Hemorrhoids are a disease that many put off treating. It is a pathology that develops in the vessels of the rectum. According to the nature of the flow, doctors distinguish external prolapse of nodes and internal hemorrhoids.
Nodular formations are located under the rectal mucosa. In severe, advanced cases, their periodic loss and moderate bleeding are possible.
Untimely appeal to the doctor can provoke the development of dangerous complications. To avoid possible unpleasant consequences, you need to understand exactly what are the signs of internal hemorrhoids and how exactly the disease manifests itself in the initial stages. The most effective treatment will be with an integrated approach.
Causes of disease formation
Internal hemorrhoids (ICD-10) assigned code - I84. The disease is classified as inflammation and significant expansion of internal varicose veins. This is a fairly common disease among adults. It occurs most frequently in women. ATmainly occurs internal hemorrhoids after childbirth. And with repeated pregnancy, the risk of acquiring varicose veins increases even more. The exact causes of the formation of internal hemorrhoids have not yet been fully established, however, there are a number of factors contributing to the formation of this pathology, in particular, such as:
- insufficient physical activity;
- weight gain;
- pregnancy and childbirth, especially multiple;
- malnutrition;
- constipation;
- regular weight lifting;
- leading the wrong lifestyle.
The hereditary factor and the presence of concomitant diseases, in particular, such as intestinal infections or pelvic tumors, are of great importance in the development of the pathological process.
Main symptoms
Symptoms and treatment of internal hemorrhoids can be very different, it all depends on the characteristics of the course of this disease. The first discomfort associated with the act of defecation. They manifest themselves in the form of discomfort and a feeling of fullness in the rectum. In addition, there may be itching and burning in the anus, a feeling of the presence of a foreign body, as well as incomplete emptying of the intestine after going to the toilet.
They may be accompanied by pain in the lower abdomen. When internal hemorrhoids are bleeding, you may notice drops of blood on the toilet paper and spotting in the stool.
In some cases, during the act of defecation, there may be a prolapse of locatedinside nodes. In this case, discomfort will not always be present, and the pain may not be sufficiently pronounced. When the disease passes into a later stage, there is hypertrophy of the nodes and expansion of the veins of the rectum. Such manifestations can provoke a narrowing of its lumen.
Such a pathology disrupts the discharge of feces, which leads to chronic constipation. As a result, painful sensations are observed, which significantly increases irritation of the mucosa due to constant pressure and prolonged contact with feces. In addition, there may be increased bleeding from the anus, and this happens after each bowel movement. This is a very disturbing sign that makes a person turn to a proctologist.
Flow Stages
Depending on the severity of the symptoms and the course of the disease, there are 4 stages. At the first, the formation of dilated venous plexuses in the vessels of the rectum is observed. At this stage, the patient is not bothered by anything or there is slight discomfort.
Internal hemorrhoids of the 2nd degree manifest themselves in the form of noticeable varicose veins, which somewhat complicate the process of defecation. This stage is characterized by an undulating course, in particular, pronounced signs are replaced by a period of remission. However, even if the patient feels better, the patient may experience discomfort during defecation.
At the 3rd stage, there is a transition of hemorrhoids to the chronic stage, when periods of improvement in well-being become lessprolonged, and varicose expansions increase in size. After a while, the symptoms become much brighter and more severe. At this stage, the disease manifests itself in the form of minor spotting during bowel movements. In this case, the node may fall out. Subsequently, the nodes may fall out when sneezing and lifting weights. At this stage, they are already well palpable. After the act of defecation, the fallen knots have to be reset by hand.
At the 4th stage, dangerous complications develop, which is why urgent treatment is required. In this case, the operation is shown.
Internal hemorrhoids can occur in acute and chronic form. During the acute stage, the symptoms are much brighter and increase very quickly. During the course of the inflammatory process in patients, the anus area can be very painful.
Diagnostics
Depending on the symptoms of internal hemorrhoids, the treatment is selected for the patient purely individually, but before that you need to conduct a comprehensive diagnosis. To determine the degree of the course of the disease, palpation of hemorrhoids is required. By carrying out diagnostics, their sizes can be indicated.
For this, the use of such instrumental methods as anoscopy and sigmoidoscopy is shown. Anoscopy is a hardware examination of the rectal mucosa. Sigmoidoscopy - the use of an endoscope to examine the rectum.
Any research method conducted by a proctologist impliespreliminary cleansing enema. If this procedure is not done in a timely manner, then the examination will not give accurate results due to overflow of the rectum with feces.
All diagnostic procedures can be quite painful for the patient, especially if there are complications. When complaining of pain, the doctor performs local anesthesia.
Features of treatment
Effective treatment of internal hemorrhoids can only be provided with an integrated approach. You can permanently get rid of this disease by applying conservative methods, maintaining a he althy lifestyle and surgical intervention.
Together with medications, it is desirable to carry out special therapeutic exercises, as well as adjust lifestyle and diet. Drug therapy involves the use of such means as:
- anti-inflammatory;
- laxatives;
- phlebotonics;
- anticoagulants.
Surgery is indicated if conservative methods did not bring the desired result or serious complications occurred.
Medicated treatment
There is no universal cure for internal hemorrhoids. Conservative therapy is used at the initial stages of development of hemorrhoids or as a complex treatment during surgery. The main problem is that during this period there are no obvious symptoms and the patient may not even be aware of the presencepathology. Treatment at the first stage of hemorrhoids involves the use of such means as:
- phlebotonics – Ginkor Forte, Venoruton, Detralex, Phlebodia 600;
- laxatives - Microlax, Guttalax, Duphalac;
- rectal suppositories - Hepazolon, Prostopin, Ekonika.
At the second stage, the first characteristic signs of the course of the disease already appear. For the treatment of internal hemorrhoids at home, rectal suppositories are mainly used. Often they have a combined effect, namely:
- painkillers;
- anti-inflammatory;
- wound healing;
- venotonic;
- anticoagulant.
To the drugs of complex effects can be attributed such as "Anuzol", "Procto-Glivenol", "Betiol". The rate of progression of the disease is largely influenced by the therapeutic process. In the third stage, hemorrhoids fall out all the time, which leads to their trauma, as well as bleeding. That is why surgical treatment or minimally invasive procedures are indicated. Medications in this case are used to eliminate pain.
When the 4th stage proceeds, the symptoms become much more pronounced. Prolapse of hemorrhoids becomes chronic without the possibility of subsequent reduction. Drug therapy is aimed at alleviating existing symptoms and is used for:
- pain relief;
- eliminationinflammation;
- stop bleeding.
The choice of a drug for internal hemorrhoids depends not only on the clinical manifestations of the disease, but also on many other factors. Many drugs are prohibited during pregnancy and breastfeeding. Candles, which include heparin, are strictly contraindicated in bleeding. With proper and timely therapy, you can get rid of the existing disease, as well as prevent the development of serious complications.
Traditional medicine
Traditional medicine has proven itself well. In particular, candles and ointments for internal hemorrhoids are widely used for treatment, which can be prepared on the basis of natural ingredients.
It is quite possible to make candles at home from beets, potatoes, lard, aloe, quince. Proven folk remedies are gauze swabs soaked in sea buckthorn oil, honey or birch tar. Such remedies quickly eliminate soreness and nourish the affected area with the required vitamins. In addition, they contribute to the healing of the walls of the affected vessels.
Treatment of internal hemorrhoids at home involves the use of microclysters. This method has a number of advantages, since the drug is absorbed very quickly and helps to eliminate the symptoms of the disease. Quite often, decoctions of medicinal herbs are used, in particular, such as chamomile, calendula, wormwood. You can also use beetroot juiceor potatoes, propolis solution. Such drugs have a tonic effect on the veins, and also have an anti-inflammatory effect. Well help to treat hemorrhoids oil enemas. You can use olive or sunflower oil.
You can use medicinal herbs for internal use. A medicinal collection prepared on the basis of calendula, strawberry leaves, linden flowers, plantain, rose petals can be quite effective. For internal use, jam made from dogwood berries is well suited.
Surgery
The easiest way to treat will be surgery. The removal of hemorrhoids is resorted to at the 3rd-4th stage of the development of the disease, as well as in the presence of complications and necrotic areas. There are two main techniques for removing affected areas, in particular hemorrhoidectomy and transanal resection. Both types of surgery are performed under general anesthesia and require careful postoperative care.
Hemorrhoidectomy is performed by widening the anus and then pulling the internal knot outward with a clamp. After that, the knot is excised, and the wound is sutured. In the presence of bleeding, electrocoagulation of the wound is performed using a laser. The operation can provoke the development of complications, which is why a rehabilitation period is required.
Transanal resection is a partial excision of a small area of the rectum, which makes it possible to tighten the hemorrhoids. This type of surgery is considered less traumatic, and patientstolerate it much better. In addition, it is worth noting a much shorter postoperative period and a quick recovery.
It is worth noting that surgical intervention has a number of contraindications, which must be taken into account. The operation is prescribed exclusively by the attending doctor, after a comprehensive examination.
Other treatments
Minimally invasive procedures are used at the initial stage of the course of the disease. They are performed on an outpatient basis and are practically painless, but it is worth noting that the effect of them is short-lived. Among the main techniques, one can distinguish such as:
- sclerotherapy;
- bipolar coagulation;
- laser coagulation;
- suture ligation;
- latex ring ligation.
The method of sclerotherapy is based on the introduction of a special substance into the dilated vein, which provokes the exclusion of the affected vessel from the circulatory system. For this, drugs such as Fibro-Wayne, Thrombovar are used.
Infrared coagulation is used in the presence of bleeding. For its implementation, a special device is used, the electromagnetic radiation of which penetrates deep into the tissues of the node, where it is converted into thermal energy. This helps stop the bleeding.
Suture ligation implies that with the help of an ultrasound sensor the location of the artery from which blood enters the hemorrhoid is determined. This vessel is then tied up.
Lifestyle
Before complex treatmentit is imperative to carry out certain measures that will help to get rid of the existing disease more efficiently and effectively. There are certain recommendations that will help get rid of the existing disease, in particular, such as:
- restoration of the defecation process;
- following a therapeutic diet;
- use of laxatives;
- leading a he althy lifestyle;
- no exercise.
It is important to watch the weight and not allow it to increase. In addition, you need to take walks in the fresh air as often as possible, give up bad habits, and also engage in moderate sports.
Possible Complications
In the chronic course of the disease, complications and exacerbation of internal hemorrhoids can often occur. Some of the manifestations may threaten the life of the patient. The course of the pathology can provoke complications such as:
- anemia;
- pinched nodes and their subsequent necrosis;
- significant blood loss;
- infection;
- thrombosis;
- malignant tumors;
- fistula formation.
If any of these manifestations occur, urgent medical intervention is required, which is most often performed surgically. Despite the high risk of developing severe complications, it is quite possible to completely get rid of hemorrhoids, the most important thing is to conduct complex treatment in a timely manner.
