Hemorrhoids - Causes, symptoms and treatment. MF.

Hemorrhoids is a disease of the vessels of the rectum, in which an increase occurs, up to the fall, of the hemorrhoids. In a normal state, hemorrhoidal nodes necessarily exist in the anal canal of each person, only abnormal increase, loss, soreness, bleeding from them is considered abnormal. In general, hemorrhoids are referred to diseases of the circulatory system( diseases of veins, lymphatic vessels and lymph nodes).

Hemorrhoids are vascular formations located in the lower part of the rectum( anal canal), in the form of three cushions. Under the influence of adverse factors, such as excessive physical activity, pregnancy, a sedentary lifestyle, stagnation of blood occurs in the nodes, and they increase. With an increase in internal nodes, they speak of internal hemorrhoids, of external hemorrhoids. Most often there is an increase in both external and internal nodes, such a hemorrhoids is called combined. The prevalence of the disease is very high and amounts to 140-160 people per 1000 adult population. Every year, people suffering from hemorrhoids become more and more, and it affects almost all age groups.

Anatomy of hemorrhoids

The arteries supplying blood to the anal canal descend from the rectum and form a rich network of blood vessels( this explains why the bleeding during a hemorrhoid of bright red, scarlet color is arterial blood, and not deep red is venous, and why bleeding happensvery serious).These arteries supply blood to the hemorrhoids.

There are 2 venous ducts that divert blood from the lower region of the rectum and anus. The first leads into the rectum, the second passes under the skin around the anus.

If hemorrhoids begin in the upper( rectal) side of the anal canal( above the so-called dentate line), it is an internal hemorrhoid. If the lower part of the anal canal is external. Hemorrhoids occur when the outflow of blood from the hemorrhoids is difficult for some reason. The vessels of the hemorrhoids swell and the tissues of the node increase in size. Convex masses of tissue protrude into the anal canal, but unlike external hemorrhoids, the inner is not visible from the outside and it is difficult to feel at an early stage.

What is hemorrhoids - photos

Causes of hemorrhoids

What causes hemorrhoids? It is not known why hemorrhoids suddenly begin to increase. There are several theories, but none of them has scientific confirmation. It is noted that the causes of hemorrhoids can be:

• Insufficient consumption of dietary fiber,
• pelvic tumors,
• constipation( pressure in the rectum increases and blood flows to the hemorrhoids, which contributes to their increase and subsequent loss);
• hereditary factors( often hemorrhoids become family diseases);
• pregnancy, childbirth( in women there is an increase in pressure in the abdominal cavity, which can cause the appearance of hemorrhoids);
• Long sitting on the toilet, excessive straining( prolonged stay in a sitting position, when the muscles of the perineum are relaxed, the natural support of the hemorrhoids is weakened);
• A sedentary lifestyle( leads to stagnation of blood in the small pelvis, which leads to an increase in hemorrhoids);
• Alcohol abuse( leads to a significant acceleration of blood flow in the anal area, which can cause hemorrhoidal bleeding);
• Excessive physical exertion and weight lifting( in this case there is an increase in intra-abdominal pressure, which leads to the loss of hemorrhoids);
• Spicy and spicy food( causes irritation in the anal canal area).

Risk factors for hemorrhoids

Presence of even one of the above reasons can provoke hemorrhoids. You are at risk if you are sedentary, suffer from constipation, or are pregnant.

Symptoms of hemorrhoids

In the anal canal, two types of nerves are visceral( above the dentate line) and somatic( below the dentate line).Somatic nerves, like the nerves of the skin, can transmit pain. Visceral nerves do not feel pain, only pressure. Thus, internal hemorrhoids are painless, it can not be seen or felt in the early stages, unlike the external one. External hemorrhoids can be seen along the outside of the anus and feel.

Most people find themselves in their hemorrhoids, feeling a lump in the anus, either seeing blood on toilet paper or in the toilet, or noticing the loss of internal hemorrhoids after defecation. Symptoms such as anal itching or discomfort may or may not be noticed.

Hemorrhoids proceed in two ways - acutely and chronically, but in essence, these are phases of the same process. With chronic , scar tissue is produced during defecation, prolapse of hemorrhoids, dull incessant pain in the anus, itching. While with acute inflammation occurs in the nodes, which, in addition to the remaining symptoms, leads to a sharp pain in the anus.

The most common complaint with internal hemorrhoids is painless bleeding. You will see a splash of bright red blood in the stool, on toilet paper or a drop of blood in the toilet. Bleeding usually does not last long.

Bleeding from the rectum is a symptom of more serious diseases, so when the appears, the first symptoms of are recommended to consult a proctologist.

The chronic course of hemorrhoids is divided into 4 stages:

• The 1st stage is characterized by the release of scarlet blood during defecation, without prolapse of hemorrhoids.
• 2-nd is characterized by prolapsed hemorrhoids, which subsequently self-correct.
• Stage 3 is characterized by prolapsed hemorrhoids, with the need for their manual insertion into the anal canal.
• Stage 4 is characterized by prolapsed hemorrhoids, without the possibility of their re-orientation. Stage 4 hemorrhoids also includes hemorrhoids with the formation of thrombi.

The acute course of hemorrhoids is divided into 3 stages:

• The 1st stage is characterized by thrombosis of the hemorrhoids without their inflammation.
• Stage 2 is characterized by the attachment of inflammation.
• Stage 3 is characterized by inflammation of the surrounding hemorrhoidal tissue node.

Hemorrhoids can lead to a condition called hemorrhoids prolapse.

Falling occurs when the internal hemorrhoids swell, and then protrudes through the anus. In this case, you can feel and grope a cone outside the anus. In many cases, it is possible to gently tilt it back through the anus and solve the problem, but if the hemorrhoids can not be corrected, the hemorrhoids can swell even more and fall into the trap outside the anus - a pinch will occur. If this happens, you urgently need to see a doctor!

In case of prolapse of hemorrhoids, itching often appears in the anus( anal itching).When traumatizing such hemorrhoids( for example, with constipation), bleeding and pain may appear.

The consequence of external hemorrhoids can be a painful condition called thrombosed hemorrhoids.

When the blood clot settles in the hemorrhoidal node, the hemorrhoids will become even swollen. This leads to an even larger increase.
Severe pain and burning sensation occur during defecation.
This is also one of the factors that may require a doctor's examination and treatment.

The presence of a constant moisture in the anus in combination can lead to a symptom such as an itch in the anus, although this is not a typical sign of hemorrhoids.

Most people with hemorrhoids have a good prognosis. Possible outbreaks - bleeding or slight discomfort from time to time, but they do not last long and can be removed by home procedures without contacting a doctor.

Some people need surgery. This operation is quite simple, and most of the patients after surgical treatment have an improvement.

Diagnosis of hemorrhoids. Analyzes and procedures

Diagnosis of hemorrhoids is not difficult. The diagnosis, as a rule, is revealed when the patient is questioned and the first outpatient examination. The examination assesses the degree of prolapse of the nodes from the anal canal, the possibility of their re-orientation, the skin of the anal region, the presence and degree of bleeding.

Sometimes you might need an anascopy.

When anascopy, a small, glowing ball( an anascope) is placed in the anus, which allows you to fully see the anus and the lower section of the rectum. The procedure causes a slight discomfort, but is easily performed in the doctor's office and does not require pain medications.

For the exclusion of oncology, a sigmoid can be carried out by rheumatoscopy, which examines the mucosa of these areas.

Hemorrhoids differentiate( clarify the diagnosis with similar symptoms with diseases):

• with an anal fissure, which can also cause bleeding and pain in the anus.
• prolapse of the mucosa or entire rectum, with the formation being cylindrical.
• with rectal cancer, which also contains bleeding. There are rare forms of cancer that look like hemorrhoids.
• with skin diseases, in particular, with condylomas.
• other causes of bleeding may be colitis( inflammation of the gut), polyps.

Treatment of hemorrhoids

General measures for the treatment of hemorrhoids

It is recommended to increase the dietary fiber in the diet, treatment of constipation. Fibers are found in fresh and dried fruits, vegetables, grains and cereals. A day recommended 20-30 grams of fiber.

Laxatives are often not recommended because diarrhea( diarrhea) aggravates the symptoms of hemorrhoids.

Home Remedies for Hemorrhoids

Treatment varies depending on the severity of the problem. Most of the time, treatment is conservative and carried out at home.

Seated hot baths with hemorrhoids

Sedentary baths are recommended 3 times a day and after each bowel movement, at least 15 minutes.
How to make a sedentary bath: sit, submerged in shallow water in the warm water in the tub.

This is the best way to reduce swelling and pain.

Do not forget to dry the skin thoroughly around the anus after each bath to prevent rubbing and cracks.

Nutrition, a diet with hemorrhoids

Drink more liquid and eat more green vegetables to relieve constipation.
An increase in the amount of bran and fiber in the diet can help suffer from constipation or stiff stools.

Laxative preparations for hemorrhoids

Laxatives can also alleviate the condition.
You must be careful in choosing a laxative.
If the stool after laxative becomes liquid or watery, it can cause an infection in the anus, this laxative should not be used.

Less to sit with hemorrhoids

Some doctors recommend people with hemorrhoids not sit for a long period of time.
Some people feel more comfortable sitting on an air cushion.

Medications for hemorrhoids without a doctor's prescription

Medications for hemorrhoids that are sold without a doctor's prescription only reduce symptoms, relieve discomfort, relieve itching. Preparations are available in the form of ointments, cream, gel, candles and foams. Ointment, cream or gel is applied a thin layer around the anus, when applied to the anal canal, a little medicine is refilled with a finger. Suppositories do not have advantages in treatment, but they are more convenient to use with internal hemorrhoids.

Self-medication does not help much, and sometimes it can even lead to complications of hemorrhoids and hampering further treatment, so consult a doctor before using any medications.

Folk Remedies for Hemorrhoids

In the treatment of hemorrhoids, folk remedies are widely used, but they should be used only on the recommendation of the treating doctor.

Conservative treatment of hemorrhoids

Treatment of acute hemorrhoids

In acute hemorrhoids, first of all, conservative treatment is indicated. Common and local anesthetics, anti-inflammatory drugs, ointment applications, cleansing enemas( only in the early stages of hemorrhoids), phlebotonic drugs are also used.

1. In pain syndrome, non-narcotic analgesics( Diclofenac, Movalis, Nyz, Voltaren, Ketonal) and local combined preparations( Ultraproct, Proctoglyenol, Gepatrombin G, etc.) are used.
2. When spreading inflammation to the surrounding tissue and subcutaneous tissue, apply ointment applications that have a strong anti-inflammatory effect( Levomecol, Levasin, Vishnevsky ointment).
3. In the treatment of acute and chronic hemorrhoids, phlebotonic( boosting the tone of venous vessels) preparations are now mandatory. The most effective is Detralex.
4. In case of bleeding, suppositories containing adrenaline, as well as local hemostatic materials( beriplast, adroxon, spongostan) are used.

Conservative treatment of hemorrhoids gives a temporary effect, therefore, after the acute inflammation subsides, it is recommended to perform minimally invasive treatment or surgical intervention, depending on the stage of the disease

If you have prolonged bleeding, prolapse of hemorrhoids that can not be replaced, uncontrollablepain or severe rectal itching, surgery is necessary.

Treatment of chronic hemorrhoids

Patients with the 1st and 2nd stage of hemorrhoids can perform minimally invasive treatment: sclerotherapy, latex ligation, photocoagulation, cryotherapy .

Contraindications for the use of these methods:

• thrombosis of hemorrhoids.
• anal fissure.
• acute and chronic paraproctitis, as well as other inflammatory diseases of the anal canal and perineum.

1. Sclerotherapy: this method consists in introducing a sclerosing agent( 1.5-2 ml) into the hemorrhoidal assembly, which causes gluing and flattening of the vessels. Introduction is recommended in no more than 2 hemorrhoids, since it is possible to develop a pain syndrome. Possible repeated sclerotherapy after 12-14 days after the first session.
2. Latex ring ligation: the method is used to treat internal hemorrhoids, on the basis of which a latex ring is applied, which causes disruption of their nutrition. Nodes with rings are rejected for 7-10 days. Sometimes it takes several sessions with an interval of 14-16 days.
3. Photocoagulation: a light guide is brought to the hemorrhoidal node before contact with it. Thermal energy affects the hemorrhoidal node, causing the desolation and gluing of blood vessels. The tip is applied to the base of the assembly 2-6 times in one procedure.
4. Cryotherapy: the hemorrhoidal node is frozen for 2-3 minutes, after thawing the node dies off and a wound is formed at the site of the exposure. This effect is most often carried out under local anesthesia.

Minimally invasive procedures, as a rule, do not require general anesthesia or hospitalization, but in case of cryotherapy or laser therapy you will need general anesthesia or epidural( spinal) anesthesia.

An essential disadvantage of all minimally invasive methods of treating hemorrhoids is their non-narcability. They do not eliminate the main cause of hemorrhoids - excess blood flow to the hemorrhoids.

Treating thrombosed hemorrhoids

o If you have thrombosed hemorrhoids, you will feel pain.
o If the pain is not severe and the hemorrhoidal junction is not enlarged, the doctor can recommend you sessile hot baths and laxatives.
o If the pain is severe or the hemorrhoidal site is too large, it may be necessary to remove the blood clot.
This procedure can be done in the doctor's office or in the emergency room, but in no case at home.
o Removal of a blood clot under local anesthesia.
o When the anesthesia works and the patient does not feel anything, the doctor will make a small incision of the hemorrhoids to remove the blood clot.
o A small piece of bandage will be injected into the hemorrhoids to stop bleeding and prevent recurrent thrombus formation.
o Another bandage will be made on the external surface of the hemorrhoids. The doctor will prescribe a sedentary bath at home, the bandage can be removed after a lapse of 6-12 hours after the operation.
o Almost everyone has pain relief after clot removal and only acetaminophen( Tylenol) or ibuprofen( Motrin) can be used for further analgesia.

Prolapse( prolapse) of internal hemorrhoids

o If you have a prolapse of internal hemorrhoids that you can not straighten through the anus, you may need the help of a doctor.
o In many cases, the doctor may gently press on the hemorrhoids and reposition it.
o If the hemorrhoids are too large and uncontrolled, or if the infection recedes again, then you may need a surgical procedure to relieve the condition.
o If the hemorrhoids remain pressed against the anus and nothing is done, then the hemorrhoids will not get enough blood and will die.
o If this happens, the hemorrhoids will be infected, and the infection can spread all over the blood, which will have a serious negative effect on your health.

Surgical treatment of hemorrhoids

So far surgical treatment of hemorrhoids is a reference, it is most often used at the 3rd and 4th stage of the disease. The excision of three hemorrhoids with the stitching of the nodes of the nodes( feeding vessels) is performed.

After the operation for hemorrhoids the patient is in hospital for 7-9 days. The total period of incapacity for work lasts about 14 days.

In the early postoperative period, complications such as pain, discomfort in the anus, suppuration of the postoperative scar are possible. In the late period, such complications as a relapse of the disease, weakening of the compressive capacity of the anus, and also a violation of the anus enlargement are characteristic. But with good training and great experience of the operating doctor in conjunction with hygiene compliance complications after surgery are minimized.

After operation of hemorrhoids

• Warm sedentary baths 3 times a day and after each defecation along with an increase in the amount of fluid and leafy vegetables in the diet.
• Any pain with hemorrhoids should be removed with drugs prescribed by a doctor.
• Laxatives should be taken only as directed by your doctor.
• If you develop increasing pains, bleeding, fever, abdominal pain, vomiting after a hemorrhoids treatment procedure, you should consult a doctor or an emergency department.

Treatment of hemorrhoids for people with diabetes

Some drugs used to treat hemorrhoids can adversely affect blood glucose levels and thus can cause physical problems for people with diabetes taking medication for diabetes. There are options for patients with diabetes who also suffer from painful hemorrhoids.

Some simple methods for treating hemorrhoids in patients with diabetes:

Eat a lot of foods high in fiber, including bran, fresh fruits and vegetables. Bran containing products can also be used to add fiber to the diet.

Avoid stress during defecation or sitting on the toilet for a long period of time. In general, do not sit for long periods of time. Ice can relieve swelling.

Sedentary baths with warm water for about 15 minutes at a time can relieve symptoms. Adding English salt to this water helps to relieve inflammation. Sitting baths take several times a day, it will also have a soothing effect.

Avoid any food or drinks that, in your experience, can cause discomfort from hemorrhoids.

If you have diabetes, you should not use vasoconstrictors( eg, ephedrine, epinephrine, phenylephrine HCI).This includes Preparation H. Although it does not contain phenylephrine, Preparation H hydrocortisone 1% contains hydrocortisone-steroids, which can lead to a change in blood sugar levels.

Other treatment options for hemorrhoids for patients with diabetes mellitus are astringents, as well as local anesthetics:

Anesthetics relieve pain and burning sensations, blocking sensations for a short period. Anesthetics should be used externally on the perianal area, since it is here that the nerve endings are the most concentrated. The active ingredients are often contained in local anesthetics: benzocaine( Lanacane Maximum Strength, Retre-Gel, etc.), dibucaine( Dibucaine, Nupercainal), lidocaine( Lidoderm, Xylocaine Jelly, etc.), pramoxine( Fleet Pain Relief Pad, Gold Bond Anti-itch, etc.) and tetracaine( Pontocaine, Viractin).

Astringents dry hemorrhoids, alleviating burning and itching, but do not apply to pain. Hamamelis Gronov is recommended for external use, provides temporary relief from itching, discomfort, irritation and burning. Zinc white and calamine( Calamine Plain), also act as astringents for hemorrhoids.

Hemorrhoids are applied to the skin and mucous membrane to reduce inflammation and prevent water loss. We recommend the use of aluminum hydroxide gel, cocoa butter, glycerin in aqueous solution( Colace, Fleet Babylax, Fleet Glycerin Candles for adults), lanolin, mineral oil, zinc oxide, calamine and starch for topical external application.

Prevention of hemorrhoids

There are no reliable methods for preventing hemorrhoids. Nutrition with a high fiber content, a special diet and avoiding tension during defecation, is believed to help in preventing hemorrhoids, but there is no way to completely eliminate the risk. Here are some recommendations that will reduce the risk of hemorrhoids:

• If you work related to a long sitting, every hour you need to walk for 10-15 minutes, make active movements.
• Drivers should not be behind the wheel for more than three hours, if possible, you need to get out of the car, do a warm-up.
• Replace soft armchairs in the house and in the office with a hard one.
• Eating food that does not cause constipation,( first courses, cereals) and also avoid long straining, as this often leads to hemorrhoids and hemorrhage.
• Eating food that does not cause diarrhea, as frequent loose stools lead to irritation of the anal area of ​​
• . Reduced consumption of alcohol, spicy, spicy food. Alcohol increases blood flow in the pelvic region, which contributes to hemorrhoidal hemorrhage. A spicy and spicy food causes irritation in the anal area.
• Rinsing with cold water after defecation.
• Pregnant gymnastics are recommended, daily walks on foot.

Treatment of hemorrhoids

In the early stages of , with hemorrhoids, the gymnastics, helps the laxative diet( beet, prune, products rich in vegetable fiber), light laxatives, hygienic care, cold water baths, candles with analgesic effect .With infectious complications, hemorrhoids are treated with antibiotics. In the late stages of hemorrhoids, especially with the prolapse of nodes and bleeding, surgical treatment is necessary.

Do not self-heal hemorrhoids. Diagnosis hemorrhoids should be confirmed by a specialist - a doctor coloproctology: under the guise of hemorrhoids can hide more serious diseases of the colon.

How to treat hemorrhoids?

Medicine since the days of Hippocrates has accumulated many methods for treating hemorrhoids .Some have gone into oblivion and cause horror at one memory of them( for example, cauterization of hemorrhoids by a red-hot iron).Others are still applied.

Methods of treating hemorrhoids can be divided into conservative( therapeutic) and operational( hemorrhoidal nodes are removed by a surgeon under anesthesia).Conservative methods are often used. Surgical methods for the treatment of hemorrhoids are used in the presence of large, dropping nodes, the lack of success from conservative treatment of , with abundant bleeding. Treatment of hemorrhoids should be done systematically, comprehensively .And although now from morning to night various powerful medicines for hemorrhoids - candles, ointments and other preparations are advertised, remember: there is not one such pill that will cure it immediately and forever.

Separately I want to say about folk methods of hemorrhoids treatment .Some of them proved to be quite good, but one should not rely on them completely, let alone postpone the visit to the doctor. The use of certain folk remedies in the treatment of hemorrhoids is possible only on the recommendation and under the supervision of a proctologist and, as a rule, only in addition to the main course of treatment.

Medication for hemorrhoids

It is possible to fight for the treatment of hemorrhoids at absolutely any phase of the disease, but it is better not to delay the referral to the doctor, because the earlier the patient turns to the proctologist for help, the more successful and easy will the treatment become.

To achieve an effective result, treatment of hemorrhoids should be comprehensive, combining the use of several drugs aimed at eliminating pain, stopping bleeding, and improving the veins.

Conservative methods for the treatment of hemorrhoids( drugs for hemorrhoids)

Conservative treatment of hemorrhoids is carried out with the help of medications and more effectively in the 1-2 stages of the disease, when the patient suffers from unpleasant burning in the anus and small bleeding.

The purpose of conservative treatment for hemorrhoids :

• Pain relief of pain in acute hemorrhoids.
• Prevention of complications( mainly - bleeding).
• Prevention of exacerbations in the chronic course of hemorrhoids.
• Preoperative preparation.
• Postoperative rehabilitation.

The medical methods of treating hemorrhoids are exceptionally symptomatic - that is, hemorrhoids are not radically treated, but can temporarily cope with unpleasant signs of hemorrhoids. It is proved that if the patient after medical treatment will follow the medical recommendations for to prevent the recurrence of hemorrhoids , surgical treatment can be avoided.

Baths in the treatment of hemorrhoids

With exacerbation of external hemorrhoids , conservative treatment usually begins with a sitting bath with a warm solution of potassium permanganate( potassium permanganate) pale pink three times a day. Baths have a soothing and bactericidal effect. In addition to the solution of potassium permanganate, there are also used herbal medicinal herbs: nettle, peppermint, clover, or a ready antihemorrhoidal collection. Preparing the infusion in this way: in the basin with boiling water, the grass is poured, it is cooled down to + 36С - and everything, the therapeutic bath is ready. The infusion can be poured into the bath. It is recommended to take a bath for 15-20 minutes. If the infusion has turned out too much, then it can be frozen - it will produce a phyto-ice, which can be applied to the anus. With internal hemorrhoids the baths are not effective .

Candles and ointments for the treatment of hemorrhoids

In , hemorrhoids are treated with topical preparations of ( rectal suppositories and ointments). Candles are used only for internal hemorrhoids ( since they are externally quite simply do not work on units), and ointments - mainly in external hemorrhoids Composition of candles and ointments for hemorrhoids and varies depending on the component may have anti-inflammatory, anesthetizing, venotonic, hemostatic effect.

The composition of ointments and suppositories can include local anesthetics( e.g. procaine, benzocaine), they are cropped pain in acute hemorrhoid, anal fissure. To reduce the pain, gels, ointments and special healing candles such as anesthesin, bupivacaine, ultraprotein, lidocaine are prescribed.

If the pain is unbearable, the doctor will perform a novocaine blockade of the anus-a few injections of novocaine in the tissue next to the anus. If the pain is caused by an anal fissure, use baralgin, spasmalgon or a patch with nitroglycerin. Local preparations based on hormonal drugs( mainly steroid) have anti-inflammatory effect, but have a restriction to apply no more than 7 days.

With frequent haemorrhages, hemorrhoids are prescribed suppositories containing adrenaline. It is also recommended to use collagen sponges. These sponges are made from natural material - collagen, which has the ability to stop bleeding. Hemostatic properties are also possessed by sponges of such materials as androxon and tachocomb.

Ice is a well-known tool , relieving pain with hemorrhoids .Its application to the hemorrhoid cone contributes to the narrowing of the vessels, helps to stop the bleeding. Ice for the treatment of hemorrhoids uses and modern medicine. Ice is used in the Krinus device. The crinus easily enters the patient's anus, while the ice lies in the reservoir, which slows down its rapid melting. The crinus is made of a special plastic, due to which the ice does not come in contact directly with the walls of the intestine. In Krinus, not frozen tap water is used, but a special liquid that is thawed much more slowly. But it should be remembered that the treatment of hemorrhoids with ice is not a panacea, the ice relieves pain, but does not eliminate the disease itself.

As a rule, the medicines are complex, ie they contain several active components. Drugs reduce tissue swelling and inflammation, reduce pain and itching. Heparin, which is part of their composition, improves blood supply, resorption of blood clots. To date, the pharmaceutical market for the treatment of hemorrhoids is represented by a wide range of medicines:. Proktozan, ultraprokt, gepatrombin, Proctosedyl etc. But all drugs have a purpose nuances in each case, so the appropriate treatment can be prescribed only proctologist.

preparations for internal use in hemorrhoids

To enhance the effectiveness of local drug required ingestion of agents which improve the tonus of the veins and prevent thrombosis( detraleks, troksevazin).In severe pain syndrome, conventional painkillers can be used, both in injections and in tablets( analgin).It is not recommended to use non-steroidal anti-inflammatory drugs when there is a threat of bleeding, as they themselves impair blood clotting( aspirin, ketorol, etc.).

The main medication for hemorrhoids are phlebotonics - preparations that improve the tone of the venous wall. They are also used in the treatment of varicose veins of the legs. Such preparations, in particular, include escusan, detralex, etc. Improve peripheral circulation hemorrhoids drugs such as endotelon, glivenol, cyclo-3 forte detraleks, ginkor forte. Konservativnye treatments are also used in certain hemorrhoid complications, such as bleeding. In this case, usually appointed haemostatic drugs, that is, hemostatic. These include calcium chloride, dicinone, and vikasol.

In addition to these drugs that improve blood clotting, with bleeding hemorrhoids uses local hemostatic drugs , which when absorbed into the anal canal dissolve, forming a fibrin film that blocks the bleeding sites of the hemorrhoidal nodes. In case of concomitant hemorrhoids, anal fissures can also be usedlocal preparations, in particular, ointments based on nitroglycerin, which perfectly remove the spasm of the anal sphincter. At the risk of thrombosis of the hemorrhoidal nodeAlso conservative( medical) therapy is carried out. It consists in applying ointments based on heparin, which reduces blood clotting and, thereby, reduces the risk of formation of a thrombus. Given the different form and stages of hemorrhoids and the features of its course, the choice of treatment tactics is usually individual. For example, in one group of patients it is enough to conduct a short course of conservative treatment, while others have to hold regular and longer courses lasting at least 1.5 - 2 months.

In almost 75% of cases of hemorrhoids, patients suffer from constipation, and laxatives have an important role in the treatment of hemorrhoids in . Constipation by itself can be a provoking factor of hemorrhoids, exacerbation of chronic course of the disease, as well as the cause of trauma of internal hemorrhoids by a solid calves. In addition, the use of laxatives allows the patient to empty the intestine at the same time, which significantly reduces soreness. The patient also must follow a diet and lifestyle that contribute to the prevention of hemorrhoids and constipation. It is recommended to eat food rich in vegetable fiber, which contributes to the good work of the intestines, to avoid sharp meals and alcohol, which can provoke an exacerbation of hemorrhoids. This is very important to remember, as adherence to a diet for hemorrhoids and prevention of constipation is one of the important factors of successful treatment.

Pain syndrome in hemorrhoids is usually associated with either inflammation of the site itself or surrounding tissues, or with thrombosis, or with knot infringement. In this case, anti-inflammatory drugs are used. Medicated treatment is also aimed at preventing not only the complications of hemorrhoids, but also the very development of hemorrhoids( for example, after successful surgical treatment). Let us recall that conservative treatment, after all, does not lead to a cure for hemorrhoids, although it allows to achieve remission of the disease, especially if after it the patient diligently observes a diet aimed at improving the work of the intestine. With the resumption of the same constipation, inaccuracies in the diet or increased physical exertion again there is a risk of another exacerbation, which will require a repeated, conservative treatment.

After the disappearance of the syndromes, the patient is advised to refrain from lifting weights, intensified sports, and be sure to follow the diet recommended by a doctor-proctologist. Curing hemorrhoids with medicines without changing the diet and lifestyle is impossible. The use of medicines can only restrain the development of the disease and temporarily reduce unpleasant symptoms or complications. Practice shows that most people are not ready to change their way of life, change jobs, eliminate all the risk factors that provoke the development of hemorrhoids. In such cases, it is advisable to resort to the help of radical surgical treatment of hemorrhoids. If conservative treatment is not effective, minimally invasive or surgical treatment of hemorrhoids is performed.

Minimally invasive treatment of hemorrhoids. Gentle surgical methods of treatment

Sclerotherapy in the treatment of hemorrhoids

A special substance is introduced into the hemorrhoidal site, which promotes the gluing of the walls of cavernous vessels. The result is that the node ceases to exist( it is replaced with a connective tissue). The operation is performed in a polyclinic, does not require general and local anesthesia. A sclerosing drug( eg, ethoxiclerol) after exposing the lumen of the rectum is inserted into the foot of the hemorrhoidal node. Manipulation requires jewelry precision and a proctologist's experience. A common method used in the early stages of the disease. Manipulation is completely painless and takes only a few minutes. You can not worry about the possible recurrence of hemorrhoids. The method is used for the 1 st stage of the disease.

Exposure to extreme temperatures in the treatment of hemorrhoids

Cryodestruction( ultra-low temperature) and focal infrared coagulation( high). In this case, the hemorrhoids undergo necrosis. With large hemorrhoidal nodes, it is possible to perform such operations for several sessions. It is considered to be a rather effective means of treating hemorrhoids at the initial and middle stages of development. Traditional methods used to treat 1-2 stages of hemorrhoids. These methods are used in the case of contraindications to deserterisation or surgical techniques. Among the shortcomings, there is a high risk of recurrence( relapse) and complications, painful procedures, and the need for treatment in several stages.

Ligation of nodes with latex rings

Rings with a special device in the stretched state are worn on the basis of the hemorrhoidal node: the nutrition of the node is stopped and necrosis occurs. After the end of the process, the node is torn off with the ring.

All these operations are low-traumatic, painless and easily tolerated by patients. In some cases, patients are concerned about the discomfort of the intervention. Occasionally, patients will note pain, but it is not intensive and is stopped with anesthetic medications. The use of small surgery in the treatment of hemorrhoids is possible at all stages of hemorrhoids, with the exception of the acute form of the disease. However, in later stages( III-IV), these techniques are mainly used as a preparation for performing a radical operation. These methods have a significant drawback - they do not remove the cause of hemorrhoids - a violation of the blood supply of hemorrhoids. Therefore, it is possible to resume the symptoms of the disease( relapse) - an average of 3-5 years. The frequency of relapses with these techniques ranges from 15% to 45%( the probability is less than at an earlier stage the operation was performed).

Radical operations - eliminate the cause of hemorrhoids

Longo operation

The most common surgical treatment for hemorrhoids .Relatively short-time procedure, which is important for contraindications to traditional hemorrhoidectomy. Operative intervention consists in excision of a site of a mucosa of a rectum above a hemorrhoidal site. However, in the postoperative period, patients are often concerned about pain syndrome. Yes, and the application of the technique is possible only in the early stages of hemorrhoids( I-II).

Excision of

nodes The traditional operation - hemorrhoidotomy( excision of the nodes themselves) is still successful. The operation is rather traumatic, it is performed under general anesthesia. The postoperative period is long and requires careful care of the rectum, the use of painkillers. Currently, leading proctologists around the world consider transanal hemorrhoidal dearterisation to be the most priority method.

doctor's commentary A classic operation for removing hemorrhoids. It is justified only in rare cases in the presence of large nodes, the risk of bleeding from the nodes, in the presence of concomitant diseases of the rectum. The operation is traumatic, performed, as a rule, under spinal anesthesia and requires a long rehabilitation period. Most often, instead of excising patients choose desarterization.

Desaturization

Is the most modern version of surgical treatment for hemorrhoids .The meaning of it is to cross the artery, which supplies the enlarged knot. To perform transanal hemorrhoidal dearterialization, special equipment( an ultrasonic device with the possibility of dopplerometry) is necessary. This allows the proctologist to work "not blindly", as, for example, with sclerotherapy. The equipment allows you to accurately find the artery, which blood supply the hemorrhoidal node and sight, under the control of vision, to cross it. This operation can be performed on an outpatient basis and does not require prescription of painkillers in the postoperative period.

Desarterization - new in the treatment of hemorrhoids. Thanks to this method, the root cause of the disease is eliminated - the pathologically altered vessels that feed the hemorrhoidal nodes are stitched. The procedure is painless, performed within 30 minutes, practically does not require a rehabilitation period. If after the operation of excision of the nodes normal presence of pain is normal for 2 weeks, then in case of dezarterization, after a couple of days the patient forgets about the problem and returns to normal life. Elimination of the cause of the disease guarantees the absence of recurrence( re-development) of the disease.

The main advantages of the technique are the minimal duration of the operation( 15 min), bloodlessness, high efficiency, the possibility of application in all stages of hemorrhoids. The operation is so low-traumatic that the patient does not need a hospital sheet and the next day can begin his usual daily duties.

Hemorrhoids in pregnant women

Hemorrhoids are common during pregnancy and childbirth. Pregnancy provokes or aggravates hemorrhoids, but why this happens is also not exactly known. Since most of the women after childbirth have hemorrhoids symptoms disappear, it is very likely that during pregnancy it is caused not only by increased pressure in the abdominal cavity and small pelvis due to the increase in the uterus, but also hormonal changes.

If the first signs of hemorrhoids are found, treatment should begin immediately .In this case, hemorrhoids can be cured quickly, reliably, painlessly.

When to call for medical assistance

When to call a doctor

If bleeding occurs between stools or mild bleeding from the hemorrhoids, you should consult a doctor when bowel movements.

If you are over 40 years old or have a family history of colon cancer, you should visit a doctor for anal bleeding of any intensity.

If you have a prolapse of hemorrhoids that can not be inserted into the anus, or significant pain in hemorrhoids, you should consult a doctor.

There are other causes of rectal bleeding, and they are much more serious than hemorrhoids. Inflammatory bowel disease and colorectal cancer, like hemorrhoids, can cause rectal bleeding. Only the doctor can estimate the bleeding from the anus. If you are older than 40, have a family history of colorectal cancer, prolonged bleeding, or experience other symptoms, then do not postpone the visit to the doctor.

When to go to the hospital

Basically, under the supervision of a doctor and following his recommendations, critical complications of hemorrhoids can be avoided, but in some situations there may be a need for emergency care.

If you have severe pain, heavy bleeding or a drop in hemorrhoids, and you can not contact your doctor, your condition should be evaluated at the hospital.

If you have a lot of rectal bleeding, weakness, dizziness, you should go to the emergency department of your hospital or call a doctor.