Hemorrhoids - a disease associated with varicose inflammation and swelling of the veins of the rectum in the anus. Affected areas protrude outward, can form large knots (bumps) that interfere with the promotion and outflow of feces. The disease affects both men and women, is dangerous for the rupture of veins, the addition of secondary infection.
Classification of hemorrhoids
Depending on the localization of the pathological site, 2 types of disease are distinguished:
- Outside. The veins in the anus, which are covered with skin, become inflamed. Due to this, it is more difficult to damage the affected areas, they have a stronger "protection". Discomfort during defecation is less, but often an unpleasant friction from linen is created. Complications from external hemorrhoids occur less frequently, it is 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 a thin epithelium, therefore they are more vulnerable to mechanical damage. The internal form of the disease often becomes chronic, it is more dangerous with complications, it is more difficult to treat.
According to the severity of the course, internal hemorrhoids are divided into 3 degrees (stages):
- Initial (1). The knots protrude, bleed, but do not fall.
- Moderate (2). With muscle tension (during defecation, exercise), swollen veins come out of the anus. When everything relaxes, they come back.
- Heavy (3). The nodes fall, even when there is no muscle tension, they do not retract.
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 knots appear (swollen sections separated from the veins), they look like deep pink or purple (rarely almost black) colored bumps, are easily palpable, and feel dense. The shade depends on the filling of the vessels: if blood clots have formed, the blood has accumulated and is not able to get out, the nodes will be dark.
internal hemorrhoids
In the first days and weeks, the disease almost does not manifest itself. It begins with edema, which does not make itself 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.
At an early stage of hemorrhoids, you can find out about its existence only by drops of blood that appear after the release of bulky and hard feces. Due to edema, the walls of the rectum narrow the lumen, the mucous membrane is more damaged during constipation. Important - with hemorrhoids, almost every bowel movement will cause a small amount of blood to appear.
Other symptoms will follow:
- Pain during bowel movements. Severe swelling will cause muscle spasms, so even soft feces will cause discomfort.
- Burning, itching. Due to inflammation of the rectum, a large amount of mucus is formed, which irritates the tissues.
- Blood. It appears in large numbers during the formation of nodes. Important: with hemorrhoids it is bright red - not dark.
- drop nodes. Appear in the later stages of hemorrhoids. First they are pulled on their own, then they need to be "pushed" with a finger.
Outside
The outer veins are lined with skin, which has many pain receptors. Already at an early stage of hemorrhoids, a person will feel discomfort if the vessels are swollen. Pain occurs when defecating, when wiping the anus, and when laundry is in close contact with the skin. If the inflammation is severe or a blood clot forms in the vein, a large bump forms. It is easy to grope, touching causes pain.
Skin with external hemorrhoids becomes tender, often gathers in folds due to swelling. The process of cleaning the anus after defecation is difficult, so the risk of secondary infections increases. Blood then appears if the hemorrhoids are damaged, but there will be less than with the formation of internal cones.
causes
The disease is associated with impaired blood flow through the veins of the rectum, often caused by congestion of the pelvic organs. Because of them, the pressure in the veins increases, which swell and protrude. In most people, this occurs due to improper lifestyle and nutrition, but doctors do not exclude the influence of heredity, genetic vascular abnormalities and increased blood clotting.
Possible reasons why hemorrhoids appear:
- Frequent constipation - leads to tension of the veins of the anus, damage to the mucous membrane when promoting solid feces.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, causes the growing uterus to press on the rectum.
- Hormonal fluctuations - cause sluggishness of the muscles of the pelvic organs.
- Oncology of the intestine (more often - the colon).
- Postponed operations on the rectum, less often - on the pelvic organs.
- Spinal cord injury, curvature of the spine, lower back, sacrum, coccyx injuries.
Additional risk factors:
- Sedentary lifestyle - causes stagnation of blood in the pelvis.
- A low-calorie, low-fiber diet causes constipation.
- Lifting weights causes muscle tension.
Diagnostic
The doctor reviews the medical history and asks clarifying questions to rule out other causes of bleeding from the anus. Hemorrhoids have similar symptoms to tumors of the digestive tract, polyps, anal fissures, mucous prolapse.
After the doctor performs a rectal exam, feel the lower part of the rectum with a finger. At an early stage of internal hemorrhoids it may not bring results, and at a later stage the procedure will be postponed if the swelling is very severe and the patient's touch causes sharp pain. To clarify the diagnosis and a more detailed examination of the anus, examinations are carried out by a surgeon or gastroenterologist.
The following methods are applied:
- Anoscopy. Inspection of a section of the rectum up to 10 cm long from the anus. The procedure is painless, but some patients benefit from local anesthesia (gel, spray).
- Sigmoidoscopy, colonoscopy. A tube is inserted into the patient's colon to rule out other causes of bleeding (tumors) and suspected lesions in the upper parts.
- MRI. Tomography is performed if it is not possible to make an accurate diagnosis on the basis of other procedures.
Laboratory research
Blood tests are rarely prescribed, it depends on the clinical picture of the disease. This is necessary if a secondary infection has appeared in order to determine the pathogen. They also do a scan in situations where bleeding from the rectum is profuse to see the level of hemoglobin, the number and activity of red blood cells. The main diagnosis does not require laboratory procedures.
Processing
If there are no symptoms of the disease, special treatment is not required. The doctor will advise you to change your lifestyle and diet so that the hemorrhoids do not grow, the stool becomes softer and does not injure the inflamed or swollen mucous membrane. The patient will be offered to move more, do gymnastics aimed at working out the muscles of the "lower press" and the small pelvis.
How to treat hemorrhoids, which cause discomfort, is determined by the doctor, taking into account the stage of the disease. In the early stages, it is really possible to manage only with medication. If there are many nodes, they are thrombosed and do not retract on their own, surgery may be required. In all situations, the patient should follow diet and lifestyle recommendations, since 50% of cases relapse. An exception is surgery: after it, repeated hemorrhoids occur in only 5% of patients.
Diet
The tasks of nutrition are to save a person from constipation, to prevent inflammation from developing. Sources of fiber are introduced into the diet: vegetables, herbs, fresh fruit. Cereals are handled with care, especially rice - they can thicken the stool. In addition, they drink purer warm water: it does not allow feces to sinter, it also speeds up the process of cleansing the intestines. Simple carbohydrates and sugar should be discarded so as not to cause inflammation.
medical therapy
- Laxatives. Preparations that soften the stool and relieve constipation, prevent further damage to the mucous membrane. They are drunk with care so as not to cause loss of intestinal muscle tone and diarrhea.
- Candles with anesthetic. Relieve pain from internal hemorrhoids.
- Vasoconstrictor. It is also a local therapy that reduces swelling.
- Anti coagulants. Stop 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 a lot of contraindications.
- Classic hemorrhoidectomy. Knots are removed with a scalpel or a special device, which then "sews" the edges of the mucous membrane. If necessary, the doctor removes blood clots during the process.
Alternative medicine
The initial stage of external hemorrhoids involves symptomatic treatment:
- Hot baths. They are made with calendula, chamomile, sage. These herbs relieve inflammation, muscle spasms. They sit in baths for 20 minutes up to 2-3 times a day.
- Compress. With grated raw potatoes, aloe juice, chamomile decoction, sea buckthorn oil. They are left on gauze for 30-60 minutes.
Prevention
To avoid the question of how to cure hemorrhoids, follow simple rules:
- Move more. When you are sedentary, get up every 1-2 hours for 5-10 minutes. Walk in the fresh air, choose the stairs instead of the elevator, the possibility of walking a few meters on foot and not driving a car.
- Watch your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.