Hemorrhoids - description, types, causes, prevention and treatment of hemorrhoids. What is hemorrhoids, and how to treat all types of diseases? Hemorrhoids disease symptoms and treatment

13.10.2023

Hemorrhoids are varicose hemorrhoidal veins in the rectum. Inflammation of the hemorrhoidal node is characterized by thrombosis, changes in shape and pathological expansion of hemorrhoidal veins that form nodes around the rectum.

According to statistics, about 25% of people suffer from hemorrhoids, which get worse from time to time. And more than 70% of people at least occasionally experience various symptoms of hemorrhoids, such as discomfort in the anus, itching and pain during bowel movements.

Hemorrhoids in women often occur during pregnancy and childbirth. Hemorrhoids during pregnancy should be treated with very gentle methods, since a pregnant woman is not recommended to take some medications for hemorrhoids that are routinely prescribed. Hemorrhoids in men are also a fairly common occurrence, caused by a number of other reasons and factors, which will be discussed further.

What are the causes of hemorrhoids?

Hereditary predisposition to hemorrhoids. This is the main factor in the appearance of hemorrhoids, which needs to be mentioned first. And although hemorrhoids are not inherited, a predisposition to this disease can be determined by genetic factors. Inheritance of certain groups of genes leads to congenital weakness or dysfunction of blood vessels located in the rectum. This is the reason for the increased inflow and insufficient outflow of blood through the cavernous veins, which leads to pathological expansion of the latter. Long-term dilation of the cavernous veins leads to thinning of the walls of blood vessels, which contributes to the appearance of bleeding in hemorrhoids.
Prolonged standing work and heavy lifting. As well as a sedentary lifestyle, physical overload also contributes to the development of hemorrhoids. First of all, this applies to people who are forced to remain in a standing position for a long time. This category includes teachers, lecturers, doormen, security guards, hairdressers and others. Lifting weights is another reason for the development of hemorrhoids and prolapse of hemorrhoids.
Sedentary lifestyle. This is a serious negative factor, mainly affecting office workers, drivers and people leading a sedentary lifestyle. A sedentary lifestyle contributes to the development of hemorrhoids through various mechanisms. First of all, this is increased pressure on the vessels of the rectum in a sitting position. When sitting for a long time, the anus area warms up slightly, which leads to congestion and dilation of blood vessels. In addition, lack of physical activity is a sure path to the development of venous insufficiency. This also applies to the veins located in the rectum.
Chronic constipation and diarrhea. People suffering from chronic constipation are also predisposed to developing hemorrhoids. Why is this happening? The thing is that with constipation, stool hardens, putting pressure on the veins in the lower intestine. This leads to a deterioration in the blood supply to the cavernous tissues and the appearance of hemorrhoids. An additional factor in constipation is the habit of straining hard during bowel movements, which creates additional pressure on the vessels in the rectum.

As well as constipation, severe diarrhea (diarrhea) also contributes to the development of hemorrhoids, which leads to irritation and inflammation of the rectal mucosa.

Pregnancy. Hemorrhoids during pregnancy and childbirth are a common occurrence, since bearing a fetus creates pressure on the venous vessels of the rectum. And intense efforts during childbirth only aggravate the course of hemorrhoids and contribute to the formation of new hemorrhoids.
Poor nutrition, abuse of spicy foods and alcohol. A significant factor in the appearance of hemorrhoids is poor nutrition. In particular, excessive consumption of spicy foods leads to irritation of the intestinal mucosa and also stimulates increased blood flow to the rectum. And insufficient consumption of fiber (plant foods) worsens intestinal motility. Alcohol, which dilates blood vessels, is also a provoking factor in the development of hemorrhoids. Taking alcoholic beverages even in small quantities can provoke an exacerbation of chronic hemorrhoids.

The main factors contributing to the development of hemorrhoids:

Obesity.
Hereditary predisposition.
A sedentary lifestyle (hypodynamia) or work associated with low physical activity.
Activities associated with excessive muscle tension (excessive physical activity).
Stress.
Impaired blood flow in the rectum.
Frequent constipation.
Inflammatory and tumor processes in the intestines and liver.
Getting infected.
Smoking.

Indoor and outdoor

Based on the location of hemorrhoids, the disease is divided into two main types: internal hemorrhoids and external.

With external hemorrhoids, the nodes form in the immediate vicinity of the anus, and therefore their sensitive surface often breaks through and bleeding with bright scarlet blood occurs. The pain associated with external hemorrhoids is quite sharp and strong, but in terms of self-diagnosis this type does not present any difficulties.

The internal form of hemorrhoids, although it poses a much more serious threat to health, is often characterized by a complete absence of pain (especially at the initial stage of the disease). This fact is explained by the fact that hemorrhoids are located deep inside, and their surface is the same insensitive rectal mucosa that lines it.

Degrees

There are usually 3 degrees of internal hemorrhoids:

1st degree. Hemorrhoidal veins are located in the anal canal and may not be palpable (even during rectal examination). Complaints of inflammation of the anus and bleeding, “twitching” pain after defecation.
2nd degree. The nodes protrude from the anus when straining and disappear on their own. In principle, the same disorders are observed here as with grade 1 hemorrhoids, however, small ruptures of the mucous membrane occur more often, and inflammation of the anus is more pronounced.
3rd degree. It is characterized by the so-called prolapse of hemorrhoids, which cannot be reduced on their own. The symptoms may be the same as in grade 2, but often additional symptoms of fecal and gas incontinence develop. Upon examination, prolapsed hemorrhoids are distinguished from prolapsed anus by radially extending grooves, cyanotic color and lumpy surface.

Symptoms of hemorrhoids

Signs of hemorrhoids characteristic of all stages of the disease:

discomfort in the anus;
pain during defecation (insignificant at first, then severe);
bleeding from the anus;
formation and growth of hemorrhoids.

Hemorrhoids (see photo) are a chronic pathology that progresses over many years. The rate of development of the disease depends on many factors, including nutrition and lifestyle.

For the initial stage The disease is characterized by a slight enlargement of the veins in the anal area. Usually this sign goes unnoticed. In this case, the patient may be bothered by bloody discharge from the rectum that occurs immediately after defecation. Blood can be easily seen on toilet paper. It is worth remembering that such a symptom is characteristic of malignant intestinal tumors, so if it occurs, you should consult a proctologist. Timely consultation with a doctor and prescription of therapy will make it easy to slow down the development of hemorrhoids.

At the second stage As the disease progresses, the patient may periodically experience discomfort in the anus and itching. Often he has a sensation of a foreign body in the anus. Hemorrhoids begin to fall out during defecation and are still easily set inward.

For the third stage Hemorrhoids are characterized by an intensification of existing symptoms. Large venous nodes in the anus complicate the process of bowel movement, cause constipation, and the act of defecation itself is accompanied by pain and bleeding. Heavy bleeding from hemorrhoids is dangerous, and over time it can lead to the development of anemia.

For the last stage The disease is characterized by an increase in the size of hemorrhoids. They cannot be adjusted by hand. The presence of dilated veins in the anus causes severe discomfort; it is painful for the patient to sit and go to the toilet. He is bothered by excessive bleeding during each bowel movement. The fourth stage of hemorrhoid development can be complicated by such unpleasant and dangerous phenomena as vein thrombosis at the end of the rectum.

Hemorrhoids in pregnant women

Very often, hemorrhoids appear during the last trimester of pregnancy and childbirth. The cause of hemorrhoids is compression by an enlarged uterus intestinal veins, which leads to deterioration of blood flow from the intestines and from the perineum. Veins increase in diameter and change shape. Periodic constipation in pregnant women can also provoke its appearance.

However, most women experience hemorrhoid symptoms after childbirth, so it is believed that the causes may include hormonal changes. It must be treated immediately after the first symptoms are detected. It is important to combat constipation, for example by taking medications for loose stool (Forlax, Laminaride, Methylcellulose), observe the rules of hygiene (washing the anus after defecation). Medicines for hemorrhoids ( Aurobin, Relief etc.) are used mainly externally in the form of ointments and suppositories. Surgery is performed only in severe cases.

Prevention of hemorrhoids should be carried out from the first days of pregnancy - create a competent diet to prevent constipation, do not wear tight belts, spend more time in the fresh air, walking is useful.

What is the danger?

Progression of the disease without proper treatment will lead to a number of very unpleasant complications.

Complications of hemorrhoids:

Anemia (develops with a long course of the disease with heavy bleeding).
Inflammatory processes in surrounding tissues, up to the development of paraproctitis (inflammation of the tissue around the rectum). Paraproctitis is considered a very serious complication requiring serious treatment.
Anal fissures. The most common cause of severe pain with hemorrhoids. Cracks create favorable conditions for the development and penetration of various infections deep into the soft tissues. This fact can lead to the development of a serious complication such as an abscess (limited purulent inflammation, which is accompanied by general malaise, fever and severe pain). This complication requires mandatory surgical intervention.
Itching. A very unpleasant complication that acts not only as a strong negative psychological moment, undermining the psycho-emotional state of the patient. Constant mechanical irritation of the anal area can significantly aggravate the course of the disease. In addition, constant tissue damage increases the risk of developing various tumor processes.
Insufficiency of the anal sphincter, incontinence of gases and feces (often in older people).

It follows from this that hemorrhoids need early diagnosis and immediate measures to be taken to solve this problem.

What hemorrhoids look like: photo

Diagnostics

As a rule, diagnosis does not involve any particular difficulties; the diagnosis is established as part of a patient interview and an initial outpatient examination. Inspection helps determine:

degree of prolapse of nodes from the anus,
assess the possibility of their reverse reduction,
skin condition,
as well as the relevance and degree of bleeding.

Symptoms of hemorrhoids are similar to some other diseases. Therefore, diagnosis must be thorough, because there is a risk of prescribing the wrong treatment. Hemorrhoids can be confused with:

anal fissure, which is also accompanied by minor bleeding and pain during bowel movements;
rectal cancer (malignant intestinal tumors occur with bleeding);
rectal prolapse;
colitis, polyps and condylomas.

If you notice the first signs of illness, do not put off going to the doctor for too long. Early diagnosis will facilitate treatment and help avoid not only complications, but also surgical intervention.

How to treat hemorrhoids?

Conservative treatment of hemorrhoids:

It is imperative to normalize bowel movements. The stool should be regular and soft. To normalize stool with hemorrhoids, foods containing dietary fiber are recommended, including wheat bran, but their amount should be increased gradually over 2-3 weeks. (from 5-10 g to 20 g per day), which eliminates the occurrence of discomfort.
For constipation, you can recommend Lactulose up to 30-40 ml per day to achieve daily soft stools and other remedies, follow a diet and recommendations for constipation.

Local medications are used in treatment: rectalcandles from hemorrhoids and ointments.

For pain, suppositories containing small doses of narcotic substances (for example, belladonna, etc.) help. You can prescribe Anuzol, Anestezol, Natalsid, Ichthyol, Proctoglivenol, Ultraproct (suppositories, ointment), Proctosedyl suppositories, depending on the symptoms and stage of the disease.
If there is no bleeding, you can prescribe suppositories or ointment Relief, Gepatrombin-G, Gepazolon, etc. But all drugs are prescribed on a case-by-case basis, so only a proctologist can prescribe the correct treatment after examining the patient.
For pain, in addition to suppositories, you can use cold lotions, but not more than 30 seconds.
To increase the effectiveness of local drugs, it is necessary to ingest drugs that improve the tone of venous vessels and prevent thrombus formation: Detralex, Phlebodia, Troxevasin.
- Detralex drink for at least 2-3 months.
For chronic hemorrhoids : take 1 tablet. 2 times a day, for 7 days. Then you can take 2 tablets. once a day with meals.
For acute hemorrhoids : within 4 days take 2 tablets. 3 times a day, then for 3 days 2 tablets. 2 times a day with meals.
Then continue taking 1 tablet. 2 times a day.
- Phlebodia drink 1 tablet (600 mg) 2 times a day, for 7 days. Then 1 tablet. once for 1-2 months.
Prolapse of hemorrhoids (prolapse) is the basis for their ligation.
For thrombosis of hemorrhoidal veins, Cold and Lidocaine (1% solution) are applied topically, and in the future it is possible to ligate the nodes.
In case of relapse, despite treatment, hemorrhoidectomy is recommended (see below).

Drug treatment methods are exclusively symptomatic - that is, hemorrhoids do not radically cure. However, they allow you to temporarily cope with the unpleasant symptoms of hemorrhoids. If the patient, after drug treatment, follows medical recommendations for the prevention of relapses, surgical treatment can be avoided.

But patients cannot always follow all recommendations.

Minimally invasive techniques

Minimally invasive treatment allows you to quickly and without serious injury get rid of such a delicate problem as hemorrhoids. Therapeutic methods in most cases only muffle the symptoms of the disease and delay the moment when it is necessary to use more radical methods. Before prescribing a particular procedure, the doctor examines the patient’s medical history, conducts a comprehensive examination, and evaluates all possible risks.

Sclerotherapy- this is a low-traumatic treatment using special sclerosing substances that are introduced into the node, glue its walls, thanks to which it is possible to stop their nutrition and die off in the future. The technique is carried out only at stages 1-3. It does not eliminate the risk of relapse of the disease and is effective only for small hemorrhoids.
Electrocoagulation carried out under the control of an anoscope. An electrode is applied to the leg of the node and the tissues are coagulated (welded), after which they quickly die. In one procedure it is possible to get rid of 1-2 pathological foci. After gluing, the hemorrhoid stops feeding and growing, and after a while it completely disappears.
Ligation with latex rings- one of the most modern methods of minimally invasive treatment of internal hemorrhoids stages 1-3. Through an anoscope, a latex ligature is applied to the leg of the node, which leads to compression of the tissues and disruption of blood circulation in them. After 8-14 days, the hemorrhoid dies and is brought out along with the latex ring.
Cryotherapy- short-term exposure to hemorrhoids with liquid nitrogen. After this, the hemorrhoidal node dies and falls off. The procedure is performed under local anesthesia, so there is no pain.

Minimally invasive procedures are contraindicated if:

exacerbation of the inflammatory process in the rectum and anus;
anal fissures, injuries;
thrombosis of hemorrhoids.

Minimally invasive methods of combating hemorrhoids can be used only at stages 1-3 of the disease, always without exacerbation of the inflammatory process. All procedures are carried out after local anesthesia. There is no need to use general anesthesia. Only 1-3 nodes can be removed in one session. Sometimes treatment takes place in several stages, at intervals of several weeks.

Surgery

Surgical treatment is the most effective treatment method in the third and fourth stages.

The operation to remove hemorrhoids, proposed back in the 30s of the last century, is still used and continues to be modified. There are mainly two types of operations performed in the world:

Closed hemorrhoidectomy. Used in stages III and IV of the disease.
Open hemorrhoidectomy. Also in stages III and IV, but complicated by anal fissure or paraproctitis.

Also in 1993, a new method of treating hemorrhoids was proposed, this was done by the Italian doctor A. Longo, which consists of circular removal of the mucous-submucosal layer of the rectum using a special apparatus.

Patients are discharged 3-4 days after surgery, restoration of work capacity occurs on 5-7 days. There is also a small percentage of postoperative complications.

Nutrition and diet after surgery

In most cases, patients after surgery for hemorrhoids can start drinking and eating within a few hours after surgery.

But follow the dietary table (according to Pevzner 1a), exclude foods and dishes that stimulate the secretion of the stomach and irritate its mucous membrane. Food must be prepared in pureed form, food must be steamed or boiled in water, and must be taken in a liquid and mushy state. Exclude: hot and cold, bread and flour products, raw vegetables, fruits, cheese, dairy products, sour cream, cottage cheese, spices, sauces, coffee, tea.

Eating 6 times a day in small portions. Restoration of normal bowel function usually occurs on the second day after surgery, therefore, you can return to your normal diet. But, of course, you should exclude all hot and spicy foods, and you should also forget about alcohol. By following these recommendations, you can reduce your recovery time after surgery and reduce the risk of complications.

Treatment at home

There are some things you can do on your own to help relieve the symptoms of hemorrhoids at home. However, it is worth remembering that they will not help get rid of the disease:

Warm baths help a lot. You can take a bath or just sit in a bowl of water. You need to place the anus area in warm water for 10-15 minutes 2-3 times a day.
Careful hygiene of the anal area. You need to take a bath or shower every day and thoroughly wash the anal area.
Do not use soap or other products that may cause irritation in the anal area. Avoid using scented wipes that contain alcohol.
Don't use regular toilet paper. It is better to use wet wipes, but without alcohol.
Use cold. To relieve swelling in the anal area, you can use cold heating pads, ice packs, or a cloth soaked in cold water.

In addition, the diet for hemorrhoids has two goals: to prevent constipation and irritation in the rectal area. Basic recommendations:

Drink enough fluids. This will help make the stool softer and make it easier to pass through the intestines.
Your diet should include more vegetables, fruits, and grains. They contain plant fiber, which helps prevent constipation.
Alcohol, coffee, and strong tea should be avoided.
Limit spicy foods and spices.
It is better to take food in small portions, 4-5 times a day.
Eat around the same time every day.
Physical activity also helps normalize bowel function.

Gymnastics

Gymnastic exercises are aimed at preventing constipation and strengthening the anal sphincter. For example, by improving blood flow and strengthening the abdominal muscle layer, you can normalize intestinal function, thereby preventing constipation:

The “scissors” exercise is performed lying on your back with your legs raised, which need to be spread and crossed alternately;
“Bicycle” is a fairly well-known exercise, which is very reminiscent of riding a bicycle, although lying on your back;
Or you can lie on the floor (on your back), put your legs together straight, lift one or the other leg, if possible, reaching a right angle in the hip joints. Or bend your knees and spread them apart, while trying to lift your pelvis off the floor as much as possible.

This is how a person is designed that he feels his “fifth point” in any position and is able to control it, therefore gymnastics to strengthen the anus does not require any devices and can be performed anywhere, and others are unlikely to notice it.

So, exercises to strengthen the sphincter:

Stand up, cross your legs and perform rhythmic relaxation and tension of the gluteal muscles;
Choose the hardest chair, sit down, leaning forward a little (you can easily do it at your desk), try to alternately contract and relax the sphincter for 10 seconds, trying to push the anus into the rectum. You should set aside 20 minutes for the exercise, which you can always find if you wish.

Which hemorrhoid removal method should you choose?

Treatment tactics will be determined by the stage of the chronic course of the disease. There are 4 stages in total.

For the first stage, the following is indicated: conservative treatment with vascular-strengthening drugs, infrared photocoagulation and sclerotherapy.
Second stage: infrared photocoagulation, sclerotherapy, ligation with latex rings.
Third stage: ligation with latex rings and disarterization of hemorrhoids.
Stage four: surgical treatment.

This approach to treatment allows for good results in 98-100% of patients.

Prevention

The best remedy for hemorrhoids is prevention. There are predisposing factors leading to the development of the disease:

irregular bowel movements, a tendency to constipation or diarrhea, the habit of straining during bowel movements or sitting for a long time in the toilet with a book;
heavy physical work and, conversely, lack of movement, prolonged sitting;
pregnancy and childbirth;
alcohol abuse.

This means that lifestyle changes will help alleviate the course of the disease.

It is advisable to reconsider your diet: give up simple carbohydrates (baked goods, sweets) in favor of complex ones (vegetables, fruits, herbs, grain bread), drink water instead of tea and coffee, preferably still - this will help normalize stool.
Avoid alcohol, including beer.
If you have hemorrhoids, horseback riding, weightlifting, and cycling are undesirable, but walking or swimming are simply necessary.
It is useful to strengthen the abdominal and buttock muscles and do Kegel exercises.
Sitting on the toilet for a long time is a bad habit. But using a bidet or rising shower to wash yourself after visiting the toilet, on the contrary, is very useful.

If, despite all preventive measures, an exacerbation could not be avoided, there is no need to panic. It is advisable to change the sitting position to a lying one, apply cool compresses soaked in a weak solution of potassium permanganate to the sore spot or arrange baths with chamomile (not hot!), do not forget about diet and personal hygiene.

Hemorrhoids are the most common disease on the planet, affecting people of all ages. Men are most prone to the appearance of hemorrhoidal cones, but this problem is not uncommon among women, especially among those who have given birth.

The first signs of hemorrhoids very often go unnoticed: either patients do not want to notice them because they are embarrassed by their problem, or they simply do not pay attention to them. Unfortunately, all this leads to the fact that the disease is diagnosed at late stages, when conservative therapy is powerless and has to be supplemented with surgical intervention.

In this topic, we would like to draw your attention to what the first signs of hemorrhoids may be, so that if you identify them in yourself, you will immediately contact a specialist. But first, let’s look at what hemorrhoids are and what are the reasons for their appearance.

Hemorrhoids: briefly about the reasons

Hemorrhoids are a disease of the anorectal area, which is characterized by enlargement of the veins of the submucosal layer of the rectum and/or saphenous veins of the anal zone with the formation of hemorrhoidal cones.

The main reason for the development of hemorrhoids is congestion in the veins of the rectum and failure of the ligaments that support hemorrhoidal tissue inside the anus.

The following factors provoke disruption of the outflow from hemorrhoidal veins:

physical inactivity and sedentary lifestyle;
unbalanced and unhealthy diet;
intestinal dysfunction (constipation, diarrhea);
hard physical labor;
alcohol abuse;
overweight;
pregnancy;
natural childbirth;
chronic respiratory diseases, which are accompanied by a prolonged cough;
cardiovascular pathology;
tumors of the pelvic organs.

But for these factors to take effect, a person must have a genetic predisposition to hemorrhoids. That is, the anatomical features of the anorectal zone, namely their elasticity and density, are inherited from close relatives - mother, father, grandparents.

Hemorrhoids: first signs

The first manifestations of the disease with hemorrhoids are almost always invisible. Many patients attribute them to other diseases or simply try not to notice them because they are embarrassed to go to the doctor. Meanwhile, the disease progresses. Therefore, you need to know what manifestations of hemorrhoids appear first.

The first signs of hemorrhoids may be the following:

discomfort and heaviness in the rectum;
itching in the anus;
pain during bowel movements;
bleeding during bowel movements.

Unpleasant sensations in the rectum are expressed by mild discomfort, heaviness and a feeling of incomplete emptying after defecation. As the disease progresses, the intensity of the listed symptoms increases, and itching in the anus and pain during bowel movements occur.

Also, at the beginning of the disease, the symptoms are periodic, that is, they appear only during bowel movements, but over time they become constant, disturbing the patient even at rest.

In addition, these symptoms may go away on their own. Patients in this case think that they have recovered. But this, unfortunately, is not the case, and after some time the disease returns with new, more painful manifestations: itching, tingling and pain in the anus.

Early diagnosis of hemorrhoids is the key to its successful treatment. Therefore, if you notice discomfort, heaviness, itching or pain in the rectum, do not be ashamed to consult a specialist. After all, a timely visit to a proctologist will help to avoid not only complications of the disease, but also large financial costs for treatment.

Bleeding during bowel movements appears when the hemorrhoidal cones have reached a sufficient size to be injured by feces. Bleeding most often appears as drops of blood on underwear, toilet paper, or streaks in stool. Profuse bleeding, when blood drips onto the toilet or trickles out of the rectal canal, is rare in the initial stages of hemorrhoids.

Signs and symptoms of hemorrhoids by stage

First, I would like to say that it is customary to distinguish between three types of hemorrhoidal cones - external, internal and combined, since the manifestations of hemorrhoids directly depend on their location.

External hemorrhoidal cones (external hemorrhoids) are formed by hypertrophy of the subcutaneous venous vessels of the anal region and are located below the dentate line of the anus. These formations can be seen with the naked eye. External hemorrhoids are less common than internal hemorrhoids.

Internal hemorrhoids are hypertrophied veins of the submucosal layer of the rectum. Such formations are located inside the rectal canal, so in the initial stages they can only be examined using anoscopy or sigmoidoscopy.

The combined type of hemorrhoids is characterized by the presence of both internal and external hemorrhoidal cones.

With external hemorrhoids, at the beginning of the disease, protrusions of a cherry or red color with a bluish tint are detected around the anus. The emerging hemorrhoidal cones are accompanied by severe pain, especially during bowel movements. Hemorrhoids can also bleed.

During internal hemorrhoids there are four stages, namely:

1st stage. The early period of hemorrhoids can last from several months to several years. At this time, patients experience mild symptoms of the disease, such as discomfort, heaviness or itching in the anus, as well as the presence of a foreign body in the rectum. Visually, the patient cannot determine the presence of hemorrhoidal cones, since they are located inside the rectal canal and have not yet fallen out. The most common harbinger of hemorrhoidal disease is discomfort in the rectum;
2nd stage. At this stage, discomfort, itching, heaviness and pain in the anus increase, and hemorrhoidal cones have already reached sufficient size to come out of the anus. This happens when lifting heavy objects, coughing, and when going to the toilet “in a big way.” But at rest, the hypertrophied hemorrhoidal veins are reduced independently into the rectal canal. Also, hemorrhoids begin to bleed more, and the patient has a tendency to constipation;
3rd stage. At this stage of hemorrhoids, hemorrhoidal cones fall out with little physical activity, but they can no longer straighten on their own. Therefore, patients use their fingers to insert them into the rectum. Very often, at the third stage, complications of hemorrhoids develop, such as strangulation, thrombosis and necrosis of hemorrhoidal formations, which are accompanied by severe pain.
4th stage. At this stage of the disease, inflamed hemorrhoidal cones are visible to the naked eye in the anus. This stage, like the previous one, is advanced. The pain is constant, and hemorrhoidal cones become unreducible and bleed at the slightest injury (defecation, walking, wearing tight underwear and clothing).

Symptoms of hemorrhoids: discomfort, itching, pain in the anus, constipation and bleeding

Discomfort in the rectum. The feeling of discomfort in the rectum can be expressed by heaviness and a feeling of incomplete bowel movement after defecation. This is explained by the fact that the hemorrhoidal veins hypertrophy and protrude into the rectal canal. Swelling of the anal tissue also plays an important role in the occurrence of these symptoms.

Itching in the anus. This symptom is present at all stages of the disease, only its intensity changes. At the beginning of hemorrhoids, the itching is not constant, but with the development of the pathological process it becomes permanent. The intensity also increases to the point of burning.

The cause of itching and burning in the anus is the secretion of mucus from the rectal canal, which irritates the perianal tissues. Also, this symptom can be caused by erosions, ulcers and tears in the anal mucosa, which often become infected, causing quite severe itching and burning.

Pain in the anus. Painful sensations can also be either periodic or permanent. In the initial stages of hemorrhoid development, pain occurs during bowel movements, and in the final stages it is constant. Particularly severe unbearable pain is accompanied by complications of hemorrhoids, such as pinching, thrombosis and necrosis of hemorrhoidal cones.

Constipation. Defecation disorders are more often observed in advanced stages of hemorrhoids, when hemorrhoidal cones narrow the rectal canal, making it difficult for the passage of feces. Constipation can also result from the patient's fear of going to the toilet. Patients specifically suppress the urge to defecate because they are afraid that it will hurt, but this only aggravates the situation. In addition, constipation itself provokes an exacerbation of hemorrhoids, since hard feces injure hemorrhoidal cones, causing their inflammation, and strong straining during bowel movements leads to an increase in venous pressure in the veins of the rectum. Thus, it creates a vicious circle: constipation-hemorrhoids-constipation.

Bleeding. This symptom is more common with internal localization of hemorrhoidal cones. The mechanism of hemorrhoidal bleeding is associated with injury to the epithelium of hypertrophied rectal veins by feces, especially with constipation when the feces are hard. As we have already said, profuse bleeding is not typical for hemorrhoids, therefore the risk of developing anemia is minimal. But in advanced cases, when the bumps bleed heavily, the symptoms of hemorrhoids can be accompanied by anemia, namely general weakness, pale skin, changes in taste, fainting, etc.

Hemorrhoids: how to treat them?

The treatment and diagnosis of hemorrhoids is carried out by a proctologist or coloproctologist, but in a district clinic where there are no specified specialists, these functions are performed by a surgeon.

The fight against hemorrhoids should be comprehensive and cover not only the relief of symptoms of the disease or its complications, but also influence the causative factors.

Thus, in the treatment of this disease, specialists are guided by the following principles:

Lifestyle correction:

rejection of bad habits;
combating physical inactivity;
weight loss and control.

Diet. Nutrition should be healthy and balanced. The menu of patients with hemorrhoids should be dominated by foods rich in plant fiber (vegetables, fruits, dried fruits, cereals, berries). Alcoholic drinks, fatty, fried, salted, smoked dishes and marinades are prohibited, as well as white cabbage, radishes, grapes and other vegetables and fruits that cause constipation and flatulence;
Sufficient water consumption – 1.5-2.5 liters;
Systemic drug therapy:

venotonics and phleboprotectors. Drugs of these groups can increase the tone of the rectal veins, strengthen their walls and eliminate venous stagnation;
non-steroidal anti-inflammatory and painkillers. Such medications help cope with pain in the anus, reduce tissue swelling and relieve inflammation;
carry-on drugs. The use of stool laxatives is resorted to if it is not possible to improve bowel function with the help of diet;
enzyme preparations. Enzymes are prescribed to normalize intestinal function - eliminate constipation or diarrhea.

Local therapy. The use of ointments, gels, creams or suppositories is mainly aimed at relieving the symptoms of hemorrhoids, such as pain, itching or burning. But many local forms also contain venotonics, phleboprotectors, antimicrobial and healing agents.

If conservative therapy is ineffective or life-threatening complications develop, the issue of surgical treatment of hemorrhoids is considered.

All surgical methods for treating hemorrhoids can be divided into minimally invasive and radical.

Minimally invasive operations for hemorrhoids include sclerotherapy, coagulation with infrared rays, ligation with silicone rings, coagulation of hemorrhoids with an electrocoagulator or laser, and others. The listed methods are low-traumatic, painless, do not require a long recovery period and have virtually no contraindications. But, unfortunately, they are powerless for advanced forms of hemorrhoids.

In advanced stages of hemorrhoids, hemorrhoids are removed, and this operation is called hemorrhoidectomy.

As a result, I would like to remind you once again that the earlier the disease is identified, the easier it is to cure it. Therefore, when you notice the first symptoms of hemorrhoids, do not self-medicate and do not be ashamed to consult a specialist, because your health is more valuable than any prejudice.

Have you or your family ever had to deal with the problem of hemorrhoids? We would appreciate your feedback in the comments.

– a disease characterized by varicose veins of the anus and rectum with the formation of hemorrhoids. Symptomatically manifested by a burning sensation, heaviness, itching in the anus, bleeding of scarlet blood from the nodes. May be complicated by prolapse, strangulation and thrombosis of hemorrhoids. Inflammation of the nodes leads to the occurrence of rectal fistulas and paraproctitis. Prolonged hemorrhoidal bleeding leads to the development of anemia.

General information

is one of the most common proctological diseases. Hemorrhoids are pathologically enlarged hemorrhoids that are prone to inflammation, bleeding and prolapse from the anus. The name of the disease is a Greek term meaning bleeding. Bleeding is the most striking, but not the only symptom of the development of hemorrhoids.

The hemorrhoidal venous plexuses in humans are located in the submucosal layer of the wall of the anal canal, are similar in structure to the cavernous bodies of the genital organs and are believed to play a role in ensuring complete closure of the anus and retention of feces. There are internal and external hemorrhoids. Most people sooner or later experience varying degrees of enlargement of these venous formations. Enlargement of hemorrhoids, detected during examination and not accompanied by clinical symptoms, is not considered a disease.

Clinically, hemorrhoids are manifested by prolapse of internal hemorrhoids, thrombosis of external hemorrhoids, bleeding, itching and burning in the rectum, and pain during defecation. Currently, in Russia, in 75% of cases, surgical removal of pathologically enlarged nodes is resorted to (compared to the USA and Europe, this figure is about 20% of cases). The effectiveness of non-surgical treatment methods is facilitated by early detection of the disease and timely consultation with a doctor.

Etiology and pathogenesis of hemorrhoids

The pathogenetic factor in the development of hemorrhoids is impaired blood circulation in hemorrhoidal venous accumulations, which contributes to the development of dystrophic changes in the connective tissue and muscle structures that secure the nodes inside the anal canal. The following factors contribute to the development of the disease: a tendency to bowel disorders (frequent constipation or diarrhea), a sedentary lifestyle, abuse of spicy foods and alcohol.

Among the professional factors, it is worth noting professions that require prolonged sitting (drivers, pilots, etc.). In addition, some sports can contribute to poor circulation in the perianal area: horseback riding, cycling, weightlifting. In women, pregnancy and childbirth can contribute to the development of hemorrhoids.

Classification and symptoms of hemorrhoids

There are acute and chronic hemorrhoids, which, in fact, are stages of one disease. There are also internal hemorrhoids, external hemorrhoids and combined.

Classification of chronic hemorrhoids:

The clinical course of hemorrhoids is divided into four stages. The first stage is characterized by periodic discharge of scarlet blood from the anus. There was no prolapse of hemorrhoids.

At the second stage, the hemorrhoids prolapse and their self-reduction occurs. It may or may not be accompanied by bleeding.

At the third stage, prolapsed hemorrhoids cannot be reduced on their own, and they must be returned to the anal canal manually. Bleeding may or may not be present.

Hemorrhoids of the fourth stage are characterized by the impossibility of repositioning hemorrhoids that constantly fall out of the anal canal. In addition, there are acute and chronic hemorrhoids.

Symptoms of hemorrhoids

Acute hemorrhoids

Clinically, acute hemorrhoids are manifested by thrombosis of external hemorrhoids, or prolapse of thrombosed internal nodes from the anal canal.

Practice shows that a third of patients suffering from hemorrhoids have diseases of the anal canal and large intestine, some of which can also cause bleeding from the anus. Often, during examination and examination for hemorrhoids, it is possible to diagnose rectal cancer.

Treatment of hemorrhoids

Treatment tactics for hemorrhoids are chosen based on the stage of the disease. For hemorrhoids of the first and second stages, you can choose conservative therapy, or offer treatment using electrocoagulation or sclerotherapy. Ligation (suture ligation or latex ring ligation) can be effective in the second and third stages.

In addition, for hemorrhoids in the third stage, the Longo hemorrhoidectomy technique can be used. Stage four hemorrhoids require surgical removal of the hemorrhoids (hemorrhoidectomy).

In the acute period of hemorrhoids, all treatment methods other than conservative therapy are contraindicated. In addition, drug treatment is often limited to the first and second stages of the disease. With conservative treatment, a diet is prescribed that helps normalize stool in case of frequent diarrhea and soften it in case of difficult bowel movements. If necessary, laxatives are prescribed. As a general therapy, drugs that help strengthen the venous walls (phlebotropic drugs - diosmin) are also recommended. Suppositories and ointments with anti-inflammatory, healing, analgesic, hemostatic and improving local blood flow agents are used locally.

The prescription of local medications depends on the severity of certain symptoms. Most often, multicomponent agents are chosen, including anti-inflammatory, anesthetic and hemostatic elements. Medicines containing anti-inflammatory drugs (corticosteroids and non-steroidal drugs) are prescribed in short courses to avoid side effects. For severe bleeding, an effective hemostatic agent sodium alginate is used.

Conservative therapy for hemorrhoids is aimed at alleviating clinical symptoms and attenuating exacerbations. It should be remembered that this is symptomatic therapy that does not lead to relief from the disease and is temporary. A tendency to a sedentary lifestyle or excessive physical activity contributes to the development of new exacerbations and the progression of hemorrhoids.

Effective measures to cure hemorrhoids in the early stages are minimally invasive methods for removing hemorrhoids (sclerotherapy, infrared coagulation, doping). Combination treatment is often used in practice. Despite the high degree of safety and convenience for patients, minimally invasive techniques are not always applicable.

To remove nodes in the later stages of the disease, surgical intervention is performed: hemorrhoidectomy. In this case, the cavernous venous plexus is excised entirely, eliminating the possibility of relapse of the disease. Modern surgical techniques make it possible to shorten the postoperative period and eliminate possible complications as much as possible.

Since hemorrhoids are not a life-threatening disease, in all cases, except for persistent bleeding leading to severe anemia, the patient himself decides on the advisability of surgical intervention, depending on the doctor’s recommendations. Since patients usually seek medical help with frequent exacerbations, hemorrhoids cause them noticeable inconvenience and significantly worsen their quality of life, the task of the proctologist is a thorough examination and competent recommendation of the optimal treatment method.

Prevention of hemorrhoids

Prevention of hemorrhoids includes preventing factors that contribute to impaired blood flow in the vessels of the rectum and measures to normalize the functioning of the digestive tract. Timely treatment of diseases manifested by constipation or diarrhea, proper balanced nutrition help normalize stool consistency and regular comfortable bowel movements.

The prevention of hemorrhoids is facilitated by hygienic measures to care for the anus: thorough cleansing after bowel movements, using soft types of paper (if necessary, avoiding toilet paper in favor of washing with cool water), regular washing, wearing underwear made from natural, breathable fabrics that do not restrict movement. At the first signs of hemorrhoids, it is advisable to abandon activities associated with regular heavy physical activity. People prone to a sedentary lifestyle should engage in physical exercise, swimming, and regular walking.

Hemorrhoids during pregnancy and after childbirth

How to treat hemorrhoids during pregnancy and breastfeeding?

Causes of hemorrhoids in women during pregnancy and after childbirth (doctor's review) - video

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Haemorrhoids is a disease in which the veins in the anus and rectum dilate.

Hemorrhoids in numbers and facts:

Although hemorrhoids can cause a lot of discomfort, they are often easy to treat and prevent.
The disease occurs 3-4 times more often in men than in women.
It is believed that hemorrhoids affect approximately 10% of adults worldwide. It accounts for 40% of all rectal diseases.
According to the Mayo Clinic, approximately half of people by the age of 50 begin to experience itching, discomfort, and bleeding in the rectal area. In most cases, these symptoms indicate hemorrhoids.
Most often, the disease affects people aged 45-65 years.
Scientists believe that 75% of people in Europe and America will experience hemorrhoids at some point in their lives.
According to statistics, only 4% of people experiencing hemorrhoid symptoms seek medical help.

Features of the anatomy of the rectum and hemorrhoidal veins

The rectum is the final section of the intestine. In humans, it begins at the level of the upper edge of the third sacral vertebra and ends with the anus. The main function of the rectum is the evacuation of feces.

The outflow of blood from the rectum is carried out through the inferior vena cava system. Venous vessels around the intestine form hemorrhoidal plexus. There are three venous plexuses:

Subcutaneous. Located under the skin in the anal area.
Submucosal. Located under the mucous membrane of the rectum, it is divided into lower, middle and upper sections.
Subfascial. Located between the muscle layer of the intestinal wall and the fascia.

What is the difference between external hemorrhoids and internal hemorrhoids?

Depending on which veins are dilated and where the hemorrhoid is located, there are four types of hemorrhoids:

Internal hemorrhoids. The veins involved are those located inside the rectum under the mucous membrane. Internal hemorrhoids are usually not painful, but painful bleeding may occur.
Prolapsed hemorrhoids. The hemorrhoid stretches so much that it falls out of the rectum and ends up outside. Usually, if you press on it a little, it will go back in.
External hemorrhoids. The node is located outside the anus, on the skin. Patients are often bothered by pain and itching. The nodes may crack and bleed.
Combined hemorrhoids. It is a combination of internal and external hemorrhoids. Occurs in approximately 40% of patients.

Why do hemorrhoids occur?

The disease occurs when the veins of the hemorrhoidal plexus become stretched. The following factors may contribute to this:

Severe straining during bowel movements due to chronic constipation.
Chronic diarrhea. Also leads to straining during bowel movements.
Obesity. The more fat tissue accumulates in the body, the more difficult it is for the heart to push blood through it. As a result, blood stagnation begins in the veins of the lower body.
Pregnancy. In pregnant women, the outflow of venous blood from the pelvic cavity is disrupted due to an enlarged uterus.
Anal sex. Frequent anal intercourse can lead to irritation of the rectal mucosa and an inflammatory process, which contributes to the development of hemorrhoids.
Hereditary predisposition. If a person's parents and close relatives suffer from hemorrhoids, the risk also increases slightly.
Poor nutrition: low protein content in the diet, frequent consumption of alcohol, coffee, spicy foods.
Sedentary lifestyle. The development of hemorrhoids is facilitated by prolonged standing or sitting, so the risk of the disease is increased in people of certain professions (office workers, surgeons who have to stand for long periods during operations).
Intense physical activity, which increases pressure in the abdominal cavity and veins.
Age. As you age, the walls of the veins weaken and stretch more easily.
Inflammatory processes in the intestines.
Frequent stress.

Symptoms

Possible symptoms of hemorrhoids:

Painless bleeding. The patient may notice blood on toilet paper or in the toilet. Sometimes the bleeding is quite heavy. In this case, the blood is not mixed with feces, but covers it.
Irritation, itching in the anal area. They occur as a result of exposure to the skin of mucus, which is secreted in large quantities by the rectal mucosa.
Nodes protruding in the anal area.
Discomfort, pain in the anus.
Swelling in the anal area.

Symptoms depend on where the hemorrhoid is located. Internal hemorrhoids usually have no symptoms, do not cause pain or discomfort, and cannot be seen or felt. When stool passes, the surface of the hemorrhoid may be damaged and bleeding may occur.

Over time, the internal node begins to fall out of the anus. Loss is often accompanied by pain, discomfort, and irritation.

External hemorrhoids most often look like a lump in the anus. Patients are often bothered by symptoms such as itching, pain, and bleeding.

Stages

There are four stages of hemorrhoids (stages of prolapse of hemorrhoids):

Stage	Description
I	The nodes protrude into the lumen of the rectum, but their prolapse does not occur.
II	During defecation, hemorrhoids fall out and then retract on their own.
III	The nodes fall out not only during bowel movements, but also with minor physical exertion. Self-reduction of the nodes does not occur: you have to set them back by hand.
IV	The fallen nodes cannot be set even by hand.

Complications of hemorrhoids

Bleeding from hemorrhoids. Sometimes bleeding from hemorrhoids is so severe that it leads to anemia. Symptoms such as pallor, weakness, increased fatigue, headaches, and dizziness occur.
Blood clot formation. Blood clots (thrombi) can form inside the hemorrhoid, causing it to swell, become painful, and become inflamed.
Incarceration of the hemorrhoidal node. A common complication at stages III-IV of the disease. The muscle sphincter of the rectum pinches the node, as a result, blood circulation in it is disrupted. There is severe pain in the anus, a sensation of a foreign body, and swelling. The color of the dropped node changes: from pink or red it becomes bluish-burgundy, black. Eventually, necrosis of the node may occur due to poor circulation. Sometimes a blood clot in a hemorrhoidal node leads to such consequences.
Eczema. Sometimes this skin disease occurs as a result of constant irritation of the skin by mucus from the rectum.
Inflammation of hemorrhoids. Quite a common complication. Infection can penetrate through damaged hemorrhoids.

What does hemorrhoids look like?

Which doctor diagnoses and treats hemorrhoids?

Diagnosis and treatment of hemorrhoids is carried out by:

proctologists– specialists in diseases of the rectum;
coloproctologists– specialists in diseases of the colon and rectum.

In what cases should you consult a doctor?

Often the first symptom of hemorrhoids that a patient notices is bleeding from the rectum. Many people do not go to the doctor, they believe that nothing serious is happening, they are treated with traditional methods or on the advice of relatives and friends.

If you experience symptoms of hemorrhoids, you should always see a doctor. In most cases, bleeding during bowel movements is actually due to hemorrhoids. But the reasons can be much more serious, even rectal cancer. In this case, early diagnosis may help save a person’s life.

If your stool has become very dark, tar-like, or if there are clots or blood in it, you need to go to the hospital to figure out which part of the intestine is bleeding.

If you have been treating hemorrhoids for some time with folk remedies, but the disease does not go away, consult a doctor.

You should call an ambulance if you have severe bleeding, weakness, dizziness, or your general health has deteriorated significantly.

What questions should you ask your doctor?

It’s better to make a list of questions in advance so that you don’t forget anything during the conversation with your doctor. You may want to know the answers to the following questions:

Why do I have these symptoms? What could possibly be the reason?
Is there a risk of complications?
What treatment will you prescribe for me? For what purpose? What effect can most likely be expected?
If the treatment is ineffective, what are you going to prescribe for me in this case?
Is surgical treatment indicated in my case? Why shown/not shown?
What else can I do on my own to cope with the disease?
I have other health problems - will this affect the treatment of hemorrhoids?

Questions your doctor may ask you

The proctologist may ask you some questions:

When did your symptoms begin?
How much inconvenience do they cause you?
How do you eat? What foods do you consume most often? How much fiber is in your diet?
Do you often drink coffee and alcohol?
What usually makes your symptoms worse?
What usually relieves your symptoms?
Has anyone in your family had hemorrhoids or rectal cancer?
Have you noticed other changes in your bowel habits?
Have you noticed blood on toilet paper or in the toilet?

Patient examination

If hemorrhoids are suspected, the doctor performs a digital examination of the rectum. The procedure is performed as follows:
1. The patient is asked to take off his clothes and take a knee-elbow position on the couch (standing on all fours, leaning on his knees and elbows).
2. The doctor puts on latex gloves and moistens the index finger with Vaseline.
3. The doctor inserts the index finger into the rectum and feels it from the inside. At the same time, he can detect hemorrhoids and other pathological formations.

Diagnosis of hemorrhoids

Study title	Description	How is it carried out?
Anoscopy	During the procedure, the doctor examines the patient's rectum using a special instrument - anoscope, - which is inserted to a depth of 12 cm. Indications for anoscopy: stool disorders; discharge of pus, mucus, blood from the anus; hemorrhoids that cannot be palpated during digital examination of the rectum; suspected rectal cancer; condylomas, polyps and other formations; inflammation of the rectum.	An anoscope is a small rod or cone with a handle, hollow inside, with a plug. Anoscopes come in reusable metal and disposable plastic. The doctor lubricates the anoscope with Vaseline and inserts it into the patient’s rectum, examining its internal surface. The study makes it possible to detect not only hemorrhoids, but also other pathological processes in the intestine.
Sigmoidoscopy	A procedure during which a doctor, using a special instrument, - sigmoidoscope, - examines the mucous membrane of the rectum and partially the sigmoid colon. Inspection is possible to a depth of approximately 25-30 cm. A sigmoidoscope is a metal tube containing a light source and a device for pumping air.	The patient is asked to lie on the couch on his left side and pull his legs towards his stomach. The procedure is virtually painless, so in adults it can be performed without anesthesia. In children, general anesthesia is most often used. The doctor lubricates the sigmoidoscope and inserts it into the patient’s rectum. During insertion of the instrument, the patient is asked to take a deep breath. The doctor gradually moves the sigmoidoscope deeper, pumping air into the rectum using a bulb. This helps to stretch the intestines and allow them to be examined better. If pain occurs or the instrument begins to move with great difficulty, the study is stopped.
Colonoscopy	A type of endoscopic examination during which a colonoscope– a tool that is a flexible hose with a light source and a miniature video camera. During a colonoscopy, the doctor can examine the patient's entire colon (approximately 150 cm). Colonoscopy for hemorrhoids may be prescribed in the following cases:: suspicion of diseases of the large intestine; the patient has risk factors for colon cancer; The patient's age is more than 50 years, if he has not undergone this study for a long time.	During the procedure, the doctor inserts a colonoscope into the patient's intestines through the anus. The procedure is painless, but may be accompanied by discomfort. Some clinics offer to undergo a study in a state of medicated sleep. A person is given a drug that induces deep sleep. Its effect lasts for about an hour. This time is enough to perform a colonoscopy. The patient can usually leave the hospital and go home the same day.
Biopsy	A biopsy is a test during which the doctor obtains a fragment of the intestinal mucosa and sends it to the laboratory for examination. This is necessary when cancer is suspected.	A fragment of the mucous membrane for biopsy can be taken during an endoscopic examination.

Treatment

If hemorrhoids are small and cause only minor discomfort to the patient, the doctor usually prescribes conservative treatment in the form of ointments, creams, and suppositories.

Suppositories for hemorrhoids

Suppositories for hemorrhoids may contain medicinal substances that have a vasoconstrictor effect, help cope with inflammation, swelling, pain and itching, improve the healing of the mucous membrane and prevent infection.

The doctor may prescribe you Relief, Anuzol, Proctosedyl suppositories, etc. To improve tissue regeneration, rectal suppositories with methyluracil are used. Typically, suppositories are recommended for use in the morning, evening and after each bowel movement. The duration of the course of treatment is determined by the attending physician.

Before using rectal suppositories, you need to perform thorough hygiene of the anal area.

Ointment

Many ointments for hemorrhoids have the same healing effects as suppositories. The doctor may prescribe ointments whose main active ingredient is heparin (Heparin ointment, Hepatrombin G) - a substance that prevents the formation of blood clots.

Ointments are applied to the skin in the area of hemorrhoids. Sometimes ointments are produced in special tubes with screw caps - such a cap must be inserted into the rectum and a small amount of ointment squeezed out, like an enema. The kit may include a special applicator for convenient application of the drug. The frequency of use and duration of treatment is determined by the attending physician.

Pills

Tablets and capsules for hemorrhoids, such as Venoruton, Vasoket, Detralex, Venarus, Phlebodia 600, strengthen and tone the vein walls and improve microcirculation. Your doctor may also recommend that you use dietary supplements to improve bowel function and normalize bowel movements, such as Proctonis.

Laxatives for hemorrhoids

Laxatives are available in the form of tablets, granules for dissolution in water, drops for oral administration, and microenemas. They help relieve constipation, which worsens the symptoms of hemorrhoids.

You should not use laxatives frequently or for a long time, especially without medical supervision. A “ricochet effect” may occur - over time, constipation worsens, and the person can no longer go to the toilet on his own, without medication. In addition, frequent unnecessary use of laxatives leads to electrolyte imbalance.

Operations for hemorrhoids

Minimally invasive interventions

Minimally invasive procedures are often used when hemorrhoids are accompanied by pain and constant bleeding. They can be performed on an outpatient basis. The following treatment methods are used:

Surgical interventions

The doctor may prescribe surgery if the hemorrhoids are large or other treatment methods have not helped. Sometimes surgical treatment can be performed on an outpatient basis, in other cases hospitalization in a hospital is necessary.

Types of operations for hemorrhoids:

Hemorrhoids: risk groups, how the disease develops, symptoms, treatment methods - video

Hemorrhoids: symptoms and complications, causes and mechanism of development, what diseases can lead to hemorrhoids, methods of diagnosis and treatment, opinion of a coloproctologist - video

Surgical treatment of hemorrhoids using the Longo method - video of the operation

How to deal with hemorrhoids at home?

There are some things you can do on your own to help relieve the symptoms of hemorrhoids. However, it is worth remembering that they will not help get rid of the disease:

Warm baths are good for hemorrhoids. You can take a bath or just sit in a bowl of water. You need to place the anus area in warm water for 10-15 minutes 2-3 times a day.
Careful hygiene of the anal area. You need to take a bath or shower every day and thoroughly wash the anal area.
Do not use soap or other products that may cause irritation in the anal area. Avoid using scented wipes that contain alcohol.
Don't use regular toilet paper. It is better to use wet wipes, but without alcohol.
Use cold. To relieve swelling in the anal area, you can use cold heating pads, ice packs, or a cloth soaked in cold water.

Diet for hemorrhoids

The diet for hemorrhoids has two goals: to prevent constipation and irritation in the rectal area. Basic recommendations:

Drink enough fluids. This will help make the stool softer and make it easier to pass through the intestines.
Your diet should include more vegetables, fruits, and grains. They contain plant fiber, which helps prevent constipation.
Alcohol, coffee, and strong tea should be avoided.
Limit spicy foods and spices.
It is better to take food in small portions, 4-5 times a day.
Eat around the same time every day.
Physical activity also helps normalize bowel function.

Is it necessary to do enemas for hemorrhoids?

For hemorrhoids, 4 types of enemas are used:

Cleansing. Used for constipation. Water at room temperature is injected into the rectum, which helps get rid of feces. Cleansing enemas are also used during preparation for diagnostic procedures, for example, colonoscopy.
Oily. Helps make stool easier to pass. 100 ml of sunflower, olive or vaseline oil at a temperature of 37 o C is injected into the rectum.
Medicinal. A solution of a medicinal substance is injected into the rectum, which helps eliminate inflammation and bleeding. Traditional medicine is often used as therapeutic enemas: infusion of chestnut, wormwood, chamomile, oak bark.
Hypertensive. A concentrated salt solution, for example, 10% sodium chloride or 30% magnesia, is injected into the rectum. Due to this, fluid enters the intestinal lumen, which dilutes the stool and facilitates its passage.

Before using any type of enemas, you should definitely consult your doctor.

Traditional methods of treatment

Herbal remedies for hemorrhoids and other traditional medicines can help relieve the symptoms of the disease and improve the condition, but they will not eliminate the cause. Before using them, you should consult your doctor. All information below is provided for informational purposes only.

Sea buckthorn oil for hemorrhoids

Medicinal effects of sea buckthorn oil for hemorrhoids:

Strengthening the vascular wall with vitamin C.
Reducing the inflammatory process and fighting infection due to organic acids and tannins.
Reducing swelling.
Acceleration of healing of the mucous membrane.

For hemorrhoids, sea buckthorn oil and suppositories are used. They can be bought in pharmacies. Soak a piece of gauze in oil and apply a bandage to the area of external hemorrhoids overnight.

Propolis for hemorrhoids

Medicinal effects of propolis for hemorrhoids:

Prevents infection by containing naturally occurring antibiotics.
Thinning the blood, preventing its stagnation in hemorrhoids and the formation of clots.
Reducing swelling in the anal area.
Improving healing of the skin, mucous membrane, preventing bleeding.
Fights itching and pain due to its drying and cauterizing action.

Folk recipe for making ointment with propolis:

Take 100 grams of butter (not salted) or animal fat. Place in a saucepan.
Put on fire, bring to a boil.
Add 10 grams of purified propolis.
To stir thoroughly. Leave for 30 minutes until completely cooled.

Mode of application: Apply to hemorrhoids in the morning and evening, as well as after each bowel movement, 2-3 times a day.

Potatoes for hemorrhoids

Folk recipes for using potatoes for hemorrhoids were common among Russian peasants of past centuries. Medicinal effects of raw potatoes for hemorrhoids:

Reducing pain, itching, irritation.
Improved healing of the mucous membrane.
Reducing swelling and inflammation.
Strengthening the vascular wall with vitamin C.

Ways to use raw potatoes for hemorrhoids:

Wash the potatoes thoroughly so that there is no dirt left on them, grate them on a fine grater. Squeeze the juice out of the resulting pulp and make microenemas of 30 ml at night for 10 days.
Make dressings with grated raw potatoes at night.

Chamomile for hemorrhoids

Medicinal effects of chamomile for hemorrhoids:

Reducing inflammation.
Reducing pain.
Antiseptic effect – preventing infection.

Chamomile decoction is used for hemorrhoids. Preparation:

Pour one glass of boiling water over two tablespoons of dried flowers.
Place in a water bath for 20 minutes.
Cool, strain.

Use of chamomile decoction for hemorrhoids:

For hygiene of the anal area.
In the form of lotions for the night.
In the form of sitz baths - in this case you will have to prepare more decoction. It should be warm, but not hot. The baths are done for 10-15 minutes, the total duration of the course is 8-10 days.
Microclysters at night for 8-10 days, 40-50 ml of decoction.

Chinese patches for hemorrhoids

Nowadays, you can often see Chinese patches and musk ointment for hemorrhoids for sale on the Internet. Do they help cope with the disease?

Chinese patches most often contain medicinal plants. Thus, they are a means of traditional medicine. They may relieve the symptoms of hemorrhoids in the early stages, but there is no reliable data on their effectiveness.

Musk is widely used in Eastern folk medicine. Its effectiveness has not been proven. In Western countries, this substance is mainly used in perfumery.

Traditional method of treating hemorrhoids - video

Exercise for hemorrhoids

Exercise can make hemorrhoid symptoms worse, especially if it involves heavy lifting. Most often, the deterioration is temporary. If exercise doesn't make you feel worse or worsen your symptoms, there's no point in giving it up.

Disease prevention

In most cases, preventing hemorrhoids comes down to preventing constipation:

Eat more fiber-rich foods: vegetables, fruits, whole grains. This will help make the stool softer and increase its volume, improving passage.
Use dietary supplements containing plant fiber. Consult your doctor first.
Drink more. 6-8 glasses of liquid daily will help soften stools and improve their passage. But it is better to avoid alcoholic drinks completely.
Don't be patient if you need to go to the toilet. The longer you wait, the harder the stool becomes.
Be physically active. Regular exercise helps improve bowel function.
Don't sit for too long. If you have a sedentary job, take periodic breaks, get up, and walk around.

Hemorrhoids during pregnancy and after childbirth

Among women haemorrhoids most often occurs during pregnancy, after childbirth . Causes:

The enlarged uterus compresses the veins, disrupting the outflow of blood from the rectum.
During pregnancy, women often experience constipation. This makes you push harder and longer on the toilet, and blood pressure in the hemorrhoidal plexus increases.

How to treat hemorrhoids during pregnancy and breastfeeding?

During pregnancy and breastfeeding, not all medications for the treatment of hemorrhoids can be used. You need to see a doctor to prescribe treatment. In addition, you must follow the recommendations described in the paragraph “How to deal with hemorrhoids at home?”.

Causes of hemorrhoids in women during pregnancy and after childbirth (doctor's review) - video

Is it possible to have sex with hemorrhoids?

Having sex with hemorrhoids is not contraindicated. But you need to remember some rules:

You shouldn't have anal sex. It can lead to damage to the intestinal mucosa and increased symptoms of hemorrhoids.
In bed, you need to choose positions in which you do not experience increased tension.
Don't have sex for too long, remember moderation.

What is the ICD code for hemorrhoids?

The general code used in ICD-10 to designate all types of hemorrhoids is I84. Codes for individual forms of the disease:

I84.0 – internal hemorrhoids with thrombosis;
I84.1 – strangulated, bleeding, ulcerated, prolapsing internal hemorrhoids;
I84.2 – uncomplicated internal hemorrhoids;
I84.3 – external hemorrhoids with thrombosis;
I84.4 – strangulated, bleeding, ulcerated, prolapsing external hemorrhoids;
I84.5 - uncomplicated external hemorrhoids;
I84.6 – residual hemorrhoidal marks on the skin;
I84.7 – unspecified hemorrhoids on the skin;
I84.8 – strangulated, bleeding, ulcerated, prolapsing unspecified hemorrhoids;
I84.9 – uncomplicated unspecified hemorrhoids.

Do hemorrhoids increase the risk of cancer?

No, hemorrhoids do not lead to cancer. But the symptoms of these diseases are often very similar. Therefore, in any case, it is worth visiting a doctor and getting examined.
Before use, you should consult a specialist.

What are hemorrhoids

Hemorrhoids (from the Greek haima - "blood", roe - "flow") is one of the most common diseases in proctology, which is based on the pathological condition of the cavernous plexuses of the rectum, accompanied by stagnation of blood in them. Hemorrhoids are manifested by periodic bleeding from the nodes, their prolapse from the anal canal and frequent inflammation. Men and women are equally susceptible to hemorrhoids

Classification of hemorrhoids

Internal hemorrhoids. With internal hemorrhoids, there are varicose hemorrhoidal veins, which are located deep in the anal canal, so such hemorrhoids are not visible during a normal examination. In order to see them, you have to resort to special research methods: anoscopy, rectoscopy. Also, such nodes can be identified during digital rectal examination. Such a sign of the disease as prolapse of hemorrhoids can cause bleeding when they are injured during the act of defecation. With significant weakness of the ligamentous apparatus of the rectum, such nodes fall out during defecation or significant straining. In addition, the internal nodes, when they fall out and spasm of the anal sphincter, can be infringed. Most often, the first signs of internal hemorrhoids are bleeding.

External hemorrhoids. In this type of hemorrhoid, the hemorrhoids are marked externally and should not be confused with prolapsed internal hemorrhoids. Most often, external nodes manifest as thrombosis. As a rule, bleeding from external nodes does not occur, since they are not injured during defecation. Such hemorrhoids hurt and cause discomfort during bowel movements. But constant stagnation of blood in them can lead to the formation of blood clots in them. Externally, the external hemorrhoidal node can be of different sizes, from 3 mm or more, which depends on its blood supply. An external hemorrhoid is usually covered by skin, while a prolapsed internal hemorrhoid is usually covered by the mucous membrane of the anal canal.

Combined hemorrhoids. As the name implies, with combined hemorrhoids, the patient has a combination of external and internal hemorrhoids.

The occurrence of hemorrhoids

Normally, all people have external and internal hemorrhoidal venous plexuses under the mucous membrane of the anal canal, which are similar in structure to the cavernous tissue of the genital organs. They play a significant role in retaining intestinal contents, ensuring complete closure of the anal canal when they are filled with blood. As a result of the influence of a number of factors, most adults experience an increase in hemorrhoidal nodes, and hemorrhoids begin to develop.

Factors influencing the development of hemorrhoids: constipation, straining; pregnancy, childbirth; hereditary factors; sedentary lifestyle; prolonged standing or sitting; excessive physical activity; practicing some sports (horse riding, cycling, weightlifting); lifting weights; overweight; hot, spicy food; drinking alcohol; prolonged exposure to heat (sauna, hot bath); prolonged diarrhea (diarrhea).

Symptoms of hemorrhoids in men and women

A person who develops hemorrhoids may experience occasional feeling of discomfort in the anus, which in most cases is the main signal of the development of hemorrhoids.

Later, other symptoms of the disease appear.

Sensation of a foreign body in the anus, hemorrhoids heaviness and inflammation. These manifestations may be one of the first symptoms of hemorrhoids. They arise due to swelling and displacement of the internal folds of the anal canal. They may not bother you all the time, but only at certain times.

Anal itching and burning. Such unpleasant symptoms of hemorrhoids arise as a result of prolapse of hemorrhoids, as well as the release of blood and mucus, which irritates the mucous membrane and skin in the anus area. Chronic hemorrhoids cause itching during bowel movements.

Bleeding. This is the most typical symptom of hemorrhoids. Bleeding is periodic and can also vary in duration and color. In most cases, they occur during bowel movements, but it is possible that they may occur in the intermediate period. Blood may be released in the form of droplets after the stool is passed, and may also be present in the stool itself. Depending on the severity of the bleeding, blood can leave marks ranging from small marks on toilet paper to large splatters on the toilet.

Prolapse of hemorrhoids. Hemorrhoids are dilated veins of the choroid plexuses of the rectum. Their loss is one of the most characteristic symptoms of hemorrhoids. There is a direct relationship between this symptom of hemorrhoids and the stage of the disease. At the initial stage, the fallen nodes are easily set inward on their own, and at later stages they are set only as a result of manual intervention, or are not set at all.

Pain. As a result of the progressive development of hemorrhoids and strangulation of hemorrhoids, pain is a common symptom of the disease. They can occur during bowel movements, while walking, while sitting, and can also be permanent. Often the pain intensifies with exacerbation of hemorrhoids.

If you have hemorrhoids and you have a question about which doctor to contact, then the answer is simple - you should make an appointment with a proctologist.

Increasing the amount of dietary fiber and fluid in your diet will help reduce symptoms. Good sources of dietary fiber include bread and bran products, fruits and vegetables. Reducing the force and duration of straining during bowel movements will reduce the pressure on hemorrhoids and prevent their prolapse.

Course and manifestation of hemorrhoids

Hemorrhoids are usually characterized by a periodic course, that is, periods of exacerbation and remission.

The listed symptoms and signs of hemorrhoids most often bother patients during the development of the disease and are serious signals for taking emergency measures.

Hemorrhoids, like many other diseases, are much easier to cure in the initial stages of the disease, otherwise the patient will face surgical intervention and a long course of treatment. If nothing is done against hemorrhoids in time, the disease may be accompanied by the occurrence of other diseases against its background, such as chronic and acute anal fissure, anemia, rectal fistula, thrombosis, ulcers around the rectum, and weakened ability to retain gases.

In advanced cases, complications of acute hemorrhoids may develop, such as massive bleeding, swelling of the anus, purulent paraproctitis (purulent inflammation of the tissue), necrosis (death) of hemorrhoidal tissue.

The dangerous consequences of hemorrhoids are polyps and malignant tumors of the intestine, which have symptoms similar to hemorrhoids. Pain and bleeding during bowel movements can be a manifestation of rectal pathologies such as polyps or cancer.

Stages	Symptoms	Clinical picture
1	Bleeding, discomfort	Hemorrhoids do not protrude from the anal canal. The vascular pattern of the mucous membrane is enhanced
2	Bleeding, prolapse of nodes, itching, mucous discharge	Hemorrhoids prolapse during bowel movements and then reset on their own
3	Bleeding, prolapse of nodes, anal itching, mucous discharge	Hemorrhoids fall out not only during defecation, but also during physical stress and are manually adjusted by the patient
4	Bleeding, constant prolapse of nodes, anal itching, sphincter incontinence, pain syndrome	Constant prolapse of hemorrhoids, with the impossibility of their reduction

Diagnosis of hemorrhoids

An examination by a coloproctologist involves complex procedures, among which it is worth noting an examination of the rectum. Upon examination, external hemorrhoidal nodes can be identified, and with careful spreading of the edges of the external anal sphincter, internal nodes can be identified. Using a digital rectal examination, which should be carried out in all cases, except those when there is an exacerbation of the process, it is possible to establish the presence of compacted hemorrhoids, the tone of the anal sphincter, and identify concomitant diseases of the rectum. To establish that hemorrhoids have come out, the patient is asked to strain. The doctor must also perform a sigmoidoscopy. A thorough examination of the patient allows us to exclude anal fissure, paraproctitis, polyps and rectal cancer.

Hemorrhoids - how to treat?

Hemorrhoids are considered a disease that can be completely cured. Modern medicine uses a number of technologies to cure hemorrhoids painlessly and effectively. The choice of treatment method depends on the stage of the disease and the severity of symptoms. Patients with the first stage can be treated conservatively with phlebotropic drugs (for example, Detralex) in combination with suppositories and ointments. These drugs help fight symptoms of hemorrhoids such as pain and itching, relieve swelling and inflammation, improve blood circulation, which, in turn, accompanies a general improvement in the patient’s condition. However, it is not possible to achieve a complete cure for hemorrhoids using medicinal methods. Minimally invasive procedures are more effective: infrared photocoagulation and sclerotherapy.

The method of choice for treating patients with the second stage is minimally invasive procedures. First of all, this is the ligation of hemorrhoids with latex rings. In some cases, infrared photocoagulation and sclerotherapy can be performed. Treatment with the listed methods is characterized by low trauma and low pain for the patient, which makes them very attractive.

Today, ligation with latex rings is becoming increasingly popular, being one of the most effective methods of treating hemorrhoids. The principle of operation of the method is that the coloproctologist uses an anoscope to gain access to the hemorrhoidal node, after which a special tool - a ligator - places a latex ring on the node. The latex ring, which resembles a rubber ring in its properties, compresses the leg of the node, thereby disrupting its blood supply, which is why the node dies and disappears after defecation after 6 days.

Ligation with latex rings is not performed if it is impossible to define a clear boundary between the internal and external hemorrhoids, which occurs with combined hemorrhoids.

In the third case, if pain due to hemorrhoids is observed, it is better to carry out treatment combining several minimally invasive procedures. Sometimes you have to resort to surgical treatment - hemorrhoidectomy.

In the fourth stage, the method of choice is surgical treatment. If hemorrhoidectomy is contraindicated, sclerotherapy should be performed in combination with ligation of hemorrhoids with latex rings and conservative therapy as supportive treatment.

Any hemorrhoids are treated by a proctologist who, upon examination, determines what shape and size your hemorrhoids are, what stage they are, prescribing a treatment method based on the test results.

Prevention of hemorrhoids

Prevention of hemorrhoids consists mainly in eliminating factors contributing to its development, and includes:

a rational diet (avoid diarrhea and constipation, do not get carried away with unhealthy - fatty, hot, spicy - foods);
instilling, starting from childhood, certain hygienic skills (thorough toileting of the anus after defecation);
sports activities and gymnastics, which helps to normalize the motor-evacuation function of the colon and prevent blood stagnation in the pelvic organs.

What are the causes of hemorrhoids?

Indoor and outdoor

Degrees

Symptoms of hemorrhoids

Hemorrhoids in pregnant women

What is the danger?

What hemorrhoids look like: photo

Diagnostics

How to treat hemorrhoids?

Minimally invasive techniques

Surgery

Nutrition and diet after surgery

Treatment at home

Gymnastics

Which hemorrhoid removal method should you choose?

Prevention

Hemorrhoids: briefly about the reasons

Hemorrhoids: first signs

Signs and symptoms of hemorrhoids by stage

Symptoms of hemorrhoids: discomfort, itching, pain in the anus, constipation and bleeding

Hemorrhoids: how to treat them?

General information

Etiology and pathogenesis of hemorrhoids

Classification and symptoms of hemorrhoids

Classification of chronic hemorrhoids:

Symptoms of hemorrhoids

Treatment of hemorrhoids

Prevention of hemorrhoids

Features of the anatomy of the rectum and hemorrhoidal veins

What is the difference between external hemorrhoids and internal hemorrhoids?

Why do hemorrhoids occur?

Symptoms

Stages

Complications of hemorrhoids

What does hemorrhoids look like?

Which doctor diagnoses and treats hemorrhoids?

In what cases should you consult a doctor?

What questions should you ask your doctor?

Questions your doctor may ask you

Patient examination

Diagnosis of hemorrhoids

Treatment

Suppositories for hemorrhoids

Ointment

Pills

Laxatives for hemorrhoids

Operations for hemorrhoids

Hemorrhoids: risk groups, how the disease develops, symptoms, treatment methods - video

Hemorrhoids: symptoms and complications, causes and mechanism of development, what diseases can lead to hemorrhoids, methods of diagnosis and treatment, opinion of a coloproctologist - video

Surgical treatment of hemorrhoids using the Longo method - video of the operation

How to deal with hemorrhoids at home?

Diet for hemorrhoids

Is it necessary to do enemas for hemorrhoids?

Traditional methods of treatment

Traditional method of treating hemorrhoids - video

Exercise for hemorrhoids

Disease prevention

Hemorrhoids during pregnancy and after childbirth

How to treat hemorrhoids during pregnancy and breastfeeding?

Causes of hemorrhoids in women during pregnancy and after childbirth (doctor's review) - video

Is it possible to have sex with hemorrhoids?

What is the ICD code for hemorrhoids?

Do hemorrhoids increase the risk of cancer?

Symptoms of hemorrhoids in men and women

Hemorrhoids - how to treat?

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