There is no such person who has never heard the word "hemorrhoids."It is used by all 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 does not always cause blood.In this case, the concept of "us hemorrhoids" is suitable for the broader concept of "hemorrhoids" - swelling, swelling that occur during garbage.
Description of the problem
Hemorrhoids are special anal formations located under the rectum.In structure, they are a plexus of venous vessels.They are located inside and outside the mucous membrane.From the location of these formations, hemorrhoids of an internal and external nature are divided.
These very plexus themselves perform a protective function: protect the rectum of liquid feces and gases incontinence 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 expert.
Which contributes to the occurrence and development of the disease
Hemorrhoids are normal only with a pair of parks.In case of heavy or prolonged physical effort, these ligaments can be torn.In case of violation of ligament integrity, hemorrhoids are overflowed with blood.The consequence of this is loss and bleeding.
Vienna, providing normal blood output from the mucosa, is squeezed.The blood begins to stagnate.
Factors that cause the development of hemorrhoids
The pathology itself does not arise like this by itself.Its occurred and development is affected by several factors:
- The hereditary factor (in the hemorrhoid node and veins, there are no valves that provide blood flow).
- Increased pressure on the veins.
- Carts in the work of the gut (constipation, diarrhea), a frequent visit to the bathroom.
- Pregnancy, delivery, improving the disease clinic.
- A sedentary lifestyle, standing up for a long time.
- Some sports and professions.
- Nutrition characteristics (alcohol, spicy food).But this contributes more to exacerbation, not development.
Pay attention!Even in the presence of anal canal bleeding, one cannot talk about the manifestation of hemorrhoids.To confirm the diagnosis, analysis and examination of the rectum are required:
- Colonoscopy.
- Yearscopy.
- Sectoroscopy.
Bleeding and we can occur with inflammation of the intestine and in malignant formations.
Hemorrhoids: symptoms and classification
The location of the nodes:
- Outdoor.
- Interior.
- Mixed.
First vision- The expansion of venous vessels located below the rectum gear line.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 the hemorrhoids themselves located below 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 the blood is released from the anus.
- The loss of plexuses within the mucosa.
- Itching and burning in the anus.
- Rectum discharge.
Symptoms of chronic hemorrhoids
Intestinal bleeding
This is the most frequent symptom with this disease occurred in 10 % of patients.According to statistics, the most frequent occurrence is when the intestinal is empty.Manifestations can be intense and not much, and are of an episodic nature.The color of the discharge is scarlet, in the form of "spray" (occurs with a strangulation) or - at the end of emptying (in the form of drops).If, after the anterior emptying in the anus, the blood remains, the next one will be released with a dark or cluster.
70-80 % of clinical manifestations of hemorrhoid cases.With constipation and diarrhea, alcohol intake, spicy foods and heavy physical effort, it also occurs bleeding.The consequence of this is the occurrence of anemia.
The manifestation of anal bleeding is not always a sign of this disease.May occur in other bowel diseases.If it occurs in people over 40 to 45, you should definitely consult a doctor.In addition, in the case of IT in people predisposed to oncology, a visit to the doctor is required.
For which diseases can bleed:
- Fun of the colon.
- Crohn's disease.
- The malignant neoplasia of the rectum.
- Intestine polyps.
If you notice the high of the anus, consult a proctologist and conduct the necessary tests of the direct and thick intestine.
Venous Plexus Protrusion
This symptom already occurs in the phase of a long course of the disease.First, it occurs with the devastation of the intestine.In addition, the symptom appears with a strangulation.If the pathology is acute, then fall in love without effort.The division is defined independently into 2 steps.In three steps, they are manually adjusted due to a decrease in the tone of the anal muscles.They fall completely in 4 steps.
Anal pain
Bleeding is not the only reason that comes to an expert.And this is not necessarily hemorrhoids.Anus pain syndrome may occur at an acute stage of the disease.Reasons:
- Constipation.
- Frequent visit to the bathroom.
- Anal crack.
- Plombosis of the nodes.
If the treatment is performed incorrectly, the anal crack will enter the chronic stage.
Intestinal discharge
The nature of high in this disease is aqueous or mucous.Arise as a consequence of the episodic loss of knots.With bleeding, pay attention to mucous secretions.Most of the time, they are when nodes or mucosa falls.Other reasons are neoplasms (villainous polyps, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with colon dysfunction.They occur, as a rule, at the late stage of the disease.
Classification
1 phase- Venous plexuses do not fall.The scarlet color of the released blood.
2 phase- The fallen nodes are adjusted (with or without blood release).
3 phase- The knots fall episodically and improve manually.
4 phase- The newspaper and the mucous membrane of the rectum begin to fall constantly.Manual reduction becomes impossible.
Acute hemorrhoids
It usually occurs with exacerbation in the chronic phase.The most frequent manifestations:
- We external with the occurrence of thrombosis.
- Protrusion of internal pushing plexuses.
If thrombosis occurs, the nodes are compacted and increased in size.A severe pain syndrome occurs in the anal opening area.
Treatment of acute hemorrhoids
In the thrombosis phase, thromboectomy (excision of a thrombus node and a thrombus removal) is possible.The operation is performed under local anesthesia.Duration - a few minutes.After operation, the pain begins immediately to decrease.
When the nodes internal hemorrhoids fall, swollen phenomena and inflammation occur.Surgical intervention is against -indicated due to possible complications.Therapy:
- The use of ointments and candles.
- Pills.
If you notice time demonstrations, the duration of the acute internship will be reduced to a week.If the pathology is not treated for a long time, purulent inflammation may occur.
3 phases of the disease in the acute course
- The appearance of blood clots in internal and external venous plexuses.There is no inflammation.
- The presence of blood clots in the knots, with the presence of inflammation.
- At the bottom of the above signals, the inflammation of the subcutaneous tissue develops.Ochha complications - bleeding, purulent inflammation.
How to treat hemorrhoids in the chronic stage
Hemorrhoids are a serious, unpleasant but reference disease.There are sufficient treatment methods for its elimination.The treatment system is being constantly improved.Each method has no doubt pros and cons.And they are used depending on the phase.The following factors affect the use of a specific methodology:
- The course of the disease.
- The nature of the discharge.
- Patient's age.
- The frequency of bleeding.
The difficulty lies in the fact that many methods are based on the same indications for treatment and the choice of ideal becomes easy.In this case, you should combine the necessary methods.According to the classification, 3 types of treatment are distinguished:
- Conservative.
- Small invasive.
- Operational.
First degree hemorrhoids
The loss of us with the release of blood or not:
- Mandatory Nutrition Standardization (with a high percentage of fiber).
- Take drugs that reduce inflammation and expansion of venous vessels.
- Rectal candles, ointments for external use for exacerbation.
II Hemorrhoids
Self -reduction of affected nodes:
- Fixing the hemorrhoid node with a latex ring.
- Introduction of a sclerosis.
- The connection of arteries bringing blood to inflamed.
- Electrocoagulation.
- Excision of external and internal nodes.
Grade III hemorrhoids
Manual Reduction:
- The use of latex rings.
- Sclerotherapy.
- Landing of the arteries.
- Electrocoagulation.
- Excision.
Grade IV hemorrhoids
The impossible reduction of knots: Removing inflamed nodes with a special device.
The stages of hemorrhoid development
Not every method is suitable for the treatment of hemorrhoids in one case or another.The final solution affects how external and internal plexuses correlate.If the pathology is prevailing in us - inside, you can be without surgery.The methods are described above.
Before making a final diagnosis, the patient needs a complete exam.The first thing to do is to examine the rectum and the large intestine.First of all, this applies to patients over 45, with a hereditary predisposition to oncology, because with hemorrhoids, there may be concomitant diseases:
- The malignant tumor of the rectum.
- Polyps.
In addition, symptoms (or rather the degree of gravity), the size of the nodes and episodality affect the choice of a specific treatment method.
With a weak severity of symptoms, rare loss, it is better to choose conservative therapy.The first and important thing is intended is the correction of nutrition, the elimination of constipation and pressure during the emptying of the intestine.The diet should contain enough water, since constipation usually occurs with lack of fluid, which is why the intestine is forced to suck it from the feces.
To facilitate this condition, the following is important:
- The predominant component in the diet is fiber.
- Periodic laxative intake.
- The appointment of phlebotrops to the patient.
Conservative therapy is used mainly during acute disease exacerbation.Another treatment is against -indicated.If the disease is in the 1st and 2nd phase, other methods will also be against -indicated.What is included in conservative treatment:
- Special diet.
- Slisping drugs.
- Rectal candles, ointments.
- Phlebotropic medicines.
Each patient is prescribed by the diet.The main objective is to normalize a chair.Often one of the main provocative factors is with precision constipation or diarrhea.The diet for this disease categorically prohibits:
- Sharp.
- Salt.
- To roast.
- Alcohol.
Diary implies additional exams.It is the result of exams that affect the correction of diet and treatment.If the patient is prone to constipation, a special diet is recommended.The list of products and other nuances can be viewed in a special section.For a laxative effect, it is recommended:
- Dry apricots.
- Plums.
- Dry apricots.
- Fig.
If the diet does not eliminate the stagnant effect on the gut, the use of laxatives begins.Now it will not be difficult to find them: just go to any pharmacy and ask.Do not take them.The dosage and mark of the drug depend on the following factors:
- Individual characteristics of the body.
- Concomitant diseases.
- Age.
- Decisions of the doctor.
Until the final treatment is prescribed, the doctor prescribes the patient 1 tbsp.l.Vaseline oil (2-3 times a day).
Basic in the treatment of pathology
But remember that no ointments and other medications will completely save you from the problem.They only temporarily eliminate symptoms, not anymore.Conservative therapy will be ineffective if venous plexuses fall regularly: only radical treatment methods will help here.
In addition, by prescribing forms of dosage of the drug, certain factors are taken into consideration.For example, rectal candles are not suitable for patients with a 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 medicines in this pathology, as it is very large.The defining factor are 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 these medications for a while, as they contain hormones and not anti -inflammatory esteroids.
The use of phlebotropic is a prerequisite for drug therapy.
Small Treatment -Invasive
Sclerotherapy
This is a method in which a special solution is introduced into the area of us hemorrhoids - sclerosis.With proper administration, manipulation does not cause pain.Local anesthesia is not used.The duration is not exceeding 10 minutes.Hospitalization is not necessary.After the procedure, you can continue to lead the same way of life.Within two days in the anus, it is possible uncomfortable sensations.This method is used in a pathology in a chronic phase (blood is released, plexuses are not protruding).This method is rarely used, since manipulation is quite complicated and, with the correct administration of the drug, mucosa necrosis is possible.As a rule, the period of calm after handling is about 3-7 years.
Infrared coagulation
The method by which radiation acts in inflamed areas.With it, hemorrhoidal 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 in 1 and 2 stages of pathology, where the size of the places is small.The calm period is 3 to 7 years, 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 nominations.
- Lack of risk of complications.
The lower line is that the latex ring is applied to the area of the site.This is done using a ligader.Due to the pressure of the ring, he begins to die and reject.The manipulation of fasting in driving (3-5 minutes), simple, practically painless.After the connection, you can carry the previous lifestyle.Painful sensations are possible for two days.The binding method is shown in phase 1-3 of the pathology.There are almost no complications.Sometimes there is blood discharge when the ring comes out.Less of the procedure - Only 1 location is removed to 1 session, the following handling is possible only after a few weeks.
ARRISSING OF ARTERIES
The proximal connection method allows you to find the location of all arteries that provide inflamed areas and courses.In this method, local anesthesia is used.Perform the procedure with one years with a knot.As a result of the curative of the arteries, the inflamed areas disappear.The duration of the procedure is about half an hour.The sensations of pain are hardly observed.Pain is possible in two days and an increase in temperature.You can lead the same lifestyle.This method is used at all stages of the pathology.
Pros:
- Lack of clean fabrics.
- Reducing the rehab period.
- Processing 1 time.
- A longer period of calm (5 to 10 years).
Cons:
- The procedure is longer compared to others.
- Pain.
- High cost.
Surgical intervention
The Milligan-Morgan operation
This method of surgical intervention involves excision of external and internal swelling, with its subsequent dressing.Apply to all phases of the disease.Nuances:
- General anesthesia.
- The need for 3-5 daily hospitalization of hospitalization.
- Reduced performance 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 and radical therapy method.The calm period is up to 12 years, repeated relapses are possible only in 15 to 30 % of cases.Painful sensations of cons for 2-4 days.We need a painkiller.The recovery period is long, as well as the occurrence of scars and a decrease in the tone of the anal sphincter.
Long teacher
This method involves tuning the mucous membrane of the rectum.It is performed using a special stapler.Locations lose the possibility of jumping and blood flow decreases.Shown by pathology in all phases.Nuances:
- General anesthesia.
- Hospitalization in the hospital for 2-4 days.
- The recovery period is 3-5 days.
The advantages of the procedure are similar to hemorrhoid, small pain severity;Recovery is fast, there are no complications.Minus the 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 treated.Cryotherapy is also used.But this method is not so widespread, as there is an incontinence of discharge from the anus, the depth of exposure is not controlled.
The patient himself has the right to decide whether to see him or not.Obviously, it is worth paying attention to the frequency of bleeding and pain, since frequent blood release causes anemia.Otherwise, hemorrhoids are not very threatening.But it is worth noting that the sooner you consult a doctor, the better.This will avoid a more radical treatment method and 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.
- Feeling of discomfort and pain - contact a proctologist immediately!In no case do not self -assert!