Hemorrhoids are hypertrophy of the cavernous bodies of the rectum , manifested by pain and bleeding from the rectum.
It is the most common proctological disease.
Content
What are hemorrhoids?
The word “hemorrhoids” itself means bleeding and this term refers to a disease of the veins of the rectal plexus, namely their nodular expansion.
There are no exact data on the incidence of hemorrhoidal disease. The problem is that many people who suffer from discomfort in the anal area are embarrassed to go to the doctor. It is believed that in developed countries at least half of people over the age of 50 suffer from this disease. Men are at higher risk of getting the disease than women. The disease can develop at any age, but the likelihood increases with age.
In elderly people, the veins of the cavernous bodies are almost always varicose. However, this is not a condition called hemorrhoids. This is a factor that increases the risk of disease.
In developing countries, hemorrhoids are less common than in developed countries. Doctors believe that, among other things, this is due to the fact that the diet in some of these regions is richer in fiber. In addition, a predominantly sedentary lifestyle is less common in these countries.
Hemorrhoids can be primary (not a consequence of other diseases). The cause of the development of primary hemorrhoids has not been established. There is no doubt about a hereditary predisposition to this disease.
Secondary hemorrhoids can be caused by congestion in the inferior vein, heart failure, as well as the reasons listed below.
Reasons for the development of hemorrhoids
The development of hemorrhoids is facilitated by factors that increase pressure in the venous hemorrhoidal plexuses.
- One of the most common causes is constipation and prolonged, strong straining during bowel movements. At the same time, due to the great tension of the abdominal press, the pressure on the hemorrhoids increases, the veins stretch, lose their elasticity and gradually expand. Stagnation of blood leads to the fact that the vessels bulge in the form of a knot.
- In addition, a sedentary lifestyle, a predominantly sedentary lifestyle or heavy physical work, excess weight and poor bowel function (including due to suppression of the urge to defecate) are considered risk factors for the disease.
- The habit of eating hot and spicy foods is also a factor contributing to the development of hemorrhoids.
- In addition, problems with hemorrhoids often occur in pregnant women. The reason for this is an increase in pressure in the abdominal cavity, which prevents the outflow of blood from the cavernous bodies.
- Data are also provided on the hormonal influence on this process.
- Hemorrhoids can also develop after childbirth.
- It is assumed that people with hereditary “weakness” of the venous wall or connective tissue also have a predisposition to hemorrhoidal disease. This contributes to the fact that the cavernous bodies form nodes with age or under the influence of the factors mentioned above.
- The development of hemorrhoids is promoted by bending of the uterus, inflammatory processes of the rectum, diseases of the pelvic organs and other causes that cause stagnation of blood in the veins of the small pelvis.
There are external and internal hemorrhoids.
External hemorrhoids
External hemorrhoids are an enlargement of the plexus of veins (corpus cavernosa) located under the skin around the anus (anus). As a result, hemorrhoids are formed, which in the form of skin folds (fimbriae) hang outside around the anal ring.
Upon examination, external hemorrhoids are visible around the anus in the form of separate formations the size of a pea to a cherry or in the form of a whole corolla of the same “bumps”.
As the disease develops, they swell and take on the appearance of large petals. At the same time, they begin to cause inconvenience when walking, and can cause irritation of the skin of the anus, softening of tissues (maceration), and itching.
If external hemorrhoids are located along the posterior semicircle of the anus, they often contribute to the formation of anal fissure. Typically, the crack begins at the base of the node and, as a rule, it must be treated surgically.
A complication of external hemorrhoids can be thrombophlebitis of the hemorrhoid. In this case, a dense formation in the shape of a hazelnut is formed in the anus. This condition is accompanied by acute pain that lasts 7-10 days, then the pain subsides.
However, the compaction at this place (thrombus) sometimes remains for a long time.
External hemorrhoids are often painful because there are nerve endings in the area of their development.
Internal hemorrhoids
Internal hemorrhoids are an enlargement of the venous plexuses (corpora cavernosa) located under the mucous membrane of the lowermost part of the rectum above the anal-cutaneous line.
Internal hemorrhoids with advanced disease can become very large and fall out of the rectum. In this case, they can be observed visually.
Otherwise, the nodes can only be detected with a special examination of the rectum. Internal hemorrhoids, even with significant enlargement, are absolutely painless. Pain appears only when it is pinched or infected ( proctitis ).
Symptoms of hemorrhoids
In mild cases, patients do not experience any discomfort.
As the disease progresses, a
- itching,
- burning,
- feeling of fullness, heat, awkwardness,
- and in the presence of inflammation or cracks in the mucous membrane - pain, especially during bowel movements.
Characteristic signs of hemorrhoids are:
- bleeding from the rectum during bowel movements,
- prolapse of nodes out through the anus,
- pain,
- itching in the anus,
- inflammation and swelling of nodes,
- thrombosis.
Bleeding during bowel movements
Developed hemorrhoids are characterized by bleeding that occurs when the wall of the hemorrhoids becomes thinner. Frequent bleeding causes anemia and weakness in patients.
Bleeding from the anus is also observed in other diseases, so their causes should be clarified by a doctor.
Bleeding occurs mainly from internal hemorrhoids when they are injured. The amount of blood released can vary greatly, from traces of blood on toilet paper to significant blood loss requiring a transfusion.
The blood is usually bright red in color. But if blood accumulates in the rectum, then during bowel movements it may be purple or have a dark color.
The release of dark blood clots occurs at the beginning of bowel movements. In some cases, blood may come out in the form of a spurting stream, which is typical for internal hemorrhoids.
Pain during exacerbation of hemorrhoids
When hemorrhoids worsen, the internal nodes are primarily affected. External nodes become inflamed due to the spread of the process along the rectum to the anus.
Inflammation of individual external nodes occurs much less frequently and is accompanied by the formation of a blood clot.
Inflammation of the nodes is accompanied by a symptom such as sharp pain, especially during bowel movements and walking. Sometimes pain is accompanied by any, even the slightest, movement. Sometimes the pain is so severe that the patient is prescribed painkillers.
Sharp pain is a sign of pinching, complications of thrombosis of hemorrhoids or the appearance of an anal fissure .
Loss of internal nodes
Loss of internal nodes occurs quite often. The first time the nodes fall out with strong straining, they are reset either by themselves or by the patient. The main reason for the loss of nodes is a weakening of the tone of the external sphincter. And with its further weakening, loss begins to occur with the slightest straining, during physical activity and even when walking.
Inflammation of internal hemorrhoids is usually accompanied by severe symptoms. The nodes swell greatly, the anal canal expands, and the anus gapes.
All this is accompanied by sensations such as:
- severe throbbing pain
- increase in body temperature,
- chills.
If patients are not bothered by severe pain, they rarely agree to surgery and the disease can last up to 20 years or more.
Stages of hemorrhoids
Depending on the degree of enlargement of the nodes and the manifestation of symptoms, there are 4 stages of hemorrhoids.
Stage I
At stage I, the nodes are slightly pronounced and disappear with pressure. There is no pain, but bleeding is possible.
Stage II
During this stage, hemorrhoids fall out with each bowel movement and must be manually reset. Nodes are often injured. The pain goes away and then returns. This stage is accompanied by a weakening
anal sphincter.
Stage III
In stage III hemorrhoids, the nodes fall out not only during bowel movements, but can also fall out spontaneously under other loads.
Self-reduction is possible, but difficult; blood is released during reduction.
IV stage of hemorrhoids
At stage IV, the nodes are enlarged so much that if they fall out, independent reduction is impossible. Loss occurs even with minor strains: coughing, sneezing, straining. The nodes often bleed.
Diagnostics
The diagnosis is made by proctological examination using a rectal speculum and proctoscope.
Digital examination does not reveal uncomplicated internal hemorrhoids.
It is necessary to identify a possible connection between hemorrhoids and other diseases. Particular attention is paid to the cardiovascular system and liver.
Bleeding from the rectum can be a symptom of such a serious disease as cancer. However, unlike bleeding with hemorrhoids, cancer of the rectum and sigmoid colon is more characterized by the release of dirty bloody mucus or dark clots both at the beginning of bowel movements and mixed with feces.
However, it is necessary to exclude the possibility of this disease.
Treatment
When treating inflammation of hemorrhoids, cold lotions and baths are used, and diet is necessary.
Surgical treatment of hemorrhoids is recommended for complications.
You can read more about the treatment of hemorrhoids in the article “ Treatment of hemorrhoids ”
Prevention
To avoid the development of hemorrhoids, it is necessary to take a number of preventive measures.
- Go to the toilet at the same time. This will develop the reflex to defecate.
- Never suppress the urge to defecate.
- Don't sit on the toilet for a long time.
- After stool, rinse the anus with water.
- It is very important to maintain a proper diet.
- Do a preventive set of gymnastic exercises.
Nutrition for hemorrhoids
The main requirement is not to consume spicy food or alcoholic beverages. In some cases, it is enough to fulfill these requirements for the bleeding to stop and recovery to occur.
On the other hand, no matter how a person is treated, if he continues to use vodka, whiskey, wine even in small quantities, then hemorrhoids will progress.
If you have constipation, you must adhere to your diet and take preventive measures to prevent it.
You can read more about preventing constipation and nutrition in the article “ Constipation .”
Gymnastics for hemorrhoids
To prevent hemorrhoids, there is a set of exercises that must be performed 2-3 times a day for 5-7 minutes.
- Walking with legs raised high, knees bent.
- Swing movements alternately with the right and left legs forward, backward and to the side.
- Bend the torso to the sides, legs shoulder-width apart, arms down along the body.
- Tension of the buttocks with simultaneous retraction of the anus. Do the exercise standing, hands on your belt, toes and heels together.
- Squat on your toes, spreading your knees wide.
- Repeat the first exercise.
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