Hemorrhoids is a disease that is associated with inflammation, as well as tortuosity and expansion of hemorrhoidal veins of a pathological nature, forming nodes near the rectum. The disease has three degrees of severity.
Thrombosis of the external hemorrhoidal node, internal node, or both nodes is classified topographically.
The first stage is characterized by their small size, tight-elastic consistency, pain during palpation. They are located under the dentate line of the anal canal. In the second stage, the severity of edema, spreading to most of the perianal region, sphincter spasms, hyperemia, is noted. Rectal examination with a finger causes severe pain. The third stage is characterized by swelling and hyperemia of the entire anal circle. Inspection reveals cyanotic-crimson or crimson-colored internal nodes that protrude from the anus. A rectal examination is not possible, due to severe sphincter spasm and acute soreness. In some cases, there is a fibrin coating on the nodes, black areas are visually detected. These sites are expressions of the walls with necrosis.
The cause of necrosis is thrombosis of the external hemorrhoid. As a rule, it is represented by a barely visible dense formation. It is located under the cutaneous epidermis of the perineum near the external sphincter. Thrombosis of the external hemorrhoid can affect the entire skin of the anal circle. However, in most cases, isolated skin edema is observed.
Characteristic symptoms include patient complaints of pain that is not associated with defecation, as occurs when cracks form. Increased pain is noted during emptying, most often in patients suffering from constipation. Along with this, swelling of the skin is noted. There is no correlation between the severity of pain and the size of the affected node. It should be noted that pain manifestations are purely individual for each. They can in some cases be unbearable, and in some cases very insignificant, despite the increased size of the formations.
Diagnosis of the acute stage of the disease, as a rule, is not difficult. Frequent are pains arising from impaired intestinal function or due to the use of laxatives. Rectal examination is painful, therefore it is carried out after the process subsides. Up to 35% of cases are characterized by necrosis accompanying thrombosis of the external hemorrhoid. In this case, spontaneous evacuation of the seal through the defect in the mucous membrane is noted. This process accompanies rapid relief, but bleeding from the defect is noted. In some cases, it is very plentiful.
Acute hemorrhoidal thrombosis results in the development of hemorrhoidal fringes. Their occurrence is provoked by skin stretching of the perianal region. These fringes, not showing soreness, in many cases are mistaken for external seals.
Treatment.
Hemorrhoidal thrombosis involves emergency hospitalization. In acute course, it is not allowed to direct the fallen seals on their own. This is associated with a high risk of mucosal damage during independent manipulations. In addition, bleeding and quite serious complications are possible. The acute course of the disease in many cases involves surgical intervention.
With the development of acute seals, sitz baths using a solution of potassium permanganate, peace, cold lotions using lead acetate or potassium bicarbonate (2% solution) are shown. After a day or two, warm baths (sessile) are recommended.