How long does it take for hemorrhoids to go away in men and how is it treated?

A disease such as hemorrhoids is not at all considered simple, because even in a mild initial form it can quickly progress and cause serious complications. As a rule, treatment of hemorrhoids can be done either independently at home or under the supervision of a doctor. For this purpose, the doctor can prescribe different tablets and topical medications, but the recovery process will be influenced not only by the effectiveness of the drugs, but also by the individual characteristics of the patient’s body.

How many days does it take to treat hemorrhoids?

Treatment of hemorrhoids involves the use of various medical techniques and modern medications of various forms, which the doctor prescribes to the patient in an individual form. The method and duration of treatment, as a rule, depends on the form and type of the disease, its overall complexity, as well as the patient’s health condition and the characteristics of his body. At the initial stage, hemorrhoids are treated quite simply and quickly; the course of treatment takes no more than 7-10 days and can be carried out at home without the supervision of a doctor.

The duration of the course of treatment, as well as the final result, will depend on the type of disease itself. Please note that internal and combined hemorrhoids are considered a more serious form of the disease and require complex treatment from a proctologist.

In the case of acute or chronic forms of hemorrhoids, treatment takes a longer period, from several weeks to several months, and should only be carried out under the supervision of a proctologist. Treatment of hemorrhoids in pregnant women and after the birth of a child is prescribed individually and the duration will depend only on the patient’s body.

External form of hemorrhoids

These nodes are the result of the progression of the disease. They occur when enlarged hemorrhoids prolapse through the rectum. How long does it take for hemorrhoids to appear? This pathology rapidly deepens in the absence of proper treatment. It occurs in several stages.

Treatment of external hemorrhoids requires an integrated approach. Additionally, surgical intervention is prescribed, which requires inpatient observation. On the first day, the patient is given a comprehensive examination. The patient is prescribed medications to relieve an acute attack of hemorrhoids. After inflammation decreases and bleeding stops, surgery to combat hemorrhoids is performed as planned.

If the prolapse is minor, therapy starts with the prescription of rectal ointments and suppositories. The duration of therapy is selected individually. It directly depends on the intensity of the disease and the volume of procedures performed. Often, the attending physician prescribes conservative therapy for a month. During this time, the patient’s well-being significantly improves, pain, burning and discomfort are minimized.

If the external nodes are large or the patient’s condition is rapidly deteriorating, surgery is performed immediately. Doctors prefer treatment with minimally invasive techniques or perform hemorrhoidectomy.

Operative methods of therapy

Minimally invasive techniques include the use of sclerotherapy or direct alloying of the cluster of nodes. This treatment has a number of advantages: it takes little time and is carried out in a hospital under medical supervision. Patients stay in the hospital for up to two weeks, and external hemorrhoids disappear after a few days.

Severe, complicated forms of hemorrhoids are treated with traditional surgery - hemorrhoidectomy. This is an operation of desperation, used in cases where other methods do not work.

Such treatment can be carried out in 1 session of going to the hospital. But in severe cases, a prolonged stay in the outpatient clinic may be required for external hemorrhoids. That is, therapy will last longer and more intensively.

On average, the duration of surgical treatment takes up to two months. It is this intervention that remains the only chance to completely get rid of external hemorrhoids. A passing illness will never bother you again after radical therapy.

What does treatment depend on?

Typically, hemorrhoids appear gradually and in most cases have a chronic form, so it is unlikely that the disease can be cured completely in a few days. Complex treatment of hemorrhoids depends on many factors, which in one way or another can affect the final result of treatment.

The main factors influencing the duration and form of treatment include:

• type of hemorrhoids - external hemorrhoids are the easiest to treat, since in this case the bumps form on the outside of the anus and the inflammation is easy to get rid of, internal hemorrhoids require long-term treatment using tablets and suppositories, the combined form is usually treated only by surgery;
• form of severity of the disease - the longer the treatment of the disease is delayed, the more difficult it is to get rid of the disease; in the early stages it is much easier to eliminate unpleasant symptoms; the aggravated form requires long-term outpatient treatment;
• the patient’s body – state of health, existing diseases, hypersensitivity and allergies can affect the duration and method of treatment of hemorrhoids, as well as delay the recovery process;
• age group of the patient - the older the person, the more difficult the form of hemorrhoids and its treatment may be; at the age of 40-50, the disease can be accompanied by more serious symptoms and an aggravated condition; there are often cases when in old age hemorrhoids give complications and stimulate other diseases.

In addition, the duration of recovery is influenced by compliance with the doctor’s treatment instructions and the chosen treatment method itself.

Signs of the disease

Hemorrhoids occur in the same way in men and women. At its core, this is a pathological enlargement of the veins of the rectum and the appearance of a node.

Symptoms of external and internal acute hemorrhoids may be as follows:

• pain at the site of the node;
• discomfort in the anus;
• itching;
• the appearance of bleeding after defecation;
• inflammation and prolapse of the node;

Prolapse of the intestine from the anus, bleeding, formation of nodes, accompanied by inflammation - these are all symptoms of one of the unpleasant diseases of the rectum. Damage to the venous plexus of the intestine by varicose veins is called hemorrhoids. This disease is universal. It affects men, women and children equally.

Emergency assistance from a surgeon in the presence of this disease is needed only in emergency cases: the veins have become greatly enlarged and bleeding has begun. If you ignore these symptoms, you may end up with anemia or pinching. Slightly enlarged nodes are common in people and are considered within normal limits. There is no need to delay treatment. Hemorrhoids are easier to cure in an unadvanced form.

Types of hemorrhoid treatment and duration

The strategy and method of treatment, as a rule, is chosen only by the attending proctologist, based on the indications and examination of the patient. Today, there are several common methods of treating hemorrhoids. Treatment methods can be divided into three categories: medicinal, surgical, and folk.

The most common and effective is medication treatment, which includes the following:

• rectal suppositories;
• pills;
• ointments, gels, creams.

Traditional methods of treatment are often used only at the initial mild stage of the disease and give a temporary effect, while medications require longer use, but can cure the cause of the disease. Surgical intervention is used exclusively in particularly severe chronic cases.

Duration of treatment

It is possible to cure an acute form of the disease. It is impossible to say how long a patient’s hemorrhoids are treated. There are many reasons why the problem does not go away; a person continues to get sick despite proper treatment.

Conservative therapy

When prescribing drug therapy, the average course duration is 10-14 days. In severe, advanced cases, the course lasts up to 30 days. The duration of exposure to medications ranges from 3 days to several weeks.

After completing the course of therapy, the patient’s pain, signs of inflammation, itching, and burning disappear. How long it takes for hemorrhoids to go away after treatment depends on the stage of development of the disease.

Minimally invasive treatment methods

Conservative methods distinguish a group of minimally invasive intervention methods - non-surgical treatment.

1. Sclerosing therapy - a special substance is injected into the cavity of the node using a thin needle, causing the walls of the enlarged node to stick together.
2. Infrared coagulation of the node.
3. Ligation of the node using special latex rings.
4. Laser coagulation.

Laser removal of hemorrhoids
The procedure takes a short period of time and requires time for rehabilitation. The exact duration of inpatient treatment is determined by the proctologist individually. The average length of hospitalization is 10 days. After a couple of days, the patient gets rid of the unpleasant symptoms inherent in hemorrhoids. While therapy and rehabilitation are ongoing, the patient is required to adhere to a gentle diet and avoid physical activity.

Drug treatment - types and duration

Medications at the initial and progressive stages help to quickly relieve symptoms and suppress pain. The effect and speed in this case will depend on the form of the disease and the medicine. Suppositories and ointments give a quick effect, which manifests itself after 2-3 days of use. During this period, suppositories help improve metabolic processes in the colon and kill bacteria, but the full therapeutic effect will appear only after 6-7 days of use.

Many patients want to know exactly how many days it takes for a hemorrhoid to go away, but neither doctors nor pharmacists can tell you the exact duration of treatment, because it is completely individual for each person.

Tablets and capsules for hemorrhoids are usually prescribed for the internal type of the disease; they fight infection and eliminate inflammation. The first improvements are noticeable after 2-4 days of use. The complete process of healing and restoration of damaged colon tissue in initial and moderate forms of severity takes up to 10 days.

Surgery

Hemorrhoids can be removed almost immediately. These methods are used if hemorrhoids do not go away with the use of medications.

At stages 2 and 3, minimally invasive techniques are used to treat the disease:

1. Sclerosing , sclerosants are injected into the seal with a very thin needle, which glue the cavities of the node.
2. Latex ring ligation , which is performed only for internal hemorrhoids, uses a special device similar to a gun to place a rubber ring on the knot, preventing blood flow. This leads to necrosis of the node.
3. Laser coagulation accurately and accurately cuts off the node; the procedure is simple and painless.
4. Cryotherapy . The nodes are frozen with cryogen, and they fall off on their own. All these operations are performed in the hospital and take less than half an hour.

A large number of patients come to the clinic for such procedures and leave on the same day after being examined by a proctologist. Recovery occurs on the 10th day after surgery.

With such modern technologies, recovery occurs within a matter of days. They will help cure even the most advanced cases. The doctor must explain this to the patient, which will enable him to understand the importance of the technique.

The doctor also prescribes additional medications to promote faster healing and scarring of wounds.

If the duration of exacerbation of hemorrhoids is very long and has already reached stage 4, in which large nodes fall out of the rectum, then surgery is necessary. This is a difficult intervention method that will require a long recovery period of 4-8 weeks.

In this case, bed and outpatient rest will be required. After recovery, you will need to lead a healthy lifestyle, otherwise a relapse is guaranteed. Men and women have a much greater tendency to relapse than children, so this applies primarily to adults.

The proctologist will tell you what to do.

It is necessary to have a healthy diet, timely bowel movements, prevent constipation, spend more time leading an active lifestyle, instead of using toilet paper after bowel movements, wash the anus, regularly see a proctologist, and be attentive to all changes.

This is the only way to avoid repeat surgery.

Complications during treatment

Treatment of hemorrhoids, even at the initial stage, does not always go quickly and smoothly. Sometimes treatment can be accompanied by a set of complications that aggravate the condition and delay recovery.

Common complications in the treatment of hemorrhoids include:

• excessive blood loss - severe bleeding develops with inappropriate treatment and when the mucous membrane is in poor condition, in which case no treatment can be started until the bleeding can be stopped;
• proctitis and paraproctitis - a severe form of an infectious disease with purulent discharge, develops when the disease is severely neglected, complicates treatment and provokes serious pathologies;
• pinching of nodes is a serious problem with hemorrhoids; it requires only professional help, since it is difficult and dangerous to pinch the nodes on your own.

In addition, treatment of hemorrhoids can be complicated if the disease is very advanced. Therefore, it is best to resort to its treatment immediately after the first symptoms appear.

Complications of hemorrhoids

• strangulation of hemorrhoids. This cannot be done without the help of doctors. It is very difficult to straighten nodes and relieve pain on your own;
• bleeding. Sometimes the disease lasts quite a long time, and the patient continues to endure, embarrassed to visit a doctor. The walls of the mucous membrane can tear and cause heavy bleeding. In this case, urgent intervention by specialists is also necessary, stopping bleeding, and measures aimed at preventing the development of infection;
• paraproctitis. A severe purulent complication that occurs in advanced cases of hemorrhoids. A favorable (abscess formation) and unfavorable (sepsis - blood poisoning) course can be observed. With sepsis, even medical intervention may not bring relief.

Duration of treatment after childbirth and surgery

After surgical intervention and surgical removal of hemorrhoidal cones, the human body is considerably weakened and requires auxiliary measures for recovery. Typically, nodes are removed in the acute chronic form of the last stage of the disease, while the recovery period depends on the individual characteristics of the patient. Typically recovery takes 3 to 4 weeks.

Surgery to remove hemorrhoids solves the problem with the symptoms, but not the cause of the disease, and may recur a couple of years after it was performed.

In the case of hemorrhoids during pregnancy, treatment takes different periods of time. If the disease appeared and was treated during pregnancy, after the birth of the child it usually goes away within 2-3 weeks after birth. However, hemorrhoids that worsen during pregnancy can make themselves felt upon reaching 30-40 years of age.

Hemorrhoids in women giving birth

The attending physician often detects hemorrhoidal neoplasms in women after childbirth. This is the most common complication of the early postoperative period. The pathology is based on blood stagnation in the pelvic organs. This happens due to the stress of carrying a baby and the intense stress of childbirth.

It is easy to cure this disease, since the acute form goes away on its own against the background of general recovery of the body after childbirth. To do this, just follow a few rules:

• add fiber to food (this will prevent stagnation of feces and constipation);
• increase your drinking ration;
• maintain an active lifestyle;
• add daily moderate exercise;
• walk in the fresh air more often;
• during an exacerbation, you need to avoid eating irritating foods (sour, spicy, salty);
• take some time to do exercises to strengthen the walls of the anus (for example, using the Kegel technique);
• do not endure the first urge to defecate (the delay period threatens hardening of the stool and the appearance of constipation).

At the first signs of discomfort after childbirth, you should consult a specialist. In the early stages, women in labor are prescribed conservative therapy with medications. Warm baths, applying ice to irritated areas, and using wet wipes instead of toilet paper are recommended. Rectal suppositories are sometimes used. In case of severe pain, anti-inflammatory drugs (Ibuprofen) are added to standard therapy. It has been proven that if you are treated, following all the doctor’s requirements, the symptoms of hemorrhoids will disappear within a few weeks.

Exacerbation of chronic hemorrhoids in women in labor cannot go away on their own. Patients complain of severe itching and burning in the anal area. In severe cases, nodes begin to fall out and bleeding appears. During lactation, the use of many medications is prohibited. Aggravated hemorrhoids can calm down after prescribing rectal suppositories and ointments for topical use. Treatment of hemorrhoidal tumors during pregnancy is very limited and takes little time. Therapy must be coordinated with a doctor.

Emergency treatment for hemorrhoids

If you notice that you have hemorrhoids and you don’t have the strength to wait for the pills to take effect, you can resort to emergency help. There are quick first aid methods for hemorrhoids with pain and bleeding, which will give a temporary anabiotic and analgesic effect:

1. A compress with cool water and ice will help to quickly relieve pain and reduce discomfort in the anal area, soothe spasms and alleviate the burning sensation a little; simply apply a cold compress to the painful area for a few minutes.
2. If acute pain occurs, you must take a supine position, lie on your back and try not to move.
3. Cold baths with herbal infusions or salt will help relieve irritation and reduce inflammation.
4. There is no need to try to give enemas or take laxative pills even with frequent diarrhea, this can only further irritate the colon mucosa and worsen the condition.

Such methods help only for a certain time, but they do not replace full treatment. The sooner you start taking medications, the faster the patient can recover.

Drug treatment

Treatment for acute hemorrhoids with medications lasts until a period of remission occurs. These can be ointments, tablets, suppositories. You cannot choose medications yourself. Only a specialist, after a detailed examination and specification of the problem, can prescribe medications and their dosage. Help is provided mainly symptomatic. If the course is favorable, symptoms disappear within 4-7 days.

For internal hemorrhoids, suppositories (with belladonna, glycerin, sea buckthorn and others) are most often prescribed. It takes very little time, a few days are enough for complete relief of symptoms if you strictly follow the doctor’s instructions, regimen and diet.

It is more convenient to combat acute hemorrhoids in the external form of the disease with the help of ointments and gels. Suppositories are also often prescribed (especially in the combined form). Drugs such as Heparin ointment, Proctosan, Vishnevsky ointment, Troxevasin ointment for hemorrhoids have long established themselves as excellent ways to combat pain and inflammation.

A tablet method of treatment is also possible. “Proctosedil”, “Detralex” and other medications can not only relieve the symptoms of hemorrhoids, but also strengthen the walls of blood vessels, normalize blood circulation in the pelvis, and eliminate congestion.

What can affect recovery

Even with active complex treatment of hemorrhoids, there are factors that in one way or another can affect the duration and result of treatment. There are often cases when, when treating hemorrhoids, the patient’s condition either improves, or the pain returns with a vengeance. The reason for this may be taking medications without changing your lifestyle.

If treatment for hemorrhoids lasts more than several months and no significant improvement is observed, the disease may be hereditary and require surgical treatment.

During the treatment period, it is necessary not only to take medications and wait for a miracle, but also to control your lifestyle, nutrition, and exercise. When treating this disease, it is recommended to go on a moderate diet, avoid fatty, floury, fried and spicy foods, since such foods aggravate the condition of the disease. It is also necessary to give up bad habits at least temporarily, moderate activity and try not to overexert yourself with physical activity.

In the first and second stages, hemorrhoids may not bother you

Dmitry Smirnov.

— Dmitry Vladimirovich, I was diagnosed with “chronic hemorrhoids and erosion of the anal canal.” What do you advise me to do?

— How are you worried about your condition?

- From time to time there is a slight itching and whining after using the toilet.

- How long does this illness last?

— I had a crack removed in 2010. These problems have been troubling us ever since.

- It is important for you to ensure that your stools are always soft. Maintain good hygiene. And use ointments - with topical hormones and for children.

- And the candles?

- No, you don’t need candles.

- I am 55 years old. Hemorrhoids just started - not more than a year ago. Now there is an exacerbation, a lump the size of a centimeter has come out. I use candles, but nothing helps so far.

— You need to add venotonic tablets. And outside, use any anti-hemorrhoidal ointment. But when the lump hides, be sure to see a proctologist. If the proctologist doesn’t succeed, go to the surgeon at the clinic. You need to look inside to understand why the lump popped up.

OINTMENTS WILL NOT CURE HEMORRHOIDS

— I developed hemorrhoids a long time ago, after my first birth. So far I have dealt with it. And now it was like warming up due to back problems, an aggravation began, something began to tingle.

- You may have neuralgia. But you need to be examined. If it is a pinched nerve, one treatment will be prescribed. If it's erosion or a crack, that's different. If there is a polyp, a completely different tactic must be chosen. You definitely need to see a doctor.

— Could the procedures harm me?

- Hard to tell. If you have a polyp, then such procedures are contraindicated for you. And if it’s something else, then there shouldn’t be any problems.

- But would I feel the polyp?

- Not at all necessary. Very often this is such an unexpected finding during a routine examination. Therefore, God protects the saved.

— I wanted to consult about my mother, she is 80 years old. Sometimes hemorrhoids bother me. How can I help her?

“She definitely needs to see at least a surgeon.” After all, much more dangerous things can be hidden under the guise of hemorrhoids.

— I’m 63 years old, I live in the regional center. I have stage 2 hemorrhoids. When the nodes come out, I use ointment, which helps me. How long can it be used?

— You must understand that no ointment for grade 2 hemorrhoids will solve the problem. It will get worse every year. And now you can be helped without surgery.

- But as?

— Literally two or three procedures are done, during which the internal hemorrhoids are tightened. Special rings are used for this. After the procedure, blood does not flow and the node dries out. You need to repeat the procedure in about a month.

— How long does this procedure take?

— Together with the preparation, about 20 minutes. After it, a person can immediately go home, even while driving. The procedure itself is painless, but after it you may ache a little for two or three days, then you should take painkillers.

— How to improve intestinal motility?

— You should consult a gastroenterologist. It all starts with the daily routine, eating by the hour. You need to eat 3 - 4 times a day - porridge, vegetables and fruits, black bread, liquids 2 - 2.5 liters per day. If, despite a strict diet and proper nutrition, constipation persists, then medications are used.

By the way, very often after removal of hemorrhoids, intestinal motility is restored on its own.

HEMORRHOIDS DO NOT THREATEN LIFE, BUT DECORATE ITS QUALITY

— My mother had colon cancer. And now she is suffering from hemorrhoids. She was prescribed suppositories and ointments, but nothing helps her.

— What is the degree of hemorrhoids?

- Second.

“That means she can be helped without surgery.” For the second degree, two procedures at intervals of a month may be sufficient. They are called vacuum ligation of internal nodes. An elastic band is put on the knot, the blood stops flowing, and the knot disappears after a couple of days. Half of the hemorrhoids are usually removed in one procedure. But for 20 days after the manipulation you need to be careful - avoid exertion, do not go to the sauna, do not take aspirin. But she definitely needs to show the proctologist the oncologist’s statement.

- Why are hemorrhoids dangerous?

“This is a disease that does not threaten life, but only worsens its quality. It is dangerous due to its complications - cracks, prolapse, pinched nodes, thrombosis. But hemorrhoids do not develop into cancer.

“I’m 75 years old, and I’ve had hemorrhoids for three years now. How to cure it?

- Who diagnosed you with this? You yourself?

— No, I was examined by a urologist. It is especially painful when there is constipation.

— At your age, surgery is risky. And your constipation is not from hemorrhoids, but rather the opposite: hemorrhoids are a consequence of constipation. Therefore, try to adjust your chair. If you cannot do this with the help of a diet, you can resort to modern means that are not addictive. They do not make stools more frequent, but make them softer.

— I still have pain often. Sometimes I wake up in pain at night.

— Hemorrhoids usually don’t hurt at night, they only hurt after or while using the toilet. You need to check your back, spine. They can give such painful sensations.

— I have cracks in my anus. My job is sedentary. And I also ride a bicycle. I apply the ointment and it seems to go away. As soon as I get on the bike, everything appears again.

- You need to see a proctologist. A narrow bicycle seat can cause injury. And a crack or erosion can occur in any absolutely healthy person. But, as a rule, in such a person they go away without any treatment, even without ointments. Most likely, you have a reason that causes the discomfort to reappear. You need to be examined by a proctologist. Often the cause of anal fissures, dermatitis, and itching is internal venous stagnation, which does not allow blood to circulate normally, and your wounds do not have time to recover.

— Doctor, advise what to do. A lump came out of a grape, I’ve been treating it for a month now, but nothing helps. And I need to have a colonoscopy soon.

— Without an examination, it’s hard for me to say what you have. Perhaps this is a thrombosed external node. The treatment tactics are as follows: venotonic tablets are taken and heparin-based ointment is used. If the lump does not go away, it needs to be removed.

AT THE FIRST AND SECOND STAGES HEMORRHOIDS MAY NOT BE A DISTURBANCE

— I have stage 2 hemorrhoids. What do they mean, these stages?

— The first stage is the easiest; sclerotherapy and oral medications help. At the second stage, ligation can be done. With the third, you can do laser or infrared coagulation. And the fourth, most difficult stage, can only be treated surgically. The gold standard treatment for the first three stages is the application of vacuum rings. The effect is visible immediately and recovery is fast.

By the way, the first and second stages often do not bother a person at all. They are discovered only during a medical examination.

— When should you contact a proctologist?

- Firstly, if there is any discomfort, pain, some formations, swellings appear, the process of defecation itself has changed, mucus and blood are noticeable.

Secondly, if there is cancer heredity. In this case, you should be examined every three years, even if nothing worries you.

Thirdly, when planning a pregnancy. Scientists have calculated that during pregnancy this area experiences the same stress as during 20 years of life without pregnancy. And during pregnancy, hemorrhoids can behave very aggressively, and treatment can be prescribed during this period very limited. And you can’t do the procedure anymore either. Therefore, ideally you need to see a proctologist before pregnancy. And if something is discovered, the problem can be easily dealt with. Now even gynecologists refer their patients to us to prevent possible complications.

Prevention of recurrence

If, after treatment, hemorrhoids continue to make themselves felt periodically, you will need to take preventive measures to avoid a recurrence.

In order to forget about such an unpleasant problem for a long time, you need to follow simple preventive measures:

• take preventive medications;
• make compresses;
• visit a proctologist regularly;
• drink vitamin and mineral complexes;
• take medications to restore and maintain intestinal microflora;
• maintain a special dietary regime;
• do special gymnastics;
• adhere to hygiene rules.

Thus, constant monitoring and maintenance of one’s own health will help to control even the hereditary form of hemorrhoids and prevent its frequent occurrence.

How long does it take to cure hemorrhoids?

The answer to this question is individual for each patient. The stage of development of the disease determines how much time will be spent on its treatment, the intensity of the process of inflammation of the rectum, and the presence of specific symptoms of the individual patient.

In unadvanced cases, hemorrhoids are treated from two weeks to a month. During this time, hemorrhoidal cones disappear. Therapy can be adjusted by the attending physician at the end of the course. Treatment with tablets continues for at least 30 days. It is aimed at increasing vascular tone.

To reduce inflammation you need to use suppositories or ointment. A remedy to strengthen veins is often prescribed. These drugs are needed to prevent the formation of new nodes. If bleeding appears at any stage of the disease, painkillers and anti-inflammatory drugs, as well as drugs with adrenaline, are urgently prescribed.

To prevent acute inflammation from recurring, you must follow the doctor’s instructions. Do not eat spicy or salty foods, do not drink alcohol, do not carry heavy things. Eat more foods with a lot of coarse fiber - fiber. If a person has a sedentary job, then exercise should become a habit every 3-4 hours. This will help stretch your muscles. Relieves tension from the hip part of the body. Do not allow the blood to stagnate. This leads to enlargement of the anal nodes. Will complicate the course of the disease. Guaranteed to complicate the disease.