are not retracted on their own, surgery may be required. In any case after the patient should follow the recommendations of diet and lifestyle, because 50% of cases recur. The exception is surgery: thereafter, recurrent hemorrhoids occur in only 5% of patients.
Diet
The job of nutrition is to save a person from constipation, to prevent inflammation from developing. Sources of fiber are introduced into the diet: vegetables, herbs, fresh fruits. Cereals are handled with care, especially rice - it can make thick stools. In addition, they drink more pure warm water: it does not allow feces to sinter, it also speeds up the process of bowel cleansing. Simple carbohydrates and sugars should be discarded so as not to trigger inflammation.
Medical therapy
- laxative. Preparations that soften stools and relieve constipation, preventing new damage to the mucosa. They are drunk with caution so as not to trigger loss of intestinal muscle tone and diarrhea.
- Candles with anesthetic. Relieves pain of internal hemorrhoids.
- Vasoconstrictor. This is also a local therapy that reduces swelling.
- Anticoagulant. Stop the bleeding.
- Hormone supplies. It is used topically (injection) for severe inflammation.
Surgical intervention
In the last stage, hemorrhoids require surgery:
- League. The device is inserted into the anus, which throws a latex ring over the knot and tightens it. The affected area disappears after 3-4 days.
- laser surgery. The procedure with minimal trauma, is almost painless, but there are many contraindications to it.
- Classical hemorrhoidectomy. The node is removed with a scalpel or special tool, which then "sews" the edges of the mucosa. If necessary, the doctor removes the blood clot in the process.
Alternative medicine
The early stages of external hemorrhoids involve symptomatic therapy:
- Take a warm shower. They are made with calendula, chamomile, sage. This herb relieves inflammation, muscle cramps. They sit in the bathroom for 20 minutes up to 2-3 times a day.
- Compressing. With grated raw potatoes, aloe juice, decoction of chamomile, sea buckthorn oil. They are left on gauze for 30-60 minutes.
prevention
To avoid the question of how to cure hemorrhoids, follow these simple rules:
- Move more. When inactive, wake up every 1-2 hours for 5-10 minutes. Walk in the fresh air, choose stairs instead of elevators, the ability to walk a few meters on foot, and not drive a car.
- Watch your diet. Eat more plant foods, keep water balance, do not abuse bread and complex carbohydrates - cereals, pasta.