Hemorrhoids is a rather delicate disease, so often people go to the doctor already at the final stages of its development, when even the right drug therapy does not give the desired result. So, hemorrhoids are most often found in men and women only after 40 years, although this disease develops much earlier. The following factors contribute to the occurrence of hemorrhoids:

• hypodynamia and sedentary work;
• alcohol abuse, taking a large number of spicy foods;
• constipation or vice versa prolonged diarrhea;
• weight lifting;
• overweight;
• congestion in the veins in the pelvic area is provoked by medication and oral contraceptives;
• excessive use of laxatives;
• cycling or motorsport;
• hereditary predisposition.

Hemorrhoids often develop during pregnancy. This is due to the fact that due to an increase in the uterus, the vessels in the rectum expand and lose their tone. In addition, during pregnancy physical activity women decreases, she is more likely to register stool disorders in the form of constipation, which also provokes congestion in the vessels of the rectum.

Hemorrhoid classification

By the nature of the course, the specified disease is acute or chronic. Depending on the etiology, it is classified as primary and secondary hemorrhoids. The primary form of the disease develops under the influence of certain provoking factors. Secondary hemorrhoids are the result of other diseases (for example, severe cardiovascular lesions, cirrhosis of the liver, cancerous pathologies in which normal blood flow in the veins is disturbed). Depending on the form, hemorrhoids can be internal, external, and also combined.

External hemorrhoids are manifested by the location of hemorrhoids outside the intestines (they are grouped around the anus). The nodes arise due to the expansion of the venous vessels that are located around the anus in the subcutaneous layer. Internal hemorrhoids is a form of the disease in which hemorrhoids are localized in the lumen of the rectum and remain invisible during the period of remission. They are located under the mucous membrane and arise due to overflow with blood.

Features of the clinical course

Hemorrhoids develop, as a rule, gradually. The main complaints of patients are discomfort and sensation of a foreign body, itching in the anus. Such manifestations of the disease appear periodically and at first disturb only with violations of bowel movements, after taking a hot bath or a diet disorder (for example, after taking spicy foods or drinking in excess). Subsequently, anal itching is combined with bleeding of varying intensity. It should be noted that hemorrhoids are characterized by a chronic course with periodic exacerbations. The chronic form is characterized by the following:

• Bleeding. There is a periodic appearance of blood from the anus. Most often, the appearance of scarlet blood during defecation is recorded. Less commonly, there may be minor bleeding between bowel movements. Rarely, rectal bleeding occurs continuously. Also, with stagnation of blood in the rectum, dark red blood clots can be recorded. If even a small amount of blood appears, you should consult a doctor, as this may be a manifestation of rectal cancer.
• Symptoms of hemorrhoids include prolapsed nodes. In the initial stages of the disease, they can be reduced independently, in the later stages their manual reduction is already required, or their constant loss is observed.
• Pain is not typical for chronic hemorrhoids. Only with a long course with frequent exacerbations can there be constant dull pain.
• Discomfort and itching in the anus. Itching mainly appears as a result of irritation of the skin by mucus released when the nodes fall out.

The period of exacerbation

Chronic hemorrhoids can be complicated by thrombosis of the hemorrhoidal veins. Acute thrombosis of internal nodes begins suddenly. There is a sharp pain, bleeding is possible. The development of such a complication contributes to the spasm of the sphincter of the anus, which develops due to irritation of the anal canal. In turn, the spasm provokes a violation of blood circulation in the nodes that have fallen out. They increase in size and swell, which makes it impossible to reposition them. thrombosis develops. In addition, mucosal necrosis may form, followed by the appearance of ulcers and bleeding.

Acute hemorrhoids with damage to the external nodes is manifested by constant pain, so it should be carried out as soon as possible effective treatment. According to the course, 3 degrees of severity are distinguished.

• The first is characterized by the appearance of tugoelastic painful formations. The perianal zone is hyperemic. Patients complain of pain of moderate intensity, itching and burning around the anus, which increases after sitting, defecation, taking acute.
• The second degree is characterized by increased hyperemia around the anus, spasm of the anal sphincter, compaction of hemorrhoids and the appearance of intense pain, which does not allow for a rectal examination.
• In the third degree, the skin around the anus is hyperemic, the inflammatory process passes from the nodes to the tissues that are located nearby. Dense purple-colored structures appear with areas of necrosis that cannot be inserted into the anal canal. In this case, it is important to quickly carry out therapeutic measures. Otherwise, the nodes become necrotic, which leads to the development of acute paraproctitis with bleeding.

Treatment of hemorrhoids at home

Sitz baths are considered a safe and popular way to deal with hemorrhoid pain. They can be cold or steam. Most people do not know if thermal procedures can be performed during an exacerbation, so it is important to note that steam baths are used only in the remission stage of chronic hemorrhoids. With exacerbation, such procedures are prohibited.

To prepare a steam bath, you need to pour boiling water into a 10-liter container and close the lid, after making a hole in it with a diameter of about 5 cm. Before the procedure, the patient needs to do a cleansing enema, after which you should sit over the steam for 15 minutes twice a day.

A cold bath is done for acute inflammation to reduce pain. To prepare it, it is enough to dial cold water and dissolve a small amount of potassium permanganate in it, and then sit in the prepared bath for no more than 5 minutes.

You can treat hemorrhoids at home with ice candles. For their manufacture, a decoction of chamomile should be cooled and frozen in fingertips from latex surgical gloves, and then inserted into the anus at night. Candles made from raw potatoes, which have an astringent and drying effect, are also considered effective.

How to treat itching with hemorrhoids? Conventional mineral oils quite effectively eliminate this unpleasant symptom. So, applying glycerin, petroleum jelly or lanolin to dry and clean skin helps to get rid of this manifestation of the disease.

To combat hemorrhoids, you can independently make a special ointment. To do this, mix sea buckthorn oil with honey or propolis and lubricate the external nodes. With internal knots, you can make gauze swabs at night. Microclysters with sea buckthorn oil are also effective.

Therapy folk remedies includes the reception of special infusions and decoctions inside. So, raspberry leaves, steamed with boiling water, have an anti-inflammatory effect. Hemostatic effect gives beetroot juice, which should be taken three times a day, 50 ml. To strengthen the vascular wall, it is recommended to drink rosehip infusion. To prepare it, you need to take 1 tbsp. l. fruits, pour them with boiling water (0.5 l) and leave for 10 hours. When used, you can add honey. Such remedies cannot get rid of hemorrhoids forever, but their use significantly reduces the risk of exacerbation of the disease.

Alternative methods of therapy for hemorrhoids include the use of lotions. The simplest is a lotion with cold water. You can also use decoctions of strawberry leaves or rowan berries. In the presence of external hemorrhoids, it is recommended to finely grate carrots or beets, wrap the resulting mass in gauze and apply to the nodes to reduce pain.

It is worth remembering that in case of severe pain and intense anal bleeding, home remedy therapy is unacceptable, since you should immediately seek help from a doctor. After the examination, he will prescribe the appropriate medication. As a rule, drugs are prescribed that:

• increase the tone of the venous wall (for example, Troxevasin);
• relieve inflammation and prevent the formation of blood clots (anticoagulants, such as Heparin);
• relieve spasm and reduce pain (suppositories with belladonna extract);
• eliminate inflammation, relieve swelling and itching (local anesthetics containing lidocaine, hydrocortisone).

How to treat hemorrhoids correctly? To determine the most optimal therapeutic tactics, one should undergo an examination, find out the causes of the development of the disease and take into account the peculiarities of its course. Only then can positive results be expected.

Bile in the stomach how to treat, every person who is worried about own health. Bile in the stomach is a very unpleasant condition, which is accompanied by a feeling of discomfort and the appearance of bitterness in the mouth. Many do not take the appearance of these unpleasant sensations very seriously. And this is a very big mistake, since bile in the stomach can indicate the presence of any serious complications in the body, up to the development of gastritis and stomach ulcers. Therefore, at the first unpleasant symptoms, you should immediately contact the professionals.

As you know, bile plays an important role in digestion. It is produced by the liver, after which it enters the gallbladder, from where it, if necessary, enters the duodenum and helps break down food. Normally, bile should not enter the stomach, this is prevented by sphincters that separate the esophagus from the stomach, and the stomach from the duodenum. But in some cases, reflux (backward throwing of bile into the stomach) can occur. This can happen if for some reason (a serious illness, malnutrition) the sphincters begin to do their job poorly.

Reasons for this condition

Doctors identify several reasons that can lead to the appearance of bile in the stomach:

1. Wrong nutrition. Quite often, discomfort in the stomach occurs due to the fact that a person abuses salty, bitter, fatty and smoked foods. The thing is that, once in the body, these harmful products cause the liver to produce too much bile, which the gallbladder cannot hold. As a result, excess bile is released into the stomach.
2. Some medications can also lead to the release of bile.
3. Often the ingestion of bile into the stomach is associated with the use of stale foods.
4. Another cause of discomfort in the stomach is constant smoking.
5. Doctors warn that constant drinking of food with water can lead to the appearance of bile in this organ.
6. Few people know, but reflux can occur due to sleeping on a full stomach on the left side.
7. Heavy physical activity immediately after eating can cause discomfort in the stomach.

Proper treatment of the disease

If the reflux of bile into the stomach occurs quite rarely, then you can get rid of the discomfort yourself. To do this, you just need to drink at least 1 liter of pure water in small sips. After a couple of minutes, the condition will noticeably improve, as the water will wash away the bile from the mucous membrane, due to which the pain and burning sensation will decrease.

However, if discomfort in the stomach appears too often, then this is a reason to sound the alarm and immediately consult a doctor. Since such symptoms can be caused by any serious disease.

If bile is found in the stomach, treatment involves the use of the following medications:

1. Selective prokinetics - such drugs contribute to the rapid emptying of the stomach and increase the tone of the sphincter. Everything is very simple: the faster the bile leaves the stomach, the faster the unpleasant symptoms will pass. Today, the most popular prokinetics are Cisapride and Motilium.
2. Antacids - these drugs affect the acidity in the stomach, namely, reduce it. The huge advantage of antacids is their low price. Most often, doctors prescribe Maalox and Almagel to the patient.
3. Proton pump inhibitors - these drugs work in the same way as antacids, so it makes no sense to combine these 2 drugs. Unlike antacids, these drugs last longer, but their price is much higher. The most effective representatives of this group of drugs are Pariet and Nexium.
4. Ursofalk - if the release of bile into the stomach has been diagnosed, then doctors often prescribe Ursofalk to patients 2 times a day, 250 grams each. This drug changes the form of bile acids to water-soluble. Ursofalk will help get rid of such unpleasant symptoms as heartburn, burning and bitter belching.

To remove unpleasant symptoms, medications are most often used, but there are times when the only way to cope with the disease is with the help of surgical intervention.

1. Laparoscopic correction of gastroduodenal reflux: this type of treatment involves a surgical intervention in which an autopsy does not occur abdominal cavity. This is the ideal solution for pyloric sphincter insufficiency.
2. Operation using laparotomy: in this case, during the operation, doctors make an incision in the abdominal wall.

To get rid of bile in the stomach, you need to follow a certain diet. Main principle diet therapy is fractional nutrition: eat often, but in small portions and at the same time. Doctors also recommend excluding spicy spices, soda, alcoholic beverages, fried, smoked and fatty foods from your diet.

The thing is that all these products can cause stomach cramps and lead to serious complications. In addition, people with this problem should limit their intake of animal fats, vegetable oils and too rich soups.

Very useful products such as oatmeal, kefir, jelly.

They delicately affect the walls of the stomach and do not cause a feeling of unpleasant heaviness after eating. In no case should you overeat, after each meal there should be a slight feeling of hunger.

Traditional medicine: features

You can remove bile from the stomach with the help of folk remedies. So, for example, to prevent the formation of sediment in the gallbladder and normalize bowel function, it is recommended to use food bran. A few tablespoons of bran per day will be enough.

Tincture of chicory and barberry is very popular.

To prepare this remedy, you will need to mix equal amounts of chicory grass, barberry root and dandelion root. 2 tablespoons of the resulting mixture should be poured with 1 liter of boiled water and left to infuse the product all night. Ready broth should be taken several times a day for 1/3 cup half an hour before meals. After 2-3 months, there will be no trace of unpleasant symptoms.

No less popular is a decoction of bitter wormwood, yarrow, transverse mint leaves, immortelle grass and ordinary fennel fruits. First, mix 2 tablespoons of each ingredient. Next, the resulting mixture must be thoroughly ground and pour 500 ml of boiling water. The remedy is infused all night, after which it can already be consumed 1/3 cup half an hour before meals. If desired, you can add a spoonful of honey to the broth.

A decoction of wild rose and dandelion root has a beneficial effect on the stomach. To prepare this remedy, you will need to mix 3 tablespoons of corn columns with stigmas and rose hips, 2 tablespoons of chamomile inflorescences and 1 spoon of birch leaves, dill fruits, cudweed and aspen bark. The resulting mixture must be crushed with a coffee grinder and pour 1 liter of boiled water. The product must be infused for at least 12 hours. Like the previous tinctures, this remedy taken several times a day before meals.

Hemorrhoids, the disease that will be discussed in our today's article, cannot be called otherwise than a delicate problem. Moreover, hemorrhoids, the symptoms of which we will consider today, in many cases, patients try to heal on their own, which, unfortunately, in no way favors its course and the consequences arising from such an attitude towards it.

general description

It may surprise you, but hemorrhoids is a fairly common disease, diagnosed on average in 10% of patients from the total population of the planet, prevailing age group, undergoing the development of this disease, is determined by the range from 30 to 50 years. This group of patients, in turn, determines the approximate number within 28% of the entire group of patients with diseases in the field of proctology. Hemorrhoids in men are 4 times more common than hemorrhoids in women.

To understand what are the causes of the development of hemorrhoids, it is important to highlight some anatomical features that are relevant to the anus, which, in fact, is affected by this disease. These features consist, first of all, in the fact that the rectum from its own lower section is surrounded by a wide network of venous bodies, defined as cavernous bodies (or hemorrhoidal veins). These veins in some way "cover" the rectum along its entire circumference. The corpora cavernosa is superior and inferior, which indicates the corresponding location in the upper or lower part of the rectum. The maintenance of the cavernous bodies is ensured by the connective tissue that is woven directly into the venous vessels (more precisely, into their walls), which, in turn, is designed to provide an obstacle to their excessive expansion. When filling the cavernous bodies with blood, additional assistance is also provided in the functions of the anal sphincter (anal sphincter is a muscle due to which the anus is closed), which directly corresponds to them, that is, assistance is provided to retain stool.

Hemorrhoids develop due to hyperplasia of the cavernous rings of the rectum, leading to varicose veins, which, as can be understood from the specifics of the disease, occurs in the anus. Hemorrhoids, the causes of which have not been reliably determined, however, there are a number of factors on the basis of which some assumptions can be made about this.

So, it is quite possible that the matter lies in the weakness of the connective tissue, which is caused constitutionally. An important role is also played by vascular dysfunction in combination with such pathological processes as an increase in the inflow of arterial blood through the cochlear arteries with a decrease in outflow in the cavernous veins, against which, as we noted initially, cavernous bodies undergo an increase and hemorrhoids appear.

Due to the dystrophic processes occurring in the anatomical structures, due to which the formation of the fibromuscular skeleton of hemorrhoids is ensured, they gradually begin to shift in the distal direction. The laying of cavernous bodies in the human body occurs by 3-8 weeks of its embryonic development, they are located diffusely (scattered), thus concentrating from the side of the base of the anal columns. Meanwhile, their grouping into three main zones is more often noted: from the left lateral wall, the right posterolateral and right anterolateral walls of the anal canal. Hemorrhoids most often occur in these areas.

The difference between cavernous bodies and ordinary veins, concentrated within the framework of the submucosa of the considered region of the rectum, is that they contain a significant number of direct arteriovenous anastomoses. Due to this feature, by the way, the fact of the allocation of scarlet blood as one of the symptoms of hemorrhoids is explained, respectively, the bleeding is of an arterial nature.

As the reasons contributing to the development of hemorrhoids, the following number of factors are also distinguished:

• hereditary predisposition. So, if the next of kin has the disease, it is a factor that increases the risk of a possible development of the disease.
• Weight lifting. When lifting weights, especially if it is done abruptly and by an unprepared person, the ligamentous apparatus is damaged, which also determines the corresponding risk for the possible development of hemorrhoids. In addition to lifting weights, another kind of load (gymnastics, wrestling, etc.) can be considered as such a factor.
• Prolonged sitting position. In particular, this applies professional activity(drivers, computer operators, programmers, etc.). Also, in general terms, a sedentary lifestyle is also considered, against the background of which stagnation develops in the pelvic organs, and this, in turn, contributes to the violation of venous outflow.
• Constipation. With frequent constipation, hemorrhoids also develop no less often, which, in addition, is accompanied by subsequent exacerbations in its own course. Straining during constipation leads to an increase in intra-abdominal pressure, and the concomitant factor of this pathology is the expulsion of hemorrhoids from the anus.
• Pregnancy. Pregnancy, oddly enough, also determines a significant risk of possible development of hemorrhoids. As you know, this period is accompanied by a systemic restructuring of the whole organism, and one of its features is a chronic increase in intra-abdominal pressure with simultaneous venous stasis. Already by the time of childbirth, these factors can reach an excess of critical values ​​for themselves, against which, in turn, irreducible knots are formed.
• Local irritation. Here, in particular, we are talking about irritation to which the mucous membrane is directly exposed, and this is the use of laxatives, the use of enemas, too intense hygienic effects on the anus, anal sex, infection, etc.
• Features of nutrition. The appearance of the disease we are considering, as well as the aggravation of its course, leads to the abuse of smoked, salty foods, spicy foods, stimulation of the functions of the rectum due to drinks (tea, coffee), addiction to alcoholic beverages, constant (chronic) overeating, etc. With an addiction to semi-finished products, an insufficient amount of fluid consumed, fruits and vegetables, the normal functioning of the intestines is also disrupted, against which constipation appears. Remarkably, frequent diarrhea is no less conducive to the development of the disease.
• Hormonal factors. In this case, hormonal changes can be distinguished due to which exacerbation of hemorrhoids occurs, they are relevant when using oral contraceptives, hormone therapy, menstruation, etc.
• Some sports. When shaking, which is relevant when riding a motorcycle, cycling, equestrianism, etc. there is also the possibility of developing hemorrhoids and its exacerbation.
• Diseases of the liver. Considering that the rectum is drained of blood through veins, which, in turn, are connected to the liver, some of the diseases of the latter (for example, cirrhosis of the liver) provoke an increase in pressure in these veins. Due to the increase in pressure, there are corresponding difficulties in the outflow of blood. In equal positions with cirrhosis are already noted features of nutrition and alcohol consumption (including alcoholism), taking certain medications, which is explained by a similar negative effect on the liver.
• Diseases of the pelvic organs. In this case, the organs adjacent to the rectum are the prostate (in men) and bladder, with inflammation of which the outflow of blood along the veins from the anus is disturbed. Hemorrhoids often appear with prostatitis (a disease in which the prostate), as well as with cystitis (a disease that occurs in men and women with concomitant inflammation of the bladder).
• The presence of tumor processes or inflammatory processes in the intestine.
• Stress.

Signs of hemorrhoids

Hemorrhoids are characterized certain features, in the presence of which, respectively, there are grounds for considering it as possible disease. The most characteristic of these signs is bleeding (possibly its manifestation in the form of smearing with blood), arising directly from the anus, it is considered in many cases as the first symptom of hemorrhoids. In more than half of the cases of the disease, bleeding occurs after the act of defecation (intestinal emptying). We have already noted that the blood in this case appears bright scarlet, which distinguishes this symptom of hemorrhoids from the state of gastrointestinal emptying, in which it is quite dark, almost black. Blood does not mix with feces, it covers its surface. In view of the possible intensity of hemorrhoidal bleeding and their duration, anemization of patients is possible.

The next, no less characteristic symptom of the disease is the prolapse of hemorrhoids, which, according to their location, occurs through the anus. The onset of the disease is accompanied by the manifestation of this symptom only during defecation and attempts to it, however, it is at this stage of its course that the nodes self-reduce, after which they become invisible. Meanwhile, the progression of the process leads to the fact that patients have to perform such a manipulation on their own more and more often, thereby adjusting the nodes. If the condition reaches edema and inflammation of the node, then it will be completely impossible to do this.

It should be noted that in general, the symptoms associated with diseases in the colon are extremely uniform, therefore bleeding may not be exclusively a symptom of hemorrhoids, indicating, for example, the relevance of polyps, ulcerative colitis, malignant tumors, etc. At the same time time and prolapse of hemorrhoids can be confused with such pathological conditions as prolapse of a villous tumor or rectum, with a fissure in the anus, etc. Considering this, it is important, regardless of the specifics of the manifestations of the actually existing disease, to seek help from an appropriate specialist for carrying out examination of the area of ​​the pathological process, as well as for other studies, with the help of which it will be possible to make an accurate diagnosis.

Further, in terms of the signs characteristic of hemorrhoids, one can note the soreness of the act of defecation, as well as the presence of soreness for some time from the moment it is completed. Soreness is noted in every tenth case of the disease, and, remarkably, during the later stages of its development, it occurs in a variety of conditions, that is, when walking, sitting, and even at rest. characteristic feature for the chronic form of the course, pain is not, its occurrence indicates that the pathological process is accompanied by inflammation, infringement or thrombosis of the nodes, the formation of an anal fissure. The nature of the manifestation of pain can be different, ranging from a slight tingling with unpleasant pulling sensations and ending with very intense pain sensations of a “pulling” type (which is important for swelling of the node).

Also, in addition to these signs, there is itching of the skin, weeping, diaper rash and burning - all these manifestations are concentrated in the area surrounding the anus. Itching in particular occurs due to maceration of the skin, and therefore, with the appearance of additional mucous secretions coming from the intestine, eczema may subsequently develop. The appearance of a sensation of incomplete emptying of the intestine is not excluded (this sensation occurs after the act of defecation). In some cases, fecal incontinence occurs.

• I stage. This stage is characterized by painlessness of hemorrhoids with their slight protrusion to the lumen of the anus. The possibility of bleeding that is not accompanied by pain is not ruled out. Anoscopic examination determines the presence of nodes, inflammation of the mucosa and the expanded state of the capillaries. The act of defecation in some cases may be accompanied by bleeding and discomfort.
• II stage. This stage is characterized by the loss of nodes, occurs only when an act of defecation is performed, which is accompanied by their subsequent independent reduction. Bleeding and discomfort are often accompanied by itching and discharge.
• III stage. As part of the course of this stage, patients experience prolapse of hemorrhoids not only during the act of defecation, but also with increased intra-abdominal pressure (physical overstrain). As already noted in the general description, when the nodes fall out, they can be set independently (their spontaneous reduction does not occur within the course of this period of the disease). The knots are manually reduced, at first it is necessary when they fall out during defecation, however, as the disease progresses, such reduction is necessary in any situations that are accompanied by an increase in intra-abdominal pressure (cough, weight lifting, etc.). In addition to the previously listed symptoms, in this case, contamination of clothing and the appearance of pain are added.
• IV stage. This stage is the most dangerous in the course of the disease. Drop-down nodes are not set either spontaneously or when they are set manually. As already noted, within the framework of this stage, thrombosis of hemorrhoids is possible, as well as the development of anemia against the background of heavy bleeding.

Hemorrhoids: forms of the disease

In accordance with the nature of the course of the disease, hemorrhoids can be acute or chronic. Mostly in practice, there is a chronic form, characterized by the gradual development of the disease with an increase in its characteristic symptoms. As a rule, the determining chronic hemorrhoids a feature is the long-term postponing by patients of the need to go to the doctor, that is, the very cases when hemorrhoids are treated with folk remedies. Unfortunately, folk treatment hemorrhoids determines often insignificant chances for their own effectiveness, which, meanwhile, does not prevent patients with this disease from continuing to experiment on themselves. In most cases, chronic hemorrhoids are subject to systematic exacerbation, which, as you can understand, implies an increase in the symptoms characteristic of the disease. Exacerbations occur against the background of physical exertion, stress, constipation, as well as against the background of changes associated with dietary habits.

Acute hemorrhoids , as already noted, develops less frequently. Symptoms of acute hemorrhoids (standard triad in the form of bleeding, itching and pain in the anus) are characterized by the speed of their own development in the patient, as a result of which the extreme degree of their severity is achieved in as soon as possible. As a rule, in this case, patients are less prone to postponing a visit to the doctor for an indefinite future - the intensity of the manifestation of symptoms, one might say, leaves no choice in this matter.

In the case of hemorrhoids, the acute form can traditionally develop into a chronic form of the course, but the option is not excluded in which the acute form develops against the background of the chronic form. The chronic course of the disease is characterized by the appearance of periods of well-being, within which there are no manifestations of symptoms and causes for concern, however, such periods are replaced by exacerbations. Exacerbation of hemorrhoids occurs against the background of thrombosis of hemorrhoids, with which, in turn, inflammation develops. The exacerbation of hemorrhoids is characterized by the manifestation of all the symptoms characteristic of it, which we examined. Remarkably, the "calm" can last quite a long time, which in particular is facilitated by the absence of factors provoking the disease.

In addition to the form of the course (acute or chronic), hemorrhoids can also be internal and external. In accordance with the prevailing symptoms, its specific forms are distinguished, this bleeding hemorrhoids , in which the main manifestation is the discharge of blood from the anus. Also this painful form of hemorrhoids, characterized by pain that occurs at the time of defecation or pain of a permanent nature. And finally, such a form of the disease as weeping hemorrhoids, in which the main manifestations of the pathological process are mucous discharge from the anus and itching of varying degrees of intensity.

Internal hemorrhoids: symptoms

The symptoms of this form of the disease are directly determined by the actual stage for it and the size of the hemorrhoids. In addition, the presence of concomitant diseases of the rectum plays an important role.

As part of the early stage of this form of hemorrhoids, there are no special symptoms. The only manifestation may be a feeling of discomfort or a foreign body in the anus, which is possible when exposed to factors that provoke the disease in general. Soreness at this stage is absent, the nodes do not come out. The emerging blood discharges are insignificant and meager, which is why patients often simply ignore the symptoms of internal hemorrhoids.

In accordance with the course of the pathological process, with its actual development, there is also an increase in the symptoms that manifest themselves in the disease. So, the nodes increase in size, which, in turn, leads to an increase in the feeling of discomfort due to the narrowing of the intestinal lumen against this background. The passage of stool with a certain degree of density for this reason can lead to the appearance of severe pain. Surrounded by nodes, the mucosa begins to become inflamed, which leads to the release of inflammatory fluid from the intestines, which also provokes irritation in the anus and a burning sensation. Due to the aggravation of the overall picture of the course of the disease, the resulting bleeding also becomes more pronounced. The completion of the act of defecation is accompanied by a drain of blood, which occurs in the form of a trickle or drops.

In the case of a low localization area of ​​the nodes, the act of defecation can lead to their crawling out, after which they are independently drawn back. As you can see, this symptomatology corresponds to the second stage of the course of hemorrhoids, which we discussed above.

If the possibility of slowing down the growth of nodes is excluded, they increasingly impede the normal act of defecation. Because of this, the walls of the intestine are stretched, its mucous membrane bursts. Against the background of these processes, cracks form, defecation is accompanied by intense pain in combination with bleeding, due to which it develops. It also notes the correspondence of the third stage of the course of hemorrhoids, in which the nodes can crawl out under certain loads, but there is the possibility of their independent reduction.

Given the fact that the disease mainly manifests itself in a chronic form, the listed symptoms of hemorrhoids are relevant in manifestations at the stage of exacerbation of the disease. Remission, indicated by us as a stage of well-being, excludes the presence of certain sensations.

External hemorrhoids: symptoms

This form of hemorrhoids, unlike the internal form, almost always occurs in combination with some unpleasant symptomatology characteristic of it, its asymptomatic course is extremely rare. External hemorrhoids sometimes may not be accompanied by the appearance of enlarged nodes. Otherwise, initially, these knots may appear as small sizes of seals, and the seals are hardly noticeable. Meanwhile, the subsequent progression of the disease, without taking appropriate measures to treat hemorrhoids, leads to a noticeable increase in nodes, cyanosis of their hue and soreness that occurs when palpated.

We note some provisions regarding how hemorrhoids look in the case of a course of the disease without concomitant exacerbations.

• Feeling of discomfort. This manifestation is relevant not only during the act of defecation and after it, but also in the normal state of the patient. Unpleasant sensations of this kind occur even at rest, sitting, sneezing, coughing and in other situations.
• Mild bleeding. At small sizes knots bleeding in general may be absent or its manifestations may be marked by traces on toilet paper. This symptom, regardless of its severity, requires immediate action. Treatment of external hemorrhoids as an ignored action on the part of patients causes the development of the disease, and this, in turn, leads to an increase in nodes and to the appearance of even more pronounced and serious bleeding against the background of the impact exerted on them by the passage of feces. In addition, blood can appear not only from nodes, but also from anal fissures, which causes very severe pain.
• Pain. Pain as a symptom of external hemorrhoids, manifests itself when the course of the disease is neglected, which is accompanied by its transition to an acute form, against which inflammation of the hemorrhoids occurs, provoking pain. The nodes acquire pronounced swelling and soreness, going to the toilet to empty the intestines is accompanied by the greatest severity of sensations and general discomfort. At this stage, topical preparations are necessarily used in the treatment, aimed at eliminating symptoms and pain in particular.
• Seals, formations surrounded by the anus. The patient can determine them independently when feeling the area. Seals can be of various sizes, they can also have a visible shape or be felt under the skin. Formations or seals always accompany external hemorrhoids, which determines the possibility of differentiating this form from the internal one.

The result of the course of external hemorrhoids is often thrombosed hemorrhoids, considered as a complication of the disease.

Hemorrhoids during pregnancy: symptoms

The disease develops during pregnancy against the background of the relevance of compression of the veins of the rectum by the uterus, increased in size during this period. Such an impact causes a violation of the outflow of blood from the rectum and perineum. Overflowing with blood, the veins of the rectum undergo a significant expansion and sagging in the form of painful knots.

An equally important role is played by constipation in pregnant women. With constipation, there is a strong expansion of the rectal mucosa in combination with the hemorrhoidal veins lying under it, as a result of which the passage of feces in their compacted form provokes their injury. A sedentary lifestyle in the later stages of pregnancy also becomes one of the reasons for the development of hemorrhoids.

Hemorrhoids after childbirth develops due to tension in the muscles of the perineal region when the hemorrhoids are stretched, which occurs directly during childbirth.

Symptoms of hemorrhoids in pregnant women correspond to the stages of the disease and the overall picture of this disease in other groups of patients. So, this includes pain that occurs during defecation, the presence of fresh scarlet blood on the feces, bleeding during defecation. Severe discomfort and itching appear in the anus, especially these manifestations intensify, again, with defecation, as well as with prolonged sitting and walking. Elastic knots appearing from the anus (sagging in the later stages of the disease) are also noted.

It should be noted that the symptoms of hemorrhoids in women after childbirth can often be confused with the manifestation of pain in terms of their localization. Patients believe that this is how pain in the perineum manifests itself due to childbirth, and, accordingly, do not assume that they are associated with hemorrhoids. Meanwhile, with prolonged persistence of pain after childbirth, the symptoms of which are further supplemented by other conditions characteristic of the disease, as a rule, does not determine the problems in establishing the disease, which is actually relevant in a particular case.

Complications of hemorrhoids

Having become acquainted with what symptoms of hemorrhoids occur in the first place, and how this disease progresses in general, the reader will probably be interested in what consequences this disease can lead to. It should be immediately noted here that hemorrhoids are not a deadly disease, however, complications of hemorrhoids are dangerous, to one degree or another.

So, most often against its background, thrombosis of hemorrhoids develops. This condition looks like this: stagnation of blood that occurs within the venous plexuses leads to the formation of blood clots, due to which the outflow of blood itself stops. The node in this case acquires a pronounced cyanosis, soreness and tension. IN frequent cases thrombosis is accompanied by fever, severe itching and pain in the anus. Thrombosis in its extensive form without treatment is followed by necrosis of the nodes, while the nodes begin to melt, resulting in general condition joins and secondary purulent infection.

The accession of infection in any case occurs due to a decrease in the body's protective properties, which determines the possibility of infection of hemorrhoids, and then - areas in the immediate vicinity. The attachment of infection is accompanied by severe itching and pain that occurs in the anus, and often the temperature is added to this.

Bleeding of hemorrhoids, which, as a rule, are insignificant in manifestation and are considered as one of the symptoms of hemorrhoids, with their own increase, can soon enough cause the patient to develop anemia. Massive bleeding with hemorrhoids is extremely rare, but it becomes a direct threat to his life. We also note that bleeding cannot be left without the attention of a doctor. Although hemorrhoids cannot develop into cancer, however, similarly to the manifestation of hemorrhoids, cancer can also be accompanied by bleeding, and cancer, you see, is a much more serious diagnosis.

Also among the complications of hemorrhoids are considered difficulties in defecation and urination.

Diagnosis

As a rule, the diagnosis of hemorrhoids is not associated with particular difficulties; the diagnosis is established as part of a patient survey and an initial outpatient examination. Examination helps to determine the degree of prolapse of the nodes from the anus, to assess the possibility of their reverse reduction, the condition of the skin, as well as the relevance and degree of bleeding.

In some cases, anoscopy is performed. This procedure consists in placing a small luminous ball (actually an anoscope) in the anus, due to which a more detailed examination of the anus and rectum is carried out. When carrying out manipulations in this procedure, a certain discomfort appears, however, it does not require anesthesia and is performed in the specialist's office.

The procedure of sigmoidoscopy helps to exclude the possible relevance of oncology, in which the areas of the sigmoid and rectum are examined with a concomitant examination of their mucosa.

Treatment

General measures in the treatment of the disease are reduced to an increase in the intake of dietary fiber, as well as the treatment of constipation in patients. Dietary fiber is found in cereals, grains and fruits. It is also important to consume more fluids. It is not recommended to use laxatives often, because diarrhea (diarrhea), similar to constipation, only aggravates the course of the disease. In most cases, the treatment of hemorrhoids is conservative and is carried out in at home.

Treatment of acute hemorrhoids is carried out using local and general painkillers (Ketanol, Diclofenac, Nise, etc.), as well as ointment applications and anti-inflammatory drugs (Vishnevsky ointment, Levomekol, etc.), cleansing enemas (this measure is possible only for the early stages of the course diseases!). Phlebotonic agents are also used (in the acute and chronic form of the disease), the greatest efficiency is achieved when using the drug Detralex. With the relevance of bleeding, suppositories are used in the composition with adrenaline, hemostatic materials of a local type.

In the absence of the effectiveness of conservative treatment after the inflammation subsides, as a rule, minimally invasive methods of therapy or surgery are prescribed (which is determined by the stage of the disease). The operation is also necessary for prolonged bleeding, combined with the impossibility of repositioning the prolapsed nodes, severe pain and intense rectal itching.

In the treatment of chronic hemorrhoids in the early stages, such minimally invasive methods of therapy as ligation using latex rings, sclerotherapy, cryotherapy, photocoagulation, laser therapy can be used. These measures are not applied in the event of thrombosis and the appearance of an anal fissure, with the development of an acute or chronic form of paraproctitis and other types inflammatory diseases perineum and anal canal. These therapies generally do not require general anesthesia and subsequent hospitalization, but laser therapy and the photocoagulation method are mostly performed under general anesthesia or spinal (epidural) anesthesia.

Surgical treatment of hemorrhoids is mainly used only within the 3rd and 4th stages of the course of the disease. By itself, such an intervention implies a measure of excision of hemorrhoids with subsequent stitching of their legs. Hemorrhoids after surgery require hospitalization for a period of 7-10 days, in general, the period of disability is about 14 days. After discharge, additional therapy is required within the framework of home conditions. So, this includes the need to take those drugs that the doctor prescribed for hemorrhoids, as well as taking sitz baths three times a day, including after each act of defecation. Again, the emphasis is on dietary nutrition.

If symptoms appear that indicate the possible relevance of hemorrhoids, you should consult a proctologist.

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

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Hemorrhoids is a disease associated with a pathological increase in hemorrhoids. Hemorrhoids are special vascular formations located in the lower part of the rectum, outside (in the area at the entrance to the anus) and inside (above the border of the anal canal).

One of the most common manifestations of hemorrhoids is the discharge of blood when visiting the toilet. However, it is important to know that such a symptom can be a sign of a much more serious problem, even a malignant neoplasm (cancer) of the rectum or other parts of the intestine. That is why do not postpone a visit to the proctologist, deciding that this is just a symptom of hemorrhoids, and this is not dangerous!

Why do hemorrhoids develop?

The rectum is abundantly supplied with blood, it is here that the arterio-venous plexuses are located - external and internal hemorrhoidal. For various reasons, in the area of ​​​​the hemorrhoidal plexus - in the anal canal and the lower part of the rectum - blood stagnation occurs. The walls of the veins are stretched, protrude in some places, a hemorrhoid is formed. It is believed that in the occurrence of internal hemorrhoids, a significant role is played by dystrophic processes in the connective tissue structures of the submucosal layer of the rectum and in the ligament, which to a certain extent holds the internal nodes inside the rectum, and when weakened, it contributes to the prolapse of the nodes from the anal canal.

Provocative factors of hemorrhoids:

1. Excessive physical activity (in this case, an increase in intra-abdominal pressure occurs, which leads to prolapse of hemorrhoids);
2. Straining with constipation (pressure in the rectum increases and blood flow to the hemorrhoids increases, which contributes to their increase and subsequent loss);
3. Alcohol abuse (vasodilation in the anal area can cause hemorrhoidal bleeding);
4. Pregnancy (with an increase in the uterus, pressure in the abdominal cavity increases);
5. Sedentary lifestyle (leads to congestion in the pelvic area and primarily in the rectum).

Symptoms of hemorrhoids

• Painful seals in the form of bumps in the anus with external;
• Prolapse of hemorrhoids during bowel movements (with internal hemorrhoids), as well as in the later stages - even when lifting weights, coughing, sneezing;
• Bleeding that occurs during bowel movements (an admixture of scarlet blood to the stool, the release of blood in the form of drops or a thin stream);
• Pain in the anus, usually associated with thrombosis of the nodes;

Discomfort in the anus, heaviness associated with a feeling of incomplete emptying of the intestine. The feeling of discomfort directly depends on the size of the hemorrhoids.

• Bleeding develops when the mucous membrane of the node is injured, which is overstretched at the site of the formation of the node and easily vulnerable when passing a dense stool. Diarrhea (diarrhea) can also provoke hemorrhoidal bleeding, irritating and damaging the mucous membrane in the area of ​​​​the hemorrhoid.

External and internal hemorrhoids

External hemorrhoids, located closer to the anus, are covered with skin with big amount pain receptors. Thrombosis of external nodes is accompanied by severe pain, which is often the reason for seeking emergency.

Internal hemorrhoids form inside the anal canal at the point of its transition into the rectum. The pain sensitivity of the nodes is insignificant, since there are practically no pain receptors in the mucous membrane above the dentate line. The first symptoms of internal hemorrhoids are bleeding and prolapse during bowel movements.

Most often, there is a simultaneous increase in both external and internal nodes, such hemorrhoids are called combined.

Hemorrhoids: clinical picture

An acute course is more often characteristic of external hemorrhoids and is the formation of a blood clot in the hemorrhoid as a result of prolonged stagnation of blood, physical activity, sudden weight lifting, etc.

Thrombosed hemorrhoids cause severe pain, aggravated by movement, coughing, sneezing. The node itself is bluish in color, swollen, tense and sharply painful. Subsequently, it is possible to attach inflammation to thrombosis with the involvement of subcutaneous tissue. Also, the acute course of the disease includes profuse bleeding from the internal nodes, which requires urgent hospitalization.

Typical signs of chronic hemorrhoids are regular bleeding, usually associated with defecation and prolapse of hemorrhoids from the anus.

The chronic course of internal hemorrhoids is divided into 4 stages:

Bleeding during bowel movements, the nodes do not fall out of the rectum

The nodes fall out, subsequently independently set into the anal canal. With or without bleeding.

The nodes fall out, manual reduction into the anal canal is required. With or without bleeding.

The knots constantly fall out, it is impossible to put them into the anal canal. With or without bleeding.

Diagnosis of hemorrhoids

The diagnosis of external or internal hemorrhoids is made on the basis of the patient's complaints and the results of an examination of the anus and anal canal. Sometimes a doctor may recommend a rectoscopy to diagnose associated diseases of the rectum and sigmoid colon, or a colonoscopy if a patient is suspected of having an inflammatory disease or neoplasm of the colon. Recommendations for colonoscopy in patients who complain of blood in the stool and discomfort in the anus are explained by the alertness of coloproctologists in relation to oncological diseases of the rectum and colon.

Treatment of hemorrhoids

Hemorrhoids - not a sentence! It can (and should) be completely cured!

The method of treatment is selected individually for each patient based on the leading complaints.

Our clinic uses methods of both surgical and conservative treatment of hemorrhoids:

Conservative treatment recommended at the initial stage, when the symptoms of hemorrhoids (increased nodes, bleeding during bowel movements) are disturbing for the first time, or if the increase in symptoms is rare and their duration is short. But even if you suffer from "hemorrhoids" for several years, this does not mean that conservative treatment is not for you. Often an understanding of the problem is necessary correct recommendations lifestyle, nutrition and preventive medication help to significantly reduce the number of exacerbations and slow down the development of the disease as much as possible. European schemes of conservative treatment, which we use, in some cases are quite effective.

Minimally invasive methods (outpatient surgery) is a mini-surgery performed in the doctor's office under anesthesia using the latest surgical techniques and instruments, after which the patient is sent home with recommendations for dressings (care for the wound for proper and quick healing) and an appointment with a doctor.

Surgical treatment– after a preliminary (preoperative) examination, the operation is performed in the operating room of a hospital, with obligatory anesthesia (pain relief), after which the patient spends one or several days in the ward under the supervision of a doctor. Usually one day is enough.

For external thrombosed hemorrhoids an operation to remove a thrombus or excision of the thrombosed node itself is performed if the time since the onset of the disease is no more than 48-72 hours and the patient experiences unbearable pain. In cases where more time has passed, the pain syndrome, as a rule, is significantly reduced, and the patient is prescribed conservative therapy. Later, after 4-6 weeks, the swollen node decreases in size and only a small seal remains under the skin or in the anal canal.

Treatment of internal hemorrhoids depends on the severity of the symptoms and the degree of prolapse of the nodes. It is extremely rare for a patient to immediately receive surgical treatment. Conservative therapy is modern approach to the treatment of patients with hemorrhoidal disease and is performed in 90% of patients with chronic hemorrhoids. If, after conservative therapy, the activity of the disease has decreased and the normal quality of life has been restored, then maintenance therapy is suggested.

Our experience shows that most cases of chronic hemorrhoids could be successfully treated at an early stage with therapeutic methods - a diet that promotes the formation of soft regular stools, hygiene procedures and, in some cases, medicines in the form of suppositories and ointments. However, the majority of patients come with complaints that are already typical for stages 2-3 with severe clinical manifestations, when self-medication does not help, and the disease causes significant inconvenience.

Surgical treatment of enlarged hemorrhoids with bleeding and prolapse up to grade 3 can be performed on an outpatient basis without hospitalizing the patient. The so-called minimally invasive techniques are used, which do not require anesthesia or are performed under local anesthesia.

Ligation- this is the imposition of an elastic latex or silicone ring on the base of the internal hemorrhoid in order to stop its blood supply. Gradually, hemorrhoids die off and are rejected during bowel movements (usually after 5-10 days), and small scars remain in their place. The method is applicable mainly for the treatment of internal hemorrhoids in the second, sometimes third stage, and when the nodes are located in the anal canal above the so-called dentate line, where there are no pain receptors, therefore, if the procedure is performed correctly, the patient does not experience severe pain. At the same time, no more than 1-2 knots can be ligated, a second procedure is carried out no earlier than after 2 weeks.

After the procedure, the patient may experience minor pain, feeling of a foreign body in the anus, false urge to defecate, which persist for several days. The process of rejection of the hemorrhoid may be accompanied by minor bleeding, which quickly passes.

Ligation is the most common method of outpatient treatment of hemorrhoids, however, practice shows that the recurrence of the disease occurs after 1.5-2 years in more than 30-70% of patients, since the procedure does not eliminate the causes of hemorrhoids.

Desarterization of hemorrhoids under the control of ultrasonic Doppler, HAL (Hemorrhoidal Artery Ligation), is used to treat stage 2-3 internal hemorrhoids. An ultrasonic sensor determines the position of the branches of the artery supplying blood to the lower part of the rectum, the vessels above the dentate line are stitched and ligated. Thus, the blood supply to the mucous membrane in the area of ​​formation of hemorrhoids is stopped. A variation of the technique is desarterization with mucopexy HAL-RAR (Recto Anal Repair). Mucopexy is an additional stitching of the sagging mucosa with a thread and pulling the stitched tissue up. Hemorrhoids collapse, stop bleeding and, in most cases, are replaced connective tissue. In addition, simultaneously with the ligation of the vessels, the internal nodes are securely fixed in the rectum.

The advantages of the method are minor pain, quick recovery. The method has been very popular in the last 10 years, but the accumulated data speak of almost 50% recurrence of the disease.

radical intervention- surgical removal of internal hemorrhoids () is used for stage 3-4 hemorrhoids, prolapsed and non-reducing nodes, in the absence of the effect of conservative treatment and the ineffectiveness or impossibility of using minimally invasive techniques.

During a hemorrhoidectomy, excess tissue that causes bleeding and prolapse is removed. In the surgical treatment of hemorrhoids in a hospital (hemorrhoidectomy by the Milligan-Morgan method), EMC coloproctologists use an ultrasonic harmonic scalpel and a bipolar coagulator: these tools provide reliable coagulation and almost bloodless removal of hemorrhoids without the use of suture material. Although the treatment is more painful, recurrence occurs much less frequently, in our experience, only 1-5% of cases. The operation is performed under general or epidural anesthesia.

In some cases, stapled hemorrhoidopexy, or Longo's surgery, is used to treat internal hemorrhoids. Excision of part of the mucous membrane reduces the blood supply to the nodes, which are gradually overgrown with connective tissue.

It should be remembered that the treatment of hemorrhoids is most effective in its initial stage. Therefore, EMC doctors recommend not postponing a visit to a coloproctologist at the first signs of hemorrhoids. You should also consult a doctor if the patient detects blood during bowel movements or in the stool, pain, itching and feeling of a foreign body in the anus, as these symptoms are observed in more serious proctological diseases, including cancer.

If the diagnosis is established on the basis of classical and modern methods functional diagnostics, remember that consent to surgery (as well as to any other treatment) is your voluntary decision. Do not agree to the proposed treatment if there is even the slightest doubt. To be sure, get

Haemorrhoids- nodular dilatation of the veins of the lower rectum (hemorrhoidal veins).
There are hemorrhoids, "bumps", external (subcutaneous) And internal (submucosal) .
Hemorrhoids develop in people suffering from prolonged constipation. Hemorrhoids are promoted by uterine bends, inflammatory processes of the rectum, a sedentary lifestyle, and other causes that cause congestion in the veins of the small pelvis.

External hemorrhoids originates from the external venous plexus.
With it, cyanotic bulging of the skin occurs in the region of the external anal ring, which does not change with straining.
Its typical complication is thrombosis. It is characterized by sudden onset, severe, unrelenting pain.

Internal hemorrhoids unlike the outer one, it is covered not with skin, but with a mucous membrane. It arises from the internal venous plexus.
Usually distinguish3 degrees of internal hemorrhoids:

1st degree.
Hemorrhoidal veins are located in the anal canal and may not be palpable (even with 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 hemorrhoids of the 1st degree, however, small ruptures of the mucous membrane are more common, and inflammation of the anus is more pronounced.

3rd degree .
It is characterized by the so-called prolapse of hemorrhoids, which do not self-reset.
The symptoms may be the same as in the 2nd degree, but often the phenomena of incontinence of feces and gases develop additionally. On examination, prolapsed hemorrhoids are distinguished from prolapsed anus by radial grooves, cyanotic coloration and a bumpy surface.

Constant prolapse of hemorrhoidal veins may be accompanied by discharge mucus and itchy skin in the perineum. Pain does not occur if not venous thrombosis, fistulas and inflammation.
Thrombosis of internal hemorrhoidal veins is characterized by rapid onset and intense pain.
Bleeding with hemorrhoids, it is characterized by the separation during the act of defecation of bright red blood or the appearance of blood on the feces. It is necessary to exclude carcinoma of the rectum and ulcerative proctitis.

Hemorrhoidal bleeding.

One of the symptoms of hemorrhoids is the presence of blood in the stool. Such bleeding is observed quite long time, often stops temporarily, after conservative treatment.

Abundant bleeding is a complication of hemorrhoids, in which the drop in hemoglobin quickly reaches up to 50-60 gl, it becomes necessary to take urgent measures.
Usually, profuse constant bleeding is preceded by periodic meager discharge of blood from hemorrhoids, which are associated with constipation, a violation of the diet.

To stop bleeding at home, necessary apply ice wrapped in a bandage.
But you do not need to calm down after stopping the bleeding, and in any case, you must urgently contact a proctologist.
The cause of bleeding can be not only hemorrhoids, but also other intestinal lesions.

Abundant bleeding can be not only with constipation, physical stress, diet violations, but also with normal stools, walking, the slightest physical exertion, etc. The blood is scarlet in color, flows in a stream, forms a blood puddle on the surface of the feces.

In addition to hemorrhoidal bleeding, the patient has symptoms of posthemorrhagic anemia (weakness, dizziness, tachycardia, pain in the heart).

If the diagnosis is accurately established that the cause of posthemorrhagic anemia is bleeding hemorrhoids with prolapsed nodes, in the absence of contraindications, surgical treatment according to Milligan-Morgan is indicated. If bleeding occurred for the first time or occurred after a long relapse, sclerosing therapy or stitching of the bleeding node is indicated.
Sclerotherapy is also indicated for persons suffering from hypertension, cardiovascular insufficiency and weakening due to severe general diseases.

TREATMENT OF HEMORRHOIDS.

Conservative treatment of hemorrhoids.

• Definitely needed normalize bowel movements. The chair should be regular, soft.
  To normalize the stool with hemorrhoids, food containing dietary fiber is recommended, including wheat bran, but their number should be increased gradually over 2-3 weeks. (from 5-10 g to 20 g per day), which eliminates the appearance of discomfort.
• Recommended for constipation Lactulose up to 30-40 ml per day to achieve daily soft stool and other means, diet and recommendations for constipation (see Constipation).

In the treatment of hemorrhoids, local preparations are used:Rectal candles for hemorrhoids and Ointments.

• Candles containing small doses help with pain narcotic in-in(For example, belladonna and etc).
  You can prescribe candles Anuzol, Anestezol, Natalsid, Ichthyol, Proctoglivenol,Ultraproject (candles, ointment) , Proctosedyl, depending on the symptoms and stage of the disease.
• If there is no bleeding, you can prescribe suppositories or ointment Relief, Gepatrombin-G, Hepazolon and etc.
  But all drugs are prescribed in each case, therefore proper treatment can only be prescribed by a proctologist after examining the patient.
• For pain, in addition to candles, 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 thrombosis. : Detralex, Phlebodia, Troxevasin.
  • Detralex drink at least 2-3 months.
  For chronic hemorrhoids : take 1 tab. 2 times a day for 7 days.
  Then you can take 2 tab. once a day with meals.
  For acute hemorrhoids : within 4 days take 2 tab. 3 times a day, then for 3 days, 2 tab. 2 times a day with meals.
  Then continue taking 1 tab. 2 times a day.
  • Phlebodia drink 1 tab. (600 mg) 2 times a day, for 7 days. Then 1 tab. once within 1-2 months.
• Prolapsed hemorrhoids (prolapse) is the basis for their Dressings.
• For thrombosis of hemorrhoidal veins, it is applied topically Cold and Lidocaine (1% solution), and in the future it is possible to carry out knot ligation.
• In case of recurrence of hemorrhoids, despite treatment, it is recommended Hemorrhoidectomy (see below).

Drug treatments are exclusively symptomatic - that is, hemorrhoids are not radically cured. 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 recurrence of hemorrhoids, surgical treatment can be avoided. But not always patients can follow all the recommendations.

Semi-surgical operations of hemorrhoids.

Sclerotherapy.

A special drug is injected into the hemorrhoidal node, acting on the affected vessel. A sclerosing drug is injected into the leg of the hemorrhoid.
As a result, the node is replaced by connective tissue.
The method is applied at the 1st stage of the disease. The procedure is completely painless and only takes a few minutes.

Photocoagulation of internal hemorrhoids with an infrared laser.

The procedure is non-invasive and painless.
By using special device carry out coagulation of the vein feeding the hemorrhoidal node. This leads to the destruction of the vascular pedicle of the node and the reduction of the node. It is used in the initial stages of the disease, stage 1, sometimes in the 2nd, with small hemorrhoids.

Ligation of hemorrhoids with latex rings.

Rings with a special apparatus are put on the base of the hemorrhoid. The rings compress the base of the node, its power stops and the node necrotizes. A day later, the knot is rejected along with the ring.
These techniques are used with 1-3 stages of hemorrhoids, with the exception of the acute form of the disease. But at the 4th stage of hemorrhoids and in difficult cases, more radical types of operations are effective.

ABOUT operations that eliminate the cause of hemorrhoids.

Hemorrhoidopexy according to the Longo method.

The most common surgical treatment for hemorrhoids. The nodes remain intact, and an excision of a section of the rectal mucosa above the hemorrhoid is performed. However, after the operation, the patient may have pain. This method is used only in the early stages of hemorrhoids (I-II).

Hemorrhoidectomyaccording to Milligan-Morgan.

The operation is quite traumatic, performed under general anesthesia.
This method is usually used for large nodes, the risk of bleeding from the nodes.
The postoperative and rehabilitation period is long, there are pains. Often after surgery, anti-inflammatory and painkillers are used.

Desarterization.

Currently leading proctologists around the world best method consider transanal hemorrhoidal desarterization under the control of ultrasonic doplerometry.

Through the lumen of an anoscope with a built-in ultrasonic sensor, the arteries that feed (blood supply) internal hemorrhoids are ligated. Cross the artery that supplies blood to the enlarged node.
The device allows you to accurately find the artery that supplies the hemorrhoids and aiming, under the control of vision, to cross it.
As a result of a decrease in blood flow by 60%, the node shrinks in size and undergoes scarring.

The technique can be used at all stages of the disease and with combined pathology (anal fissure, enlarged external hemorrhoids, protruding anal papillae, marginal fistulas of the rectum).The operation is less traumatic.
The procedure is painless and lasts 15-30 minutes. Restorerenewal takes place in a short time.
After a few days the patient feels quite well.