There is no person of the genre who has never heard the word "hemorrhoids".It is used by all those who are not lazy, even those who have nothing to do with medicine.
The term "hemorrhoids" itself comes from two Greek words -"Heem"("Blood") e"Rhos"("bleeding").
The concept is ambiguous, because not every bleeding is a consequence of hemorrhoids and does not always cause blood.In this case, the concept of "hemorrhoidal knots" is suitable for the wider concept of "hemorrhoids" - swelling, swelling that occur during a garbage.
Description of the problem
Hemorrhoids are special anal formations located under the rectum.In the structure, they are a plexus of venous vessels.They are located inside and outside the mucosa.From the position of these formations, the hemorrhoids of internal and external nature are divided.
These plexus themselves perform a protective function: to protect the rectum from the incontinence of feces and liquid gases and also completely close the anal channel.According to statistics, 20 % of adults suffer from this disease.And it is precisely this disease that is the cause of the campaign for the specialist.
Which contributes to the occurrence and development of the disease
The 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 the integrity of the ligaments, the hemorrhoids are overflowing with blood.The consequence of this is their loss and bleeding.
Vienna, which provides a normal flow of blood from the mucosa, is crushed.Blood begins to stagnate.
Factors that cause the development of hemorrhoids
The pathology itself does not present itself just like that, alone.It has occurred and the development is influenced by several factors:
- The hereditary factor (in the hemorrhoid node and in the veins there are no valves that provide flow of blood).
- Increase in pressure in the veins.
- Wagons in the work of the intestine (constipation, diarrhea), a frequent visit to the bathroom.
- Pregnancy, childbirth, improvement of the disease clinic.
- A sedentary lifestyle, standing location for a long time.
- Some sports and professions.
- Characteristics of nutrition (alcohol, spicy food).But this contributes more to exacerbation, not to development.
Be careful!Even in the presence of bleeding from the anal channel, we cannot speak of the hemorrhoid event.To confirm the diagnosis, analysis and examination of the rectum are necessary:
- Colonoscopy.
- Anoscopy.
- Sectoroscopy.
Bleeding and nodes can occur with inflammation of the intestine and in evil formations.
Hemorrhoids: symptoms and classification
The position of the knots:
- External.
- Internal.
- Mixed.
First sight- the expansion of venous ships located under the line of the rectum.This species is characterized by edematous manifestations, the presence of discomfort in the rectum.With this type of pathology, severe pain is characterized.
The second view- the expansion of the hemorrhoids themselves located under the line.The hemorrhoids are divided into 1, 2, 3 and 4 degrees (the severity of the disease depends on the severity of the knots).There are also acute and chronic hemorrhoids, deriving from a disease.
Chronic hemorrhoids
Clinical image:
- Periodically, the blood is released from the anus.
- The loss of plexus inside the mucosa.
- Itching and burning in the anus.
- Discharge from the rectum.
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.The manifestations can be intense and not much and are of a episodic nature.The color of the exhaust is scarlet, in the form of "spray" (it occurs with a strangle) or - at the end of the emptying (in the form of drops).If, after the previous emptying in the anus, the blood remained, the next to the next will be released with a dark or a cluster.
70-80 % of the clinical manufacture cases of hemorrhoids.With constipation and diarrhea, alcohol intake, spicy foods and heavy physical efforts, bleeding occur.The consequence of this is the occurrence of anemia.
The manifestation of anal bleeding is not always a sign of this disease.It can occur in other intestine diseases.If it occurs in people over the age of 40-45, then you absolutely must consult a doctor.In addition, in case of it in people with a predisposition to oncology, a visit to the doctor is required.
For what diseases can occur bleeding:
- Diverticollase of the colon.
- Crohn's disease.
- The evil neoplasm of the rectum.
- Intestine polyps.
If you notice the discharge from the anus, consult a proctologist and conduct the necessary exams of the direct intestine and collapse.
Welcome to the plexus venosis
This symptom already occurs in the phase of a long cycle of the disease.First of all, it occurs with the devastation of the intestine.In addition, the symptom appears with a stranger.If the pathology is acute, then falling effortlessly.Divide the sets independently into 2 phases.At 3 phases, they are manually regulated due to a decrease in the tone of the anal muscles.They completely fall into 4 phases.
Anal pain
Bleeding is not the only reason why a specialist comes.And this is not necessarily hemorrhoids.Pain syndrome in anus can occur in an acute stage of the disease.Reasons:
- Constipation.
- Frequent visit to the bathroom.
- Anal crack.
- Plrombosis of the knots.
If the treatment is performed incorrectly, the anal crack will enter the chronic phase.
Intestinal unloading
The nature of the exhaust in this disease is watery or mucous membrane.Arise as a consequence of the episodic loss of the nodes.With bleeding, pay attention to mucous secretions.Very often, they are when the knots or the mucosa fall.Other reasons are neoplasms (polyps villi, tumor).
Itching in the anus
These symptoms, such as itching in the anus, as well as anal discomfort, occur with colon dysfunction.Normally, they occur in the advanced phase of the disease.
Classification
1 phase- The venous plexus do not fall.The scarlet color of the blood released.
2 phase- The fallen nodes are regulated by themselves (with or without release of blood).
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 events:
- External knots with a occurrence of thrombosis.
- Protrusion of interior fuck plexus.
If thrombosis occurs, the nodes are compact and increased size.A serious pain syndrome occurs in the anal opening area.
Treatment of acute hemorrhoids
In the stadium of thrombosis, thromboetomy is possible (excision of a thrombus node and removal of a thrombus).The operation is performed under local anesthesia.Duration - A few minutes.After the operation, the pain immediately begins to decrease.
When internal hemorrhoidal nodes fall, swollen phenomena and inflammation occur.The surgery is contraindicated due to possible complications.Therapy:
- The use of ointments and candles.
- Pills.
If you notice events in time, the duration of the acute phase is reduced to a week.If the pathology is not treated for a long time, purulent inflammation can occur.
3 phases of the disease in the acute path
- The appearance of blood clots in the internal and external plexus venous.There is no inflammation.
- The presence of blood clots in the nodes, with the presence of inflammation.
- By the background of the above signs, the inflammation of the subcutaneous tissue develops.Complications occur: bleeding, purulent inflammation.
How to treat hemorrhoids in the chronic phase
Hemorrhoids are a serious, unpleasant, but reference disease.There are enough treatment methods for its elimination.The treatment system is constantly improved.Each method has no doubts, pros and cons.And they are used based on the phase.The following factors influence the use of a particular methodology:
- The course of the disease.
- The nature of the exhaust.
- Age of the patient.
- The frequency of bleeding.
The difficulty lies in the fact that many methods are based on the same indications for the treatment and the choice of the optimal becomes not easy.In this case, you must combine the necessary methods.According to the classification, 3 types of treatment are distinguished:
- Conservative.
- Small invasive.
- Operating.
First degree hemorrhoids
The loss of nodes with the release of blood or not:
- Mandatory normalization of nutrition (with a high percentage of fiber).
- Taking drugs that reduce the inflammation and expansion of venous vessels.
- Rectal candles, ointments for external use for exacerbation.
Grade II hemorrhoids
Auto -Riduction of the nodes concerned:
- Fixation of the hemorrhoidal node with a latex ring.
- Introduction of a sclerling.
- The binding of the arteries that bring blood to inflamed nodes.
- Electrocoagulation.
- Excision of external and internal nodes.
Hemorrhoids of III degree
Manual reduction:
- The use of latex rings.
- Sclerotherapy.
- Cand of arteries.
- Electrocoagulation.
- Excision.
Hemorrhoids of the degree IV
The impossible reduction of nodes: Removal of inflamed nodes with a special device.
The phases of the development of hemorrhoids
Not all methods are suitable for the treatment of hemorrhoids in one case or another.The final solution affects how to correlate external and internal plexus.If the pathology is prevalent nodes - inside, then you can do without surgery.The methods are described above.
Before carrying out 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 the age of 45, with a hereditary predisposition to oncology, since with hemorrhoids there may be concomitant diseases:
- The malignant tumor of the rectum.
- Polyps.
Furthermore, the symptoms (or rather, the degree of its severity), the size of the nodes and the episodality influence the choice of a particular method of treatment.
With a weak severity of the symptoms, a rare loss, it is better to choose conservative therapy.The first and important thing to which it is targeted is the correction of nutrition, the elimination of constipation and pressure during the emptying of the intestine.The diet should contain a sufficient amount of water, since constipation often occurs with a lack of liquid, which is why the intestine is forced to suck it from the stool.
To facilitate this condition, the following is important:
- The main component in the diet is fiber.
- Periodic intake of laxatives.
- The appointment of the phlegmatropi to the patient.
Conservative therapy is mainly used during an acute exacerbation of the disease.Another treatment is contraindicated.If the disease is in the first and 2nd phase, other methods are also contraindicated.What is included in the conservative treatment:
- Special diet.
- Slasping Drugs.
- Rectal candles, ointments.
- Flebotropic drugs.
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.
- Roast.
- Alcohol.
The diary implies further exams.It is the result of exams that influence the correction of the diet and treatment.If the patient is subject to constipation, then a special diet is recommended.The list of products and other shades can be displayed 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 in the intestine, the use of laxatives begins.Now it will not be difficult to find them: go to any pharmacy and ask.Don't take them alone.The dosage and the drug of the drug depend on the following factors:
- Individual characteristics of the body.
- Concomitant diseases.
- Age.
- Decisions of the doctor.
Until the final treatment has been prescribed, the doctor prescribes the patient 1 spoon.the.Vaselino oil (2-3 times a day).
Basis in the treatment of pathology
But it is worth remembering that no ointment and other medicines will save you completely from the problem.They temporarily eliminate symptoms and no longer.Conservative therapy will be ineffective if the venous plexus decreases regularly: only the radical treatment methods will help here.
In addition, when prescribing forms of drug dosage, some factors are taken into consideration.For example, rectum candles are not suitable for patients with pronounced pain syndrome.In this case, exunction is preferable.In some cases, the combinations are acceptable.
It is not necessary to list the entire list of drugs from this pathology, since it is very large.The decisive factor are the individual characteristics of the body and the patient's personal complaints.
What affects the choice of ointments or candles:
- Acute hemorrhoids with thrombosis.
- Inflammation.
At the same time, anesthetic, anti -inflammatory drugs that relieve edema are prescribed.It is necessary to use these drugs for a certain time, as they contain anti -inflammatory hormones and non -steroids.
The use of the phlebotropic is a prerequisite for drug therapy.
Small -invasive treatment
Sclerotherapy
This is a method in which a special solution is introduced in the area of hemorrhoidal nodes - sclerosing.With correct administration, manipulation does not cause pain.Local anesthesia is not used.The duration is no more than 10 minutes.Hospitalization is not necessary.After the procedure, you can continue to conduct the same way of living.Within two days from the anus, uncomfortable sensations are possible.This method is used in a pathology in a chronic phase (the blood is released, the complexes do not protrude).This method is rarely used, since manipulation is quite complicated and with the correct administration of the drug, necrosis of the mucosa is possible.As a rule, the period of calm after manipulation is about 3-7 years.
Infrared coagulation
The method by which radiation acts on inflamed areas.With it, the hemorrhoidal tissue begins to die gradually.After manipulations, you can drive the previous lifestyle.Painful sensations are possible for two days.The AI method is used in 1 and 2 phases of pathology, in which the size of the sites is small.The calm period is 3-7 years, without serious complications.
Fixation with latex rings
This procedure is the most common among all other methods.Its advantages:
- Low cost.
- A wide range of indications.
- Lack of risk of complications.
The bottom line is that the latex ring is applied to the site area.This is done using a ligator.Due to the pressure of the ring, he begins to die and refuse.The manipulation of fasting in the conduction (3-5 minutes), simple, practically painless.After the binding, you can drive 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 are blood discharges when the ring leaves.Less than the procedure: only 1 site is removed for 1 session, the following manipulation is possible only after a couple of weeks.
Landing of the arteries
The proximal binding method allows you to find the location of all arteries that provide inflamed areas and bands.Local anesthesia is used in this method.Perform the procedure with an analoscope with a knot.As a result of the medication of the arteries, the inflamed areas disappear.The duration of the procedure is about half an hour.The sensations of pain are not almost observed.Pains are possible within two days and an increase in temperature.You can drive the same lifestyle.This method is used on all phases of the pathology.
Pros:
- Lack of cleaning fabrics.
- Reduce the rehabilitation period.
- Processing 1 time.
- A longer period of calm (5-10 years).
Against:
- The procedure is longer than others.
- Pain.
- High cost.
Surgery
The operation of the Milligan-Morgan
This method of surgery involves the excision of external and internal swelling, with their subsequent dressing.Apply on all phases of the disease.Nuances:
- General anesthesia.
- The need for 3-5 daily hospital hospitalization.
- Reduced performance within 10-15 days.
- A long recovery period - about 1 month.
- The duration of the 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 recurrences are possible only in 15-30 % of cases.Against painful sensations for 2-4 days.We need analgesics.The recovery period is long, as well as the occurrence of scars and a decrease in the tone of the anal sphincter.
Professor Longo
This method provides for the truncation of the mucous membrane of the rectum.It is carried out using a special pinzer.The sites lose the possibility of protruding and the blood flow decreases.Shown by pathology in all phases.Nuances:
- General anesthesia.
- Hospitalization in hospital for 2-4 days.
- The recovery period is 3-5 days.
The advantages of the procedure are similar to bleeding, small severity of pain;Recovery is fast, there are no complications.Less in high costs (due to the use of a pinzer).
Conclusion
The methods described in the article are not the only ones with whom hemorrhoids are treated.Cyotherapy is also used.But this method is not so widespread, since there is an unloading from the anus, the depth of exposure is not controlled.
The patient himself has the right to decide whether or not to see it.Of course, it is worth paying attention to the frequency of bleeding and pain, since the frequent release of blood causes anemia.Otherwise, hemorrhoids are not very threatening.But it is worth noting that first a doctor is consulted, the better.Therefore, you will avoid a more radical treatment method and you will 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 proccologist immediately!In no case not to immerse!