HEMORROUS is a disease, which is based on the pathological condition of the cavernous rectum, accompanied by stagnation of blood in them. The development of hemorrhoids contributes to the violation of the outflow of blood from the cavernous plexus, located in the wall of the rectum, due to chronic constipation, sedentary lifestyle, circulatory disorders of the pelvic organs, for example during pregnancy.
Distinguish between internal hemorrhoids, when the cavernous plexus, located on the walls of the rectum, and external hemorrhoidal nodes, which are formed from the venous-arterial plexus of the lower hemorrhoidal vessels, distributed under the skin around the anus, expand.
In the clinical picture , a period of precursors is distinguished, during which unpleasant sensations appear in the anus region, slight itching, difficulty with defecation. Then there are bleeding from the anus during a bowel movement (from blood traces to its abundant discharge), which may be accompanied by the development of anemia . Further possible loss of internal hemorrhoids from the anus (stage I - nodes fall out during bowel movements and self-reset; II - nodes fall out during defecation, but do not reset themselves, their manual reposition is necessary; III - nodes fall out at the slightest physical load) . In some cases, possible thrombosis of hemorrhoids and their infringement. Hemorrhoidal thrombosis (acute hemorrhoids) is characterized by pain in the anus, swelling and inflammatory infiltration of the nodes, in some cases necrosis and swelling of the tissue around the anus. In advanced cases, acute paraproctitis may develop.
In the diagnosis, the results of the examination and digital rectal examination, which are produced in the patient's knee-elbow position, are of primary importance. On examination, it is possible to identify the external hemorrhoids, and with careful pushing apart the edges of the external sphincter of the anus, internal nodes. Using digital rectal examination, which should be carried out in all cases, except for those who have exacerbated the process, it is possible to establish the presence of compacted hemorrhoids, the tone of the sphincter of the anus, to identify associated rectal diseases. In order to ascertain the loss of hemorrhoids, the patient is offered to stretch. The doctor, in addition, must produce sigmoidoscopy. A thorough examination of the patient eliminates anal fissure, paraproctitis , polyps and rectal cancer.
In the initial stages of hemorrhoids, conservative treatment is indicated. The patient is recommended a diet that prevents the development of constipation (vegetables, wholemeal bread, lactic acid products); irritating foods, spices and alcohol are excluded. Prescribe medicinal and cleansing enemas, cool baths and washing away; candles with belladonna extract, anesthesin, heparin, proteolytic enzymes. In acute external hemorrhoids, warm baths, ointment with anesthesin or heparin, and laxatives are shown. For rectal bleeding, rectal suppositories with adrenaline are used.
In cases of treatment failure, the occurrence of complications (heavy bleeding, thrombosis of hemorrhoids or their infringement), the patient must be hospitalized.
In the hospital, surgical intervention can be undertaken, especially in cases where there is a loss of internal hemorrhoids or heavy bleeding with the development of anemia . The most effective surgical intervention is hemorrhoidectomy - excision of internal and external hemorrhoids and restoration of the mucous membrane of the anus. The patient’s ability to work after the operation is restored within 3-4th week.
Non-progressive and uncomplicated hemorrhoids can cause the patient only some inconvenience for many years. Early conservative treatment, rational mode of work and rest in these cases often contribute to the fact that the patient becomes practically healthy.
Prevention - the exclusion of factors contributing to the development of hemorrhoids, rational diet, inculcation, starting from childhood, certain hygiene skills (careful toilet of the anus after defecation). Persons leading a sedentary lifestyle, regardless of whether they work sitting or standing, should be engaged in gymnastics, which contributes to the normalization of the motor-evacuation function of the colon and the prevention of blood stagnation in the pelvic organs.