Hemorrhoids

Hemorrhoids - an increase in the volume of cavernous corpuscles of the rectum, accompanied by bleeding, and sometimes with thrombosis and inflammation, itching and other symptoms.

Etiology, pathogenesis. At the heart of the disease are violations of the regulation of inflow and outflow of blood in the cavernous veins of the rectum, leading to stagnation of blood in them. This is facilitated by a sedentary lifestyle, constipation and inflammatory or tumor processes in the rectum and other pelvic organs. Long-term overflow of cavernous bodies causes expansion, thinning of their walls and integumentary tissues, easily exposed to injury with the formation of small erosions and ruptures. As a result, bleeding occurs during an act of defecation or hygienic treatment of the anus. In addition, the formation of erosions and cracks in the integumentary tissues creates conditions for their infection and the development of inflammatory processes against the background of thrombosis of hemorrhoids (acute hemorrhoids).

Symptoms, course. In uncomplicated hemorrhoids, itching, sensation of foreign body, allocation of drops or a trickle of scarlet blood at the end of the act of defecation, anemia. In case of complications, severe pain occurs, the temperature rises, swelling and hyperemia occurs around the anus, difficulty in the act of defecation, and sometimes retention of urine. The course is often prolonged with periodic exacerbations and complications up to severe anemia and purulent inflammation, with thrombosis and necrosis of the nodes.

The diagnosis is made on the basis of characteristic complaints, detection of dropping nodes ("cones") in the region of the anus, the results of digital rectal examination and sigmoidoscopy. Hemorrhoids need to be differentiated mainly from bleeding polyps and colon tumors, as well as from diverticulosis and inflammatory lesions.

Treatment in the early stages of conservative: hygienic and industrial gymnastics, a relaxing diet, light laxatives, a careful moist toilet after the act of defecation, trays with cool water, candles with proctoglivenol, local anesthetics. In acute complications - thrombosis and inflammation of the nodes - bed rest, weakening diet, local cooling agents (lead lotion, ice pack, cool baths with potassium permanganate solution), antibiotics. With severe prolapse of nodes and bleeding, surgical treatment. Absolute indications for the direction of the patient in the hospital is hemorrhoids with severe anemia and acute inflammation of the nodes.

The forecast is usually favorable. When treated in the early stages, the process can stabilize and even stop. After surgical treatment, the majority of patients recover. After 1-1,5 months after the operation, the work capacity is fully restored,