Hemorrhoids are a disease that many people put off treating. It is a pathology that develops in the vessels of the rectum. By the nature of the course of the doctor, external prolapse of the nodes and internal hemorrhoids are distinguished.
Nodular formations are located under the rectal mucosa. In severe, advanced cases, they may periodically fall out and moderate bleeding.
Untimely access to a doctor can provoke the development of dangerous complications. To avoid possible unpleasant consequences, you need to understand exactly what are the signs of internal hemorrhoids and how exactly the disease manifests itself in the initial stages. The most effective treatment will be with an integrated approach.
Causes of the disease
Internal hemorrhoids (according to ICD-10) are assigned a code - I84. The disease is classified as inflammation and significant expansion of internal varicose veins. This is a fairly common disease among adults. Most often it occurs in women. Mostly internal hemorrhoids occur after childbirth. And with repeated pregnancy, the risk of acquiring varicose pathology increases even more. The exact causes of the formation of internal hemorrhoids have not yet been fully established, however, there are a number of factors that contribute to the formation of this pathology, in particular such as:
- lack of physical activity;
- weight gain;
- pregnancy and childbirth, especially multiple;
- malnutrition;
- constipation
- regular lifting weights;
- misconduct.
Of great importance in the development of the pathological process is the hereditary factor and the presence of concomitant diseases, in particular, such as intestinal infections or pelvic tumors.
Main symptoms
Symptoms and treatment of internal hemorrhoids can be very different, it all depends on the characteristics of the course of this disease. The first discomfort associated with the act of defecation. They appear in the form of discomfort and a feeling of fullness in the rectum. In addition, there may be itching and burning in the anus, a feeling of the presence of a foreign body, as well as incomplete bowel movement after visiting the toilet.
They may join pain in the lower abdomen. With the occurrence of internal hemorrhoids with bleeding, you can notice drops of blood on toilet paper and spotting in the stool.
In some cases, during the act of defecation, there may be a prolapse of the nodes located inside. In this case, discomfort will not always be present, and the pain may not be severe enough. When the disease goes to a later stage, then there is hypertrophy of the nodes and expansion of the veins of the rectum. Similar manifestations can provoke a narrowing of its lumen.
Such a pathology disrupts the discharge of feces, which leads to chronic constipation. As a result, painful sensations are observed, which significantly increases the irritation of the mucosa due to constant pressure and prolonged contact with feces. In addition, an increase in bleeding from the anus may be observed, and this occurs after each defecation process. This is a very alarming sign that makes a person turn to a proctologist.
Flow stages
Depending on the severity of symptoms and features of the course of the disease, there are 4 stages. On the first, the formation of dilated venous plexuses in the vessels of the rectum is observed. At this stage, the patient is not worried or there is slight discomfort.
Internal hemorrhoids of the 2nd degree are manifested in the form of noticeable varicose nodes, which somewhat complicate the process of defecation. This stage is characterized by a wave-like course, in particular, pronounced signs are replaced by a period of remission. However, even in the case of improvement in well-being, the patient may experience discomfort during bowel movements.
At the 3rd stage, there is a transition of hemorrhoids to the chronic stage, when periods of improvement in well-being become shorter and varicose enlargements increase in size. After a while, the symptoms become much brighter and heavier. At this stage, the disease manifests itself in the form of minor spotting during bowel movement. This may cause the node to drop out. Subsequently, the nodes may fall out when sneezing and lifting weights. At this stage, they are already well felt. After the act of defecation, the nodes that have fallen have to be set back by hand.
At the 4th stage, dangerous complications develop, which is why urgent treatment is required. In this case, the operation is indicated.
Internal hemorrhoids can occur in acute and chronic form. With the course of the acute stage, the symptoms are much brighter and grows very quickly. With the course of the inflammatory process in patients, the anus can be very painful.
Diagnostics
Depending on the symptoms of internal hemorrhoids, the treatment is selected by the patient purely individually, however, before this, a comprehensive diagnosis is necessary. To determine the degree of the course of the disease, palpation of hemorrhoids is required. By conducting diagnostics, their sizes can be indicated.
For this, the use of instrumental methods such as anoscopy and sigmoidoscopy is shown. Anoscopy is a hardware examination of the rectal mucosa. Sigmoidoscopy - the use of an endoscope for examining the rectum.
Any research method conducted by a proctologist implies a preliminary cleansing enema. If this procedure is not done in a timely manner, then the examination will not give accurate results due to overflow of the rectum with fecal masses.
All procedures used for diagnosis can be quite painful for the patient, especially if complications are observed. In case of complaints of pain, the doctor carries out local anesthesia.
Treatment features
Effective treatment of internal hemorrhoids can only be with an integrated approach. You can permanently get rid of this disease by applying conservative techniques, adhering to a healthy lifestyle and surgical intervention.
Together with medications, it is advisable to conduct special therapeutic exercises, as well as adjust the lifestyle and diet. Drug therapy implies the use of such means as:
- anti-inflammatory;
- laxatives;
- phlebotonics;
- anticoagulants.
The operation is indicated if conservative methods did not bring the desired result or serious complications arose.
Drug treatment
There is no universal cure for internal hemorrhoids. Conservative therapy is used at the initial stages of the development of hemorrhoidal nodes or as a complex treatment during surgery. The main problem is that during this period there are no obvious symptoms and the patient may not even suspect the presence of pathology. Treatment at the first stage of hemorrhoids implies the use of such means as:
- phlebotonics - “Ginkor Forte”, “Venoruton”, “Detralex”, “Phlebodia 600”;
- laxatives - "Mikrolaks", "Guttalax", "Dufalac";
- rectal suppositories - “Gepazolon”, “Prostopin”, “Econika”.
At the second stage, the first characteristic signs of the course of the disease already appear. For the treatment of internal hemorrhoids at home, rectal suppositories are mainly used. Often they have a combined effect, namely:
- painkillers;
- anti-inflammatory;
- wound healing;
- venotonic;
- anticoagulant.
The complex effects include “Anuzol”, “Procto-Glivenol”, “Betiol”. The therapeutic process largely affects the rate of progression of the disease. In the third stage, hemorrhoidal nodes fall out all the time, which leads to their trauma, as well as bleeding. That is why surgical treatment or minimally invasive procedures are indicated. Medications in this case are used to eliminate pain.
With the course of the 4th stage, the symptoms become much more pronounced. Hemorrhoidal prolapse becomes chronic without the possibility of subsequent reduction. Drug therapy is aimed at alleviating the existing symptoms and is used to:
- pain relief
- eliminate inflammation;
- stop bleeding.
The choice of a drug for internal hemorrhoids depends not only on the clinical manifestations of the disease, but also on many other factors. Many drugs are forbidden to use during pregnancy, as well as breastfeeding. Suppositories, which include heparin, are strictly contraindicated in bleeding. With the correct and timely treatment, you can get rid of the existing disease, as well as prevent the development of serious complications.
Traditional medicine
Well-proven traditional medicine. In particular, suppositories and ointments for internal hemorrhoids, which can be prepared on the basis of natural components, are widely used for treatment.
At home it is quite possible to make candles from beets, potatoes, lard, aloe, quince. Proven folk remedies are gauze swabs soaked in sea buckthorn oil, honey or birch tar. Such funds quickly eliminate pain and nourish the affected area with the required vitamins. In addition, they contribute to the healing of the walls of the affected vessels.
Treatment of internal hemorrhoids at home implies the use of microclysters. This method has a number of advantages, since the drug is absorbed very quickly and helps to eliminate the symptoms of the disease. Quite often, decoctions of medicinal herbs are used, in particular, such as chamomile, calendula, wormwood. You can also use beet or potato juice, propolis solution. Such drugs have a tonic effect on the veins, and also have an anti-inflammatory effect. Oil enemas help to treat hemorrhoids well. You can use olive or sunflower oil.
You can use herbs for internal use. Drug collection prepared on the basis of calendula, strawberry leaves, linden flowers, plantain, rose petals can be quite effective. For internal use, jam made from cornel berries is well suited.
Surgical intervention
The easiest way to treat is to have surgery. Hemorrhoidal nodes are removed at the 3-4th stage of the development of the disease, as well as in the presence of complications and necrotic areas. There are two main techniques for removing affected areas, in particular hemorrhoidectomy and transanal resection. Both types of operations are performed under general anesthesia and require careful care in the postoperative period.
A hemorrhoidectomy is performed by expanding the anus, and then the internal node is pulled out by a clamp. After this, the knot is excised, and the wound is sutured. In the presence of bleeding, electrocoagulation of the wound is carried out using a laser. The operation can provoke the development of complications, which is why a rehabilitation period is required.
Transanal resection is a partial excision of a small area of the rectum, which makes it possible to tighten the hemorrhoids. This type of operation is considered less traumatic, and patients tolerate it much better. In addition, it is worth noting a much shorter postoperative period and quick recovery.
It is worth noting that surgical intervention has a number of contraindications, which must be taken into account. The operation is prescribed exclusively by the attending doctor, after a comprehensive examination.
Other treatments
Minimally invasive procedures are used at the initial stage of the course of the disease. They are performed on an outpatient basis and are practically painless, however, it is worth noting that the effect of them is short-lived. Among the main techniques can be identified such as:
- sclerotherapy;
- bipolar coagulation;
- laser coagulation;
- suture ligation;
- Ligation with latex rings.
The sclerotherapy method is based on the introduction of a special substance into the dilated vein, which provokes the exclusion of the affected vessel from the circulatory system. For this, such drugs as Fibro-Vane, Trombovar are used.
Infrared coagulation is used in the presence of bleeding. For its implementation, a special device is used, the electromagnetic radiation of which penetrates deep into the tissue of the site, where it is converted into thermal energy. This allows you to stop bleeding.
Suture ligation implies that using an ultrasound probe, the location of the artery from which the blood enters the hemorrhoid is determined. Then this vessel is bandaged.
Lifestyle
Before carrying out complex treatment, certain measures must be taken that will help to get rid of the existing disease more efficiently and effectively. There are certain recommendations that will help get rid of an existing disease, in particular such as:
- restoration of the bowel movement;
- adherence to a therapeutic diet;
- the use of laxatives;
- maintaining a healthy lifestyle;
- refusal of physical activity.
It is important to monitor the weight and prevent its increase. In addition, you need to take walks in the fresh air as often as possible, abandon bad habits, and also engage in moderate sports.
Possible complications
In the chronic course of the disease, quite often complications and exacerbation of internal hemorrhoids can occur. Some of the manifestations may endanger the patient's life. The course of the pathology can provoke complications such as:
- anemia;
- pinched nodes and their subsequent necrosis;
- significant blood loss;
- infectious lesion;
- thrombosis;
- malignant tumors;
- fistula formation.
If any of these manifestations occurs, urgent medical intervention is required, which is most often performed surgically. Despite the high risk of developing serious complications, it is completely possible to completely get rid of hemorrhoids, the most important thing is to conduct complex treatment in a timely manner.