Hemorrhoids - a disease associated with varicose veins and swelling of the veins of the rectum in the anus. Affected areas protrude outward, can form large nodules (bumps) that prevent the promotion and excretion of feces. The disease affects men and women, it is dangerous to rupture veins, add secondary infection.
Classification of hemorrhoids
Depending on the location of the pathological site, 2 types of disease are distinguished:
- External. The veins of the anus, which are covered with skin, become inflamed. Therefore, it is more difficult to damage the affected areas, they have a stronger "protection". The discomfort during defecation is less, but often creates an unpleasant rubbing of underwear. Complications from external hemorrhoids occur less frequently, easier to treat.
- Interior. The affected veins are located in the rectum above the anus, which makes it difficult to determine the early stage of the disease. The vessels are covered with thin epithelium, which makes them more vulnerable to mechanical damage. The internal form of the disease often becomes chronic, more dangerous with complications, more difficult to treat.
According to the severity of the course, internal hemorrhoids are divided into 3 stages (stages):
- Initially (1). The nodes protrude, bleed, but do not fall out.
- Moderate (2). With muscle tension (during defecation, exercise) swollen veins come out of the anus. When everything relaxes, they return.
- Heavy (3). Knots fall off, even when there is no muscle tension, they do not go away on their own.
Symptoms
The main signs 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 (individual swollen areas of the veins) appear, they look like bumps of dark pink or purple (rarely almost black) color, are easy to palpate and feel thick. The shade depends on the filling of the vessels: if blood clots have formed, the blood has collected and cannot come out, the nodules will be dark.
internal hemorrhoids
In the first days and weeks the disease hardly manifests itself. It starts with swelling that is not felt if you do not start probing the rectum from the inside. There are no pain receptors in this part, so a person does not feel discomfort even during the process of defecation.
In the early stages of hemorrhoids, you can find out about its existence only from drops of blood that appear after the release of large and hard stools. Due to swelling, the walls of the rectum narrow the lumen, the mucosa is more damaged in constipation. Important - in hemorrhoids, almost every bowel movement will lead to the appearance of a small amount of blood.
Other symptoms will follow:
- Pain during bowel movements. Severe swelling will provoke muscle spasm, 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 nodules form. Important: for hemorrhoids it is bright red - not dark.
- omission of nodes. They appear in the last stages of hemorrhoids. First they pull themselves back, then they have to be "pushed" with a finger.
External
The external veins are covered with skin that has many pain receptors. Even in the early stages of hemorrhoids, a person will experience discomfort if the vessels are swollen. The pain occurs during defecation and when wiping the anus and in close contact of underwear with the skin. If the inflammation is severe or a blood clot forms in the vein, a large swelling forms. Easy to touch, 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. Then blood appears if the hemorrhoids are damaged, but there will be less than in the formation of internal cones.
Reasons
The disease is associated with impaired blood flow in the veins of the rectum, which is often caused by congestion in the pelvic organs. They increase the pressure in the veins, which swell and bulge. In most people, this happens due to improper lifestyle and diet, but doctors do not rule out the influence of heredity, genetic vascular abnormalities and increased blood clotting.
Possible causes of hemorrhoids:
- Frequent constipation - lead to tension in the veins of the anus, damage to the mucous membranes during the promotion of hard stools.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, provokes pressure from the growing uterus on the rectum.
- Hormonal fluctuations - provoke atony of the muscles of the pelvic organs.
- Intestinal oncology (more often - colon).
- Delayed operations on the rectum, less often - on the pelvic organs.
- Damage to the spinal cord, curvature of the spine, injuries to the lower back, sacrum, coccyx.
Additional risk factors:
- Sedentary lifestyle - causes blood stasis in the pelvis.
- A low-calorie, low-fiber diet causes constipation.
- Lifting weights causes muscle tension.
Diagnosis
The doctor examines the medical history and asks clarifying questions to rule out other causes of anal bleeding. Hemorrhoids are similar in symptoms to tumors of the digestive tract, polyps, anal fissures, mucosal prolapse.
After the doctor performed a rectal examination, feeling the lower part of the rectum with a finger. In the early stages of internal hemorrhoids, this may not work, and at a later stage the procedure will be postponed if the swelling is very strong and touching the patient causes severe pain. To clarify the diagnosis and a more detailed examination of the anus, examinations are performed by a surgeon or gastroenterologist.
The following methods are used:
- Anoscopy. Inspection of a section of the rectum up to 10 cm long from the anus. The procedure is painless, but some patients receive local anesthesia (gel, spray).
- Sigmoidoscopy, colonoscopy. A tube is placed in the patient's colon to rule out other causes of bleeding (tumors) and suspected lesions in the upper parts.
- NMR. Tomography is performed if it is not possible to make an accurate diagnosis based on other procedures.
Laboratory researches
Blood tests are rarely prescribed, depending on the clinical picture of the disease. This is necessary if a secondary infection has occurred to identify the pathogen. They also analyze in situations where rectal bleeding is heavy to see the level of hemoglobin, the number and activity of red blood cells. The basic diagnosis does not require laboratory procedures.
Treatment
If there are no symptoms of the disease, no special therapy is needed. Your doctor will advise you to change your lifestyle and diet so that hemorrhoids do not develop, so that the stools become softer and do not injure the inflamed or swollen mucosa. The patient will be asked to move more, to do gymnastics aimed at training the muscles of the "lower press" and the pelvis.
How to treat hemorrhoids that cause discomfort is determined by the doctor, taking into account the stage of the disease. In the early stages, it is really possible to deal only with drugs. If there are many nodules, they are thrombosed and do not go away on their own, surgery may be needed. In any situation, after the patient must follow the recommendations for diet and lifestyle, as 50% of cases are recurrent. The exception is surgery: after it recurrent hemorrhoids appear in only 5% of patients.
Diet
The tasks of nutrition are to save a person from constipation, to prevent the development of inflammation. Sources of fiber are introduced into the diet: vegetables, herbs, fresh fruits. Cereals are treated carefully, especially with rice - they can make the stool thick. In addition, they drink more clean warm water: it prevents stools from pouring, also speeds up the process of cleansing the intestines. Simple carbohydrates and sugar should be discarded so as not to provoke inflammation.
Medical therapy
- Laxatives. Preparations that soften stools and relieve constipation prevent new damage to the mucous membranes. Drink carefully so as not to provoke loss of intestinal muscle tone and diarrhea.
- Candles with anesthetic. Relieve the pain of internal hemorrhoids.
- Vasoconstrictor. It is also a topical therapy that reduces swelling.
- Anticoagulants. Stop the bleeding.
- Hormonal preparations. They are used topically (injections) for severe inflammation.
Surgical intervention
At the last stage, hemorrhoids require surgery:
- Ligation. An instrument 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 nodes are removed with a scalpel or a special device, which then "stitches" 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:
- Warm baths. They are made with calendula, chamomile, sage. These herbs relieve inflammation, muscle spasm. They sit in baths for 20 minutes to 2-3 times a day.
- Compresses. With grated raw potatoes, aloe juice, chamomile decoction, sea buckthorn oil. Leave on gauze for 30-60 minutes.
Prevention
To avoid the question of how to cure hemorrhoids, follow simple rules:
- Move more. When you are stuck, get up every 1-2 hours for 5-10 minutes. Take a walk in the fresh air, choose the stairs instead of the elevator, the opportunity to walk a few meters and not drive.
- Watch your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.