Hemorrhoids today is a common disease, which is the expansion of the veins of the rectum with the formation, and sometimes the loss of such an inclusion as a hemorrhoid. Such a pathology has recently been often diagnosed in proctology, which is associated more with a sedentary lifestyle of people. At the same time, a person experiences such unpleasant symptoms as constipation, pain during bowel movements, a burning sensation and itching, bleeding.
Description and description of the problem
A hemorrhoid is a seal consisting of an accumulation of small veins and vessels that pass in the rectum, which can be both inside and outside. The appearance of these formations, their inflammation and prolapse are usually associated with a violation of the muscles that hold the accumulation of blood vessels, or a violation of the functionality of the blood vessels themselves, loss of their tone. Inside the nodes are clots of venous blood.
Pathology develops slowly, which is its danger. Usually people do not pay attention to the appearance of a little discomfort, therefore they do not go to a medical institution, thereby exacerbating the course of the disease. If untreated, the problem can only be solved with surgery.
If hemorrhoidal nodes fall out, this indicates that hemorrhoids has passed to the last stages of development. This phenomenon is observed with a prolonged absence of therapy for pathology, tissue atrophy in the anus, decreased muscle tone, and also with severe damage to the muscles of the anus.
The number and size of nodes that drop out is different. Sometimes there is one lump, in other cases their number can be large. The sizes of formations range from five millimeters to three centimeters. The difficulty in the treatment of this pathology lies in the fact that cracks and tears can form on the epithelium of the anus as a result of trauma to it with solid feces, which provoke the development of bleeding.
Varieties of pathology
In medicine, several types of pathology are distinguished, depending on where the nodes are located:
- Internal hemorrhoidal nodes are most often diagnosed. They form under the epithelium of the rectum and require careful diagnosis.
- External formations are rare, with cones (nodes) forming under the skin surrounding the anus. When diagnosing, the doctor often discovers one or more seals.
- Combined nodes are a complication of the disease, in which both types of formations are present.
Reasons for the development of pathology
The formation and inflammation of hemorrhoids occurs due to an increase in intra-abdominal pressure, weakness of blood vessels and veins of the rectum. The following factors provoke the appearance of such phenomena:
- Lack of therapy at the initial stage of the disease, the development of a chronic form of the disease.
- Lack or absence of physical activity as a result of serious illness, conditions of professional activity or laziness of a person.
- Prolonged use of certain groups of medicines, non-compliance with the dosage of drugs.
- Presence of addictions.
- Chronic stool disorders: diarrhea or constipation.
- Obesity.
- Prolonged stress and nervous tension.
- Heavy power loads for a long period of time.
- Improper nutrition.
- Hemorrhoidal nodes often appear during pregnancy and during labor of a woman.
- Diseases of the digestive tract, heart and blood vessels.
- Genetic predisposition.
The risk group includes people of advanced age, people who lead an improper and sedentary lifestyle, as well as pregnant women and people with a hereditary predisposition.
Symptoms and signs of the disease
The formation and inflammation of hemorrhoidal nodes occurs gradually, so many people do not pay attention to the appearance of a little discomfort. You can recognize the disease by the following signs:
- Feeling of fullness and pressure in the anus.
- Sensation of incomplete bowel release after bowel movement.
- Itching and burning in the anus.
- Pain during bowel movements.
For the first time you can notice the loss of hemorrhoids after defecation. A person develops minor pain and blood discharge. After some time, the node becomes in its original place, that is, hiding inside. If untreated, the bumps do not disappear on their own, they are often accompanied by swelling and inflammation, increased pain and bruising. Usually this phenomenon is observed during physical exertion. The nodes remain outside in the form of skin sacs around the anus. In this case, the hemorrhoid that has fallen out gives the person constant discomfort. In advanced cases, the formations become inflamed and pass to the surrounding tissue.
During the disease, calm periods are observed when the seals are located inside the intestine, and periods of exacerbation, which are characterized by the loss of cones.
The degree of development of the disease
Depending on the severity of the disease, the following stages of its development are distinguished:
- The first stage is characterized by stagnation of blood and a slow stretching of the vascular walls. Symptoms at this stage do not appear, the pathology is easily amenable to therapy with timely diagnosis.
- The second stage is caused by severe symptoms, the development of bleeding, the hemorrhoid begins to fall out during bowel movements, and then independently return to its original place.
- The third stage, in which the seals cannot independently return inside the rectum, in most cases, surgical treatment is required. At this stage of the disease, treatment is necessarily necessary, since it is possible to pinch the nodes due to sphincter spasm. This can provoke a disorder of the blood flow in the pelvic region, thrombosis of the hemorrhoid can also appear, the treatment of which will be long.
- The fourth stage is characterized by severe constant pain, blue knots, their increase. At this stage, complications of the disease appear, the nodes are infringed, heavy bleeding occurs, and thrombosis of the hemorrhoid appears. Treatment of such a pathology requires immediate, in this case, surgical intervention is used. This stage of the development of pathology indicates its neglect, so treatment can be lengthy. The pain syndrome in humans is constantly present and does not stop with painkillers.
Diagnosis of the disease
When hemorrhoidal nodes are formed and inflamed, what to do, the proctologist will tell you after diagnosing and making an accurate diagnosis.
First, the doctor studies the history of the disease and conducts an external examination of the patient in the knee-elbow position. The examination helps to evaluate the shape of the anus, its deformation, state of the epithelium, the degree of development of the pathology, stage of the disease. Then the doctor palpates the rectum in order to detect the condition of the sphincter, the presence of pain, polyps or scars, as well as other injuries. But this technique is not able to determine the size and location of the seals, since when pressed, they decrease in size.
The proctologist appoints a study using a probe to view the walls of the rectum, to identify cracks on its surface. If a hemorrhoid has fallen, the method helps to determine the degree of its loss. When using anoscopy, you can examine the rectum at a depth of up to twelve centimeters.
Sigmoidoscopy in the knee-elbow position is mandatory. A rectoscope tube is inserted into the patient in the anus to a depth of twenty-five centimeters. If for any reason this technique is not possible, the doctor prescribes a colonoscopy. As additional diagnostic methods, laboratory tests of blood and feces, irrigoscopy, ultrasound of the peritoneal organs are used to identify concomitant diseases of the nearest organs. In medical practice, in every third case, hemorrhoids are accompanied by pathologies of the rectum and colon, which are provoked by bleeding. Often observed anal fissures.
In the presence of bleeding or bleeding, the doctor prescribes a more thorough examination of the person, since such a phenomenon can be a symptom of colorectal cancer. After conducting a comprehensive diagnosis, during which a fallen hemorrhoid was detected, the proctologist develops a treatment tactic.
Drug therapy of the disease
At the initial stages of the development of the disease, the fallen node can be corrected independently. Doctors recommend for this to first anesthetize the anus area with a special cream or gel, then choose a convenient position and push a lump into the anus with a finger. After that, it is necessary to squeeze the buttocks and lie down for half an hour. This procedure is carried out in rubber gloves.
Therapy of the disease begins with the restoration of the elasticity of the vascular walls. For this, the doctor prescribes venotonics in the form of tablets, for example, Troxevasin or Venarus. These medications reduce swelling and inflammation, thin the blood and improve its circulation. Thanks to this, the pathological site is restored in a short time. Such drugs are recommended to be used after the disappearance of the symptoms of pathology in order to prevent the development of relapses. Rectal suppositories, such as Proctosan or Relief, may also be prescribed. Suppositories help relieve inflammation and pain, swelling and muscle spasm. Typically, this therapy is used to treat cones inside the rectum.
To eliminate external nodes and thrombosis, special ointments are used that relieve swelling and reduce the size of the seals. In the presence of anal fissures, antibacterial ointments, for example, Levomekol, can be used.
With an increase in body temperature, the doctor prescribes anti-inflammatory, analgesic and antipyretic drugs. If constipation is observed, laxatives and probiotics are used. Often, a proctologist prescribes immunomodulators to increase the body's defenses.
Ligation of hemorrhoids with latex rings
To eliminate internal cones in proctology, latex ligation is often used. This technique was first described by Hippocrates, and in the twentieth century began to use a ligator for this. Today in proctology, two types of therapy are used: vacuum and mechanical ligation. Such treatment is effective in the first three stages of the development of the disease.
Ligation of hemorrhoidal nodes with latex rings involves the introduction of an anoscope into the rectum to gain access to the internal seals. Then, a latex ring is put on the node with the help of a ligator, which compresses it, preventing the flow of blood, which leads to necrosis of the tissue and rejection of formation. Rejection usually occurs up to seven days. Some doctors put on two rings at once.
During the procedure, patients may feel pain and discomfort in the intestine, urge to defecate. After establishing the ring, the patient is advised not to empty during the day.
Surgical intervention
In severe and advanced cases, as well as in the presence of the fourth stage of the development of pathology, hemorrhoidectomy and the Longo method are used. These techniques involve surgical excision of nodes under general anesthesia. In this case, not only the seal is subject to removal, but also the place of its fastening. The operation takes forty minutes of time. Sometimes the doctor can pull the knot up by resection of the intestinal epithelium. This contributes to the deprivation of blood supply, so the cone is overgrown with connective tissue.
Other treatments
Doctors often prescribe sclerosis of hemorrhoids. In this case, a special substance is introduced into the anus, which contributes to the gluing of the cones, as a result of which their size decreases and bleeding stops.
In this case, the medicine is injected with a special syringe to the place where the node is supplied with blood to turn off a large number of blood vessels from the bloodstream. These vessels are thrombosed and inflamed, sclerosis of the node occurs, it decreases in size, edema, bleeding and inflammation are eliminated.
Typically, sclerosis of hemorrhoids is performed several times with interruptions of five days. This is due to the fact that most often in patients there are several seals at once.
Also, laser therapy and cryo-freezing are often used. These methods allow you to quickly get rid of the problem. After carrying out the procedures, it is necessary to follow all the appointments and recommendations of the proctologist so as not to provoke the development of relapse.
Forecast and Prevention
Usually, the prognosis of the disease is favorable. It is only necessary to consult a doctor in a timely manner to undergo examination and treatment of pathology.
Today, surgery is one of the most effective methods of treating hemorrhoids, which is accompanied by prolapse of the nodes. But after the operation, it is necessary to change the lifestyle, nutrition in order to prevent the development of relapse.
For the purpose of prevention, doctors recommend leading a mobile lifestyle, eating properly, observing bowel hygiene, and carefully monitoring their health. At the first symptoms of pathology, you must consult a doctor, as in the early stages of the disease it can be cured without surgery.