Hemorrhoids today is a common disease, which is an expansion of the veins of the rectum with the formation, and sometimes loss of such an inclusion as a hemorrhoid. Such a pathology has recently been often diagnosed in proctology, which is associated to a greater extent with a sedentary lifestyle of people. At the same time, a person experiences such unpleasant symptoms as constipation, pain during defecation, burning and itching, bleeding.
Characteristics and description of the problem
Hemorrhoids are seals, consisting of a cluster of small veins and vessels that run in the rectum, which can be both inside and outside. The appearance of these formations, their inflammation and prolapse are usually associated with a violation of the activity of the muscles that hold the accumulation of blood vessels, or a violation of the functionality of the vessels themselves, the loss of their tone. Inside the nodes are venous blood clots.
Pathology develops slowly, which is its danger. Usually people don'tpay attention to the appearance of a slight discomfort, so they do not go to a medical institution, thereby aggravating the course of the disease. If left untreated, the problem can only be solved with the help of surgery.
If there was a prolapse of hemorrhoids, this indicates that the hemorrhoids have moved to the last stages of development. This phenomenon is observed with a long absence of pathology therapy, tissue atrophy in the anus, a decrease in muscle tone, as well as with severe damage to the muscles of the anus.
The number and size of nodes that drop out varies. Sometimes one bump is observed, in other cases their number may be large. The sizes of the formations range from five millimeters to three centimeters. The difficulty in the treatment of this pathology lies in the fact that cracks and ruptures can form on the epithelium of the anus as a result of injury by hard fecal masses, which provoke the development of bleeding.
Varieties of pathology
In medicine, several types of pathology are distinguished depending on where the nodes are located:
- Internal hemorrhoids are diagnosed most often. They form under the epithelium of the rectum and require careful diagnosis.
- External growths are rare, with bumps (nodules) forming under the skin surrounding the anus. During the diagnosis, the doctor often finds one or more seals.
- Combined knotsact as a complication of the disease, in which both types of formations are present.
Causes for the development of pathology
The formation and inflammation of hemorrhoids is due to an increase in intra-abdominal pressure, weakness of the vessels and veins of the rectum. The appearance of such phenomena is provoked by the following factors:
- Lack of therapy at the initial stage of the disease, the development of a chronic form of the disease.
- Lack or absence of physical activity as a result of serious illness, conditions of professional activity or laziness of the person.
- Prolonged use of certain groups of medicines, non-compliance with the dosage of drugs.
- Having bad habits.
- Chronic stool disorders: diarrhea or constipation.
- Obesity.
- Prolonged stress and nervous tension.
- Heavy strength training for a long period of time.
- Wrong diet.
- Hemorrhoids often appear during pregnancy and during labor in women.
- Diseases of the digestive tract, heart and blood vessels.
- Genetic predisposition.
The risk group includes the elderly, people who lead an unhe althy and sedentary lifestyle, as well as pregnant women and people with a hereditary predisposition.
Symptoms and signs of disease
The formation and inflammation of hemorrhoids occurs gradually, so many people do not pay attention to the appearance of a smalldiscomfort. You can recognize the disease by the following signs:
- Feeling fullness and pressure in the anus.
- Feeling of incomplete bowel emptying after a bowel movement.
- Itching and burning in the anus.
- Pain during defecation.
For the first time you can notice the prolapse of hemorrhoids after a bowel movement. A person has a slight pain and bleeding. After some time, the node returns to its original place, that is, it hides inside. If left untreated, the bumps do not disappear on their own, they are often accompanied by swelling and inflammation, increased pain and bruising. Usually this phenomenon is observed during physical exertion. The knots remain outside in the form of pouches of skin around the anus. At the same time, the prolapsed hemorrhoidal node gives a person constant discomfort. In advanced cases, the formations become inflamed and pass to the surrounding tissues.
During the course of the disease, there are calm periods when the seals are located inside the intestine, and periods of exacerbation, which are characterized by the prolapse of bumps.
Degrees of development of the disease
Depending on the severity of the course of the disease, the following stages of its development are distinguished:
- The first stage is characterized by stagnation of blood and slow stretching of the vascular walls. Symptoms at this stage do not appear, the pathology is easily treatable with timely diagnosis.
- The second stage is caused by severe symptoms, the development of bleeding, the hemorrhoid begins to fall out duringbowel movements, and then independently return to their original place.
- The third stage, in which the seals cannot return to the inside of the rectum on their own, in most cases, surgical treatment is required. At this stage of the disease, treatment is necessary, since pinching of the nodes due to spasm of the sphincter is possible. This can provoke a disorder of blood flow in the pelvic region, and thrombosis of the hemorrhoid may also occur, the treatment of which will be long.
- The fourth stage is characterized by severe constant pain, blue nodes, their increase. At this stage, complications of the disease appear, the nodes are infringed, profuse bleeding occurs, thrombosis of the hemorrhoid appears. Treatment of such a pathology requires immediate, in this case, surgical intervention is used. This stage of development of the pathology indicates its neglect, so treatment can be lengthy. The pain syndrome in a person is constantly present and is not stopped by painkillers.
Disease diagnosis
When hemorrhoids formed and inflamed, what to do, the proctologist will tell you after the diagnosis and accurate diagnosis.
First, the doctor examines the history of the disease and conducts an external examination of the patient in the knee-elbow position. Inspection helps to assess the shape of the anus, its deformation, the state of the epithelium, the degree of development of the pathology, the stage of the disease. Then the doctor palpates the rectum in order to identify the state of the sphincter, the presence of pain,polyps or scars, as well as other damage. But this technique is not able to determine the size and localization of the seals, because when pressed, they decrease in size.
Proctologist appoints a study using a probe to view the walls of the rectum, to identify cracks on its surface. If a hemorrhoid has fallen out, the method helps to determine the degree of its prolapse. When using anoscopy, you can examine the rectum up to a depth of twelve centimeters.
Mandatory sigmoidoscopy in the knee-elbow position. The tube of the proctoscope is inserted into the anus to a depth of twenty-five centimeters. If for some reason this technique is not possible, the doctor prescribes a colonoscopy. As additional diagnostic methods, laboratory tests of blood and feces, irrigoscopy, ultrasound of the peritoneal organs are used to identify concomitant diseases of nearby organs. In medical practice, in every third case, hemorrhoids are accompanied by pathologies of the rectum and colon, which are provoked by bleeding. Anal fissures are often observed.
If there is blood discharge or bleeding, the doctor prescribes a more thorough examination of the person, as this phenomenon may be a symptom of colon or rectal cancer. After a comprehensive diagnosis, during which a prolapsed inflamed hemorrhoid was identified, the proctologist develops a treatment strategy.
Drug therapydiseases
At the initial stages of the development of the disease, the dropped node can be set independently. For this, doctors recommend that you first anesthetize the anus with a special cream or gel, then choose a comfortable position and push the lump into the anus with your finger. After that, it is necessary to squeeze the buttocks and lie down for half an hour. This procedure is carried out with rubber gloves.
Therapy of the disease begins with the restoration of the elasticity of the vascular walls. To do this, the doctor prescribes venotonics in the form of tablets, such as Troxevasin or Venarus. These medicines reduce swelling and inflammation, thin the blood and improve its circulation. Due to this, the pathological area is restored in a short time. Such drugs are recommended to be used after the disappearance of the symptoms of the pathology in order to prevent the development of relapses. Rectal suppositories can also be prescribed, for example, Proctosan or Relief. Candles help relieve inflammation and pain, swelling and muscle spasm. Typically, this therapy is used to treat bumps inside the rectum.
To eliminate external nodes and thrombosis, special ointments are used that relieve swelling and reduce the size of seals. In the presence of anal fissures, you can apply antibacterial ointments, for example, Levomekol.
When the body temperature rises, the doctor prescribes anti-inflammatory, analgesic and antipyretic drugs. If constipation occurs, laxatives are used andprobiotics. Often, the proctologist prescribes immunomodulators to increase the body's defenses.
Ligation of hemorrhoids with latex rings
To eliminate internal bumps in proctology, latex ligation is often used. This technique was first described by Hippocrates, and in the twentieth century they began to use a ligator for this. Today, two types of therapy are used in proctology: vacuum and mechanical ligation. Such treatment is effective in the first three stages of the development of the disease.
Ligation of hemorrhoids with latex rings involves the introduction of an anoscope into the rectum to gain access to internal seals. Then, with the help of a ligator, a latex ring is put on the node, which compresses it, preventing blood flow, which leads to tissue necrosis and rejection of the formation. Rejection usually occurs within seven days. Some doctors wear two rings at once.
During the procedure, patients may feel pain and discomfort in the intestine, the urge to defecate. After the ring is installed, the patient is advised not to defecate throughout the day.
Surgery
In severe and advanced cases, as well as in the presence of the fourth stage of the development of pathology, hemorrhoidectomy and the Longo method are used. These techniques involve surgical excision of nodes under general anesthesia. In this case, not only the seal is subject to removal, but also the place of its attachment. The operation takes forty minutes. Sometimes the doctor maypull the node up by resection of the intestinal epithelium. This contributes to the deprivation of blood supply, so the bump is overgrown with connective tissue.
Other treatments
Often, doctors prescribe sclerosis of hemorrhoids. In this case, a special substance is injected into the anus, which helps to stick the bumps together, as a result of which their size decreases and the bleeding stops.
In this case, the medicine is injected with a special syringe into the place where the node is supplied with blood to turn off a large number of blood vessels from the bloodstream. These vessels become thrombosed and inflamed, node sclerosis occurs, it decreases in size, swelling, bleeding and inflammation are eliminated.
Usually sclerosis of hemorrhoids is performed several times with breaks of five days. This is due to the fact that most often patients have several seals at once.
Also often used laser therapy, cryofreezing. These methods allow you to quickly get rid of the problem. After the procedures, it is necessary to follow all the appointments and recommendations of the proctologist so as not to provoke the development of a relapse.
Forecast and prevention
Usually the prognosis of the disease is favorable. It is only necessary to consult a doctor in a timely manner for examination and treatment of pathology.
Today, surgery is one of the most effective ways to treat hemorrhoids, whichaccompanied by loss of nodes. But after the operation, it is necessary to change the way of life, nutrition in order to prevent the development of relapse.
For the purpose of prevention, doctors recommend to lead a mobile lifestyle, eat right, observe defecation hygiene, and also carefully monitor your he alth. At the first symptoms of pathology, it is necessary to consult a doctor, since in the early stages of the disease it can be cured without surgery.
