Hemorrhoids are varicose veins that are located in the anus. This phenomenon occurs due to the accumulation and stagnation of venous blood in them, forming hemorrhoids. There are two types of hemorrhoids - external and internal. External hemorrhoids are located near the anus. After emptying the bowels or being in a sitting and standing position for a long time, a person experiences discomfort in the anus. External hemorrhoids are detected during an external examination.
Causes of external hemorrhoids
There are a number of factors that lead to stagnation in the pelvis, and the appearance of external nodes. These include:
- Sedentary lifestyle. This is one of the main causes of stagnation of blood in the veins. Most people in the workplace have to sit or stand for long periods of time. Therefore, as a preventive measure, it is necessary to do elementary exercises every day and walk.
- Wrong diet. Fast food and in a hurryoften contributes to constipation or diarrhea, which puts additional pressure on the veins of the anus and leads to the formation of external hemorrhoids.
- Nicotine and alcohol addiction provokes various failures in the human body and negatively affects many internal organs and systems.
- Overweight. There is strong pressure on the small pelvis, all organs work with increased load, negatively affecting blood flow.
- Frequent stressful conditions. During this period, constant damage to the walls of the veins by stress hormones occurs.
- Hereditary predisposition. Congenital weakness of the venous walls of blood vessels contributes to the development of external hemorrhoids (photo below) and varicose veins of the lower extremities.
- Great physical activity. People engaged in heavy physical labor have a strong blood flow to the pelvic organs.
- Pregnancy and childbirth. In women during this period, there is a strong load on the pelvic organs.
- Inflammatory processes also lead to spasms and trauma to the rectal veins.
Symptoms of external hemorrhoids
According to medical observations, people of both sexes aged 20 to 50 years suffer from hemorrhoids. The appearance of external hemorrhoids is accompanied by the following symptoms:
- Pain and discomfort occur during bowel movements and prolonged sitting in a sitting position or during excessive physical exertion. Pain syndrome has differentintensity, from mild discomfort to severe pain with thrombosis.
- Itching and burning. The skin covering the nodes is irritated and damaged due to impaired blood circulation, swelling occurs.
- Bleeding. They are usually of low intensity. Traces of blood appear on toilet paper or underwear. However, if treatment is not started in time, then there is an increase in external hemorrhoids (photo below), which are injured during bowel movements and already cause heavy bleeding. Sometimes blood comes out of anal fissures, causing severe pain.
- Constipation, which further aggravates the disease.
- The appearance of a painful formation in the anus - a rounded seal is formed, bluish in color, causing pain.
- An increase in body temperature occurs when the nodes become inflamed.
Most often, the patient goes to the doctor when there is a prolapse of external hemorrhoids, not attaching importance to the first symptoms of the disease.
Complications of external hemorrhoids
In the absence of complex therapy, complications of external hemorrhoids occur, thrombosis (acute hemorrhoids) and anal fissures appear. At the same time, the pain syndrome increases and the inflammatory process begins, the body temperature rises. In medical practice, there are three stages in the development of acute external hemorrhoids:
- Nodes become bluish in color, become painful, but no inflammatory process is observed.
- Inflammation occurs, it captures not only the nodes, but also the tissues adjacent to them, the anal canal swells, the pain intensifies.
- An urgent removal of the external hemorrhoid is required, as necrotic changes occur. The node turns black and dies, there is a possibility of blood poisoning.
Conservative treatment of acute hemorrhoids
For treatment, symptomatic therapy is used, which does not give a complete cure for the disease. The patient is prescribed ointments containing non-steroidal or hormonal components to relieve swelling and reduce pain, as well as discomfort. In addition, the patient is advised to follow a diet, be sure to perform light exercises and not engage in heavy physical labor. In the treatment of thrombosis of external hemorrhoids, anticoagulants are used - Fraxiparin and Heparin. In the early stages of acute hemorrhoids, thrombolytics are used: Urokinase and Streptokinase. If conservative therapy does not give positive results, then surgical intervention is indicated.
Minimally invasive techniques in the treatment of hemorrhoids
Not every form of hemorrhoids can be cured in a conservative way. Sometimes effective drugs have no effect on the disease, and the only way to alleviate the condition of the patient is to remove the nodes.
To do this, both special surgical operations and minimally invasive manipulations are used. All methods have their own peculiarities, but they have in common:
- Minimumtissue damage.
- The procedure for removing external hemorrhoids takes no more than half an hour and is performed on an outpatient basis.
- All manipulations are done without general anesthesia, sometimes using local anesthesia. Painful sensations of low intensity occur within two days after the procedure.
- After several hours of intervention, the individual returns to his usual life. The period of incapacity for work is minimal.
- After the procedure, there is no scarring and tissue deformation.
- Minimally invasive manipulations have few contraindications, so they are used to alleviate the condition of people who have comorbidities.
- They are often used in the initial stages of the disease.
Types of minimally invasive procedures
The following procedures are used for treatment:
- Cryotherapy. It is carried out using liquid nitrogen. The tissues of the thrombosed external hemorrhoidal node are frozen, which subsequently dies.
- Ligation with latex rings. It is put on the leg of the knot, pressing down on the blood vessels. Deprived of nutrition, the hemorrhoid dies. This procedure applies only to internal nodes.
- Infrared photocoagulation. Focused infrared rays, acting on the leg of the node, contribute to its death. The procedure has a good effect on the initial stages of hemorrhoids and bleeding.
- Sclerotherapy. A sclerosing agent is introduced into the hemorrhoidal bump, its wrinkling occurs and significantsize reduction. The method is used for internal and external arrangement of nodes in the initial stages or later to stop bleeding.
- Laser coagulation. Removal by laser in acute thrombosis of the external hemorrhoid is painless. The patient feels only heat waves. The nodes are removed in 10-15 minutes, and the patient can immediately go home, and the next day, start work. The property of the laser to cauterize wounds does not cause the risk of bleeding.
Complications after minimally invasive techniques
In some cases, minimally invasive methods give complications, although they differ in minimal intervention:
- Pain syndrome. Moderate pain occurs after any manipulation of the hemorrhoids, because there are many nerve endings in the rectal mucosa. Severe pain occurs when the latex rings are incorrectly applied, when he althy tissues are captured, or when using the procedure for several nodes at once. Intense pain appears after infrared photocoagulation.
- Bleeding. Such a consequence is possible when using any technique, except for laser coagulation.
Thrombosis of the external hemorrhoid (photo above). This complication sometimes appears when installing latex rings, when there are no clear boundaries between internal and external hemorrhoids. In addition, when using infrared coagulation, in some cases, the blood vessel supplying the node does not completely die, into itblood begins to flow, stagnation occurs and a blood clot forms
Disadvantages of minimally invasive methods
Despite all the advantages of minimally invasive technologies, they have a number of disadvantages, which are as follows:
- Possibility of relapse. With all manipulations, the consequence is eliminated, and not the cause of the disease.
- Expensive. Some techniques for removing hemorrhoids are expensive.
- You need to contact highly qualified doctors. Requires excellent knowledge of anatomy, jewelry accuracy and the ability to handle instruments.
In advanced cases, when it is pointless to use minimally invasive techniques, they resort to surgical methods of treatment.
Therapy of hemorrhoids with surgical intervention
In complicated hemorrhoids and the appearance of thrombosis, surgical intervention is required, otherwise tissues will die and an abscess will occur. In this case, the patient is urgently hospitalized and undergoes an operation - thrombectomy.
So, how to remove an external hemorrhoid? After ineffective treatment with a conservative method, surgical intervention is used. The patient is given local anesthesia and the formed blood clots are removed from the inflamed node. The process lasts only a few minutes, the patient does not need follow-up medical supervision and can lead a normal life.
The patient experiences relief: excruciating pain disappears, swelling subsides, inflammation decreases. HealingThe incision after the operation occurs after a few days. There are no complications after thrombectomy of the external hemorrhoid. The patient is advised to carefully monitor the hygiene of the anal area and diet.
Surgical operation to remove hemorrhoid nodes
Indications for hemorrhoidectomy are:
- External knots of large size, causing discomfort to the patient and making it difficult to carry out hygiene procedures in the anal area.
- The presence of internal and external hemorrhoids in an aggravated form.
In preparation for the operation, the patient takes tests and undergoes a complete examination. Surgery is performed under general anesthesia or using spinal anesthesia. Excision of the external hemorrhoid is carried out as follows:
- The node is being captured and pulled.
- The leg of the knot is tied up, and it is excised. Most often, an electric knife is used, with the help of which cauterization of blood vessels occurs immediately.
- Wounds are sutured and sometimes left open to heal on their own.
For the patient the most difficult are the first two days. Severe pain is eliminated with local anesthetics, ointments and suppositories with methyluracil are used for healing. The patient is advised to follow a diet. Complications after surgery are rare, wounds heal quickly. This operation allows the individual to get rid of advanced hemorrhoids for many years.
External hemorrhoids. Home treatment
For treatmentexternal hemorrhoids to help medications, you can use folk recipes. Here are some of them:
- Grate raw potatoes, wrap in gauze, cool in the refrigerator and apply to the sore spot. Helps relieve swelling and reduce pain.
- Apply birch tar on a gauze swab and apply to hemorrhoids. The tool is used to relieve inflammation.
- Kidney grass. Brew tea and drink three times a day to relieve itching and inflammation.
- Birch leaves. How to treat external hemorrhoids using them? To do this, take 100 g of dry raw materials, pour boiling water, leave for an hour. Strain and use for a sitz bath. As a result, swelling is removed and pain is reduced.
- Series, calendula, sage, chamomile. Take each herb in equal amounts. In 100 g of raw materials, add at least two liters of boiled water, insist, add raw potato juice and use for a sitz bath. Used to relieve the inflammatory process.
Before using folk recipes, you should consult your doctor about their effectiveness. It should be noted that they serve only as complementary therapy to the main drug treatment.
Prevention
Preventive measures to avoid exacerbation of the disease:
- Dieting. The diet should contain a large amount of vegetable fiber and dairy products. Avoid spicy food.
- Physical activity. Daily walks and simple exercises help improve blood flow, improve metabolism, and strengthen pelvic muscles.
- Drinking the required amount of liquid.
- Stool normalization. Be sure to avoid diarrhea or constipation, as this contributes to the formation of hemorrhoids.
- Restricting the intake of strong alcoholic beverages.
- Timely treat chronic inflammation in the perianal area.
- Constantly monitor body weight.
- Timely treat diseases associated with venous insufficiency, gastrointestinal tract, arterial hypertension.
Special attention should be paid to the prevention of acute hemorrhoids for women planning pregnancy. For natural delivery, hemorrhoids are not a contraindication, but a woman needs to be observed by a proctologist so as not to aggravate her condition. For persistent constipation, use laxatives recommended by your doctor.
