Internal hemorrhoids: symptoms, treatment, photos, causes

Hemorrhoids is a proctologic disease in which the involvement of the rectum is occurring.

Their wall is thinned, protrusions appear and conditions for the development of complications are created.

The disease is divided into three main types:

1. 1) External hemorrhoids - enlarged hemorrhoidal nodes outside the rectum sphincter
   
2. 2) Internal - the hemorrhoidal nodes are located above the level of the rectum sphincter, so in the early stages of the disease without a special survey, they can not be identified
   
3. 3) Mixed, which is a combination of signs of external and internal hemorrhoids.

Causes of internal hemorrhoids

The final causes of internal hemorrhoids are not established. However, it is customary to identify the so-called predisposing factors. If they are present, a person is more likely to develop this disease. These include:

1. 1) Low level of physical activity of the person( hypodynamia)
   
2. 2) Constipation, which increases intra-abdominal pressure
   
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3. 3) Irrational nutrition, in which little plant fiber and water is needed to soften stool. Against this background, conditions are created for the development of constipation
   
4. 4) Pregnancy and childbirth. In this case, the enlarged uterus exerts pressure on the intestine and adjacent organs. In addition, the blood flow in the uterus increases - this is a normal adaptive mechanism for pregnancy, on the one hand. However, on the other hand, he predisposes to the development of hemorrhoids( see hemorrhoids after childbirth).
   
5. 5) Heavy physical labor
   
6. 6) Heavy lifting and some others.

All these factors contribute to the development of stagnant phenomena in the pelvic organs. The increased volume of blood exerts an increased pressure on the venous wall, leading to its dystrophic changes.

According to statistical data, the greatest number of predisposing factors is in women. Therefore, this disease is most often found in them( see treatment of hemorrhoids in women)..Thus, women are at risk of developing this pathology.

Symptoms of internal hemorrhoids

Clinical manifestations and their severity depend on the stage of the disease. The more advanced it is, the more symptoms of hemorrhoids appear. However, when there are clinical signs of internal hemorrhoids, a person should seek medical help. As you know, the initial stages of any pathological process are easiest to treat.

So, the first symptoms of internal hemorrhoids in women and men can be suspected by the characteristic manifestation:

1. 1) Sensation of foreign body in the rectum or feeling of incomplete emptying after visiting the toilet
   
2. 2) Then there are pains. They come to replace the above characteristics. The pain is localized in the rectum and is strengthened after the act of defecation. In the last stage of the disease, they can reach the greatest intensity, sharply limiting the habitual way of life of a person. The pains are caused by the fact that the nodes become larger in size and are easily traumatized by calves, especially dense ones. Another cause of pain can be inflammation of the rectum wall, in which the synthesis of prostaglandins
   
3. is observed. 3) After the act of defecation, bloody discharge appears. In the initial stage, this is only a vein of bright red blood on the stool, and in more advanced stages this is the appearance of bleeding of varying intensity. Sometimes it is so pronounced that you have to make urgent surgery to stop it
   
4. 4) The appearance of the above hemorrhoid symptoms in the first stage of the disease is difficult to connect with the presence of hemorrhoids, since they are not visible. However, with the progression of the pathological process, the hemorrhoidal nodes are well visualized. In addition, it is possible to develop various complications that to some extent change the clinical picture of the
   
5. disease. 5) In the beginning, the nodes become prominent when straining, and then they protrude even in the absence of an increase in intra-abdominal pressure.
   
6. 6) There is a feeling of itching and burning around the anus,the background of which the patient becomes irritable, his nervous system is exhausted.

Complications of internal hemorrhoids

Internal hemorrhoids, as a rule, proceed chronically, that is, periods of exacerbation alternate with periods of remission.

And the shorter the first and the long second, the more favorable the prognosis is for this disease. However, despite this, hemorrhoids are characterized by some or other complications that can develop at any time. They can create a different threat to the health and life of the patient.

The main complications of internal hemorrhoids are:

1. 1) Thrombosis of hemorrhoids. This condition is characterized by a sharp increase in pain, which makes it practically impossible for the act of defecation, since a person forcibly restrains it. As a result, constipation appears, which additionally damages the venous wall. This closes the vicious circle. The danger of thrombosis is that a blood clot from the rectum with blood flow enters various organs, including the heart and brain.
   
2. 2) Inflammation of the pararectal tissue, as the inflammatory process passes from the rectum to the nearby cellulose. Microorganisms can enter either direct contact, or carry a current of blood, and also the lymphogenous path of spreading
   
3. is possible. 3) Infringement of the hemorrhoidal node that has fallen out. Symptomatics in this case is very similar to manifestations of thrombosis - pains reach the greatest intensity and limit the habitual rhythm of a person's life.

See also, hemorrhoids in men.

Diagnosis

Diagnosis of internal hemorrhoids presents certain difficulties in comparison with the diagnosis of external hemorrhoids, since nodes in the initial stage of the disease are not visible. Therefore, rectal examination in the first stage of hemorrhoids proves to be of little informative, in connection with which it becomes necessary to apply additional diagnostic tests.

The main ones, which provide the most informative, are the following:

1. 1) It is still necessary to perform rectal examination using it to palpate hemorrhoidal nodules protruding into the lumen of the intestine( they have a soft elastic consistency, and also their soreness can be determined).However, the nodes, which are located very high from the external anal sphincter, are not available for sensation. In this case
   
2. can not be done without additional methods of examination 2) Anoscopy, for which special endoscopic equipment is used. The device is inserted into the rectum and thanks to the illumination and magnification system one can view the rectal mucosa. This method has certain limitations, which are connected with the fact that the rectum can be considered only at a distance of 10 cm from the external anal sphincter.
   
3. 3) Recto-manoscopy is a similar method of research, but its diagnostic value is higher. In this case, a rectal segment is accessible at 20-25 cm, so even high-positioned hemorrhoidal nodes are accessible to the visualization.

However, this procedure is not very pleasant, so not many patients agree to it. In this case, a person experiences a feeling of discomfort, there is no soreness. In addition, patients are hard to agree to a sigmoidoscopy because of their own shame.

Treatment of internal hemorrhoids

Treatment of internal hemorrhoids can be both operational and conservative.

However, in one and the other case, it is necessary to adhere to general recommendations that would prevent the progression of the disease by reducing intra-abdominal pressure( see prevention).Also, special physical exercises that are aimed at training the muscles of the pelvic floor have proved to be very good.

Operative treatment for women is made only after they have decided that they will not give birth again. Otherwise, the risk of recurrence of internal hemorrhoids is large enough. The main indications for surgical intervention are:

• presence of complications of hemorrhoids
  
• frequent exacerbation of the disease
  
• the patient's desire to solve this problem once and for all
  
• ineffectiveness of conservative treatment.

Conservative therapy of internal hemorrhoids includes the administration of drugs from the following pharmacological groups:

1. 1) Phlebotonic. This means pathogenetic therapy, which contribute to strengthening the tone of the venous wall of the rectum. They prolong the period of remission. Treatment with these drugs should be long( several months)
   
2. 2) Non-steroidal anti-inflammatory drugs that effectively suppress the inflammatory reaction and stop the pain syndrome
   
3. 3) Laxatives that help normalize the stool and prevent the progression of the disease, and also indirectly reduce the pain during the defecation act
   
4. 4) Anticoagulants, the use of which is indicated for the prevention of thromboses at their high risk.

See also: how to treat hemorrhoids at home

Prevention of

The main preventive measures that reduce the likelihood of this disease are:

• weight lifting
  
• optimization of physical work
  
• sufficient rate of physical activity( prevention of hypodynamia)
  
• rational nutrition in whicha sufficient amount of vegetable fiber and water
  
• to fight constipation with a variety of laxatives and changes in nepa healthy diet.

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