Hemorrhoids - a disease associated with varicose inflammation and swelling of the veins in the rectum. Affected areas protrude, forming large nodules (bumps) that interfere with the promotion and exit of feces. The disease affects both men and women and is dangerous for rupture of veins and secondary infection.
Classification of hemorrhoids
Depending on the location of the pathological site, two types of disease are distinguished:
- External. Skin-covered veins at the anus become inflamed. As a result, the affected areas are more difficult to damage and "protected" more strongly.
- Internal. The affected veins are located in the rectum, above the anus, making it difficult to determine the early stages of the disease. The blood vessels are covered with a thin epithelium, making them more susceptible to mechanical damage. The internal form of the disease often becomes chronic, with complications more dangerous and more difficult to treat.
Depending on the severity of the runoff, the internal hemorrhoid is divided into 3 degrees (stages):
- Initial (1). The nodes protrude, bleed, but do not fall out.
- Moderate (2). With muscle tension (defecation, exercise), the swollen veins exit the anus. When everything relaxes, they will return.
- Difficult (3). The nodes fall out, even if there is no muscle tension.
Symptoms
The main signs of hemorrhoids are bleeding in the anus, pain in the muscles of the rectum. The whole picture depends on the stage of the disease. If lumps appear (separate, swollen sections of the veins), they appear dark pink or purple (rarely almost black) bumps, easy to feel, and dense. The hue depends on the filling of the blood vessels: if blood clots form, the blood is collected and cannot exit, the nodes will be dark.
internal hemorrhoids
In the first days and weeks, the disease hardly appears. It starts with edema, which is not felt if you do not start probing the rectum from the inside. There are no pain receptors in this part, so one does not feel discomfort even during the defecation process.
In the early stages of hemorrhoids, you can know its existence only from the droplets of blood that appear after the large and hard stools are released. Due to edema, the walls of the rectum narrow the lumen, and constipation causes more damage to the mucous membranes. Important - In hemorrhoids, almost every bowel movement causes a small amount of blood to appear.
Other symptoms include:
- Pain during defecation. Strong swelling causes muscle cramps, so even soft stools cause discomfort.
- Burning, itching. Inflammation in the rectum produces a lot of mucus, which irritates the tissues.
- Blood. It appears in large numbers when nodes are formed. Important: for hemorrhoids, bright red - not dark.
- drop nodes. It appears in the last stage of hemorrhoids. They pull themselves back first and then have to be "pushed" with a finger.
External
The external veins are covered with skin, which has a number of pain receptors. Already in the early stages of hemorrhoids, one will experience an uncomfortable feeling when the vessels swell. Pain occurs during defecation, wiping the anus, and close contact of the canvas with the skin. If the inflammation is severe or a blood clot forms in the vein, a large bulge will form. Easy to feel, touch causes pain.
The outer hemorrhagic skin becomes sensitive and often wrinkles due to swelling. The process of cleaning the anus after defecation is cumbersome, increasing the risk of secondary infections. Blood will appear if the hemorrhoid is damaged, but it will be less than if internal suppositories were formed.
Cause
The disease involves a violation of blood flow in the veins of the rectum, often caused by congestion of the pelvic organs. They increase the pressure in the veins, which swell and protrude. For most people, this is due to poor lifestyle and nutrition, but doctors do not rule out the effects of heredity, genetic vascular disorders, and increased blood clotting.
Possible causes of hemorrhoids:
- Frequent constipation - leads to tension in the veins of the anus and damage to the mucous membranes during the promotion of solid stools.
- Diarrhea - acute and chronic.
- Pregnancy - causes swelling, pressure from the growing uterus to the rectum.
- Hormonal fluctuations - provoke atony of the muscles of the pelvic organs.
- Intestinal oncology (more often - colon).
- Delayed operations on the rectum, less often - on the pelvic organs.
- Spinal cord injury, spinal curvature, waist, sacrum, tailbone injuries.
Additional risk factors:
- Sedentary lifestyle - causes blood stagnation in the pool.
- A low-calorie, low-fiber diet causes constipation.
- Weightlifting causes muscle tension.
Diagnostics
The doctor will examine the medical history and ask clarifying questions to rule out other causes of bleeding from the anus. Symptoms of hemorrhoids are similar to gastrointestinal tumors, polyps, rectal ruptures, and mucosal depressions.
After the doctor performs a rectal examination, touch the lower part of the rectum with your finger. In the early stages of internal hemorrhoids, this may not work and later intervention is postponed if the swelling is very severe and the patient’s touch causes acute pain. A surgeon or gastroenterologist will perform tests to clarify the diagnosis and examine the anus in more detail.
The following methods are used:
- Anoscopy. Examination of a section of the rectum not exceeding 10 cm in length 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 (tumors) and suspected lesions in the upper parts.
- MRI. Tomography is performed when an accurate diagnosis cannot be made based on other procedures.
Laboratory research
Blood tests are rarely prescribed, depending on the clinical picture of the disease. This is required if a secondary infection has occurred to determine the pathogen. Analysis is also performed in situations where there is heavy rectal bleeding to look at hemoglobin levels, red blood cell counts, and activity. The main diagnosis does not require laboratory procedures.
Treatment
If the disease has no symptoms, no special therapy is needed. Your doctor will advise you to change your lifestyle and diet so that you do not develop hemorrhoids, your stools become softer and you do not damage your inflamed, swollen mucous membranes. The patient is offered to exercise more, exercise the muscles of the "lower press" and the small pool.
The treatment for hemorrhoids that cause discomfort will be determined by your doctor, taking into account the stage of the disease. In the initial stage, it can really only be treated with medication. If there are many nodules, they are thrombotic and do not recede on their own, surgery may be needed. In any situation, the patient should follow diet and lifestyle recommendations because they relapse in 50% of cases. The exception is surgery: recurrent hemorrhoids occur in only 5% of patients.
Diet
The functions of nutrition to save a person from constipation are to prevent the development of inflammation. Fiber sources are introduced into the diet: vegetables, herbs, fresh fruits. Handle grains with care, especially rice - they can make stools thick. In addition, they drink more clean warm water: it does not allow the sintering of the stool, it also speeds up the process of bowel cleansing. Simple carbohydrates and sugar should be discarded so as not to provoke inflammation.
Medical therapy
- Laxatives. Faecal softening and constipation products prevent further damage to the mucous membranes. They are watered carefully so as not to cause loss of bowel tone and diarrhea.
- Candles with anesthetic. Relieves pain caused by internal hemorrhoids.
- Vasoconstrictor. It is also a topical therapy that reduces swelling.
- Anticoagulants. Stop the bleeding.
- Hormonal preparations. It is used topically (as an injection) for severe inflammation.
Surgical intervention
In the last stage, hemorrhoids require surgery:
- Binding. An instrument is placed in the anus that throws a latex ring on the knot and tightens it. The affected area will disappear after 3-4 days.
- Laser surgery. The procedure with minimal trauma is almost painless, but there are several contraindications.
- Classical hemorrhoidectomy. The nodes are removed with a scalpel or a special device that then "sews" the edges of the mucosa. If necessary, the doctor will remove blood clots during the process.
Alternative medicine
The initial stage of external hemorrhoids includes symptomatic therapy:
- Hot baths. They are made with marigolds, chamomile and sage. These herbs relieve inflammation, muscle cramps. They sit in the bath for 20 minutes, even 2-3 times a day.
- Compresses. Grated raw potatoes, aloe juice, chamomile decoction, sea buckthorn oil. Leave on gauze for 30-60 minutes.
Prevention
To avoid the issue of curing hemorrhoids, follow these simple rules:
- Move more. Get up every 1-2 hours for 5-10 minutes while sitting. Walk in the fresh air, choose the stairs instead of the elevator to walk a few meters and not drive.
- Take care of your diet. Eat more plant foods, keep your water balanced, don’t abuse bread and complex carbs - cereals, pasta.