Hemorrhoids are varicose veins of the plexus that are located in the anus. This phenomenon occurs due to the accumulation and stagnation of venous blood in them, forming hemorrhoidal nodes. There are two types of hemorrhoids - external and internal. External hemorrhoidal nodes are located near the anus. After emptying the intestines or, being a long time in a sitting and standing position, a person experiences discomfort in the anus. External hemorrhoids are detected during an external examination.
Causes of external hemorrhoids
There are a number of factors leading to stagnation in the pelvis, and the appearance of external nodes. These include:
- Sedentary lifestyle. This is one of the main causes of stagnation of blood in the veins. Most people in the workplace have to sit or stand on their feet for a long period. Therefore, for preventive purposes, you need to do basic exercises every day and walk.
- Improper nutrition. Fast food and in a hurry often contributes to constipation or diarrhea, which gives an additional load on the veins of the anus and leads to the formation of external hemorrhoids.
- Nicotine and alcohol addiction provokes various malfunctions in the human body and negatively affects many internal organs and systems.
- Overweight. Strong pressure is applied to the small pelvis, all organs work with increased load, negatively affecting blood flow.
- Frequent stressful conditions. During this period, permanent damage to the walls of the veins by stress hormones occurs.
- Hereditary predisposition. Congenital weakness of the venous walls of blood vessels contributes to the development of external hemorrhoidal nodes (photo below) and varicose disease of the lower extremities.
- Great physical activity. People engaged in heavy physical labor, there is a strong flow of blood to the pelvic organs.
- Pregnancy and childbirth. Women in this period have a strong load on the pelvic organs.
- Inflammatory processes also lead to spasms and injury to the veins of the rectum.
Symptoms of external hemorrhoids
According to medical observations, people of both sexes aged 20 to 50 years suffer from hemorrhoids. The appearance of external hemorrhoidal nodes is accompanied by the following symptoms:
- Pain and discomfort occur during bowel movements and prolonged sitting, or with excessive physical exertion. The pain syndrome has a different intensity, from mild discomfort to severe pain with thrombosis.
- Itching and burning. The skin covering the nodes, in connection with circulatory disorders, is irritated and damaged, swelling occurs.
- Bleeding. Usually they are of low intensity. Traces of blood appear on toilet paper or linen. However, if treatment is not started in time, then there is an increase in the external hemorrhoidal nodes (photo below), which are injured during bowel movements and cause already heavy bleeding. Sometimes blood is released from the anal fissures, causing severe pain.
- Constipation, which exacerbate the disease.
- The appearance of a painful formation in the anus - a round seal is formed, bluish in color, causing pain.
- An increase in body temperature occurs with inflammation of the nodes.
Most often, the patient consults a doctor when external hemorrhoid nodes fall out, without attaching importance to the first symptoms of the disease.
Complications of external hemorrhoids
In the absence of complex therapy, complications of external hemorrhoidal nodes occur, thrombosis (acute hemorrhoids) and anal fissures appear. At the same time, the pain syndrome intensifies and the inflammatory process begins, the body temperature rises. In medical practice, there are three stages of the development of acute external hemorrhoids:
- The nodes become bluish in color, become painful, but the inflammatory process is not observed.
- Inflammation occurs, it captures not only the nodes, but also the tissues adjacent to them, the anal canal swells, the pain intensifies.
- Urgent removal of the external hemorrhoid is required, as necrotic changes occur. The node turns black and dies, there is a chance of blood poisoning.
Conservative treatment of acute hemorrhoids
For treatment, symptomatic therapy is used, which does not completely cure the disease. The patient is prescribed ointments containing non-steroidal or hormonal components to relieve swelling and reduce painful as well as unpleasant sensations. In addition, the patient is advised to follow a diet, be sure to perform light exercises and not engage in heavy physical labor. In the treatment of thrombosis of external hemorrhoidal nodes, anticoagulants - Fraxiparin and Heparin are used. In the early stages of acute hemorrhoids thrombolytics are used: Urokinase and Streptokinase. If conservative therapy does not give positive results, then surgical intervention is indicated.
Minimally invasive techniques in the treatment of hemorrhoids
In a conservative way, not every form of hemorrhoids can be cured. Sometimes effective medications have no effect on the disease, and the only way to alleviate the condition of the patient is to remove the nodes.
To do this, use both special surgical operations and minimally invasive procedures. All methods have features, but common to them is:
- Minimal tissue damage.
- The duration of the procedure to remove external hemorrhoidal nodes takes no more than half an hour and is performed on an outpatient basis.
- All manipulations are done without general anesthesia, sometimes using local anesthesia. Painful sensations of small intensity occur within two days after the procedure.
- After several hours of intervention, the individual returns to his usual life. The period of incapacity for work is minimal.
- After the procedure, there is no scar or tissue deformation.
- Minimally invasive manipulations have few contraindications, therefore they are used to alleviate the condition of people who have concomitant pathologies.
- Often they are used in the initial stages of the disease.
Types of minimally invasive procedures
The following procedures are used for treatment:
- Cryotherapy. It is carried out using liquid nitrogen. There is a freezing of the tissues of the thrombosed external hemorrhoid, which subsequently dies.
- Ligation with latex rings. It is put on the leg of the knot, crushing blood vessels. Deprived of nutrition, the hemorrhoidal node dies. This procedure applies only to internal nodes.
- Infrared photocoagulation. Focused infrared rays, acting on the leg of the node, contribute to its death. The procedure has a good effect in the initial stages of hemorrhoids and with bleeding.
- Sclerotherapy. The sclerosing substance is introduced into the hemorrhoidal cone, it is wrinkled and a significant reduction in size. The method is used for internal and external arrangement of nodes in the initial stages or at later stages to stop bleeding.
- Laser coagulation. Laser removal for acute thrombosis of the external hemorrhoid is painless. The patient senses only heat waves. The nodes are removed in 10-15 minutes, and the patient can immediately go home, and the next day, get to work. The property of a laser to cure wounds does not cause a risk of bleeding.
Complications after minimally invasive techniques
In some cases, minimally invasive methods give complications, although they differ in minimal intervention:
- Pain syndrome. Moderate pain occurs after any manipulation of hemorrhoidal nodes, because there are many nerve endings in the rectal mucosa. Severe pain occurs when improperly applied latex rings, when there is a capture of healthy tissues or when using the procedure for several nodes at once. Intense pain appears after infrared photocoagulation.
- Bleeding. Such a consequence is possible using any technique other than laser coagulation.
- Thrombosis of the external hemorrhoidal node (photo above). This complication sometimes appears when installing latex rings, when there are no clear boundaries between the internal and external hemorrhoids. In addition, when using infrared coagulation in some cases, the blood vessel supplying the node does not die completely, blood begins to flow into it, stagnation occurs and a blood clot forms.
The disadvantages of minimally invasive methods
Despite all the advantages of minimally invasive technologies, they have several disadvantages, which are as follows:
- The possibility of relapse. With all manipulations, the effect is eliminated, and not the cause of the disease.
- High cost. Some methods of eliminating hemorrhoidal nodes are of high cost.
- You need to contact highly qualified doctors. Excellent knowledge of anatomy, jewelry accuracy and the ability to handle devices are required.
In advanced cases, when it is pointless to use minimally invasive techniques, they resort to surgical methods of treatment.
Therapy of hemorrhoids with surgical intervention
With complicated hemorrhoids and the appearance of thrombosis, surgical intervention is required, otherwise tissue death and the occurrence of an abscess will occur. In this case, the patient is urgently hospitalized and undergoes an operation - thrombectomy.
So, how to remove the external hemorrhoid? After ineffective treatment with a conservative method, surgical intervention is used. The patient is given local anesthesia and the formed blood clots are removed from the inflamed node. The process lasts only a few minutes, the patient does not need subsequent medical supervision and can lead a familiar life.
The patient is relieved: excruciating pains disappear, swelling subsides, inflammation decreases. The healing of the incision after surgery occurs in a few days. There are no complications after thrombectomy of the external hemorrhoid. The patient is advised to carefully monitor the hygiene of the anal area and follow a diet.
Surgery to remove hemorrhoids
Indications for hemorrhoidectomy are:
- External nodes of large sizes, causing discomfort to the patient and making it difficult to conduct hygienic procedures in the anal area.
- The presence of internal and external hemorrhoids in an acute form.
In preparation for surgery, the patient passes tests and undergoes a full examination. Surgery is performed under general anesthesia or using spinal anesthesia. Excision of the external hemorrhoid is carried out as follows:
- The node is gripped and pulled out.
- The leg of the knot is bandaged, and he is excised. Most often, an electric knife is used, with the help of which cauterization of blood vessels occurs immediately.
- Stitches are sutured and sometimes left open for self-healing.
For the patient, the first two days are the most difficult. Severe pain is eliminated with local anesthetics, ointments and suppositories with methyluracil are used for healing. The patient is recommended to follow a diet. Complications after surgery are rare, wounds heal quickly. This operation allows an individual to get rid of advanced hemorrhoids for many years.
External hemorrhoidal nodes. Home treatment
For the treatment of external hemorrhoids, medications can be used to help medications. Here are some of them:
- Grate raw potatoes, wrap in cheesecloth, refrigerate in the refrigerator and attach to a sore spot. It will help relieve swelling and reduce pain.
- Apply birch tar on a gauze swab and attach to hemorrhoidal nodes. The tool is used to relieve inflammation.
- Scaly grass. Brew tea and drink three times a day to relieve itching and inflammation.
- Birch leaves. How to treat external hemorrhoids using them? To do this, take 100 g of dry raw materials, pour boiling water, leave for an hour. Strain and apply for a sitz bath. As a result, swelling is relieved and pain is reduced.
- Series, calendula, sage, chamomile. Take each grass in equal amounts. In 100 g of raw materials add at least two liters of boiled water, insist, add raw potato juice and use for a sitz bath. Used to relieve the inflammatory process.
Before using alternative recipes, it is necessary to consult a doctor regarding their effectiveness. It should be noted that they serve only as an adjunctive therapy to the main drug treatment.
Prevention
Preventive measures that exclude exacerbation of the disease:
- Compliance with the diet. A large amount of plant fiber and dairy products should be present in the diet. Eating spicy foods should be ruled out.
- Physical exercise. Daily walks and simple exercises help improve blood flow, establish metabolic processes, and strengthen the pelvic muscles.
- Drinking the right amount of fluid.
- Normalization of the stool. Be sure to ensure that there is no diarrhea or constipation, as this contributes to the formation of hemorrhoids.
- Limit the intake of strong alcoholic beverages.
- Timely treat chronic inflammatory processes in the perianal region.
- Constantly monitor body weight.
- Timely treat diseases related to venous insufficiency, gastrointestinal tract, arterial hypertension.
Particular attention should be paid to the prevention of acute hemorrhoids to women planning a pregnancy. For delivery in a natural way, hemorrhoids are not a contraindication, but a woman needs to be observed by a proctologist so as not to aggravate her condition. For persistent constipation, use laxatives recommended by your doctor.