Hemorrhoids are diseases that occur as a result of thrombosis, inflammation or pathological expansion of hemorrhoidal veins located around the rectum. During life, every second person faces this pathology, so hemorrhoids are called the most common non-infectious disease of our time.
Causes of the disease
With the development of hemorrhoids, an imbalance of arterial and venous blood flow of the rectal vessels occurs: blood clots begin to accumulate in the glomeruli of the annular veins (cavernous corpuscles), which eventually transform into hemorrhoids (cones).
The main causes of hemorrhoids include:
- sedentary lifestyle, leading to stagnation of blood in the pelvic region;
- excessive physical activity that increases pressure on the muscles surrounding the rectum;
- lifting weights;
- pregnancy and childbirth;
- obesity and related abnormalities in tissues and blood vessels;
- hereditary predisposition;
- difficulties with defecation (constipation);
- inflammation or tumor lesion of the liver and intestines.
The list of the root causes of hemorrhoids includes more than a dozen items, representatives of any ethnic and social groups can face pathology, regardless of gender, this explains the prevalence of the disease.
Symptoms of hemorrhoids
The disease is classified depending on the localization of hemorrhoids (cones), the severity of pain and loss of nodes (1-4 degree). Hemorrhoids can be external (external) and internal. The external develops in the skin directly around the opening of the anus, the internal – on the walls of the rectum.
Symptoms of external hemorrhoids:
- burning, itching, discomfort in the anal area;
- blood during defecation, pain syndrome;
- sharp (shooting) pain in the pelvic region at rest, when walking, sudden movements, coughing, sneezing;
- a swelling (hemorrhoidal lump) appears around the anus, touching it is painful.
Symptoms of internal hemorrhoids:
- itching and burning during defecation;
- traces of blood in the stool;
- feeling of incomplete bowel emptying;
- nodes are enlarged, fall out during defecation.
Most patients consider their problem “shameful” and prefer not to be examined and treated, but to take medications that suppress symptoms, which is fundamentally wrong. If at an early stage hemorrhoids respond well to conservative therapy, then at the stage of a chronic disease of 3-4 degrees it is treated exclusively by surgery.
Diagnosis of hemorrhoids
Rectal bleeding is the first sign of hemorrhoids, but the root cause of this pathology may be a completely different disease. Therefore, the diagnosis of hemorrhoids requires additional procedures, and the examination itself is performed according to the following scheme:
- visual examination of the patient, anamnesis collection;
- finger examination of the rectum (detection of nodes or tumor-like formations);
- anoscopy or rectoromanoscopy (the anus and rectum are examined using a special tube or fibroscope – an optical device);
- blood test for anemia (typical for regular bleeding).
Visual examination, finger examination and anoscopy can be carried out in one consultation. Rectoromanoscopy is prescribed as an additional, more objective, research method when it is necessary to study the general condition of the rectum.
Conservative treatment of hemorrhoids
Drug therapy is used in the treatment of hemorrhoids of early and late stages. In the first case, with the help of medications, the pain syndrome and other symptoms of the disorder are stopped, after which treatment is carried out using a special set of drugs. In the second case (in the later stages), medications relieve symptoms at the stage of preoperative preparation.
Conservative treatment begins with a course of painkillers and bactericidal baths. Oral analgesics or injections are used as an analgesic. Baths for the rectum are made on the basis of plant extracts and potassium permanganate. After the symptoms are removed, they begin to treat the root causes of hemorrhoids, prescribing candles, ointments or a combination of them to the patient. Rectal preparations contain local analgesics and anti-inflammatory drugs, as well as drugs for correcting the tone of the venous mesh.
The risk of a blood clot is reduced with the help of drugs that control blood clotting. Laxatives are prescribed for constipation.
The main goal of conservative treatment is the remission of chronic hemorrhoids with complete or partial disappearance of symptoms. It is possible to get rid of hemorrhoids completely and forever only with the help of surgery.
Surgical treatment of hemorrhoids
The operation (standard surgery or minimally invasive method) is prescribed only after the signs of an acute process have been eliminated (usually after 5-7 days of taking medications).
The main methods of treatment of hemorrhoids include.
- Node sclerosis is an injection of a special drug into a problematic vein, which is carried out under careful hardware control. Under the influence of the drug, the hemorrhoid node literally deflates, the operation itself is relatively painless.
- Cryodestruction of internal nodes — cauterization of foci of inflammation with subsequent rejection of the treated area. The operation refers to minimally invasive techniques and is effective at 1-2 stages of the disease.
- Ligation of hemorrhoids — ligation of the node with latex rings. The technique is effective at 2-3 stages of the development of internal hemorrhoids.
- Operation Longo is an improved version of rectal resection with stitching, involving the operation using a special tool (apparatus from the set of PPN 01). The doctor restricts blood flow to the lump and stitches the tissues with titanium staples. The technique was developed in 1993 by the Italian surgeon A. Longo.
- Hemorrhoidectomy is a radical operation involving the removal of a node at 3-4 stages of the development of the disease, when minimally invasive techniques no longer give tangible results. This technique involves cutting off the problem area with a classic scalpel or laser tool. Hemorrhoidectomy guarantees a complete cure of the disease and the absence of relapses.
The choice of therapeutic technique depends on the general condition of the patient and the degree of neglect of the disease. Therefore, if you have symptoms of hemorrhoids, do not delay a visit to the doctor, go through the necessary examinations and treatment as early as possible.