Hemorrhoids: signs of the disease in men and women

Hemorrhoids are varicose hemorrhoidal veins in the rectum. Inflammation of the hemorrhoidal node is characterized by thrombosis, changes in shape and pathological expansion of hemorrhoidal veins that form nodes around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which get worse from time to time. And more than 70% of people at least occasionally experience various symptoms of hemorrhoids, such as discomfort in the anus, itching and pain during bowel movements.

Hemorrhoids in women often occur during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very gentle methods, since a pregnant woman is not recommended to take some medications for hemorrhoids that are routinely prescribed. Hemorrhoids in men are also a fairly common occurrence, caused by a number of other reasons and factors, which will be discussed further.

What are the causes of hemorrhoids?

It is generally accepted that hemorrhoids develop due to increased blood flow or insufficient outflow, which leads to stagnation. The causes and factors for the development of hemorrhoids are:

• Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which needs to be mentioned first. And although hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. Inheritance of certain groups of genes leads to congenital weakness or dysfunction of blood vessels located in the rectum. This is the reason for the increased inflow and insufficient outflow of blood through the cavernous veins, which leads to pathological expansion of the latter. Long-term dilation of the cavernous veins leads to thinning of the walls of blood vessels, which contributes to the appearance of bleeding in hemorrhoids.
• Prolonged standing work and heavy lifting. As well as a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First of all, this applies to people who are forced to remain in a standing position for a long time. This category includes teachers, lecturers, doormen, security guards, hairdressers and others. Lifting weights is another reason for the development of hemorrhoids and prolapse of hemorrhoids.
• Sedentary lifestyle. This is a serious negative factor, mainly affecting office workers, drivers and people leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is increased pressure on the vessels of the rectum in a sitting position. When sitting for a long time, the anus area warms up slightly, which leads to congestion and dilation of blood vessels. In addition, lack of physical activity is a sure path to the development of venous insufficiency. This also applies to the veins located in the rectum.
• Chronic constipation and diarrhea. People suffering from chronic constipation are also predisposed to developing hemorrhoids. Why is this happening? The thing is that with constipation, stool hardens, putting pressure on the veins in the lower intestine. This leads to a deterioration in the blood supply to the cavernous tissues and the appearance of hemorrhoids. An additional factor in constipation is the habit of straining hard during bowel movements, which creates additional pressure on the vessels in the rectum.

As well as constipation, severe diarrhea (diarrhea) also contributes to the development of hemorrhoids, which leads to irritation and inflammation of the rectal mucosa.

• Pregnancy. Hemorrhoids during pregnancy and childbirth are a common occurrence, since bearing a fetus creates pressure on the venous vessels of the rectum. And intense efforts during childbirth only aggravate the course of hemorrhoids and contribute to the formation of new hemorrhoids.
• Poor nutrition, abuse of spicy foods and alcohol. A significant factor in the appearance of hemorrhoids is poor nutrition. In particular, excessive consumption of spicy foods leads to irritation of the intestinal mucosa and also stimulates increased blood flow to the rectum. And insufficient consumption of fiber (plant foods) worsens intestinal motility. Alcohol, which dilates blood vessels, is also a provoking factor in the development of hemorrhoids. Taking alcoholic beverages even in small quantities can provoke an exacerbation of chronic hemorrhoids.

The main factors contributing to the development of hemorrhoids:

1. Obesity.
2. Hereditary predisposition.
3. A sedentary lifestyle (hypodynamia) or work associated with low physical activity.
4. Activities associated with excessive muscle tension (excessive physical activity).
5. Stress.
6. Impaired blood flow in the rectum.
7. Frequent constipation.
8. Inflammatory and tumor processes in the intestines and liver.
9. Getting infected.
10. Smoking.

Constipation

The most common cause of hemorrhoids is constipation. Let's take a closer look at this phenomenon.

Constipation occurs as a result of dysfunction of the large intestine , manifested by rare or difficult bowel movements and accompanied by a feeling of incomplete bowel movement.

Each person has his own individual frequency and stool pattern. It depends on his lifestyle and eating habits. But frequently repeated delay or incomplete bowel movement for more than 48 hours is chronic constipation.

Diseases that may cause constipation

• anal fissure
• Bowel cancer
• Depression
• Diverticulitis (diverticulosis)
• Haemorrhoids
• Hirschsprung's disease is one of the severe congenital diseases of the gastrointestinal tract in children.
• Hypothyroidism
• Irritable bowel syndrome
• Multiple sclerosis
• Parkinson's disease
• Scleroderma

Possible causes of constipation

• Hormonal changes in the menstrual cycle
• Diet low in fiber
• Medicines
• Pelvic floor dysfunction
• Pregnancy
• Spinal injury

Causes of constipation

The causes of constipation are varied.

• Organic constipation is associated with taking medications, various diseases, and pathological changes in the intestine.
• Most often, constipation is caused by taking antacids (for example, Almagel), antidepressants , antihistamines (suprastin), diuretics, antihypertensive drugs, calcium supplements. When they are cancelled, the stool is restored.
• Toxic constipation occurs when poisoned by lead, mercury , etc. Poisoning more often occurs in industrial conditions, and the degree of manifestation depends on the amount of toxic substance that enters the human body. In addition to constipation, lead poisoning is characterized by increased blood pressure, anemia , weakness, malaise, paroxysmal abdominal pain, and the appearance of a “lead border” - a purple-gray strip along the edge of the gums.
• Endocrine constipation occurs primarily with hypothyroidism, diabetes, and menopause. Hypothyroidism occurs when the function of the thyroid gland decreases. It is characterized by weakness, lethargy, hair loss , dry skin, decreased blood pressure, constipation, and weight gain.
• Constipation due to impaired water-electrolyte metabolism occurs in chronic cardiovascular failure. It is manifested by weakness, shortness of breath, the appearance of edema, and heaviness in the right hypochondrium.
• Neurological diseases can cause constipation.
• Injuries, diseases, tumors of the spinal cord , especially the lumbar and sacral regions, from where the pelvic organs are innervated, are manifested by constipation.
• Hirschsprung's disease (aganglionosis of the colon) appears from the first days of a child's life; the leading symptom is persistent long-term constipation, an increase in the size of the abdomen, and loss of appetite .
• Constipation is observed in patients with structural changes in the anus (hemorrhoids, anal fissures). The diseases develop gradually; against the background of constipation, itching appears in the anus, discharge of scarlet blood, pain during bowel movements or prolapse of hemorrhoids, with hemorrhoids.
• Tumor lesions of the colon are accompanied by mechanical compression of the intestine and manifest as constipation. The initial stages of the disease are characterized by persistent constipation, periodic appearance of blood and mucus in the stool, and pain during bowel movements.
• Reflex constipation occurs with diseases of the digestive system (peptic ulcer, exacerbation of chronic cholecystitis).
• Constipation can also result from helminthiasis, a disease caused by parasitic worms. They are asymptomatic for a long time, then general weakness, nausea, abdominal pain associated with eating, bloating, constipation, and anemia are noted. These complaints can be combined with allergic manifestations - itchy skin, asthma attacks, rhinitis, urticaria .

When all intestinal diseases and extraintestinal causes of constipation are excluded, then functional constipation is diagnosed.

Psychological factors predisposing to the development of functional constipation are the most common; they are associated with dysregulation of intestinal motility by the centers of the cerebral cortex. These are depression and anxiety. Suppression of the urge to defecate with limited access to a toilet, changes in the usual rhythm and lifestyle.

Alimentary constipation develops with an irrational and monotonous diet of mechanically gentle food with limited fiber. Products that delay bowel movements include semolina and rice porridge , baked goods, jelly, strong tea , chocolate , coffee .

In patients who are kept in bed for a long time, the elderly develop hypodynamic constipation due to a decrease in physical activity.

In irritable bowel syndrome, intestinal motility is impaired. The syndrome is manifested by a combination of abdominal pain and defecation disorders (diarrhea, constipation, or alternating diarrhea and constipation) without pathological changes in the intestines. The development of the syndrome is preceded by fasting , taking laxatives, frequent cleansing enemas to reduce body weight, and changes in psycho-emotional state (depression).

Acute constipation is a sudden absence of stool for several hours and occurs with intestinal obstruction. Accompanied by cramping intense abdominal pain, nausea, vomiting, gas retention, constipation. The patient's condition quickly and sharply deteriorates and requires urgent medical examination.

Examination for constipation

To determine the cause of constipation, a number of examinations are necessary. Complete blood count to rule out inflammation and anemia.

Blood sugar test to detect diabetes.

Colonoscopy, irrigoscopy, sigmoidoscopy, to exclude pathological processes in the intestines, fibrogastroduodenoscopy - to diagnose peptic ulcers, ultrasound of the abdominal organs - to identify organic diseases of the digestive organs. Blood test for occult blood, coprocytogram - to determine the inflammatory process in the intestines, stool test for eggs . Bacteriological examination of feces - to determine normal microflora and identify pathogenic and opportunistic intestinal microflora.

Indoor and outdoor

Based on the location of hemorrhoids, the disease is divided into two main types: internal hemorrhoids and external.

With external hemorrhoids, the nodes form in the immediate vicinity of the anus, and therefore their sensitive surface often breaks through and bleeding with bright scarlet blood occurs. The pain associated with external hemorrhoids is quite sharp and strong, but in terms of self-diagnosis this type does not present any difficulties.

The internal form of hemorrhoids, although it poses a much more serious threat to health, is often characterized by a complete absence of pain (especially at the initial stage of the disease). This fact is explained by the fact that hemorrhoids are located deep inside, and their surface is the same insensitive rectal mucosa that lines it.

Disease clinic

Different types of hemorrhoids have their own psychosomatics, completeness and intensity of manifestations. Patients at risk should be involved in the prevention of hemorrhoids. Most patients experience severe pain in the anal area. It is pain that is the main sign of the development of pathology. Sometimes the symptom is more reminiscent of the presence of a foreign body, heaviness, tingling or other discomfort.

Many, under the influence of provoking factors, note the appearance of mucous discharge from the anus or the feeling that during bowel movements there was incomplete bowel movement. It is important to pay attention to such manifestations, since treatment with early stages of pathology is more effective.

Often hemorrhoidal inflammation is accompanied by prolapse of the affected nodes, bleeding from anal fissures, and pain during defecation. Patient complaints often include the presence of blood in the stool.

The clinic does not weaken over time. Without proper treatment, the disease progresses quickly. Patients with acute hemorrhoids rarely come to the proctologist. Few people pay attention to such manifestations, so the disease progresses quickly.

Variety of cones

From a clinical point of view, hemorrhagic formations form inside the intestines or directly around the anus itself. Not only the clinic, but also the classification of hemorrhoids depends on this. According to modern data, according to the location of the nodes, the disease is divided into:

• external;
• interior.

This classification of hemorrhoids fully determines the clinical picture, course and principles of treatment of the pathology. In addition, the classification identifies forms and stages of the process, which are determined based on the well-being of patients and objective examination data.

How to recognize the disease? In the clinic, signs of hemorrhoids are not always clearly expressed. Whatever types of hemorrhoids patients have, self-detection is very difficult. The fact is that in the early stages, external nodes do not cause discomfort and do not differ in color from other areas of the skin. Only in more advanced stages do they notice a strong increase and pain.

The internal location of the nodes can only be revealed by a specialist in the clinic during a digital examination of the inner surface of the rectum. Clinical guidelines suggest a full examination of all patients with suspected hemorrhoids. Various methods are used in diagnosis.

After a tactile examination, they proceed to examining the intestine using an anoscope. Due to its mirror surface, it becomes possible to examine the anal canal to a depth of up to 15 cm. Additionally, clinical recommendations imply the appointment of a stool test for the presence of hidden blood. Comprehensive examinations allow not only to identify the disease, but to determine its prevalence and severity.

Degrees

There are usually 3 degrees of internal hemorrhoids:

• 1st degree. Hemorrhoidal veins are located in the anal canal and may not be palpable (even during rectal examination). Complaints of inflammation of the anus and bleeding, “twitching” pain after defecation.
• 2nd degree. The nodes protrude from the anus when straining and disappear on their own. In principle, the same disorders are observed here as with grade 1 hemorrhoids, however, small ruptures of the mucous membrane are more common, and inflammation of the anus is more pronounced.
• 3rd degree. It is characterized by the so-called prolapse of hemorrhoids, which cannot be reduced on their own. The symptoms may be the same as in grade 2, but often additional symptoms of fecal and gas incontinence develop. Upon examination, prolapsed hemorrhoids are distinguished from prolapsed anus by radially extending grooves, cyanotic color and lumpy surface.

During pregnancy

During the period of bearing a child, hemorrhoids are quite often observed, which is explained by an increase in pressure on the pelvic area.

In the initial stages, the disease is accompanied by:

• itching;
• burning;
• discomfort;
• pain;

At the next stage of the disease, an exacerbation of the symptoms of the disease is observed. Women may experience bleeding. They observe red blood stains on toilet paper or underwear.

If the disease is not treated, this leads to prolapse of hemorrhoids. Initially, a woman can adjust them herself. But at subsequent stages, this procedure becomes useless, which is explained by a pronounced weakening of the sphincter muscles.

Symptoms of hemorrhoids

Signs of hemorrhoids characteristic of all stages of the disease:

• discomfort in the anus;
• pain during bowel movements (minor at first, then severe);
• bleeding from the anus;
• formation and growth of hemorrhoids.

Hemorrhoids (see photo) are a chronic pathology that progresses over many years. The rate of development of the disease depends on many factors, including nutrition and lifestyle.

The initial stage of the disease is characterized by a slight enlargement of the veins in the anal area. Usually this sign goes unnoticed. In this case, the patient may be bothered by bloody discharge from the rectum that occurs immediately after defecation. Blood can be easily seen on toilet paper. It is worth remembering that such a symptom is characteristic of malignant intestinal tumors, so if it occurs, you should consult a proctologist. Timely consultation with a doctor and prescription of therapy will make it easy to slow down the development of hemorrhoids.

At the second stage of the disease, the patient may periodically experience discomfort in the anus and itching. Often he has a sensation of a foreign body in the anus. Hemorrhoids begin to fall out during defecation and are still easily set inward.

The third stage of hemorrhoids is characterized by an intensification of existing symptoms. Large venous nodes in the anus complicate the process of bowel movement, cause constipation, and the act of defecation itself is accompanied by pain and bleeding. Heavy bleeding from hemorrhoids is dangerous, and over time it can lead to the development of anemia.

The last stage of the disease is characterized by an increase in the size of hemorrhoids. They cannot be adjusted by hand. The presence of dilated veins in the anus causes severe discomfort; it is painful for the patient to sit and go to the toilet. He is bothered by excessive bleeding during each bowel movement. The fourth stage of hemorrhoid development can be complicated by such unpleasant and dangerous phenomena as vein thrombosis at the end of the rectum.

Anal fissure

Anal fissure (anal fissure) - the disease ranks third after colitis and hemorrhoids. Women are more often affected.

The chair for the sick becomes a tragedy. By avoiding stool, patients refuse to eat.

Causes of anal fissures:

1. constipation and diarrhea;
2. injuries from foreign bodies in feces;
3. chronic diseases of the gastrointestinal tract (gastritis, ulcer , cholecystitis ); 4) nonspecific diseases of the rectum (proctitis);
4. anal itching;
5. haemorrhoids;
6. gynecological and urological infections;
7. childbirth;
8. anal sex .

The fissure is a slit-like tear in the mucous membrane of the anal canal, located on the posterior wall. Its depth may vary.

Clinical picture

Irritation of the nerve endings of the mucous membrane with prolonged existence of cracks causes sharp pain and spasm of the anus. Anal fissure causes pain leading to spasm.

Triad of symptoms:

1. pain during or after bowel movements;
2. sphincter spasm;
3. scanty bleeding during bowel movements.

Pain can radiate (move) to the sacrum and perineum. They can cause dysmenorrhea (menstrual disorders characterized by pain in the lower abdomen, lower back and sacrum in combination with general symptoms). Pain during defecation is typical for an acute fissure, and after it - for a chronic one.

Diagnosis of hemorrhoids

• Examination of the anus area.
• Digital examination of the rectum.
• Rectoscopy.

Treatment of hemorrhoids

Treatment of anal fissures should be aimed at relieving pain and sphincter spasm, normalizing stool and healing the fissures.

A diet (fermented milk, vegetable) is recommended. Exclusion of spicy, salty dishes, alcoholic beverages, boiled beets , prunes , dried apricots, apricots, figs.

Any treatment is prescribed by a doctor, individually for each patient.

Surgical treatment

Chronic scar fissures, persistent spasm of the sphincter and narrowing of the anal canal are subject to surgical treatment. The operation consists of excision of the crack.

Hemorrhoids in pregnant women

Very often, hemorrhoids appear during the last trimester of pregnancy and childbirth. The cause of hemorrhoids is the compression of the intestinal veins by the enlarged uterus, which leads to a deterioration in blood flow from the intestines and from the perineum. Veins increase in diameter and change shape. Periodic constipation in pregnant women can also provoke its appearance.

However, most women experience hemorrhoid symptoms after childbirth, so it is believed that hormonal changes may be the cause. It must be treated immediately after the first symptoms are detected. It is important to combat constipation, for example, by taking medications to loosen stools (Forlax, Laminaride, Methylcellulose), and observe good hygiene (washing the anus after defecation). Medicines for hemorrhoids (Aurobin, Relief, etc.) are used mainly externally in the form of ointments and suppositories. Surgery is performed only in severe cases.

Prevention of hemorrhoids should be carried out from the first days of pregnancy - create a competent diet to prevent constipation, do not wear tight belts, spend more time in the fresh air, walking is useful.

Female version of the pathology

Women are more susceptible and more likely to suffer from hemorrhoids. Often, the etiological factor of the disease is hormonal changes and changes in the body during pregnancy. It is women in an interesting position who make up the bulk of the proctologist’s patients.

The reasons for the appearance of hemorrhoids during this period are commonplace. The main one is serious hormonal changes in the body. Progesterone increases in the blood, which reduces the elasticity of blood vessels. Because of this, symptoms of blood stagnation appear in the lower extremities and pelvic structures. Lack of mobility in pregnant women only worsens the symptoms of the disease. The uterus gradually enlarges, beginning to put pressure on other pelvic organs. This is another factor that provokes symptoms of blood stagnation in the pelvic veins.

Symptoms of hemorrhoids occur in susceptible women who are unable to cope with stress. Frequent encounters with stress for women cause internal worries, a surge in blood pressure and the development of signs of illness. Women are much more susceptible to stress than men. Another factor that provokes symptoms of hemorrhoids is women’s addiction to all kinds of diets. Because of this, digestion suffers greatly and the entire gastric tract is destabilized.

What is the danger?

Progression of the disease without proper treatment will lead to a number of very unpleasant complications.

Complications of hemorrhoids:

1. Anemia (develops with a long course of the disease with heavy bleeding).
2. Inflammatory processes in surrounding tissues, up to the development of paraproctitis (inflammation of the tissue around the rectum). Paraproctitis is considered a very serious complication requiring serious treatment.
3. Anal fissures. The most common cause of severe pain with hemorrhoids. Cracks create favorable conditions for the development and penetration of various infections deep into the soft tissues. This fact can lead to the development of a serious complication such as an abscess (limited purulent inflammation, which is accompanied by general malaise, fever and severe pain). This complication requires mandatory surgical intervention.
4. Itching. A very unpleasant complication that acts not only as a strong negative psychological moment, undermining the psycho-emotional state of the patient. Constant mechanical irritation of the anal area can significantly aggravate the course of the disease. In addition, constant tissue damage increases the risk of developing various tumor processes.
5. Insufficiency of the anal sphincter, incontinence of gases and feces (often in older people).

It follows from this that hemorrhoids need early diagnosis and immediate measures to be taken to solve this problem.

Etiology of the disease

The appearance of acute and chronic hemorrhoids is associated with many factors. Their presence increases the risk of progression of hemorrhoidal pathology. The most common causes of hemorrhoids are sedentary work and a sedentary lifestyle. To make a diagnosis, doctors in clinics study Davosi's medical history.

They must write the results of all studies to the medical clinic. This will allow other specialists to determine the presence or absence of concomitant diseases. Any patient complaint should alert the proctologist. Inactivity plays a major role in the pathogenesis of hemorrhoids.

Persons engaged in sedentary work (programmers, secretaries, operators, drivers, office workers) are most at risk. A person leading a passive life is faced with the task of changing his lifestyle.

The pathogenesis of hemorrhoids is frequent constipation. They increase the risk of developing the disease. Constipation occurs as a result of improper or unbalanced nutrition. It is useful to add fiber to your diet. Errors in nutrition are the main cause of male hemorrhoids.

What causes hemorrhoids to appear? The presence of inflammatory processes. We are talking about inflammatory lesions of the pelvic structures, a tendency to benign neoplasms. A similar situation occurs in pregnant women.

Minor risk factors

Additional reasons for the appearance of bumps:

1. Frequent digestive system disorders. We are talking about indigestion, intestinal problems, diarrhea.
2. Obesity, overweight. It has been proven that every extra kilogram burdens the body, creating additional stress. First of all, problems arise with the hemorrhoidal node.
3. Anal intercourse. People who prefer unconventional sex often experience signs of hemorrhoids. Excessive addiction to anal sex mechanically damages the anus and part of the rectum. In this way, an inflammatory process occurs in hemorrhoidal structures.
4. Hemorrhoids, as is written in many medical publications, can be provoked by psychological factors.

Other provoking factors are:

1. Genetic predisposition. This is especially true if there are cases of the disease in the family.
2. Regular diarrhea. Treatment of hemorrhoids has to be done even when the patient has a tendency to frequent diarrhea. Pimples may appear on the face and the temperature may rise.
3. The presence of frequent, hacking cough in a chronic form. Provoking cough shocks sharply increase the pressure in the abdominal cavity, which increases the likelihood of inflammation of the hemorrhoids.

Diagnostics

As a rule, diagnosis does not involve any particular difficulties; the diagnosis is established as part of a patient interview and an initial outpatient examination. Inspection helps determine:

• degree of prolapse of nodes from the anus,
• assess the possibility of their reverse reduction,
• skin condition,
• as well as the relevance and degree of bleeding.

Symptoms of hemorrhoids are similar to some other diseases. Therefore, diagnosis must be thorough, because there is a risk of prescribing the wrong treatment. Hemorrhoids can be confused with:

• anal fissure, which is also accompanied by minor bleeding and pain during bowel movements;
• rectal cancer (malignant intestinal tumors occur with bleeding);
• rectal prolapse;
• colitis, polyps and condylomas.

If you notice the first signs of illness, do not put off going to the doctor for too long. Early diagnosis will facilitate treatment and help avoid not only complications, but also surgical intervention.

Some statistics

A disease such as hemorrhoids - its symptoms are familiar to many - is the most common of all pathological conditions of the rectum. According to statistics, out of 1000 adult Russians, from 120 to 160 people suffer from this disease. Of course, colitis, polyps, benign and malignant intestinal tumors are also common occurrences. But hemorrhoids are still in the lead.

The disease equally often affects men and women of working age - from 25 to 65 years. Moreover, the living conditions of modern man, especially in large cities, contribute to the emergence of pathology. City residents move little, eat insufficient amounts of cereals, vegetables and fruits, and suffer from constipation.

Note! Cereals, vegetables and fruits are sources of dietary fiber. Constipation, colitis and even cancer are considered to be a consequence of a lack of dietary fiber in the diet.

The listed factors provoke the development of hemorrhoids, especially if there is a hereditary predisposition. So the treatment of the disease is still relevant today.

How to treat hemorrhoids?

Conservative treatment of hemorrhoids:

1. It is imperative to normalize bowel movements. The stool should be regular and soft. To normalize stool with hemorrhoids, foods containing dietary fiber are recommended, including wheat bran, but their amount should be increased gradually over 2-3 weeks. (from 5-10 g to 20 g per day), which eliminates the occurrence of discomfort.
2. For constipation, you can recommend Lactulose up to 30-40 ml per day to achieve daily soft stools and other remedies, follow a diet and recommendations for constipation.

Local medications are used in treatment: rectal suppositories for hemorrhoids and ointments.

• For pain, suppositories containing small doses of narcotic substances (for example, belladonna, etc.) help. You can prescribe Anuzol, Anestezol, Natalsid, Ichthyol, Proctoglivenol, Ultraproct (suppositories, ointment), Proctosedyl suppositories, depending on the symptoms and stage of the disease.
• If there is no bleeding, you can prescribe suppositories or ointment Relief, Gepatrombin-G, Gepazolon, etc. But all drugs are prescribed on a case-by-case basis, so only a proctologist can prescribe the correct treatment after examining the patient.
• For pain, in addition to suppositories, you can use cold lotions, but not more than 30 seconds.
• To increase the effectiveness of local drugs, it is necessary to ingest drugs that improve the tone of venous vessels and prevent thrombus formation: Detralex, Phlebodia, Troxevasin.
• Detralex is taken for at least 2-3 months.

For chronic hemorrhoids: take 1 tablet. 2 times a day, for 7 days. Then you can take 2 tablets. once a day with meals. For acute hemorrhoids: take 2 tablets for 4 days. 3 times a day, then for 3 days 2 tablets. 2 times a day with meals. Then continue taking 1 tablet. 2 times a day.

Phlebodia is taken 1 tablet (600 mg) 2 times a day for 7 days. Then 1 tablet. once for 1-2 months.

Drug treatment methods are exclusively symptomatic - that is, hemorrhoids do not radically cure. However, they allow you to temporarily cope with the unpleasant symptoms of hemorrhoids. If the patient, after drug treatment, follows medical recommendations for the prevention of relapses, surgical treatment can be avoided.

But patients cannot always follow all recommendations.

Therapy for cones

Prevention and treatment of hemorrhoids is always selected individually. In the initial stages of the disease, complex treatment using medications and alternative medicine has proven itself to be excellent. It is often recommended to add {tooltip}sclerotherapy{end-texte}{end-tooltip} as an additional technique. To combat hemorrhoids, you can and should use modern, most effective techniques. It is important to note that with different methods, the effectiveness of therapy may be completely different.

For primary manifestations, treatment options include the use of medications that help small hemorrhoids resolve. This is practiced for any type of illness. The patient is definitely recommended to reconsider and normalize his lifestyle. Sometimes it’s enough to increase your physical activity and go for recreational jogging.

The diet also needs to be radically changed - this is an excellent remedy for relapses of hemorrhoids. The diet includes dairy products and fiber. Dishes high in animal fats, spices, and spicy foods are strictly excluded. The menu should be balanced.

The classification of complex treatment provides for the prescription of suppositories, ointments and tablets. Their action is aimed at increasing the tone of the veins and improving blood microcirculation in the tissues. The use of tablets is quite long. Usually the duration is up to 3 months.

To eliminate itching and burning of the anal area, anti-inflammatory agents are used. In addition, they have wound healing and analgesic properties. Most often they are produced in the form of suppositories, but ointments with a similar effect can also be used.

For successful therapy, all drugs should be used only as prescribed by a doctor and according to the regimens proposed by the doctor. In addition, traditional medicine recipes are often prescribed. But such funds can only be used after consultation with the treating doctor. Sometimes they are used to prevent exacerbations.

Herbal treatment

A person suffering from hemorrhoids is sometimes ready to do anything to recover from the disease. Therefore, many patients prefer to use non-traditional treatment recipes for the disease. Among the most popular plants are:

1. St. John's wort - a decoction is prepared from the herb. To do this, pour boiling water over the crushed leaves and boil for several minutes over low heat. You can treat the disease with it after infusion and straining. The medicine perfectly relieves inflammation, pain, and accelerates the healing of minor damage to the mucosa. In addition, it is an effective preventative.
2. Knotweed - used for the prevention and treatment of illness. Used as a decoction. In addition, it helps in the treatment of complicated forms of hemorrhoids, as it has a laxative and analgesic effect. They are often used to prevent relapses.
3. Potatoes are also popular. A candle is cut out of a fresh vegetable and inserted into the anus overnight. In this way, they perfectly relieve inflammation and bleeding, and relieve other symptoms of the disease.
4. Due to its high efficiency, propolis is increasingly used. Candles are made from it. To do this, melt Vaseline suppositories in a water bath and add propolis extract. Therapy in these ways relieves pain and infection. Often the medicine is prescribed for symptoms of bleeding and itching in the anal area. You can use honey instead of propolis. The clinical value of the remedy is no less.

If signs of pathology occur, it is better to immediately consult a specialist rather than self-medicate. Timely contact with a specialist is the key to quickly getting rid of many types of hemorrhoids.

For reasons, hemorrhoids are a multifactorial pathology. Regardless of the etiology, in the presence of an acute disease, doctors often recommend the use of surgical treatment methods. This will relieve attacks of the disease and prevent relapses. A similar treatment is used to combat chronic hemorrhoids. All types of pathology are subject to treatment.

Under general anesthesia, the patient's nodes are excised and removed, eliminating all unpleasant manifestations of the pathology. In the initial stages of the acute course of the disease, local remedies are also successfully used. We are talking about ointments, creams and preventive measures. But this is all just a fight against the consequences of the disease. Nothing eliminates the factors that provoke the development of hemorrhoids.

If the patient does not reconsider his lifestyle or change his eating habits, there is a high probability of developing a relapse of chronic hemorrhoids. Therefore, it is extremely important and necessary to prevent the occurrence of hemorrhoids. To do this, you need to carefully monitor your daily diet and follow hygiene procedures.

Minimally invasive techniques

Minimally invasive treatment allows you to quickly and without serious injury get rid of such a delicate problem as hemorrhoids. Therapeutic methods in most cases only muffle the symptoms of the disease and delay the moment when it is necessary to use more radical methods. Before prescribing a particular procedure, the doctor examines the patient’s medical history, conducts a comprehensive examination, and evaluates all possible risks.

• Sclerotherapy is a low-traumatic treatment using special sclerosing substances that are injected into the node, glue its walls, making it possible to stop their feeding and die off in the future. The technique is carried out only at stages 1-3. It does not eliminate the risk of relapse of the disease and is effective only for small hemorrhoids.
• Electrocoagulation is carried out under the control of an anoscope. An electrode is applied to the leg of the node and the tissues are coagulated (welded), after which they quickly die. In one procedure it is possible to get rid of 1-2 pathological foci. After gluing, the hemorrhoid stops feeding and growing, and after a while it completely disappears.
• Ligation with latex rings is one of the most modern methods of minimally invasive treatment of stage 1-3 internal hemorrhoids. Through an anoscope, a latex ligature is applied to the leg of the node, which leads to compression of the tissues and disruption of blood circulation in them. After 8-14 days, the hemorrhoid dies and is brought out along with the latex ring.
• Cryotherapy is a short-term treatment of hemorrhoids with liquid nitrogen. After this, the hemorrhoidal node dies and falls off. The procedure is performed under local anesthesia, so there is no pain.

Minimally invasive procedures are contraindicated if:

• exacerbation of the inflammatory process in the rectum and anus;
• anal fissures, injuries;
• thrombosis of hemorrhoids.

Minimally invasive methods of combating hemorrhoids can be used only at stages 1-3 of the disease, always without exacerbation of the inflammatory process. All procedures are carried out after local anesthesia. There is no need to use general anesthesia. Only 1-3 nodes can be removed in one session. Sometimes treatment takes place in several stages, at intervals of several weeks.

Features of male illness

Male types of hemorrhoids have their own specific appearance. The main provoking factor is poor nutrition. The diet of the stronger sex mainly consists of heavy meat, fatty, fried foods. The stronger sex is more susceptible to dietary errors than women.

It often contains a huge amount of sweet, smoked and salty. And in combination with strong or even light alcohol, it becomes fertile ground for the occurrence of inflammatory processes in the pelvic organs. What is the reason? Such a diet disrupts digestion, impairs peristalsis and blood flow in the pelvic veins. All this provokes the occurrence of hemorrhoids.

Another factor in the occurrence of the disease is alcohol abuse, to which males are more prone. During the stage of intoxication, strong changes occur in the body: the veins are filled with blood, but there is no outflow. This causes expansion of the pelvic veins and the formation of nodes.

A specific factor causing the formation of pathology is excessive physical work. Heavy loads and heavy lifting are activities more typical for the stronger sex.

Only a specialist can identify pathology, diagnose it and prescribe adequate therapy. Therefore, at the first signs of an acute illness, you should immediately consult a doctor. A spontaneous favorable outcome will not occur, and delaying therapy will only lead to worsening of hemorrhoids (the appearance of a chronic form of the pathology).

Surgery

Surgical treatment is the most effective treatment method in the third and fourth stages.

The operation to remove hemorrhoids, proposed back in the 30s of the last century, is still used and continues to be modified. There are mainly two types of operations performed in the world:

1. Closed hemorrhoidectomy. Used in stages III and IV of the disease.
2. Open hemorrhoidectomy. Also in stages III and IV, but complicated by anal fissure or paraproctitis.

Also in 1993, a new method of treating hemorrhoids was proposed, this was done by the Italian doctor A. Longo, which consists of circular removal of the mucous-submucosal layer of the rectum using a special apparatus.

Patients are discharged 3-4 days after surgery, restoration of work capacity occurs on 5-7 days. There is also a small percentage of postoperative complications.

Stages of hemorrhoids

Hemorrhoids have 4 stages of development:

Stages of the disease

1. At stage 1, the nodes begin to hurt and swell, forming blood clots in the cavernous bodies.
2. At stage 2 (as the nodes increase in size), inflammation and swelling in the anus develop, although the cavernous formations do not yet fall out, and in the case of a slight protrusion from the anus, they are completely reset back on their own.
3. At stage 2, the nodes fall out with each successive physical stress at moments of increased intra-abdominal pressure, do not reset themselves back even manually, and begin to fall out in almost any situation: lifting heavy objects, coughing, sneezing. Pain and heaviness in the anus become obvious.
4. At stage 4, the nodes fall out spontaneously, cannot be set by hand, and constantly bleed. The development of anemia and thrombosis of the colon veins is likely.

Reference! Each stage of hemorrhoids has characteristic symptoms. If there is pronounced pain and swelling around the circumference of the anus, the discharge of inflammatory exudate with blood particles, then you should consult a doctor for emergency treatment. The consequences (tissue necrosis, perirectal abscess) can be sad.

Nutrition and diet after surgery

In most cases, patients after surgery for hemorrhoids can start drinking and eating within a few hours after surgery.

But follow the dietary table (according to Pevzner 1a), exclude foods and dishes that stimulate the secretion of the stomach and irritate its mucous membrane. Food must be prepared in pureed form, food must be steamed or boiled in water, and must be taken in a liquid and mushy state. Exclude: hot and cold, bread and flour products, raw vegetables, fruits, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.

Eating 6 times a day in small portions. Restoration of normal bowel function usually occurs on the second day after surgery, therefore, you can return to your normal diet. But, of course, you should exclude all hot and spicy foods, and you should also forget about alcohol. By following these recommendations, you can reduce your recovery time after surgery and reduce the risk of complications.

Main types

According to the clinical course, hemorrhoids can be chronic or acute. However, these phases are components of one process. Based on the location of hemorrhoidal cones, three types of this disease are distinguished:

Internal hemorrhoids. In this case, hemorrhoidal formations are located under the mucous membrane of the rectum, above the rectal-anal line. In other words, in those places where the internal venous plexus is located.

External hemorrhoids. With this type of disease, hemorrhoids are located below the rectal-anal line under the skin.

Combined hemorrhoids. In this case, there is a combination of internal and external hemorrhoids.

Stages

There are several stages in the development of this disease. Each of them reflects the degree of complication of hemorrhoids. There are only four successive stages:

1. In the first stage, hemorrhoidal cones protrude, but do not fall out, in the intestinal lumen. During defecation, a small amount of blood is discharged from the anus.
2. In the second stage, during defecation, hemorrhoidal cones fall out and retract on their own.
3. At the third stage, even with a slight load, hemorrhoids prolapse. They no longer recover on their own. You need to adjust them by hand.
4. At the fourth stage, the fallen nodes cannot be set even by hand.

Treatment at home

There are some things you can do on your own to help relieve the symptoms of hemorrhoids at home. However, it is worth remembering that they will not help get rid of the disease:

• Warm baths help a lot. You can take a bath or just sit in a bowl of water. You need to place the anus area in warm water for 10-15 minutes 2-3 times a day.
• Careful hygiene of the anal area. You need to take a bath or shower every day and thoroughly wash the anal area.
• Do not use soap or other products that may cause irritation in the anal area. Avoid using scented wipes that contain alcohol.
• Don't use regular toilet paper. It is better to use wet wipes, but without alcohol.
• Use cold. To relieve swelling in the anal area, you can use cold heating pads, ice packs, or a cloth soaked in cold water.

In addition, the diet for hemorrhoids has two goals: to prevent constipation and irritation in the rectal area. Basic recommendations:

• Drink enough fluids. This will help make the stool softer and make it easier to pass through the intestines.
• Your diet should include more vegetables, fruits, and grains. They contain plant fiber, which helps prevent constipation.
• Alcohol, coffee, and strong tea should be avoided.
• Limit spicy foods and spices.
• It is better to take food in small portions, 4-5 times a day.
• Eat around the same time every day.
• Physical activity also helps normalize bowel function.

Treatment for women

All prescriptions for medical therapy are usually made by a proctologist. In the future, he will supervise the course of treatment and make possible changes to the tactics. The use of Relief Ultra ; if the stage is not started, the box is enough for 1 course.

They are usually administered twice a day, after a bowel movement has occurred. In this case, before inserting the suppository, you need to thoroughly wash the area of ​​the perineum and anus. Treatment within 5 days will stop the development of an unpleasant disease.

Suppositories with sea buckthorn are also good; they are even prescribed for pregnant and lactating women. The composition is completely natural, they are inexpensive, but their therapeutic effect is good. The only thing is that the course of treatment will be longer than that of the previous drug. The first time, suppositories with sea buckthorn oil are placed for 14 days, after which they take a month's break. Further repetition is possible; there are no restrictions on the number of courses.

For externally located hemorrhoids, Heparin ointment has proven itself. It can be applied 2 times a day, it helps relieve swelling, prevents thrombosis and relieves inflammation. The duration of treatment is prescribed by the proctologist; he chooses the period depending on the patient’s symptoms.

We must not forget that additional intake of venotonics is required. You can purchase Phlebodia tablets, which will increase blood circulation, remove congestion and strengthen weakened vascular walls. Take the drug once a day on an empty stomach, provided that hemorrhoids are at an early stage. If the patient's condition is complicated, the dosage can be increased. The course of treatment lasts 60 days.

Gymnastics

Gymnastic exercises are aimed at preventing constipation and strengthening the anal sphincter. For example, by improving blood flow and strengthening the abdominal muscle layer, you can normalize intestinal function, thereby preventing constipation:

• The “scissors” exercise is performed lying on your back with your legs raised, which need to be spread and crossed alternately;
• “Bicycle” is a fairly well-known exercise, which is very reminiscent of riding a bicycle, although lying on your back;
• Or you can lie on the floor (on your back), put your legs together straight, lift one or the other leg, if possible, reaching a right angle in the hip joints. Or bend your knees and spread them apart, while trying to lift your pelvis off the floor as much as possible.

This is how a person is designed that he feels his “fifth point” in any position and is able to control it, therefore gymnastics to strengthen the anus does not require any devices and can be performed anywhere, and others are unlikely to notice it.

So, exercises to strengthen the sphincter:

1. Stand up, cross your legs and perform rhythmic relaxation and tension of the gluteal muscles;
2. Choose the hardest chair, sit down, leaning forward a little (you can easily do it at your desk), try to alternately contract and relax the sphincter for 10 seconds, trying to push the anus into the rectum. You should set aside 20 minutes for the exercise, which you can always find if you wish.

Hemorrhoids forms of the disease

Hemorrhoids are classified according to their shape:

Types of hemorrhoids

1. External (external) in case of damage to the nodes and the development of inflammation slightly below the level of the anal sphincter. The first signs of hemorrhoids are severe pain in the anus, bleeding during bowel movements.
2. Internal with localization of inflamed bumps that are not visually visible from the outside. Hypertrophy of the venous plexus of the rectum develops just above the sphincter. The disease is often detected only at the 3rd stage, when the cones clearly fall out of the rectal canal.
3. Combined, in which signs of external and internal disease appear, the external and saphenous veins of the rectum are severely inflamed.

Which hemorrhoid removal method should you choose?

Treatment tactics will be determined by the stage of the chronic course of the disease. There are 4 stages in total.

1. For the first stage, the following is indicated: conservative treatment with vascular-strengthening drugs, infrared photocoagulation and sclerotherapy.
2. Second stage: infrared photocoagulation, sclerotherapy, ligation with latex rings.
3. Third stage: ligation with latex rings and disarterization of hemorrhoids.
4. Stage four: surgical treatment.

This approach to treatment allows for good results in 98-100% of patients.

Signs of hemorrhoids

With hemorrhoids, a stream of blood begins to ooze from the anus or smearing is observed every time you visit the toilet. Bleeding after a bowel movement is rare, although it is an obvious sign of inflammation of the ileum.

Distinctive features of hemorrhoids from other diseases:

Plasma in the stool

• discharge of bright scarlet blood without mixing with feces;
• prolapse of hemorrhoids and bulging outward when pushing during defecation;
• inflammation and swelling of the nodes with persistent constipation as the disease progresses.

The note! It is not difficult to recognize the first signs of hemorrhoids, but in no case should you self-medicate. Symptoms in the colon area may indicate ulcerative colitis, oncology, the formation of polyps or fissures in the anus. Only a proctologist, based on a visual examination and diagnostic methods, will help establish an accurate diagnosis and advise the correct treatment.

It happens that rectal pain appears periodically, when walking or sitting. The chronic form of the disease often occurs without visible signs in the anus, periodically manifesting itself in the form of minor pulling sensations or tingling like twitching with severe swelling of the nodes.

Nonspecific signs may also be observed:

• urinary and fecal incontinence;
• itching, diaper rash around the circumference of the anus due to the leakage of a mucous mass that causes skin irritation.

Treatment

The choice of treatment method largely depends on the stage of the disease, as well as the nature of the complications associated with it.

Diet for patients is required only in certain cases. If a patient has thrombosis, the doctor may recommend a protein-plant diet, in which you can eat plant foods rich in fiber. In this case, it is necessary to exclude alcohol, spicy and fried foods, and all kinds of spices from the diet.

If the patient has concomitant diseases, for example, nonspecific colitis, diverticular disease, irritable bowel syndrome, then the diet should be aimed at normalizing stool.

If thrombosis is accompanied by severe constipation, the doctor may prescribe microenemas to the patient that can cleanse the intestines. If the patient leads a sedentary lifestyle, the doctor may recommend exercise. The exceptions are cycling and weightlifting.

Patients suffering from hemorrhoids should pay special attention to personal hygiene. During periods of exacerbation, the patient should take cool showers several times a day. After each bowel movement, it is necessary to wash the anus and canal, as well as the perineal area. If water procedures are not available to the patient, then special wet wipes can be used.

Drugs

In conservative therapy, drugs containing bioflavonoids - hesperidin and diosmin - are usually prescribed. The latter are traditional medications for the treatment of hemorrhoids. However, thanks to modern biotechnology, Detralex was created. This is a micronized drug. It is approximately 30% more effective than its predecessors and is more bioavailable.

Bioflavonoids have many benefits. First of all, they are able to increase the tone of the veins and enhance lymphatic drainage, reduce vascular fragility, and also improve microcirculation. All of the above qualities make it necessary to use Detralex in the event of node thrombosis.

This drug is prescribed according to the following scheme:

• First, 4 days - two tablets three times a day.
• The next 7 days, one tablet four times a day.

"Detralex" is able to prevent and reduce the development of bleeding and exacerbations of the disease. This remedy is usually prescribed for prevention. In this case, it must be taken for six months, two tablets per day.

The use of micronized bioflavonoids, the sources of which are red grape seeds, is allowed even during pregnancy. However, such products cannot be used for long - up to a week. Such medications are well tolerated and very rarely cause side effects or allergic reactions.

Currently, a drug such as Phlebodia 600 is used to treat hemorrhoids. This remedy has a prolonged effect. This allows you to use the medication only once a day.

If a patient experiences node thrombosis, accompanied by severe pain, the doctor may prescribe non-steroidal anti-inflammatory drugs, as well as analgesics. It is extremely difficult to assess the effect of such drugs. Therefore, the doctor decides on the prescription of such drugs, based on the characteristics of hemorrhoids.

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Local therapy with conservative treatment

Treatment with topical medications for hemorrhoids is usually prescribed to relieve inflammation, as well as for analgesia. Among the medications in this group, experts usually recommend using Posterizan Forte ointment or suppositories with the same name. Such preparations contain hydrocortisone and a suspension of Escherichia coli culture. The latter component is capable of enhancing immune responses, which are accompanied by the release of cytokines, especially intraleukin-1.

In addition, a suspension of an Escherichia coli culture can cause the formation of immunoglobulin A, which forms a rather delicate film on the intestinal mucosa. This film is an important component that plays the role of a kind of protective barrier.

The second component of this drug is hydrocortisone. This substance helps to quickly eliminate any inflammatory processes and also accelerates tissue regeneration.

Posterizan is prescribed rectally twice a day. If there is severe inflammation, such as in patients with nonspecific colitis, then the frequency of administration of this medication can be increased. In this case, the frequency of stool is taken into account. The maximum course of such therapy is no more than 21 days. If you need to continue treatment with a similar drug, you can use Posterizan, which contains only a suspension of a culture of E. coli.

For acute hemorrhoids, you can use pharmaceutical products that have a complex effect. In this case, the doctor may prescribe Relief Advance suppositories. These suppositories contain 10% benzocaine. This substance has a rapid analgesic effect. In addition, the drug contains shark liver oil, saturated with fat-soluble vitamins, free fatty acids, as well as alkylglycerol and squalene. Such components are considered powerful reparants. This allows the drug to be used even during the postoperative recovery period in those patients who have undergone surgery related to hemorrhoids. The frequency of administration of the medication is from 3 to 5 times during the day. It is worth noting that this drug is quite effective and is well tolerated by patients without causing adverse reactions.

Surgical intervention

In the first few days of thrombosed hemorrhoids, before the onset of the inflammatory process in the tissues of the node, surgical intervention can be performed. It is usually performed using local anesthesia. The operation consists of removing thrombotic masses, as well as hematomas. However, there is an opinion that it is worth eliminating the affected node itself, along with the damaged section of the vein. Such tactics are justified only in the presence of one or several large nodes or in severe pain.

Alas, such surgical interventions are not performed so often, since most patients seek advice from specialists already in the presence of an inflammatory process. And this, as a rule, only increases the pain syndrome. In this case, surgical intervention is carried out only if there are difficulties with hygiene, after a recent thrombosis and persistent anal itching. As statistics show, recently patients have begun to turn to proctologists for aesthetic reasons.

As for internal hemorrhoids, there are many minimally invasive methods for its elimination; they are mainly used for isolated hemorrhoids of the initial or second stage. In some cases, the indications for their use can be significantly expanded. This mainly applies to elderly people when there are concomitant serious illnesses.

Minimally invasive methods include:

• Transanal ligation, which is carried out under Doppler control.
• Ligation with latex rings.
• Photocoagulation.

The last two methods have been used in medical practice for a very long time. All their advantages and disadvantages have long been studied. Therefore, it is worthwhile to dwell in more detail on transanal ligation under the control of doplemetry.

The essence of this method is that during a doplemetric examination, the distal branch of the superior artery is detected, which supplies the internal nodes with blood. For this, an anoscope equipped with a Doppler sensor and an electronic unit are used. This method can only be used in the presence of stage 1–3 hemorrhoids. This procedure can be carried out within 24 hours, but only in a hospital setting. On average, treatment lasts no more than 40 minutes. It does not require general anesthesia or restrictions on physical activity. Also, the patient's temporary incapacity for work is not required. In the postoperative period, there are no difficulties with bowel movements.

Operation Longo

The prerequisite for the creation of this method of therapy was prolapse of the mucous membrane of the anus along with internal formations, which is caused by damage to the ligamentous and muscular apparatus of the plexuses, accompanied by changes in the anatomical relationships between the internal and external nodes, as well as disruption of their blood supply. This intervention involves restoring the anatomical position of the nodes, tightening the mucosa, and normalizing blood flow.

In clinical practice, Longo's operation has been performed since 1993. Such an intervention is carried out with a disposable set of tools. This procedure is indicated if the patient has stage 2–4 hemorrhoids. Longo's operation is most effective for circular prolapse of hemorrhoids. The procedure is performed under local or regional anesthesia.

Advantages of Longo's operation:

• The duration of the operation is from 20 to 40 minutes.
• The duration of hospitalization is no more than a day.
• The pain syndrome is eliminated without the use of narcotic painkillers.
• There is no need for dressings.
• The patient can return to work after five days.