Hemorrhoids

General Illness Information

Medical Term: Hemorrhoids

Common Name: Hemorrhoids, piles

Description: Hemorrhoids is a disease of the so-called hemorrhoidal veins located around the rectum and anus. The disease is accompanied by a pathological increase in the volume of these vessels, as well as their thrombosis, which often leads to the formation of nodes, their prolapse from the rectum to the outside, changes in the mucous membranes. The disease causes considerable inconvenience to patients, sometimes – severe pain and can have serious complications – necrosis of strangulated nodes. The disease is equally common in men and women.

Causes:

Hemorrhoids develop due to increased blood flow or insufficient outflow, which leads to stagnant processes. The causes and factors of hemorrhoid are as follows:

• Excessive physical activity (with an increase in intra-abdominal pressure);
• Сonstipation (pressure in the rectum increases and blood flow to the hemorrhoids increases, which contributes to their increase and subsequent loss);
• Alcohol abuse;
• Pregnancy (with the increase in the uterus, the pressure in the abdominal cavity increases);
• Sedentary lifestyle (leads to stagnation in the pelvic area and primarily in the rectum).

Signs & Symptoms:

There are two main symptoms of hemorrhoids:

1. Bleeding during defecation. Stagnation of blood in the hemorrhoids contributes to their expansion and thinning. Over time, small ruptures appear in the walls of blood vessels. With hemorrhoids, bleeding is directly associated with defecation. It occurs before, during or after a bowel movement. Blood stains on toilet paper or underwear are a clear sign of hemorrhoidal bleeding. In severe cases, hemorrhagic bleeding is so intense that it contributes to the development of iron deficiency anemia;
2. Prolapse of hemorrhoids from the rectum. Hemorrhoidal nodes are attached to the walls of the rectum with the help of a fibrous-muscular skeleton. The development of dystrophic processes in connective and muscle fibers leads to a gradual displacement of the nodes towards the anus. Abnormal physical activity, chronic constipation and habit of pushing with defecation contribute to the dropout of hemorrhoids.

In addition to the above signs, there are other symptoms of hemorrhoids, for example:

• pain during defecation, soreness when probing the hemorrhoids;
• sensation of a foreign body in the rectum;
• feeling of heaviness in the lower abdomen while doing physical work;
• itching and burning in the anus;
• pain in the anus when walking or sitting.
• Classification:

Depending on the nature of the pathological process, the following types of hemorrhoids are distinguished:

1. acute hemorrhoids – characterized by intense pain in the anus;
2. chronic hemorrhoids – episodic bleeding and periods of exacerbation.

Depending on the location of the nodes, the following types of hemorrhoids are distinguished:

1. external hemorrhoids – hemorrhoids are located outside the anus;
2. internal hemorrhoids – hemorrhoids are almost invisible and located inside the rectum.

Diagnosis:

Diagnosis of hemorrhoids is not difficult. Diagnosis, as a rule, can be based on only an external examination. More accurate methods are finger examination of the anus, research with an anoscope, a sigmoidoscope.

Treatment:

Treatment of hemorrhoids can be conservative or surgical. The conservative methods of treating hemorrhoids include:

Local treatment of hemorrhoids. This type of therapy is aimed at eliminating the inflammatory process, thrombosis and hemorrhoids. Local remedies include special ointments and suppositories that have anti-inflammatory, analgesic and anti-edematous effects. Baths and microclysters are also widely used. Hemorrhoids of the first and second degree are treated with special phlebotonic agents (phlebodia, detralex, troxevasin), local anti-inflammatory, non-narcotic analgesics in the form of ointments, suppositories and creams (glycerin, sea buckthorn, propolis, methyluracil, ichthyol, ribenoside, analgin). To stop bleeding, patients use suppositories with adrenaline, local haemostatic agents.
Systemic treatment of hemorrhoids. For the treatment of hemorrhoids, systemic medicines are also used, for example, phlebotrophic drugs. They increase the tone of blood vessels, improve microcirculation in cavernous veins and improve blood flow.

Conservative treatment of hemorrhoids gives only a temporary effect, a complete cure is possible with the use of minimally invasive or surgical intervention. Such methods of treatment include:

• Sclerotherapy. This method of treatment is used in the early stages of the disease. With the help of an anoscope and a special syringe in the hemorrhoids, the doctor introduces a drug, under which the blood vessels in the nodes are replaced with a connective tissue. So it is possible to stop bleeding and reduce the size of the nodes;
• Ligation of hemorrhoids by latex rings. This method of treatment is used when nodes fall out. With the help of a special device, a latex ring is pushed onto the hemorrhoidal assembly, which compresses the node, disrupting the blood circulation in it. So, over time the node is rejected;
• Infrared photocoagulation. This method of treating affects the node of the directed focused heat flux;
• Hemorrhoidectomy. This is an surgical treatment for hemorrhoids, which is carried out both “outside-in-the-inside” and “inside-out.” The choice of this or that technique depends on the age of the patient and the state of his health;
• Long’s surgery. This is mucosal resection, which is carried out above the dentate line with a special hemorrhoidal circular stapler. Long’s surgery is effective for patients of all ages, especially with hemorrhoids of 2-3 stages.

Diet:

Dietary treatment of hemorrhoids is aimed at normalizing the stool and reducing blood flow in the hemorrhoidal veins. It is necessary to increase the consumption of vegetables and fruits. The patient should completely refuse alcohol and spicy dishes.

Prevention:

• To prevent the development of hemorrhoids should adhere to a balanced diet, as mentioned above.
• It is recommended to avoid overload during defecation (excessive straining).
• To reduce venous stasis during pregnancy, daily gymnastics, walking, a rational diet are recommended.
• Remember that hemorrhoids should be treated by professionals. Self-treatment is not recommended.

Other:

Not specified.

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