Hemorrhoids is a result of poor circulation and inflammation in the vascular plexus straight ulcer, which is accompanied by thrombosis, varicose veins and venous sclerosis and often complicated bleeding.
Causes
The main factors that provoke the development of hemorrhoids, traditionally considered the following:
- constipation;
- violation of venous circulation in the lower half of the body that develop during prolonged standing on his feet, a sedentary lifestyle, obesity, asthma;
- violation of the rectum function, causing spasm of the internal sphincter (psycho-emotional disorders, adhesive disease);
- blood flow disturbance due to alcohol abuse, fatty foods, use of certain medications;
- chronic inflammatory diseases of the rectal area and the pelvic organs (bacterial salpingo-oophoritis, prostatitis, cystitis), Leading to inflammation of the vascular lesions, circulatory problems and the spread of infection in the rectal plexus; pregnancy.
manifestations of hemorrhoids
For hemorrhoids is characterized by two main symptoms:
- bleeding and
- loss of nodes of the anal canal.
also notes
- anal itching,
- discomfort in the anus,
- mucus.
Under the guise of hemorrhoids, particularly the allocation of blood from the rectum, often occur diseases such as polyps and colorectal cancer. Therefore, when any form of intestinal discomfort and particularly the allocation of blood from the rectum is necessary to conduct a survey (rectoscopy, colonoscopy or barium enema).
Symptoms of hemorrhoids in stages
Depending on the degree of increase of hemorrhoids are four stages of the disease.
- For the first step of hemorrhoids characteristic feature is the discharge of blood from the rectum without loss of hemorrhoids.
- The second stage is characterized by loss of hemorrhoids with an independent reduction in the anus (with or without bleeding).
- A distinctive feature of the third stage is the need to manually reposition hemorrhoids a roll (with or without bleeding). First loss node occurs only during a bowel movement, later - with any increase in abdominal pressure, such as during heavy lifting or coughing.
- The fourth stage is characterized by a permanent loss of nodes and the inability to reposition the rectum. It is often observed pain in the anus, as well as heavy bleeding.
Hemorrhoids affect people of any age, and is more common in males and city dwellers, leading a sedentary lifestyle.
Treatment and Diagnosis
For a correct diagnosis of hemorrhoids statement it is mandatory to pass not only viewing, but also digital examination of the rectum and anoscope or sigmoidoscopy up to 15-60 cm above the level of the anus. At the slightest suspicion of a neoplasm and identifying multiple polyps in the colon carried colonoscopy or barium enema.
Hemorrhoids Home Treatment
Regular bowel movements is a prerequisite not only prevention, but also to the successful treatment of hemorrhoids.
The following are appointed protivogemorroidalnye means:
- enzyme preparations,
- Means, which influence on the microflora and reduce the small and large intestine,
- dietary fiber, on the background of a regular fluid intake.
As a source of dietary fiber in our country traditionally used wheat bran, laminaria and flaxseed in their natural form or in the form of preparations. Abroad often use psyllium husks and seeds, and flaxseed.
The indications for medical treatment are the initial stage and acute hemorrhoid disease course.
Conservative treatment of hemorrhoids is composed of general and local. Local treatment is aimed at the elimination of pain, inflammation or thrombosis of hemorrhoids, and bleedings.
The basis for the general treatment is the use of drugs affecting veins increased tone, normalizing blood flow therein. This group includes a lot of drugs, e.g.
- Diosmin.
When choosing the topical treatment of acute hemorrhoids should take into account the prevalence of one of the manifestations - the pain, thrombosis, the incidence of inflammation.
Hemorrhoids pain syndrome often associated with infringement of the haemorrhoid or appearance anal fissure. Therefore, to eliminate pain shows the use of local anesthetic drugs combined
- gepatrombin D,
- Aurobin,
- proktoglivenol et al.
Thrombosis of hemorrhoids is an indication for anticoagulant drugs. This group includes
- gepatrombin D,
- and heparin
- trokserutinovaya ointment.
Bleeding is one of the main signs of hemorrhoids. The continued for 1 chasa a sign of acute bleeding process. To eliminate it is also used local hemostatic materials consisting of fibrinogen and thrombin. When administered into the anal canal they dissolve, forming a fibrin film.
Outpatient treatment of hemorrhoids at different stages
Sclerosing treatment and infrared photocoagulation conducted in patients with early stages of hemorrhoids with a predominance of bleeding.
Ligation of hemorrhoids latex rings is performed in the later stages of hemorrhoids, whose main feature is the loss of hemorrhoids.
Contraindication for sclerotherapy and photocoagulation is thrombosis of hemorrhoids, acute and chronic paraproctitis, anal fissure and other inflammatory diseases of the anal canal and perineum.
In the initial stages of hemorrhoids shows the use of infrared photocoagulation hemorrhoids. When infrared coagulation necrosis occurs as a result of exposure to high temperature. This interference is used as a method for ambulatory patients with hemorrhoids I-II stage. At stage III disease method less effective.
Sclerosing treatment is performed at stages I and II hemorrhoids. As venoskleroziruyuschih drugs commonly used 3% solution of sodium tetradecyl and polidocanol.
Ligation of hemorrhoids latex rings have been successfully applied at III and IV occasionally at the stage of disease after reduction of hemorrhoids. Sometimes treatment must be carried out in several sessions. It takes 3-4 weeks.
Properly selected indications for ligation of internal hemorrhoids can avoid surgery in approximately 80% of patients.
Patients with stage I are shown: conservative treatment with venotonic agents, infrared photocoagulation and sclerotherapy.
In step II may conduct infrared photocoagulation, sclerotherapy, ligation of hemorrhoids latex rings and conservative therapy.
At stage III disease is best done ligation or - in the absence of the boundaries between the external and internal hemorrhoids - excision of hemorrhoids. When contraindications to surgery should be carried out ligation of hemorrhoids latex rings or conservative therapy as maintenance treatment.
It should be noted that if the conservative treatment of acute and chronic hemorrhoids can be performed by general practitioners, and the sclerotherapy photocoagulation should be performed only by a physician-coloproctologist an outpatient, at least - stationary conditions. Surgery - excision of hemorrhoids - should also be carried out in specialized clinics.
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