Hemorrhoids - a disease associated with varicose veins and swelling of the veins of the rectum in the anus. Affected areas protrude outwards, may form large lumps (bumps) that interfere with fecal transport and evacuation. The disease affects both men and women, is dangerous for vein ruptures, the addition of a secondary infection.
Hemorrhoids Classification
Depending on the location of the pathological site, 2 types of the disease are distinguished:
- Outer. The veins in the anus, which are covered with skin, become inflamed. As a result, it is more difficult to damage the affected areas, they have greater "protection". There is less discomfort during a bowel movement, but there is often an unpleasant friction from the laundry. Complications from external hemorrhoids are less common, they are easier to treat.
- Inner. The affected veins are located in the rectum above the anus, which makes it difficult to determine the early stage of the disease. Vessels are covered with a thin epithelium, so they are more susceptible to mechanical damage. The internal form of the disease often becomes chronic, it is more dangerous with complications, it is more difficult to treat.
Depending on the severity of the course, internal hemorrhoids are divided into 3 grades (stages):
- Initial (1). The nodes stick out, bleed, but do not fall out.
- Moderate (2). When muscles are tense (during bowel movements, during sports), swollen veins emerge from the anus. When everything relaxes, they return.
- Hard (3). The knots fall out, even in the absence of 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 overall picture depends on the stage of the disease. When nodules appear (separate swollen sections of the veins), they look like bumps of dark pink or purple (rarely almost black) color, are easily palpated, and are dense to the touch. The shade depends on the filling of the vessels: if blood clots have formed, the blood has pooled and cannot escape, then the nodes will be dark.
internal hemorrhoids
In the first days and weeks, the disease almost does not manifest itself. It starts with edema, which is not felt unless you start examining the inside of the rectum. There are no pain receptors in this part, so a person does not feel any discomfort even during a bowel movement.
At an early stage of hemorrhoids, you can determine their existence only by drops of blood that appear after the release of large and hard feces. Due to edema, the walls of the rectum narrow the lumen, the mucous membrane is damaged more with constipation. Important – with hemorrhoids, a small amount of blood escapes with almost every bowel movement.
Other symptoms will follow:
- pain during bowel movements. Severe swelling provokes muscle spasms, so even soft droppings cause discomfort.
- burning, itching. Due to inflammation in the rectum, a lot of mucus is produced, which irritates the tissue.
- Blood. It appears in large numbers when knots are formed. Important: Hemorrhoids are bright red - not dark.
- drop knots. Appear in the last stages of hemorrhoids. First they are pulled back themselves, then they need to be "pushed" with a finger.
Outer
External veins are covered with skin, which has many pain receptors. Even at an early stage of hemorrhoids, a person will experience discomfort when the vessels are swollen. Pain occurs during defecation and when wiping the anus, and with close contact of linen with the skin. If the inflammation is severe or a blood clot forms in the vein, a large bump will form. It is easy to touch, touching causes pain.
The skin with external hemorrhoids becomes sensitive, often gathers in folds due to swelling. Cleaning the anus after a bowel movement is difficult, increasing the risk of secondary infections. Blood occurs when the hemorrhoid is damaged, but less of it than when internal cones form.
causes
The disease is associated with impaired blood flow in the veins of the rectum, often caused by congestion in the pelvic organs. This increases pressure in the veins, which cause them to swell and protrude. In most people, this occurs due to the wrong lifestyle and diet, but doctors do not exclude the influence of heredity, genetic vascular anomalies and increased blood clotting.
Possible reasons for the appearance of hemorrhoids:
- Frequent constipation - leads to tightening of the veins of the anus, damage to the mucous membrane when promoting solid feces.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, provokes pressure from the growing uterus on the rectum.
- Hormonal fluctuations - provoke atony of the muscles of the pelvic organs.
- Oncology of the intestine (more often - large intestine).
- Postponed operations on the rectum, less often - on the pelvic organs.
- Spinal cord injury, spinal curvature, lower back injuries, sacrum, coccyx.
Additional risk factors:
- Sedentary lifestyle - causes blood stasis in the pelvis.
- A low-calorie, low-fiber diet causes constipation.
- Lifting weights causes muscle tension.
diagnosis
The doctor examines the medical history and asks clarifying questions to rule out other causes of bleeding from the anus. In their symptoms, hemorrhoids resemble tumors in the digestive tract, polyps, anal fissures, prolapses of the mucous membrane.
After the doctor performs a rectal exam, they palpate the lower part of the rectum with a finger. At an early stage of internal hemorrhoids, this may not give any results, and at a later stage, if the swelling is very severe, and touching the patient causes acute pain, then the procedure is postponed. To clarify the diagnosis and a more detailed examination of the anus, examinations are carried out by a surgeon or a gastroenterologist.
The following methods are used:
- anoscopy. Inspection of a section of the rectum up to 10 cm long from the anus. The procedure is painless, but some patients are given a local anesthetic (gel, spray).
- sigmoidoscopy, colonoscopy. In order to rule out other causes of bleeding (tumors) and suspected lesions in the upper sections, a tube is inserted into the patient's colon.
- MRI. Tomography is done when it is not possible to make an accurate diagnosis using other methods.
laboratory research
Blood tests are rarely prescribed, it depends on the clinical picture. This is necessary if a secondary infection has occurred in order to determine the causative agent. They also conduct an analysis in situations where there is heavy bleeding from the rectum to see the level of hemoglobin, the number and activity of red blood cells. The main diagnosis does not require laboratory procedures.
treatment
If there are no symptoms of the disease, no special therapy is required. The doctor will advise you to change your lifestyle and diet so that hemorrhoids do not develop, the stool becomes softer and the inflamed or swollen mucous membrane is not injured. The patient is offered to move more, do gymnastics to train the muscles of the "lower press" and small pelvis.
Treatment for hemorrhoids that cause discomfort is determined by the doctor depending on the stage of the disease. In the early stages, it really is possible to get by with just medication. If there are many nodes and they are thrombosed and will not go away on their own, surgery may be needed. In any situation after that, the patient must follow the diet and lifestyle recommendations, since 50% of cases relapse. An exception is surgery: after this, repeated hemorrhoids occur in only 5% of patients.
diet
The task of nutrition is to save a person from constipation and prevent the development of inflammation. Sources of fiber are included in the diet: vegetables, herbs, fresh fruit. Grains are handled with care, especially rice - they can thicken the stool. In addition, they drink more pure warm water: it does not allow the feces to sinter and also accelerates the cleansing of the intestines. Simple carbohydrates and sugars should be discarded to avoid causing inflammation.
Medical therapy
- Laxative. Preparations that soften the stool and relieve constipation prevent new damage to the mucous membranes. They are drunk carefully so as not to provoke loss of tone of the intestinal muscles and diarrhea.
- Candles with anesthetic. Relieves pain from internal hemorrhoids.
- vasoconstrictor. This is also a local therapy that reduces swelling.
- anticoagulants. stop bleeding
- hormonal preparations. They are used topically (injections) for severe inflammation.
Surgical intervention
At the last stage, hemorrhoids require surgery:
- Ligature. An instrument is inserted into the anus, throwing a latex ring over the knot and tightening it. The affected area disappears after 3-4 days.
- laser treatment. The procedure with minimal trauma is almost painless, but there are many contraindications to it.
- Classic hemorrhoidectomy. The knots are removed with a scalpel or a special apparatus, which then "sews" the edges of the mucosa. If necessary, the doctor removes blood clots.
alternative medicine
The initial stage of external hemorrhoids involves symptomatic therapy:
- Warm 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.
- compressed. 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. If you are sitting, stand up for 5-10 minutes every 1-2 hours. Go for fresh air, choose the stairs instead of the elevator, the opportunity to walk a few meters and not drive a car.
- Watch your diet. Eat more plant foods, maintain water balance, do not abuse bread and complex carbohydrates - cereals, pasta.