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Chronic hemorrhoids - a sentence or an easily removable nuisance?

Chronization of the process occurs when exposure to adverse factors, most often this is due to the wrong lifestyle. The factors that contribute to the transition of the disease into a chronic form include:

  1. Low physical activity. Sedentary work, a sedentary lifestyle lead to weakness of the musculo-ligamentous apparatus. This helps to increase the veins of the rectum, their loss.
  2. Alcohol abuse, smoking. Bad habits also adversely affect the state of hemorrhoidal veins.
  3. Improper nutrition. Frequent consumption of fatty, spicy, fried foods increases blood flow in the intestines. This can lead to stagnation of blood and aggravate the course of the disease.
  4. Hard physical labor. Weight lifting, professional weightlifting classes can trigger the loss of hemorrhoids. This is due to a sharp increase in pressure in the abdominal cavity.
  5. Inflammatory bowel disease. Diseases such as colitis and proctitis can also lead to a chronic process. Prolonged inflammation reduces the effectiveness of the treatment.

Classification

The chronic form of the disease develops gradually. The course of hemorrhoids includes four stages:

  1. First stage. In the initial period of hemorrhoids, visual changes are absent. The nodes are inside the rectum, do not fall out. A person may be disturbed by bleeding, discomfort, itching.
  2. Second stage. In this period, hemorrhoids fall out of the anus, but are repaired on their own. Additional signs of the second stage are pain, skin manifestations.
  3. Third stage. At this stage, the nodes are adjusted only with the help of hands.
  4. The fourth stage. The terminal stage is characterized by the fact that the hemorrhoid cones do not fit back into the rectum. This leads to frequent injuries and inflammation of the nodes.

According to the location of the lesion, hemorrhoids are classified as follows:

  1. Interior. The nodes are localized inside the rectum, above the dentate line. During a routine examination, they are not detected.
  2. Outer. The nodes are below the dentate line, fall out of the anal canal. Visible and palpable even without additional research.
  3. Combined. In this case, the hemorrhoidal nodes are located both inside the rectum and outside. This is the most severe form of the disease.

Symptomatology

Chronic hemorrhoids develop gradually, at the beginning of the disease the symptoms are mild. Over time and the transition of the disease to the next stage, the signs become more pronounced, bring discomfort.

Clinical manifestations depend on the stage of the disease and its localization. The characteristic symptoms of hemorrhoids include:

  1. Discomfort in the anus. They are characteristic of the internal form of the disease.
  2. Pain in the anal area.
  3. Bleeding. It may be internal, in which blood is secreted from the rectum, or external.
  4. Loss of enlarged nodes. Appears in the second stage of the disease.
  5. Skin lesion in the perianal region. Manifested in the form of itching, burning, diaper rash.

Forms

According to how the nodes are located, this pathology is divided into:

  • outdoor
  • internal
  • combined (mixed).

With external hemorrhoids, the nodes are located near the anus, you can see or feel them yourself. If the patient has chronic internal hemorrhoids, then the nodes will be in the rectum and fall out only with exacerbation.

Combined hemorrhoids are a fairly common occurrence.The nodes in this case will be located both near the anus and in the rectum.

Pathology

In the human rectum are the so-called cavernous bodies. These are quite complex formations, the healthy state of which depends on good blood flow. They are called hemorrhoidal nodes, which are internal and external.

As the pathology progresses, the hemorrhoidal nodes increase in size

If the outflow of blood from the corpora cavernosa is impaired, they overflow with blood and pathologically expand. In the acute stage, various complications are added to the enlargement of the nodes: anal fissures, blood clots, inflammatory processes.

Uncomplicated hemorrhoids - a chronic disease. Experts distinguish four stages in its course, each of which lasts for weeks, and often months.

In recent years, proctologists have diagnosed combined hemorrhoids: a combination of signs of both external and internal pathology.

Causes of the disease

The disease "starts" under the influence of various adverse factors. Most often these are constipation, diarrhea, irritation of the intestine. They diagnose the disease in people with an inactive lifestyle, especially with sedentary work. Among other reasons - excessive physical exertion, various pathologies of the pelvic organs. In men, the main reason is smoking and alcohol. In women, hormonal failure during pregnancy and childbirth.

Symptoms of the disease

At the first signs of the disease, many simply do not pay attention. Symptoms of hemorrhoids are minor and bring only inconvenience.

In the first stage, small smears of blood appear on toilet paper or feces. Most often itching and burning in the anal area, as well as a feeling of full intestines after defecation. It is at this stage of the disease that you need to go to the proctologist to avoid prolonged treatment.

In the acute course of the disease, the patient may feel pain and a feeling of incomplete bowel movement.

Disease development

Exacerbation of the disease is manifested by complications:

  • when bowel movements occur, short-term prolapse of enlarged nodes occurs, they are pulled in by themselves,
  • not only defecation, but also physical activity threatens with the loss of nodes, which then have to be manually adjusted,
  • hemorrhoids fall out for no apparent reason, cannot be repaired.

Internal hemorrhoids are very difficult to recognize on time. At the first symptoms, instrumental examination of the rectum is necessary.

Table: Degrees of the chronic course of the disease

StagesSymptoms
1 degreeAnal inflammation, bleeding, itching
2 degreeInflammation of the anal area, exacerbation, bleeding, itching, prolapse of nodes and rapid self-reduction
3 degreeInflammation of the anal area, bleeding, itching, prolapse of nodes and manual method of their reduction
4 degreeHemorrhoidal nodes cannot be corrected, bleeding and constant pain

Stage 1-2 is amenable to medical treatment, stage 3-4 only surgery

You cannot die from a disease, but you can get a huge discomfort. In addition to pain, a person often develops anemia. And this means endless fatigue, loss of strength and many other disorders in the body.

Do not forget about colon cancer. Such a complication may occur in the absence of treatment and the protracted course of hemorrhoidal disease.

Chronic hemorrhoids of the 2nd degree is the most dangerous! It is during this period that pathology can be launched to serious complications that require immediate surgical intervention.

Effective treatment and prevention

How to treat if the disease begins to resemble itself? At home, treatment is ineffective! It is better to immediately go to the doctor for help.Among folk remedies that can relieve unpleasant symptoms for a while, one can distinguish baths with potassium permanganate and rectal suppositories from raw potatoes.

The methods of treating chronic diseases of the rectum are very closely related to what stage the pathology has. If the first, then in most cases only medicines will be required. Local preparations (suppositories, ointments and / or creams) will facilitate bowel movements, reduce pain, and improve blood flow. With exacerbation, baths with medicinal herbs, microclysters are also used. If the doctor prescribes pills, then it can be painkillers, anti-inflammatory drugs, as well as drugs that contribute to more active blood circulation.

Consultation with a proctologist is required!

Treatment of chronic hemorrhoids is carried out only according to the scheme of a doctor who conducts diagnostics before prescribing drugs.

It is very important to know and remember! At the first stage, fighting the disease is relatively easy. While the manifestations of the disease are minor, symptoms can be minimized or even eliminated. Later, to achieve such an effect without surgery will be much more difficult or simply impossible.

More often, patients are prescribed drug therapy in combination with local preparations in the form of ointments, gels and rectal suppositories. Phlebotropic drugs are very popular.

For example, Detralex is a French drug for veins and blood vessels. Detralex treatment for chronic hemorrhoids helps to relieve all the symptoms of the disease, while improving the tone of veins and blood vessels. Recently, a new Russian drug, Venarus, has appeared in pharmacotherapy. The drug is cheaper than the French counterpart and has a similar spectrum of actions.

In the second and third stages, drugs do not always help. Often patients are recommended operations that are called minimally invasive. These are relatively gentle surgical interventions and subsequent recovery of the body.

Such operations are performed in 20 minutes

During surgery, an anoscope and various instruments are used, the choice of which depends on the method of treatment of hemorrhoids. For example, during transanal ligation, the legs of the nodes are clamped with special rings that block the access of blood to the nodes and cause their separation and excretion with feces. And for infrared coagulation, you need a device that forms a narrow light beam, which affects hemorrhoidal nodes.

There are a lot of methods of minimally invasive treatment of proctologic ailment! Each has its pros and cons. But if the disease has reached the last stage, most doctors recommend a classic operation called hemorrhoidectomy. Such an intervention requires the patient to spend several days in the hospital. Full recovery of the body occurs after about a month.

An alternative to such an operation is the Longo method, in which hemorrhoidal nodes are reduced and seem to be established in their physiological places due to the hemming of the intestinal mucosa. The method is practiced relatively recently, although it has already earned a lot of positive reviews. Intervention is quite expensive if only because it is made with a disposable device and a set of tools.

What is all the same to treat chronic hemorrhoids? The proctologist must answer this question. First of all, the specialist will check whether it is really a question of hemorrhoidal disease. After all, similar symptoms occur in other intestinal ailments. Then the doctor will determine if there are any contraindications to prescribing a specific drug or technique. And only then it becomes clear what the treatment of pathology will be.

The third stage of chronic pathology is characterized by prolapse of nodes, which can no longer be corrected without assistance. The patient experiences sharp pains, constant itching and frequent bleeding.In the fourth stage, prolapse of nodes occurs with the mucous membrane of the rectum. The patient is tormented by constant itching, fecal incontinence, discharge from the anus, eczema, dermatitis.

How is chronic hemorrhoids diagnosed and diagnosed? The doctor should be diagnosed after a thorough examination of the patient. The specialist conducts an examination, collects an anamnesis and performs a digital rectal examination. After which the doctor prescribes a diagnostic examination: anoscopy, blood and stool tests, coprogram, etc.

Treatment of a protracted disease begins with conservative methods. They include the appointment of medications and local medicines: ointments, rectal suppositories, physiotherapy, normalization of the digestive tract.

If conservative treatment does not give the desired result, they resort to a radical solution to the problem. These are minimally invasive treatments or surgery. In Russia, sclerotherapy and laser coagulation methods are popular. With surgical removal of hemorrhoids, hemorrhoidectomy is used.

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Conservative

Conservative treatment consists in the use of medications. The most commonly used groups of drugs are:

  1. Venotonic. This is a group of drugs that affect the mechanism of the development of the disease. They strengthen the vascular walls, reduce their permeability, increase the tone of the veins. Most often used in pill form. For example, Detralex, Normoven, Venus. The duration of treatment is several months.
  2. Painkillers Most often applied topically, in the form of ointments, gels or rectal suppositories. They include local anesthetics that block pain receptors. The following medicines are used: Emla cream, Lidocaine ointment.
  3. Anti-inflammatory drugs. These are medications that eliminate the signs of inflammation: redness, swelling, pain. Used in the form of candles or ointments. For example, suppositories "Diclofenac", ointment "Proctosan".
  4. Medicines that accelerate regeneration. In the later stages of the disease, the nodes are often injured, which is often accompanied by trauma to the rectal mucosa. For the healing of wounds and cracks use "Sea buckthorn candles", ointment "Methyluracil".

Minimally invasive

With the ineffectiveness of conservative therapy, they switch to minimally invasive techniques. These are operations that do not require a tissue incision and the use of a scalpel. Most of these procedures are performed under local anesthesia.

The most commonly used methods are:

  1. Laser coagulation. Enlarged nodes are removed using a laser.
  2. Ligation. A latex ring is applied to the base of the hemorrhoidal cone, which presses blood vessels and stops the blood supply to the node. This leads to its necrosis.
  3. Sclerosis. A sclerosing drug is injected into the hemorrhoidal vein. This leads to a gradual decrease in the node.

The advantage of such methods is low tissue trauma, a short recovery period.

Radical

In the fourth stage, the only effective treatment is open surgery. The operation consists in excising the deformed nodes with a scalpel. Surgery is performed under general anesthesia or spinal anesthesia. There are two main types of such an operation: with wound closure and without.

After surgery, a recovery period begins. In the hospital, the patient is on average 2-7 days, depending on the type of operation and the presence of complications. In this period, pain often occurs, postoperative bleeding and infectious complications may develop.

Folk

In the initial period of the disease, alternative recipes can be used for treatment. At the third and fourth stages, their use is ineffective.

Folk remedies can be used both internally and for external treatment. The list of the most popular recipes:

  1. Sedentary bath with sage. Take 4 tbsp. l dry sage leaves, pour 200 ml of water, boil for 10 minutes. Pour the resulting broth into a bowl of warm water. Sitting in such a bath needs 15 minutes.
  2. Chamomile broth. For cooking, you need 2 tbsp. l dried chamomile flowers, 200 ml of water. Boil water with flowers for 10 minutes, let cool. The broth is taken orally, 50 ml 30 minutes before a meal. The course of treatment lasts 7-10 days.
  3. Sea buckthorn oil. Oil is used to heal wounds and fissures in the anal area. Take a few drops of oil, rub into the affected area with gentle movements. Repeat 2-3 times a day. The course of treatment is 4-7 days.

Symptoms of hemorrhoids

In most cases, hemorrhoids begin unnoticed. For some time, people may feel a feeling of heaviness and slight discomfort in the anus. Since these symptoms do not affect general well-being and performance, a person does not consult a doctor. However, it is this stage that is most favorable for preventive measures. In the future, patients have pronounced discomfort in the anus, pain of various kinds and bleeding associated with bowel movements.

Main feature hemorrhoids The disease is the presence in a person of hemorrhoidal nodes - enlarged, saccular and blood-filled veins of the rectum. They can be located in the lower parts of the rectum, and then only a doctor can detect them. But often they go outside and become visible upon examination.

Hemorrhoidal nodes are rounded formations, covered with either a mucous membrane or thin skin. Usually they are soft or elastic to the touch and, if there are no complications, painless. On average, hemorrhoidal nodes across have a size of 0.5 to 2 cm. In case of inflammation or thrombosis, they increase significantly, becoming extremely sensitive and painful.

Hemorrhoids are characterized by a symptom such as bleeding. It almost always occurs at the time of bowel movement: when a person is pushing, the thinned and expanded hemorrhoidal nodes overflow with blood, after which they are injured by passing fecal masses. Most often they are damaged by constipation, when the feces have a fairly solid consistency.

Bleeding usually stops quickly, but may recur with the next stool. With hemorrhoids, blood droplets never mix with feces, but are usually visible on their surface or on toilet paper. Chronic blood loss during hemorrhoids can lead to anemia (iron deficiency anemia).

Pain is the most severe and unpleasant symptom in hemorrhoids. It appears due to inflammation and trauma to the mucous membrane and skin with feces.

Pain is a characteristic sign of both acute and chronic stages of the disease. In chronic hemorrhoids, pain is almost always clearly associated with stool and feels like burning or bursting in the anus. After bowel movement, the discomfort gradually subsides, but the burning sensation can remain for quite some time.

With exacerbation, the pain intensifies sharply, especially in the case of inflammation and thrombosis of hemorrhoids. It can be so pronounced and painful that people cannot sit and sleep at night. The pain can be bursting, pulsating in nature and significantly increase during bowel movement, coughing, sudden movements and touching the nodes.

If you find such symptoms in yourself, do not rush to diagnose yourself and treat yourself. Various intestinal diseases, including colon tumors, may have similar symptoms.Therefore, if there are signs of hemorrhoids, examination and treatment according to the algorithms proposed by the doctor is mandatory.

Summary

The treatment of hemorrhoids is a long process that does not always lead to the expected result.

It is much more effective to prevent the development of the disease, adhering to preventive measures. To do this, you need to eat right, move more, eliminate heavy loads, get rid of bad habits. It is also important to undergo regular medical examinations to identify pathology at an early stage.

What is an ailment?

Hemorrhoids are an extension of the hemorrhoidal vein. Due to stagnation of blood in the pelvic organs in the rectum, a lump forms, which falls out. Chronic hemorrhoids occur with periods of remission and relapse. It is impossible to get rid of him. All doctors can do is to extend the period of remission and reduce the severity of symptoms.

Chronic hemorrhoids - a long-existing expansion of the cavernous plexus located in the submucosa of the lower part of the rectum

The chronic form of the disease for a long time can be asymptomatic and occasionally manifest itself as minor bloody impurities in the feces. If chronic hemorrhoids is not diagnosed in a timely manner, a person may experience iron deficiency anemia. You can determine the stage of relapse by unpleasant sensations in the form of pain, itching and burning. Symptoms increase dramatically with physical exertion.

At the stage of remission, a lull is noted. At stage 1, the symptoms completely disappear, and the patient can lead a familiar life. Relapse of the disease can cause negative factors:

  • weight lifting
  • emotional shakes
  • decreased immunity,
  • constipation.

A person suffering from a chronic form of the disease must undergo corrective therapy once every six months in order to prevent symptoms.

Reasons for development

It is impossible to cure chronic hemorrhoids without determining the cause of its development. To identify the root cause, it is necessary to study the patient’s lifestyle. Causal factors:

  • Sedentary work and sedentary lifestyle. This leads to stagnant processes in the legs and pelvic organs. Blood stops circulating normally.

In the list of conditions conducive to the development of chronic hemorrhoids, specialists include sedentary work, a sedentary lifestyle

  • Large physical exertion and frequent overwork. The main load falls on the legs. The tibial muscles perform the function of a pump, which pushes blood back to the heart. If a person experiences stress on a regular basis, the muscle ceases to function normally and begins to function more slowly. As a result, blood circulation slows down. In the pelvic organs, stagnation forms, which, with prolonged accumulation, form nodes.
  • The tendency to varicose veins. The weakness of the vascular walls, which expand with the slightest disturbance of blood circulation, can be inherited.
  • Improper nutrition.
  • Impaired functioning of the gastrointestinal tract, in which intra-abdominal pressure increases and the veins in the rectal mucosa expand.
  • Inherited location.
  • Pregnancy and childbirth. During pregnancy, the uterus grows and presses on the pelvic organs, provoking stagnation and prolapse of the hemorrhoid. In the process of labor, a woman experiences a large load on the pelvic region and rectum, which falls out under pressure.
  • The consequences of an infectious disease.
  • Age-related changes. The older the person, the greater the risk of encountering an ailment due to muscle weakness and decreased tone in the vessels of the pelvic organs.

Causes may be related to traumatic anal sex. It is very important to identify the root cause, because further treatment tactics depend on it.

The initial period of the disease lasts from several months to several years

The degree of development of the disease

According to the existing classification, 4 stages of hemorrhoidal vein expansion are noted:

  • symptoms occur sporadically, oral medications can cure the disease,
  • the symptoms are aggravated, bleeding is added during bowel movements and the prolapse of the hemorrhoid cone, which is easily set back,
  • chronic hemorrhoids of the 3rd degree has pronounced symptoms and prolapse of the hemorrhoid, which is difficult to correct. Long-term treatment required
  • the most severe form, the nodes that fell out, do not set and often become inflamed.

The patient's condition worsens, surgical treatment of pathology is required.

Combined hemorrhoids are the most severe form of the disease that is the most difficult to treat.

In addition to the stages, types of the disease are also determined:

The external type is characterized by prolapse of the hemorrhoidal node, and with internal localization, the nodes become inflamed inside the rectum and do not bulge outward.

The combined type combines the symptoms of internal and external hemorrhoids. Most often, internal hemorrhoids of the 2nd degree are diagnosed.

At this stage, the nodes do not fall out, but the rectum constantly bleeds and there is an unbearable itch, although outwardly reddening and swelling of the tissues are not noted.

Internal nodes increase and become painful, over time they can fall out of the rectum

The mechanism of development of chronic hemorrhoids

The initial stage of varicose veins of hemorrhoidal veins can stretch from one month to severalyears. In this phase, long periods of remission predominate, when the disease does not bother, and there seems to be no need to contact a proctologist.

Over time, especially under adverse conditions, during bowel movements, discomfort appears, the feeling of the presence of a foreign object is disturbing. After bowel movement, traces of fresh scarlet blood from burst capillaries can be seen. And this is only the first bell. The ailment continues to progress and already every trip to the toilet "for great need" accompanies pain in the anal canal, the intensity of which increases with violations of the rhythm of defecation. If the drops of pure red blood from the capillaries are replaced by jet discharge of dark venous, this may indicate a developing inflammation. Similar symptoms are characteristic of other serious pathologies, so differential diagnosis at this stage is mandatory.

The venous plexuses at this stage no longer just remind themselves of discomfort during bowel movements - overflowing with blood, they painfully react to any mechanical or chemical irritation. The loose, ulcerated mucosa is stretched, under the weight of dense feces with constipation or from frequent straining with diarrhea, the inflamed internal nodes move out. Already at the second stage of the development of the disease, they fall out of the anus.

In total, according to the international classification, there are 4 degrees of the development of the disease in chronic hemorrhoids of the internal form:

  1. The initial stage is characterized by the absence of pronounced symptoms, with the exception of short bleeding, while the nodes grow, but remain in place.
  2. In the second stage, the cavernous plexuses can fall out when the intestines are empty, but at the end of the act they return without any problems.
  3. With hemorrhoids of the third degree, hemorrhoids are no longer independently retracted, but if you help them with your hand, they are kept in a normal position.
  4. With the advanced form, the cones respond to the slightest physical stress - muscle loads, coughing, laughing, sneezing. It is not possible to return them to their place on their own - medical, most likely, surgical help is needed. Easily vulnerable nodes become inflamed with the slightest trauma.With blood stasis, blood clots often form in them, dangerous necrosis and other serious complications.

External hemorrhoids are classified in three degrees, since it eliminates the stage of prolapse of nodes. But in general, both internal and external, and combined chronic hemorrhoids require urgent treatment, since already with the second degree, few people manage to avoid the operating table with all the ensuing consequences.

Symptoms of the pathological process

Chronic internal hemorrhoids - an insidious disease. In the first stages, it can be hidden. The first symptoms are itching and burning in the anus. Further, a person begins to notice spotting in the stool and pain during bowel movements.

When it strains, enlarged hemorrhoids and thinned vascular walls are overflowing with blood. In the process of promoting feces, they are injured and bleed. Blood does not go for a long time, after a bowel movement, bleeding stops, but can be repeated during the next act of defecation.

Sometimes, patients mark droplets of blood on their underwear without straining.

Symptoms develop gradually. A person rarely seeks help at this stage. An alarm is triggered when real torment already begins (a hemorrhoidal lump occurs).

Hemorrhoidal nodes can be of different sizes from a few millimeters to 10 cm. Outwardly, they resemble a pouch covered with thin red or burgundy skin. The bump is elastic and soft to the touch, but very painful.

As the disease progresses, the bump becomes inflamed and acquires a bright red color.

An exacerbation may occur due to clogging of blood veins in the pelvic organs. A purulent inflammatory process sometimes joins the fallen cones. On the surface of the fallen cones, ulcers appear, which are an ideal medium for the reproduction of bacteria. It is very important to observe the hygiene of the genitals and carefully follow the doctor's recommendations in order to avoid bacterial infection.

Initially, patients with chronic hemorrhoids note slight discomfort and a feeling of heaviness in the anus

The most unpleasant of the symptoms is unbearable pain, which can not always be stopped with painkillers. Chronic hemorrhoids show symptoms when straining. When calm, the pain subsides. Painful sensations can be pulsating sharp and lasting in nature.

Because of them, the patient cannot work, sleep, lie and sit. He constantly tries to take a position that allows him to ease the pain, which is why he very often faces a situation when his legs and lower back begin to hurt.

This is due to the fact that often the poses chosen by the patient are very uncomfortable and lead to swelling of soft tissues in a certain area.

Among the common symptoms of the disease can be noted:

  • refusal of food
  • sleep disturbance,
  • fever
  • decreased performance
  • general fatigue
  • increased nervousness.

Treatment Options for Recurrent Hemorrhoids

Treating chronic hemorrhoids yourself (on the Internet, on the advice of friends) is ineffective, and sometimes even dangerous. Without examination by a proctologist, it is impossible to say with certainty that you have hemorrhoids.

When choosing a treatment regimen, the proctologist focuses on several criteria: the prevailing symptoms of hemorrhoids in the patient, the stage and form of the disease, the presence of concomitant diseases, and the general condition of the body. Therefore, only a specialist can diagnose a specific patient. He will draw up an individual therapy scheme.

Pharmaceutical companies have developed several classes of medications to effectively treat the chronic form of hemorrhoidal disease. But 100% conservative treatment is effective only for hemorrhoids of the first degree.

Treatment

How to cure hemorrhoidal expansion of veins, only a qualified doctor can tell on the basis of an examination. Self-medication is unacceptable, since there is a risk of complications. Before treating chronic hemorrhoids, the doctor determines what stage of the pathology takes place.

Conservative treatment is indicated in the early stages of chronic hemorrhoids, it consists of two stages

Conservative therapy is prescribed in the first three stages of the disease. Doctors prescribe hemorrhoids medications that:

  • strengthen the walls of thinned vessels,
  • normalize blood circulation,
  • stop the pain
  • have a restorative effect.

The patient is shown local drugs that relieve pain and swelling of the anal area, reduce the hemorrhoidal bump. Drugs are prescribed to prevent constipation, and the patient’s diet is also adjusted.

At stages 3 and 4, surgery can be prescribed. The patient is excised with fallen hemorrhoids. A minimally invasive treatment technique, cryotherapy, is popular.

The principle of the procedure is that the hemorrhoid is burned out with liquid nitrogen. Latex ring therapy is also used.

A special ring is put on the hemorrhoid that has fallen, which blocks the blood flow. Over time, the node dies.

The treatment of chronic hemorrhoids and the selection of medications are prescribed by the doctor individually, taking into account the patient’s age, the presence of concomitant diseases, as well as a tendency to varicose veins.

At the same time with medications, you can, using the advice of a doctor, use alternative recipes

Often, patients turn to traditional medicine for help. The effect of recipes of traditional healers is observed only in the first two stages. At an advanced stage, they stop some symptoms, but do not eliminate the disease.

Very well from chronic hemorrhoids showed themselves baths and microclysters with chamomile broth. A good effect is given by a remedy for hemorrhoids based on onions and milk. Pour onion gruel with a glass of milk and cook for 5 minutes.

A cotton pad is moistened in a liquid and applied to the inflamed area.

Medicinal Techniques

In the chronic form of pathology, tablets, ointments, suppositories are already used as adjunctive therapy: for prophylactic purposes, in preparation for operations, in the recovery period after surgery, for symptomatic treatment.

To reduce relapse, it’s important to:

  • To improve the digestive system
  • Optimize muscle loads
  • Restore the rhythm of bowel movements,
  • Observe hygiene standards.

Lifestyle modification is that reliable foundation, without which no way to treat hemorrhoids would be absolutely effective.


In conjunction with the listed measures, the doctor prescribes:

  1. Venotonic. Means help strengthen weak veins, as they serve as a prerequisite for the development of the disease. Flebodia 600, Detralex, Venoruton, Venarus, as well as Troxevasin gel and tablets (used in parallel) will help increase elasticity and normalize blood supply.
  2. Antiseptics. This group of medicines is necessary for the spread of infection. Pathogenic microorganisms are destroyed by bioactive complexes based on sea buckthorn oil, propolis, calendula extract, as well as chemical active components (bismuth, zinc). Locally disinfect with Anuzol, Neo-Anuzol, Anestezol, as well as suppositories based on ichthyol, sea buckthorn.
  3. NSAIDs. For local treatment of inflammation and other symptoms, non-hormonal suppositories and ointments are used - Levomekol, Relief, Indomethacin, Vishnevsky ointment. There are hormonal analogues based on hydrocortisone, but their effectiveness is proportional to the number of side effects.
  4. Anesthetics.The pain during exacerbation of hemorrhoids is so severe that there is no way to endure it, and there is no need for this. Even at home, symptoms can be alleviated with the help of Ibuklin, Nise, Pentalgin. At the local level, they are anesthetized with candles with belladonna extract, novocaine or Anestezol, Relief Advance, Ginkor Procto, Neo-Anuzol, Procto-Glivenol. Bezornil ointment can be applied to external hemorrhoids.
  5. Wound healing preparations. Suppositories with methyluracil, sea buckthorn oil, propolis and shark liver oil accelerate the recovery of damaged tissues.
  6. Anticoagulants. With a tendency to thrombosis, ointments and suppositories based on heparin are prescribed: Heparin and Troxevasin ointments, HepatrobinG. They thin the blood.
  7. Hemostatics. Drugs of this class are necessary for bleeding. Of the tablets, Vikasol is prescribed, for topical application, candles with adrenaline are suitable. To narrow the venous plexuses, to restore the damaged walls of blood vessels, you can use Advance, Relief, Relif Procto-Glivenol, Natalsid.


If there are problems with constipation, to improve bowel function, eliminate congestion and reduce pressure on the hemorrhoids from the intestines crowded with feces help: Guttalax, Duphalac, Portalac, Normase.

Operational techniques

In cases of hemorrhoidal disease, grade 2-4 drugs can prolong the period of remission, but only operations - invasive and minimally invasive can fundamentally solve the problem.

Both the coloproctologist and the patient have plenty to choose from:

  • Photocoagulation - the nodes are affected by a narrow beam. The infrared coagulator accelerates the coagulation rate of the protein in the seals, they are depleted and die. The technique is effective for bleeding.
  • Sclerosis - placement of sclerosant in the nodes by injection. They literally glue the blood vessels, replacing the blood supplying organ with connective tissue. Gradually, the node dies and heals. Seals are getting smaller.
  • Ligation - constriction of the leg with a latex ring superimposed on the node to stop its blood supply. After dying, waste tissue comes out naturally during bowel movements.
  • Cryodestruction - freezing with liquid nitrogen of problem areas.


Minimally invasive surgery is performed in a few minutes. Due to the low invasiveness they are done on an outpatient basis, anesthesia is not required. There is no serious interference with the body, the anatomy of the anal canal is preserved, therefore, there are less risks of complications, and the rehabilitation period is short.

If hemorrhoidal disease is started, periods of exacerbation are complicated by hemorrhoid vein thrombosis, paraproctitis, minimally invasive operations are contraindicated. In such cases, classic hemorrhoidectomy is recommended.

Hemorrhoid plexuses will be excised under stationary conditions under general anesthesia. The scalpel in modern conditions replaces the electric knife, which not only cuts tissues very accurately, but also cauterizes the edges, preventing bleeding. At the preparatory stage, the mucous surface is disinfected and a rectal mirror is inserted into the anal canal.

A node from the intestine is pulled out with a clamp, the base of the legs is stitched with catgut threads. After excision of the hemorrhoids, the leg is securely tightened. After stitching the edges of the wound, followed by disinfection, a turunda soaked in ointment is introduced into the intestine. The whole procedure takes up to 40 minutes.

When excising nodes, the wound is sometimes not sutured: it is believed that the open form heals faster. The operation is quite traumatic, as many tissues are involved, therefore, the operated on for several days left in a hospital under supervision. The recovery period lasts on average six months.

A modified version of hemorrhoidectomy, requiring a highly qualified doctor, is a Long operation.The base of the knot is pinched with a one-time tool, similar to a stapler, to worsen its blood supply. At the same time, the nodes are not excised, only the mucous zone is cut out around, fixing the edge with a circular suture. The vessels through which the blood passing through the nodes passed are clamped with titanium brackets. Not receiving proper nutrition, the cones are replaced by connective tissue. The procedure takes about an hour, general anesthesia is used. Since the damage is much less, the patient is discharged on the third day. The recovery period will also be much shorter.

Exacerbation

As a prevention of the development of the disease, nutrition adjustment is in the first place. Excessive consumption of fast foods and heavy side dishes leads to constipation. Additional straining increases pressure in the peritoneum. The stool hardens and moves very hard in the rectum, giving the patient a lot of torment.

Try to consume more fiber-rich foods, namely:

Reduce physical activity, stay in the same position for less time. If your work involves long sitting, do not forget to take a short break every hour. Follow the hygiene of the anal area.

Small cracks and damage without treatment can be the optimal environment for the development of infection. As a prophylaxis, once a year undergo examinations by a proctologist.

At the first symptoms of the disease, seek medical help, and do not self-medicate.

Symptoms of chronic hemorrhoids, causes and treatment of 1, 2, 3 and 4 degrees, disease prevention

Seventy percent of adult men and women over 41 years old are familiar with the manifestations of hemorrhoids (varicose veins of anorectal veins). Since this condition is delicate, many people avoid contacting a specialized doctor (proctologist), preferring to solve the problem by self-medication: folk or pharmaceutical means.

What to do if hemorrhoids worsen

The lack of treatment in the right amount leads to the transition of the disease into a sluggish (chronic) form, which can worsen when any provoking factor occurs. Therefore, this material will describe the causes and stages of hemorrhoids with their symptoms. And also, because of what is aggravating, examination methods and how to treat the disease.

Nutrition for hemorrhoids

The basis of the therapeutic diet for varicose veins is table No. 3 with fractional (5-6 times a day) nutrition, non-intestinal irritating foods. To control the rhythm of bowel movements, it is important to follow the drinking regime - up to 2-2.5 liters of clean water per day.

Options for heat treatment of products exclude fried, smoked dishes, as well as canned food, marinades, pickles, spices. Legumes and chocolate, which stimulate gas formation, are not useful.

A special place in the diet is given to fiber, which normalizes intestinal motility. Grain, as well as vegetables and fruits in fresh, baked, boiled form will help maintain the norm. Coarse fibers of radish or cabbage are injured in the intestinal wall.

The basis of the diet for chronic hemorrhoids is mashed soups, baked vegetables, viscous cereals, dairy products (restrictions on the amount of cottage cheese).

Exclude from the menu white bread, rice, jelly, potatoes, as well as strong tea, coffee and all types of alcoholic beverages.

Only with constant observance of the recommendations for therapeutic nutrition in the intestine does an environment favorable for the healing of the mucosa and the maximum activity of the drugs be formed.

Causes of Chronic Hemorrhoids

Hemorrhoids determine the insufficient tone of anorectal veins (venous insufficiency), which occurs due to stagnation of arterial blood in caverns (accumulations of rectal vessels). As a result of this, cavernous formations overflow with blood, expand and are squeezed into the hemorrhoidal node (cone).

So, the occurrence of hemorrhoidal cones can be triggered:

  • genetic factor
  • sedentary lifestyle,
  • predisposition to obstructed bowel movements due to improper bowel function,
  • excessive consumption of salted, spicy and fatty foods, as well as spices,
  • physical stress (weight lifting),

Weight lifting as a cause of hemorrhoids

  • obese
  • pregnancy with childbirth.

Diagnostics

At the first stage of development, chronic hemorrhoids can be diagnosed exclusively with a routine examination by a specialized doctor (proctologist).

If there are suspicions or the presence of an appropriate symptom complex, a detailed examination of the rectum from the knee-elbow position or gynecological chair is necessary.

In this case, the development of the disease will be indicated by cracks in the rectum, mucous membranes and blood discharge from the anus, as well as enlarged hemorrhoids.

Further diagnostic measures are carried out by:

  • finger research
  • anoscopy
  • sigmoidoscopy,
  • colonoscopy
  • irrigoscopy.

Colonoscopy

Also, measures for an internal examination of the intestines with the stomach are carried out to exclude / confirm serious damage to the digestive tract.

In addition to the above diagnostic procedures, you will need to visit a gastroenterologist with a therapist. The neglected form or serious complications of chronic hemorrhoids require hospitalization.

And only in the absence of thrombosis with anemia, home treatment is allowed.

Chronic hemorrhoids treatment methods

As mentioned above, the treatment of chronic hemorrhoids is directly related to the neglect and complexity of the disease. So, to eliminate the manifestations of the disease and prevent the appearance of nodes in the future, such methods are often used:

  • Drug therapy involves the use of not only tablets, but also suppositories with ointments. The main directions of their impact are: strengthening the walls of blood vessels, anesthesia, relieving inflammation and stopping bleeding. The main condition is the use of medications prescribed by a doctor, especially for women who are expecting or breastfeeding a child,
  • Minimally invasive treatments for chronic hemorrhoids are also used mainly up to stage 3. They include: sclerotherapy, based on the injection of a sclerosing drug directly into the hemorrhoidal cone, laser coagulation, which involves the use of a laser, the use of latex rings that compress the problem area before it dies. These methods completely cure chronic internal hemorrhoids, either external, but exclusively in the early stages,
  • Surgical intervention in the treatment of chronic hemorrhoids is indicated in the late stages of development, with the ineffectiveness of other methods. The decision on the operation is made taking into account the risks of possible complications and the expected benefits.

Chronic treatment of hemorrhoids

As you can see, chronic hemorrhoids are a treatable disease, especially if you seek medical help in the early stages of development. But the method should be determined exclusively by a specialized doctor based on the severity and neglect of the disease.

Preventive actions

As you know, the most effective treatment for the disease is its prevention. So, to provide a stable remission of the chronic form of hemorrhoids or to prevent its appearance is much easier than to cure a disease of 3 or 4 degrees. To do this, it is enough to adhere to such simple recommendations:

  • the preference in eating vegetables containing large amounts of fiber is recommended,
  • take food at least 3 times a day, to avoid intestinal overload,
  • wash the anus and rectum with cold water after each emptying,
  • during bowel movements do not sit on the toilet for a long time and do not push,
  • sit less and move more (especially walk, do special exercises) to strengthen the muscles of the pelvis and legs,
  • refrain from lifting heavy objects (more than 20 kg) so that the hemorrhoidal nodes do not fall out,
  • if possible, sleep on a hard surface with a small roller under the head (according to the Japanese recipe),
  • avoid hypothermia and colds,
  • Do not provoke constipation
  • regularly enema infusions of chamomile with calendula,
  • take baths with infusions of herbs and plants.

Important! If chronic hemorrhoids is caused by a hereditary predisposition, it is recommended to follow a diet and undergo medical treatment every six months, which strengthens the walls of blood vessels. And the acute form of the disease requires a temporary refusal to exercise in general.

As follows from the above, the treatment of the chronic form of hemorrhoids is reduced to reducing its manifestations, stopping the growth of hemorrhoid cones and preventing the disease from transitioning to the acute stage, which is fraught with dangerous consequences and requires radical measures. At the initial stages of hemorrhoids, the disease can be cured by combining a first-aid kit (folk recipes) and traditional methods.

Chronic hemorrhoids: symptoms and treatment

Various abnormalities in the structure of blood vessels are found in 80% of people. Often they do not cause their carriers any discomfort, but under the influence of some factors can manifest themselves in the form of serious diseases.

One of these abnormalities is the expansion of superficial veins, leading to impaired blood flow and problems in the functioning of the valves.

Some patients due to such a deviation in the structure of blood vessels have to treat chronic hemorrhoids of the first degree at home.

What is chronic hemorrhoids

Many people sometimes experience an expansion of the cavernous plexus located in the submucosal layer of the lower part of the rectum and near the exit of the anal canal.

Often this ailment occurs in women during pregnancy and in weightlifters due to the large load on the muscles of the pelvic floor. Chronic internal hemorrhoids develop if inflammation is severely triggered.

The treatment of this form of the disease is always long and complicated.

Features of the disease

Hemorrhoids - vascular disease in the pelvic area. In the rectal region there are 2 large veins, one of which lies under the skin, and the second under the mucosa.

With obstructed blood circulation, adhesions form in the vessels, the walls are injured, large nodes appear on them, prone to overgrowth. The bowel movement becomes painful, accompanied by constant trauma and bleeding.

What is acute hemorrhoids and what is chronic? Acute hemorrhoids are characterized by severe pain, burning, itching, prolapse of nodes, fever.

It is impossible to ignore this condition, with frequent symptoms, men sooner or later go to the doctor. However, sometimes they relieve pain attacks with conventional anesthetics, possibly delaying a visit to a specialist.

Symptoms become less pronounced or pass away for a while, but the disease continues to develop and sooner or later makes itself felt with another attack.

For chronic hemorrhoids, an alternation of seizures with periods of rest is characteristic. During remission, the patient does not feel pain, slight itching in the anus and minor rectal bleeding are possible.

If untreated, the periods of rest become shorter, and exacerbations become more frequent, and the symptoms become more pronounced. As you can see, acute hemorrhoids and chronic are 2 completely different forms of the disease, which should not be confused.

Experts believe that treating chronic hemorrhoids is more difficult than acute. Symptoms of the disease are less pronounced, while the therapeutic regimen should include the widest possible range of drugs.

The main manifestations and forms

The disease can be external, internal and combined:

  1. Chronic external hemorrhoids develops with lesions of a vein running under the skin in the rectum and small subcutaneous capillaries. As a result, hemorrhoids and edema are localized near the anus, with tension during defecation they go outside and require repositioning.
  2. Chronic internal hemorrhoids - what is it? This form of the disease is caused by problems with a vein under the mucosa.

The nodes are localized along the walls of the rectum. You can detect them and accurately determine the size only with a rectal examination or ultrasound. This form can be detected quite late, the treatment is complicated.

  • Chronic combined hemorrhoids (mixed) combines external and internal nodes. A very common option, characteristic of men with a hereditary vascular pathology.
  • Now that you know about the types of chronic hemorrhoids, symptoms are the next topic that will be addressed by our specialists in this article.

    Symptoms and development of the disease

    The main symptom of chronic hemorrhoids is rectal bleeding. The initial form is characterized by light traces on linen and toilet paper.

    With a running illness, you can detect splashes during bowel movements, noticeable red heels appear on the linen, and in the feces you can find not only fresh drops, but also dark clots of clotted blood. The latter option is especially dangerous, it speaks of permanent internal injuries and accumulation of blood in the rectum.

    Additional symptoms include:

    • burning and itching
    • frequent constipationthat may alternate with diarrhea,
    • general lethargy, apathy, insomnia, loss of appetite,
    • increased irritability and anxiety.

    There are 3 stages of chronic hemorrhoids:

    1. initial stage hr hemorrhoids are almost asymptomatic. It is characterized by rare drops of blood during bowel movements, mild itching in the anus. Hemorrhoidal nodes are small and practically not inflamed.
    2. Second phase chronic hemorrhoids is characterized by prolapse of nodes with severe tension or constipation. Cones are easily set by hands, bleeding becomes more pronounced, edema occurs around the anus.
    3. For third stage frequent exacerbations of pain and burning are characteristic. Hemorrhoidal nodes can fall out even with a slight voltage, they often become inflamed, pus can mix with the blood. Appearing external cracks are delayed with difficulty, which indicates the development of anemia.

    Before we move on to the topic: “Chronic hemorrhoids: treatment”, I would like to mention the consequences that await the patient in case of refusal of treatment.

    Potential danger to men

    The main danger of a chronic form is false complacency. Without feeling severe pain, the patient does not consider it necessary to consult a doctor.

    However, permanent loss of blood can provoke very unpleasant consequences. Among them:

    • the appearance of large non-healing anal fissures,
    • anemia,
    • the occurrence of purulent fistulas,
    • colorectal cancer.

    Constant bleeding speaks of numerous internal ruptures that become a breeding ground for bacteria. Damaged rectal walls provoke the development of cancer cells; at the initial stage, rectal cancer is difficult to diagnose.

    Anemia in men can cause many problems, including heart failure and a variety of brain pathologies.

    • Detailed description of the various stages: first, second, third, fourth,
    • Features of the internal course of the disease and external manifestations,
    • The list of medicines, suppositories and ointments that are used in the treatment of this disease can be found here.

    There are also materials that may be of interest to you:

    You can find out about harmful and useful products for the male organ here.

    Treatment methods

    How to treat chronic hemorrhoids? The treatment of hemorrhoids depends on the form and stage of the disease.

    Self-diagnosis is best not to do. The treatment regimen is prescribed by the doctor after detailed analyzes, rectal examination and analysis of the course of the disease.

    For the initial stage, it is important to normalize blood flow, strengthen the walls of blood vessels. Venotonics are actively used in the form of capsules, tablets, suppositories.

    In this period Detralex, Hepatrombin and Hepatrombin G are used. To relieve pain, anesthetic ointments with lidocaine, adrenaline, prednisone are possible. Ointments based on antibiotics will help to remove external inflammations: synthomycin, tetracycline, levomecithin.

    Treatment with each drug lasts from 7 to 14 days, followed by a break. The drugs are used comprehensively, but it is necessary to take into account their compatibility.

    For example, ointments with lidocaine can not be used with other drugs in this group. Antibiotics used in courses of 5 days, then they are replaced with lighter drugs.

    If you are going to stay incognito with a chronic hemorrhoid disease, home treatment is ideal for your case. To tint veins and capillaries, alcohol tinctures and water decoctions of horse chestnut, celandine, wormwood are used.

    If there are problems with stool, you can use cleansing and therapeutic enemas. Microclysters help with minor internal bleeding and microtrauma, they relieve swelling and inflammation.

    Purchased medicines can be replaced with home ones. For instance, homemade candles from wax, potatoes, candied honey are used to moisturize the skin and regenerate tissues. Ointments with rosehip oil or sea buckthorn will help remove external inflammation and cure cracks in the anus.

    The therapeutic regimen must be supplemented with changes in lifestyle. Patients with chronic hemorrhoids should increase motor activity, walk more.

    Swim, do gymnastics. Useful exercises. Contributing to the normalization of blood circulation in the pelvic area, various yoga asanas, martial arts.

    Avoid overwork, lifting weights and sports associated with sharp and short-term stress.

    Patients are prescribed a sparing diet with a low calorie content. Chronic hemorrhoids can worsen from fatty, spicy, too hot dishes.

    Their menu should exclude red meat, fast food, caffeinated drinks, industrial sweets. The basis of the diet for chronic hemorrhoids will consist of foods rich in fiber: whole grain cereals, fresh and stewed vegetables, fruits and berries.

    Useful low-fat dairy products, fish, lean poultry. All types of alcohol and smoking are strictly prohibited.

    With a lack of necessary products, you need to use vitamin supplements and dietary supplements. They are indispensable for constant loss of blood and the risk of anemia.

    Conclusion

    Chronic hemorrhoids are a serious illness requiring timely diagnosis and thoughtful treatment. It will be long, but with the patient's strict adherence to the instructions of the attending physician, one can count on success. We hope it helped you learn more about chronic hemorrhoids and how to treat it.

    Causes of Hemorrhoids

    The risk of hemorrhoids depends on the genetic predisposition. By inheritance to a person, weakness of the walls of venous vessels can be transmitted. Therefore, the likelihood of encountering hemorrhoids is higher in people whose relatives suffered from this disease or varicose veins.

    Another predisposing factor to the onset of the disease is age.The older a person, the less elastic the walls of his vessels are. So, protrusions are easier to form in them. Therefore, the disease more often bothers people of middle and old age.

    However, not all people with a genetic predisposition develop hemorrhoids. Other causes provoke its occurrence. Moreover, they can be affected, and thereby reduce the risk of a disease. These include:

    • sedentary lifestyle and prolonged sitting, leading to stagnation of blood in the veins of the legs and rectum,
    • constipation, in which people have to push,
    • weight lifting, accompanied by an increase in intra-abdominal pressure and vein overload,
    • improper diet: refusal of food rich in fiber, insufficient intake of water, abuse of spicy food and alcohol.

    In women, a factor that often provokes hemorrhoids is pregnancy and childbirth. The growing uterus presses on the intestines, the walls of the pelvis and the veins located in it. This leads to constipation, stagnation of blood and the appearance of hemorrhoidal nodes. During childbirth, problems are exacerbated by straining.

    Aggravation

    The cause of the deterioration can be a variety of factors. The most common ones include:

    • constipation
    • weight lifting
    • long sitting
    • diet disorders (especially alcohol and spicy food abuse).

    Exacerbation of hemorrhoids is always accompanied by pain: from sufficiently pronounced to intolerable. Acute pain can occur due to clogging of the veins with blood clots (thrombosis of the internal or external hemorrhoidal nodes), as well as due to prolapse and pinching of the nodes in the anus. The pain increases sharply when you visit the toilet, when you touch the nodes, sitting, walking and physical work.

    Hemorrhoidal nodes in the acute course of the disease swell, increase in size, acquire a bluish tint. They are either set with difficulty, or not set at all. If a strangulated or thrombosed node ruptures, bleeding appears. It can be quite strong, but the pain with this development is reduced.

    In severe cases, acute hemorrhoids are complicated by purulent inflammation of the perineal tissues. Due to circulatory disorders, ulcerations may appear on the surface of the nodes, which become the “gateway” for pathogenic bacteria. In such situations, in addition to local phenomena, the general well-being of the patient is significantly disturbed: a pronounced malaise appears, and body temperature rises. Perhaps even the development of such a serious complication as sepsis.

    Therefore, exacerbation of hemorrhoids requires the earliest possible and intensive treatment under the supervision of a proctologist.

    Hemorrhoid Prevention

    In order to prevent the development of hemorrhoids or to prevent its further progression, a number of recommendations must be observed.

    • Watch the regularity of the stool, do not allow constant constipation. Remember that this problem can be associated not only with poor nutrition, but also with insufficient motor activity, and with low water consumption. Drink at least 1.5 liters of regular water every day to soften stools and make bowel movements easier.
    • Limit in your diet foods that increase blood flow to the pelvis: spices, spicy, pickled and smoked foods, and especially alcohol. Give preference to vegetables and fruits that are rich in fiber and improve bowel function.
    • Try to walk and swim more, especially if you have to stand or sit for a long time during the day. By the way, this will also be the prevention of varicose veins of the legs, which often accompanies hemorrhoids. Active movements will not allow blood to stagnate in the legs and pelvis.
    • Do not lift weights.
    • Try to wash the area of ​​the anus with cool water after each stool.So you will not injure the mucous membrane and give training to the vessels. If you can’t wash yourself, use cold, wet wipes.
    • Perform special exercises to prevent hemorrhoids. The simplest of them is to compress the muscles of the perineum and anus, and then relax them. Such an exercise can be done several times a day in any setting. The main thing is regularity.

    Minimally invasive treatments

    Methods of treating hemorrhoids, which allow you to remove hemorrhoids with minimal trauma to the surrounding tissues, are called minimally invasive. In essence, they are surgical manipulations, however, such interventions practically do not deprive the patient of disability. These include infrared photocoagulation, cryotherapy, ligation of nodes with latex rings and some other methods. Sometimes hemorrhoids are treated with a laser.

    With infrared photocoagulation, special thermal infrared rays affect the leg of the hemorrhoid. As a result, the vessels that feed the hemorrhoid are damaged. The blood supply to the node stops, and after a while it dies.

    Cryotherapy - This is the freezing of hemorrhoids with liquid nitrogen. As a result of a short-term powerful cold exposure, the tissues of the node die and are rejected after some time. The moment of exposure does not cause the patient serious pain, and after rejection of the nodes there are no scars. This method gives the best effect in the second and third stages of the disease.

    Such a method of treating hemorrhoids as ligation with latex rings is widely used. With this method of treatment, a dense latex ring is put on the node leg. It compresses the vessels that feed the node. After some time, the tissues, deprived of blood supply and nutrition, die off and come out with the ring during defecation.

    Minimally invasive procedures are usually performed on an outpatient basis. If pain occurs after the intervention, then their duration is from several hours to two days. The pains are usually mild and relieve well with conventional painkillers. Patients do not need a sick leave, after a few hours they can begin to work.

    Surgical removal

    Surgery to remove hemorrhoidal nodes is now resorted to only in the most difficult cases - for example, at the third or fourth stage of hemorrhoids, when other methods are ineffective. This operation is performed in a hospital using intravenous anesthesia, spinal or local anesthesia. Depending on the type of operation, the patient spends from 2 to 7 days in the hospital.

    Stages

    Several stages of hemorrhoids are distinguished, depending on the size of the hemorrhoidal nodes and the degree of their loss.

    • First stage manifested by small nodes - up to 1 centimeter in diameter. They never fall out of the anus and can only be found with a digital examination of the rectum or examination using endoscopic techniques. Usually, patients at this stage do not show any complaints except discomfort at the time of bowel movement.
    • In the second stage hemorrhoidal nodes increase to 1-2 cm in diameter, during stool they can go outside, causing discomfort, but quite quickly spontaneously return to the rectum. At this stage, characteristic signs of hemorrhoids appear: itching, burning, a feeling of a foreign body in the rectum, minor bleeding.
    • Third stage hemorrhoids is characterized by prolapse of hemorrhoids, and they do not set back. However, the patient can return them back by himself, using a finger. Such nodes can be infringed in the anus, thrombosis often develops in them. Itching, burning, bleeding, discomfort and pain can be both constant and periodic.
    • In the fourth stage Hemorrhoidal diseases fall out of the anus, not only during a visit to the toilet, but also with any physical stress that increases intra-abdominal pressure - weight lifting, coughing, laughing. The nodes at this stage are almost impossible to fix on their own. All symptoms are very pronounced, bleeding can be quite profuse. Hemorrhoids at this stage are often accompanied by complications - thrombosis, weeping of the skin around the anus. Perhaps the appearance of erosion, skin ulcers, getting through the damaged areas of the infection and the development of a serious disease - paraproctitis. When the fourth stage of hemorrhoids is detected, surgery is indicated.

    Preventative measures

    In chronic hemorrhoids, with alternating periods of exacerbation of the disease and relative rest, preventive measures will help reduce the number of relapses:

    • Constant adherence to the principles of therapeutic nutrition.
    • Monitoring timely bowel movements.
    • Optimization of physical activity in accordance with age, state of health and other criteria.
    • The regular implementation of a set of therapeutic exercises that the doctor will recommend.
    • Occupation with accessible sports: walking, swimming, dancing - choose those that are to your liking and strength.
    • Control your weight and drinking regimen.
    • Compliance with personal hygiene.

    Many believe that it is not customary to talk about hemorrhoids. But with complications of acute hemorrhoids, when vascular thrombosis develops, purulent paraproctitis, the fallen cones are restrained, tissue necrosis begins, there will no longer be a good tone. The sooner you manage to defeat false modesty and discuss your problem with your doctor, the greater the chance of recovery.

    On the video - the proctologist's opinion about the methods of treatment and prevention of hemorrhoids.

    Grade 4

    The hardest stage. The nodes are enlarged to such sizes that it is no longer possible to adjust them yourself. Moreover, in most cases they become inflamed, thrombosis may develop. The patient experiences severe pain. In the period of exacerbation, when all the symptoms are manifested with a vengeance, urgent hospitalization is necessary.

    As a rule, treatment of chronic hemorrhoids 3 and 4 degrees is not complete without rehabilitation. All treatment methods with the exception of advanced surgery in the later stages will be ineffective.

    Symptoms of exacerbation of chronic hemorrhoids

    Varicose cavernous plexuses are characterized by phases of exacerbation and remission. The complete disappearance of the symptoms of the disease can be achieved if the patient follows the doctor's recommendations. Deterioration in hemorrhoids can be triggered by a violation of the diet, weight lifting, or prolonged constipation. The characteristic symptoms of an exacerbation of a chronic form of the disease are as follows:

    • severe pain syndrome
    • swelling of hemorrhoids,
    • bleeding
    • purulent inflammation of the tissues of the perineum.

    Possible complications

    If untreated, the patient may develop acute thrombosis. The disease is accompanied by oxygen starvation of tissues and gangrene. In the worst case scenario, a blood clot can come off and reach the heart. Anemia is considered a more common problem with chronic hemorrhoids. A patient with bowel movements regularly loses a little blood, which leads to a shortage of red blood cells.

    Profuse bleeding is one of the possible complications of varicose cavernous plexuses. Under the condition of strong pressure, the node can burst, the integrity of the vessel is broken.

    Stopping bleeding at home will be very difficult. You must immediately call an ambulance or consult a doctor on duty at the nearest clinic.

    With prolonged bleeding, the patient may lose consciousness.

    Rectal candles

    With internal nodes, drugs that quickly penetrate the intestinal mucosa should be used. For this reason, candles are used to treat hemorrhoids.They help well with the external type of disease. Suppositories quickly dissolve blood clots, eliminate inflammation, and promote the rapid healing of blood vessels. The most effective drugs of this type:

    • Betiol contains belladonna extract, which quickly removes inflammation and enhances regeneration. The drug begins to be absorbed immediately after administration. It is suitable for men who have problems with the prostate gland. Candles are made on a plant basis, so they should not be used for allergy sufferers. Betiol is not recommended for the treatment of children under 14 years of age.
    • Nigepan can be used to treat external and internal nodes. It quickly eliminates itching, burning. The advantages of the drug include an instant analgesic effect. Nigepan enhances blood circulation in the inflamed area, so regeneration is enhanced. Suppositories can not be used to treat children under 14 years of age and during pregnancy. The drug is not suitable for the treatment of hemorrhoidal necrosis.

    Special diet

    With exacerbation of chronic type hemorrhoids, fatty and spicy foods should be abandoned. Various sauces, marinades, fatty confectionery are prohibited. You can not eat vegetables that provoke fermentation and gas formation (cabbage, beans, etc.). The patient can eat cereals, vegetables and fruits. Dishes must be steamed. Crude fiber is undesirable.

    General information

    Chronic hemorrhoids - a chronic pathological increase in the arteriovenous cavernous plexuses in the anus, accompanied by bleeding, prolapse, thrombosis and infringement of hemorrhoids. It is the most common proctologic disease. Data on the frequency of pathology is mixed. According to statistics, in Russia, 13-14.5% of the adult population suffers from chronic hemorrhoids. Foreign scientists indicate figures from 4.4 to 36%. Researchers believe that the cause of such conflicting statistical information is the frequent asymptomatic course of chronic hemorrhoids. According to American proctologists, 80% of patients with hemorrhoidal nodes identified during a routine medical examination did not seek help because of the lack of complaints.

    Pathogenesis

    Chronic hemorrhoids develops with a pathological increase in the arteriovenous cavernous plexuses that form during the period of intrauterine development and in their structure resemble cavernous bodies of the external genital organs. One group of such plexuses is located above the dentate line, in the submucosal layer of the lower parts of the rectum. The second is localized under the dentate line, in the subcutaneous tissue of the zone of exit from the anal canal. Both groups of formations are interconnected by anastomoses.

    Due to its ability to fill with blood, cavernous bodies in the anus provide additional sealing of the anus with a closed sphincter. It was traditionally believed that chronic hemorrhoids result from varicose veins of a given anatomical zone, however, modern researchers believe that the disease develops under the influence of a number of factors. Among the factors contributing to the occurrence of chronic hemorrhoids is an increase in the amount of blood in the cavernous bodies due to accelerated arterial inflow and / or slowed venous outflow, thrombosis, inflammatory changes in the vascular wall and dystrophic processes in the muscles and ligaments of this anatomical zone.

    It has been established that in patients suffering from chronic hemorrhoids, the upper rectal artery is wider than in healthy people. In addition, in patients with this pathology, an increase in the number and density of small vessels in the anus zone is detected. Due to the weakening of muscles and ligaments, hemorrhoids become mobile. Fecal pressure and straining contribute to the displacement of nodes in the distal direction.With a prolonged course of chronic hemorrhoids, degeneratively altered ligaments break, nodes located above the dentate line begin to fall out of the anus.

    Surgical methods

    Surgery is a last resort for chronic hemorrhoids. It is carried out if the patient suffers from severe pain. Minimally invasive and traditional methods of surgical treatment are distinguished.

    The first category includes infrared photocoagulation, cryotherapy, ligation of nodes with latex rings.

    The essence of these methods is that with the help of a laser, nitrogen or rubber polymers survive the vessels that feed the node.

    Traditional surgical treatment is resorted to in the last stages of the disease. The operation is performed under general anesthesia. The surgeon removes damaged vessels and nodes, creates alternative blood circulation paths. After surgery, the patient may experience infection, bleeding and narrowing of the anus. Some patients have fistulas.

    Folk remedies

    Candles from potatoes and suppositories from mummies help even in the advanced stages of hemorrhoids. They should be used 2 times a day. Potato candles are made from fresh fruits.

    For the manufacture of suppositories from mummies, whole pieces of the product are used. The black mass should be slightly heated, and then a small candle should be formed from it.

    It is not recommended for use in the manufacture of suppositories of mummy in tablets.

    Chronic hemorrhoids - symptoms and treatment

    Chronic hemorrhoids is already a more serious cause for concern, since it is much more difficult to deal with it, and the disease can provoke dangerous further consequences for human health. The course of the disease is spasmodic: either mild symptoms or very severe exacerbation, which is influenced by various factors.

    The development of chronic hemorrhoids

    At the initial stage of the disease, which can last for a couple of months or several years, the signs of hemorrhoids are very weak. After a certain time, the disease makes itself felt: there is a sensation of a foreign body in the anus, pain during bowel movements, itching, traces of blood on toilet paper or slight bleeding.

    Further, the development of the disease continues, in which the symptoms are already difficult to detect. Bleeding becomes more intense and there is a risk of anemia, bowel movement brings burning and pain, hemorrhoid cones increase and can leave the rectum. It is at this stage that I distinguish four stages of the progression of chronic hemorrhoids:

    1. Chronic hemorrhoids of the 1st degree. Bleeding from the anus, but the nodes have not yet come out.
    2. Chronic hemorrhoids of 2 degrees. This stage is characterized by prolapse of hemorrhoids during an act of defecation or lifting weights, but they are still pulled in without assistance.
    3. Chronic hemorrhoids of 3 degrees. The pain intensifies, the nodes go outside, but it is already possible to correct them only manually.
    4. The fourth stage. Insignificant physical activity, coughing, walking cause instant loss of nodes, they increase to maximum sizes, a severe inflammatory process occurs and the patient urgently needs hospitalization.

    In the third and fourth stages, chronic hemorrhoids will require very long-term therapy in a hospital setting and often can not do without urgent surgery.

    Drug therapy

    Unfortunately, in chronic hemorrhoids, the use of conservative methods of treatment gives a weak effect and their use is possible only at the first stages of the development of the disease. Medicines will only help alleviate the condition of the patient and reduce the frequency of exacerbations of the disease.

    As a rule, the doctor prescribes medications in the form of suppositories and ointments that tone the veins, establish blood microcirculation, relieve swelling, inflammation and pain, help stop bleeding - Detralex, Posterisan, Aurobin, heparin ointment, Androxon, Levasin, Levomekol, etc. d.

    Minimally invasive treatments

    In the treatment of chronic hemorrhoids, modern therapeutic procedures that are carried out on an outpatient basis without general anesthesia are very well established and are highly effective and gentle:

    It is prescribed for stages 1,2 and 3 of chronic hemorrhoids. The node is exposed to liquid nitrogen, it is frozen and destroyed under the influence of a very low temperature.

    The procedure is possible at stages 1 and 2 of the disease, takes a couple of minutes. A latex ring is superimposed on the hemorrhoidal node and stops its blood supply. As a result, the node leaves the rectum on its own during the act of defecation.

    Suitable for the treatment of chronic hemorrhoids in the early stages. The patient is given a special injection and a sclerosing solution is injected into the hemorrhoid. The substance in its composition has an effect on the vessels, so they stop supplying the node with blood. As a result of this procedure, it begins to decrease and gradually disappears.

    It is used in case of chronic hemorrhoids accompanied by bleeding. An anoscopy is performed in which a thin tube with a special infrared coagulator and a light guide is inserted into the rectum. A stream of light is directed to the node, it weakens and is later rejected by the body.

    Surgical methods

    When chronic hemorrhoids is in a particularly neglected form, thrombosis forms and heavy bleeding is present, the above treatment methods no longer work, so doctors resort to surgical intervention.

    The classical operation is performed using general anesthesia in stationary conditions for 30-50 minutes. Its purpose is to remove the hemorrhoid in such a way as to restore the tissue of the rectum.

    Another new treatment has recently appeared: Longo surgery. It takes about one hour under general anesthesia, while the patient's recovery processes are very fast. The essence of such an operation is that the node itself is not removed, since special procedures simply allow you to reduce its size and over time it overgrows with connective tissue.

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