Hemorrhoids

August 13, 2011

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Hemorrhoids   (in Greek - bleeding ) - A very common disease that occurs as a result of the increase located in the anal canal hemorrhoids . Under adverse conditions, the hemorrhoidal tissue is a stagnation of blood, leading to an increase in size of hemorrhoids and fracture of ligaments and muscles that hold the components inside the anus.

Hemorrhoids are composed of cavernous cells And are arranged in a 3-pads in the anus (these are internal nodes) and 3 pillows in the perineum near the anus (external components).

Allocate internal   haemorrhoids, increased only when the internal hemorrhoids, and outer When external components are increased. There has also been an increase in both internal and external sites, then we can talk about combined   hemorrhoids.

In addition, there are two types of hemorrhoids - primary   and secondary . Primary occurs due to an increase in intra-abdominal pressure during pregnancy, heavy physical work, sedentary work, often constipation , Severe abuse, smoked food, alcohol. Secondary appears as a consequence of other diseases, such as cirrhosis of the liver, tumors, resulting in disruption of the venous outflow of blood from the pelvis and rectum. There are also chronic   and sharp   hemorrhoids. The acute form is most often a complication chronic   hemorrhoids. Hemorrhoids affect more than 10% of the adult population.

Causes of Hemorrhoids

Most experts agree that the main cause of hemorrhoids - dysfunction of the blood vessels of the lower rectum, which results in increased blood flow and its stagnation in the veins of the rectum, resulting in hemorrhoids increases. Another factor of hemorrhoids is the so-called mechanical factor . Under the influence of unfavorable factors and enlarged hemorrhoids, there is a gradual destruction ligament-muscular system Which holds the components in the anus. Thus, by increasing the hemorrhoids and degenerative changes in the muscles and ligaments holding them inside, they begin to move to the edge of the anal canal and fall out of the anus.

But this is only one of the possible factors besides the causes of hemorrhoids are the following:

• a genetic predisposition to hemorrhoids;
• frequent constipation;
• diarrhea ;
• prolonged sitting on the toilet, straining during defecation;
• pregnancy   and childbirth ;
• excessive eating spicy, canned food, causing irritation in the anal region;
• frequent use of strong coffee, tea, alcoholic beverages;
• sedentary, increasingly sedentary lifestyle;
• strong physical exertion;
• lifting weights;
• overweight;
• anal sex;
• stressful situations;
• diseases of the pelvic organs.

Symptoms of hemorrhoids

Usually hemorrhoids it develops gradually, initially discomfort is felt only in disorders of the intestine, after intense physical exertion, overheating or hypothermia. The most common hemorrhoids occurs in chronic form with periodic exacerbations.

The first symptoms manifest discomfort of hemorrhoids in the anal area, light anal itching , Burning sensation, feeling of heaviness, a feeling of a foreign body, the allocation of bright red blood in the stool. Due to expansion and thinning of the walls of the cavernous vessels formed small gaps, with the result that there bleeding . These symptoms may disturb the person for several years. Gradually, the symptoms are worse during bowel movements, pain, discharge of blood during stool, pain when walking and while sitting in the stool can be observed blood stains. The gradual increase of hemorrhoids and development of degenerative processes in the muscle and ligaments cause the displacement of the nodes in the strontium anus. This leads to their precipitation. Against this background, there may be anemia , Weakness, breathlessness , Palpitations, decreased hemoglobin levels.

Chronic hemorrhoids are divided into four stage :

First stage   characterized by the formation of hemorrhoids in the rectum, does not protrude from the anus. You may experience discomfort during a bowel movement may also be bleeding. However, these symptoms of hemorrhoids may not always observed.

In second stage   hemorrhoids during bowel movements fall outside the anus, but independently reduce a. Nodes increase in size, which causes that wall thinning of the mucous membranes and to the permanent unit bleeding during defecation. Patients often complain of burning   in the anal area.

In third step   musculo-ligamentous apparatus holds the nodes in the anal canal, but degenerative changes interfere with the normal reduction of muscle, anal sphincter   weakens, so fallen during defecation sites need to reduce a self. Worried severe itching, excessive bleeding occur. Blood loss can lead to a sharp decrease in the level of hemoglobin in the blood.

Fourth Stage   characterized by the fact that hemorrhoids and rectal mucosa fall at the slightest exertion. At this stage, it destroyed the musculo-ligamentous apparatus of the anal canal, which held assemblies. There thrombosis hemorrhoids , Heavy bleeding, involuntary discharge of liquid feces, mucus.

Acute hemorrhoids is often a complication of chronic hemorrhoids and thrombosis occurs with external and internal painful swollen hemorrhoids. Allocate three stages of acute hemorrhoids .

In first   Patients feel a burning sensation in the anus, especially after a bowel movement, hemorrhoids are small in size, painful on palpation.

With second stage   pain in the anus are observed constantly aggravated by walking and in sitting position, palpation   Seal the inflamed hemorrhoids are very painful, body temperature rises.

To third step   characterized by swelling of the anus, thrombosis extended to hemorrhoids, nodes become purple or dark-cherry color, very intense pain.

If any form of the disease requires prompt treatment of hemorrhoids, in the absence of nodes gradually dropped necrotic , Mucous membranes ulcerate, which may lead to severe paraproctitis .

Hemorrhoids in pregnant women

Very often, hemorrhoids appears during the last trimester of pregnancy and childbirth. The causes of hemorrhoids is experienced an increase in uterus veins of the intestine , Which leads to deterioration of the intestine and the bloodstream from the perineum. Vienna increased in diameter and change shape. Periodic constipation in pregnancy can also trigger the appearance of hemorrhoids.

However, most women have symptoms of hemorrhoids are the postpartum period, so it is believed that the causes of hemorrhoids can be hormonal changes . Treat Hemorrhoids should immediately after the discovery of its first symptoms. It is important to deal with constipation, for example, for taking drugs loose stools   ( Forlaks , Laminarid, Metiltselyulozu), observe the rules of hygiene (cleaning the anus after defecation). Medicines for hemorrhoids ( Aurobin , Relief et al.) Are mainly used 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 - to make a competent diet for the prevention of constipation, do not wear tight belts, spend more time outdoors, hiking helpful.

Diagnosing hemorrhoids

Hemorrhoids is diagnosed when viewed from the anus of the patient. External hemorrhoids are defined as bahromok Surrounding the anus. In the first stage of the disease internal hemorrhoids are determined with difficulty, and the development of the disease begin to appear in the lumen of the anal canal during straining, they can fall out. The main diagnosis of hemorrhoids include:

• palpation   rectum;
• rektoromanskopiya   carried out to explore the mucous membrane of the forward and the lower portion of the sigmoid colon;
• Colonoscopy   It is used to determine the state of the rectal mucosa;
• anoscopy Conducted with hemorrhoids, makes it possible to assess the presence, location and extent of the increase of internal nodes. With anoscopy performed the choice of treatment.

These comprehensive studies also allow us to identify the associated diseases of the gastrointestinal tract, and, if necessary, carry out the treatment.

The treatment of hemorrhoids

Treatment options Hemorrhoids It depends on the stage of disease, severity of symptoms, as well as concomitant diseases. For the treatment of hemorrhoids are usually complex treatment.

At the initial stage chronic hemorrhoids (1st and 2nd phase) is subject to conservative treatment , To combat exacerbations, accompanied by bleeding, for the elimination of pain. If you start treatment on time, it can really slow down the progress of the disease. It is important to observe a special diet and a proper diet, regular bowel movement. From diet to exclude sharp, spicy, fatty food and alcohol. We need to eat foods rich in dietary fibers (fresh vegetables, grains, cereals), bran, drink more mineral water, exercise regularly, wash the anus with cool water after defecation . Without compliance with these rules exacerbation of the disease will be repeated more often.

Hemorrhoid treatment is successfully using both general and local anesthetics , Ointment compresses, anti-inflammatory and flebotonicheskie   drugs. Candles are mainly used for internal hemorrhoids, ointments - in outdoor.

If you have an itch, and other pain recommended rectal suppositories with anestezin . novocaine , based cocoa butter   or lanolin . When treating hemorrhoids used candles Thrombin . Pain syndromes associated with inflammatory processes in the thrombosed site or in the surrounding tissues, removed via non-narcotic analgesics   ( Nise . Voltaren . diclofenac ), And the combined local anesthetic drugs in the form of ointments   and Gels   ( Mr. gepatrombin . ultraprokt ).

In the surrounding host tissue to remove the cause of inflammation ointment compresses   ( levomekol . Vishnevsky ointment ). If itching can make compresses of ointment hydrocortisone , Candles proktosedilom . Thrombosis hemorrhoids   treated using combined drugs with analgesic, anti-inflammatory and thrombolytic components, reduces inflammation in the nodes ( gelpan . gepatrombin . venobene ).

If bleeding is used hemostatic drugs that are absorbed when administered in the anal canal to form a film, blocking the bleeding areas of nodes (sponge adroksonom . beriplast ). Doctors also prescribe flebotonicheskie drugs that increase vascular tone ( detraleks ).

To improve the efficiency of local products, requires reception of funds, improve the tone of the veins and prevents thrombosis ( troksevazin . detraleks . Fort ginkor . endotelon ). In chronic forms of hemorrhoids use of combination drug therapy can have a positive temporary effect.

All the more common minimally invasive techniques   hemorrhoid treatment carried out on an outpatient basis. Operation is necessary if the patient has a prolapsed hemorrhoid that can not be right in place, strong rectal pain, itching, bleeding. For the treatment of patients of the 1st and 2nd stages of hemorrhoids Use the following method:

• sclerotherapy   (introduction to the node causing a flattening of the vessel sclerosing agent);
• focal infrared coagulation   (effect of heat on the node that causes bonding of the vessel due to evaporation of intracellular water);
• ligation of hemorrhoids latex rings   (based on units snapped up the ring, causing a violation of the blood supply, due to which nodes are rejected);
• cryotherapy   (freezing unit 2-3 min., whereupon the latter dies).

Another common treatment for hemorrhoids is Longo method   (truncated portion of the rectal mucosa above the hemorrhoid). Surgical removal of the nodes ( hemorrhoidectomy ) Is shown in the 3rd and 4th stages of the disease, the presence of large knots, heavy bleeding, concomitant diseases of the rectum. Recently we started to apply Method stapler hemorrhoidectomy   (brackets) - the imposition of a circular protrusion on the bracket anorectal mucosa using stapler.

It should be noted, in spite of their low-impact and low morbidity (except gemorroidektomii) of manipulation, after the elections may develop complications, such as: relapse, rectal bleeding, severe pain, abscess.

It is important to remember that the symptoms of hemorrhoids may be symptoms of other diseases, such as anorectal bleeding, tumors of the rectum and anal canal, anal fissure . hemangioma .   Endometriosis , Injuries of the rectum, loss of the anal canal, and many others. Therefore, the first appearance of the above symptoms, do not delay your visit to the doctor.

At home, to reduce swelling and pain, hemorrhoids are shown sitting fifteen-minute warm baths three times a day, after a bowel movement. In the water you can add a solution of potassium permanganate ( permanganic acid ), Or a decoction of medicinal herbs - nettle, alder leaves, clover, grass mountaineer pepper. The pharmacy you can buy special protivogemorroidalny collection .

In the treatment of hemorrhoids are often used folk remedies, but without consulting a physician self can lead to undesirable consequences. Hemorrhoids in pregnant women treated only under medical supervision, under any circumstances, should not be used traditional medicine during pregnancy.

Preventing Hemorrhoids

Prophylaxis of hemorrhoids disease development before and after the operation is to normalize the activity of the digestive tract, reduced calorie diet compliance, the treatment of constipation. To prevent the formation of hemorrhoids is necessary to ensure the normal functioning of the intestines, to deal with disorders of the chair to avoid overvoltage during defecation.

You should also eat right, drink as much mineral water, limit the use of sharp, spicy and pickled food, liquor, causing blood flow to the pelvic area, observe the rules of hygiene, wash the anus with cool water after a bowel movement, exercise regularly. It is necessary to avoid hypothermia. When sedentary work every hour is 10 minutes to perform some physical exercise while standing. Pregnant recommended gymnastics . Hiking .