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Hemorrhoids are associated with a pathological change in the blood vessels of the rectum. That is why with the development of this disease there is pain and blood during bowel movements in the anal canal. Of all proctologic (proktós - anus) diseases, it is the most common. About a quarter of the world's population suffers from hemorrhoids. The age of patients usually exceeds 25 years.
With hemorrhoids, the volume of cavernous bodies, which are plexuses of the blood vessels surrounding the rectum, increases significantly when injured, which causes blood during defecation. This is due to stagnation of blood in the veins as a result of dysregulation of its inflow and outflow. The factors contributing to the disease are the functional pathology of the connective tissue supporting the cavernous bodies, as well as changes in the nervous regulation of the tone of the walls of the blood vessels.
Hemorrhoids can be inherited and acquired.
Factors that increase pressure in the peritoneum or cause stagnation of blood in the cavernous vessels and, subsequently, blood during defecation predispose to the disease:
• high physical activity,
• work associated with prolonged standing
• pregnancy and childbirth,
• constipation associated with improper diet: excess in the diet of sharp foods and lack of dietary fiber,
• alcohol abuse,
• obesity,
• low mobility,
• liver damage,
• diseases of the pelvic organs,
• tumors of the rectum,
• anal sex.
At the onset of the disease, a heaviness in the groin is felt. Then itching and pain occur in the anus, a feeling of incomplete bowel movement appears . Hyperemia and edema are later observed. In the future, hemorrhoidal nodes may fall out of the anal canal. Defecation is disturbed, becoming very painful, often scarlet blood is released during defecation. This is due to the rupture of the walls and integumentary tissues of cavernous bodies, overflowing for a long time. If eroded areas become infected, inflammatory processes develop.
According to the localization, hemorrhoids can be external (subcutaneous), when the corpora cavernosa located at the exit of the rectum becomes inflamed, and internal (submucosal). The disease can be chronic and acute.
In a chronic course, an alternation of the stages of remission and exacerbation is observed. There are no visible manifestations of the disease during remission. However, predisposing factors cause clinical symptoms.
Acute hemorrhoids, otherwise called hemorrhoidal thrombophlebitis, impaired hemorrhoids, thrombosis of hemorrhoidal nodes - most often occurs against a background of chronic and is accompanied by very severe pain. With a rupture of the tissues of the anal canal, scarlet blood may be released during bowel movements. Often, body temperature rises. Severe pain is caused by pinching of the prolapsed nodes or blockage of hemorrhoidal veins with blood clots. Circulatory disturbance in the prolapsed nodes leads to ulceration, which in the future can cause their necrosis and decay. Among the most dangerous complications of acute hemorrhoids are purulent inflammation and the general intoxication of the body associated with it. In debilitated patients with untimely treatment, there is a possibility of sepsis. Other complications: purulent and fecal fistulas of the rectum, vaginal fistulas .
Diagnosis of hemorrhoids includes:
• finger examination,
• sigmoidoscopy,
• irrigoscopy,
• anoscopy,
• colonoscopy,
• coprogram,
• fecal analysis to detect occult blood.
Treatment of hemorrhoids initially involves conservative methods that relieve acute manifestations, especially if blood breaks during bowel movements testify to tears inside the anal canal. At the same time, a complex of drugs of various orientations is recommended: phlebotropic, analgesic, hemostatic, sedative and anti-inflammatory. Treatment should be accompanied by measures of a non-pharmacological nature: following a diet, excluding heavy loads, etc.
Microclysters with a sea buckthorn and rosehip oil, with Vishnevsky ointment facilitate the patient’s condition . As hemostatic agents , Vikasol, Vicinone are used inside, externally - suppositories with methyluracil, and Ultraproct ointment. The drug “Hepatrombin G” (suppositories and ointment), which has a complex effect, has proven itself well. Of the phlebotropic preparations used internally, diosmin, which quickly stops the manifestations of the acute stage of the disease, is highly effective. This drug is also used for preoperative preparation.
Successful treatment is facilitated by the use of minimally invasive (sparing) methods: sclerotherapy, infrared photocoagulation, cryotherapy, ligation of nodes with latex rings, desarterization of nodes.
Surgical intervention is indicated for chronic hemorrhoids with prolapse of the nodes or severe bleeding.