Hemorrhoids - a disease associated with inflammation of the varicose veins and swelling of the anorectal veins. The affected area protrudes outward and can form large nodules (lumps) that interfere with the advancement and passage of stool. The disease affects both men and women and is dangerous for ruptured veins, in addition to secondary infections.
Classification of hemorrhoids
Depending on the location of the pathological site, two diseases can be distinguished:
- outside. The skin-covered veins in the anus can become inflamed. As a result, the affected areas are more difficult to destroy, they have a stronger "protection". Less discomfort during bowel movements, but often unpleasant linen friction. Complications from external hemorrhoids occur less frequently and are easier to treat.
- Internal. The affected vein is located in the rectum just above the anus, making it difficult to pinpoint the early stages of the disease. Blood vessels are covered by a thin epithelium, so they are more susceptible to mechanical damage. The internal form of the disease often becomes chronic, with more dangerous complications and more difficult to treat.
According to the severity of the disease, internal hemorrhoids are divided into 3 degrees (stages):
- Initial (1). Nodes stick out and bleed, but don't fall off.
- Medium (2). Swollen veins drain from the anus due to muscle tension (during bowel movements, exercise). When everything was relaxed, they came back.
- Heavy (3). The nodes fall off, and they don't retract on their own even without muscle tension.
symptom
The main symptoms of hemorrhoids are bleeding from the anus and tight and painful rectal muscles. The overall situation depends on the stage of the disease. If nodes (separate swollen parts of veins) appear, they look like dark pink or purple (rarely almost black) bumps that are easy to palpate and feel dense. The shading depends on the filling of the vessel: if a clot forms, the blood has pooled and cannot be drained, the node will be darkened.
Internal hemorrhoids
In the first few days and weeks, the disease shows little or nothing. It starts with edema, which you won't feel if you don't start probing the rectum from the inside. There are no pain receptors in this part, so the person does not feel discomfort even during bowel movements.
In the early stages of hemorrhoids, you can only know their presence by the droplets of blood that appear after the large, hard stools are passed. The rectal wall narrows the lumen due to edema, and the mucosa is more damaged during constipation. Important - With hemorrhoids, almost every bowel movement causes a small amount of blood to appear.
Other symptoms will follow:
- Pain during bowel movements. Severe swelling can cause muscle spasms, so even soft stools can cause discomfort.
- burning, itching. As the rectum becomes inflamed, a large amount of mucus forms, irritating the tissue.
- blood. When nodes form, it pops up in large numbers. Important: For hemorrhoids, it's bright red - not black.
- Discard nodes. Appears in the final stages of hemorrhoids. First, they themselves are pulled back, and then they have to "push" with their fingers.
outside
The external veins are covered by skin, which has many pain receptors. Already in the early stages of hemorrhoids, a person can experience discomfort if the blood vessels are swollen. Pain during bowel movements, wiping the anus, and when the sheets are in close contact with the skin. A large lump can form if the inflammation is severe or if a blood clot forms in the vein. It is easy to grope and can be painful to touch.
The skin with external hemorrhoids becomes sensitive and often gathers into folds due to swelling. The process of cleaning the anus after a bowel movement is difficult, so there is an increased risk of secondary infection. If the hemorrhoid is damaged, there will be blood, but less than when the inner cone is formed.
reason
The disorder is associated with impaired rectal venous blood flow, which is often caused by congestion of the pelvic organs. Because of them, the pressure in the veins increases, swells and protrudes. In most people, this is due to improper lifestyle and nutrition, but doctors do not rule out the influence of genetics, inherited vascular abnormalities, and increased blood clotting.
Possible causes of hemorrhoids:
- Frequent constipation - causes tension in the anal veins, damaging the mucous membranes in the process of promoting solid stool.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, causing pressure on the growing uterus on the rectum.
- Hormonal fluctuations - cause muscle tension in the pelvic organs.
- Intestinal oncology (more commonly colon).
- Postponement of surgery on the rectum, less commonly - the pelvic organs.
- Spinal cord injury, spinal curvature, lower back, sacrum, coccyx injury.
Other risk factors:
- A sedentary lifestyle - leads to stagnant blood in the pelvis.
- A low-calorie, fiber-poor diet can lead to constipation.
- Lifting weights can cause muscle tension.
diagnosis
Doctors review the medical history and ask clear questions to rule out other causes of anal bleeding. Symptoms of hemorrhoids are similar to gastrointestinal tumors, polyps, anal fissures, and mucosal prolapse.
After your doctor performs a rectal exam, feel the lower part of your rectum with your fingers. Internal hemorrhoids may not be effective in the early stage, and the swelling will be severe in the later stage, and the patient will cause severe pain when touching, which will delay the operation. For clarification of the diagnosis and a more detailed examination of the anus, the examination is performed by a surgeon or gastroenterologist.
The following methods were applied:
- Anoscopy. Check for a section of the rectum up to 10 cm from the anus. The procedure is painless, but some patients receive local anesthesia (gel, spray).
- Sigmoidoscopy, colonoscopy. A tube is inserted into the patient's colon to rule out other causes of bleeding (tumor) and suspected lesions above.
- nuclear magnetic resonance. Tomography is done if an accurate diagnosis cannot be made with other procedures.
laboratory research
Blood tests are rarely prescribed, depending on the clinical presentation of the disease. This is necessary if secondary infection develops to identify the causative agent. They also performed analyses in the presence of heavy rectal bleeding to look at hemoglobin levels, the number and activity of red blood cells. Primary diagnosis does not require laboratory procedures.
treat
If there are no symptoms of the disease, no special treatment is required. Your doctor will recommend that you make changes to your lifestyle and diet so that hemorrhoids don't develop, your stools become softer, and you don't damage the inflamed or swollen mucous membranes. The patient will be given more exercise, doing gymnastics aimed at working the "press down" and small pelvic muscles.
How to treat hemorrhoids that cause discomfort is up to the doctor, taking into account the stage of the disease. In the early stages, it can really be managed with medication alone. Surgery may be necessary if there are many nodes that can form clots and do not retract on their own. Patients need to follow dietary and lifestyle recommendations in any case, as recurrence occurs in 50% of cases. One exception is surgery: after surgery, only 5% of patients experience recurring hemorrhoids.
diet
The task of nutrition is to free a person from constipation and prevent the development of inflammation. Fiber sources are introduced into the diet: vegetables, herbs, fresh fruits. Grains should be handled with care, especially rice - they can thicken the stool. In addition, they drink more pure warm water: it doesn't sinter the stool and also speeds up the process of cleaning the bowel. Simple carbohydrates and sugars should be discarded so as not to cause inflammation.
medical treatement
- laxative. A preparation to soften stools and relieve constipation, preventing new damage to the mucous membranes. Drink with care to avoid hypotonia and diarrhea.
- Candle with anesthetic. Relieve the pain of internal hemorrhoids.
- Vasoconstrictor. It is also a topical treatment to reduce swelling.
- Anticoagulants. Stop bleeding.
- Hormonal preparations. They are used topically (by injection) for severe inflammation.
operation treatment
In the final stages, hemorrhoids require surgery:
- ligation. Insert the instrument into the anus, loop the latex loop over the knot and tighten. Affected areas disappear after 3-4 days.
- Laser surgery. The minimally invasive procedure is nearly painless, but it has many contraindications.
- Classic hemorrhoidectomy. Nodes are removed with a scalpel or special device, and then the mucosal edges are "sutured". If necessary, the doctor will remove the blood clot during this procedure.
alternative medicine
The initial stage of external hemorrhoids involves symptomatic treatment:
- Warm bath. They are made with calendula, chamomile, sage. These herbs can relieve inflammation and muscle spasms. They sit in the tub for 20 minutes, up to 2-3 times a day.
- compression. Use grated raw potatoes, aloe vera juice, chamomile decoction, sea buckthorn oil. Leave them on the gauze for 30-60 minutes.
prevention
To avoid questions about how to heal hemorrhoids, follow simple rules:
- move more. When sedentary, get up every 1-2 hours for 5-10 minutes. Walk in fresh air, choose stairs instead of elevators, and be able to walk a few meters instead of driving.
- Watch your diet. Eat more plant-based foods, stay hydrated, and don’t overuse bread and complex carbohydrates—cereals, pasta.