Hemorrhoids (haemorrhoids) have haemorrhoids, haemorrhoids - every second Pole. Symptoms of haemorrhoidal disease are itching in the anal area initially, followed by pain and burning. Fortunately, there are effective treatments for hemorrhoids, including gumming, sclerotherapy, laser therapy, surgical method. What do hemorrhoids look like? What symptoms of hemorrhoids should be worrying? Are hemorrhoids ointments effective? Are there any home remedies for hemorrhoids worth using?
Hemorrhoids - what is it?
Haemorrhoids , colloquiallyhemorrhoids , we all have,haemorrhoidsonly some .Hemorrhoids look like cushions filled with blood and have an extremely important function . They seal the anal canal and, together with the sphincter muscles, control the passing of stool and gases.
When there is a nerve impulse that feels like a thrust, the hemorrhoids empty of blood, allowing you to defecate. The problem begins when the hemorrhoids are stretched, fill with blood excessively and not completely empty of blood.
Due to the retention of blood, inflammation develops over time, including both nodules (dilated venous plexuses) and rectal tissues. We are talking then about the development of haemorrhoidal disease, i.e. haemorrhoidal varicose veins.
What do hemorrhoids look like? Photo:
Causes of hemorrhoids (haemorrhoids)
Anal varices can happen regardless of age.
Common causes of hemorrhoids:
- They are favored by a sedentary lifestyle, lack of physical activity (causes pressure disturbance in the venous system around the anus). They suffer from horse riders, computer users, cyclists and drivers.
- A bad diet is also to blame. Insufficient amounts of fiber (vegetables, fruit, thick groats, wholemeal bread) and too little fluid cause constipation and force the intestines to work harder. Then, during defecation, the mucosa of the perianal area is stretched. Also contributing to constipation is the slowing down of metabolism with age and taking medications, e.g. sedatives, antitussives with codeine, indigestion, hypertension or iron supplements.
- Anal varicose veins are favored by pregnancy and the associated hormonal changes. Moreoverthe growing fetus sometimes puts pressure on the venous system, obstructing the outflow of blood, and impairs the function of the intestines. Sometimes strong pressure during labor leads to the enlargement of the nodules. After delivery, hemorrhoids may shrink on their own and do not require treatment.
- The disease is more common in obese people, suffering from laxative-induced diarrhea, with chronic circulatory failure, after anal and perineal surgery, who engage in anal sex, and women who have had several children.
- Due to the lower muscle tension, it also develops more often in the elderly. There is talk of a genetic predisposition to hemorrhoids.
- Too long sitting on the toilet and tightening the abdominal muscles leads to overloading of the venous system in the pelvis and the anus area, and consequently to enlargement of hemorrhoids. It is worth giving up the habit of reading in the toilet - a physiological activity should only last as long as it is necessary.
- The disease affects people suffering from diarrhea caused by laxatives (they irritate the anal mucosa) more often, so you should always follow the doctor's instructions when taking them.
- One of the causes of hemorrhoids is long-term constipation, so it is worth avoiding them. It should help to eat a diet rich in fiber and to keep an eye on the daily amount of physical activity, and if necessary - use laxatives.
Symptoms of hemorrhoids
Hemorrhoids give characteristic symptoms:
- One of the first signs of the disease is itching in the anus and its vicinity. We usually underestimate this, which delays the diagnosis of the disease.
- Itching may be accompanied by slight damage to the mucosa and skin (the result of scratching) and oozing of secretions that favor inflammatory and allergic reactions (we feel moisture around the anus).
- Enlarged bumps sometimes give the impression of incomplete bowel movements, which prompts a greater pressure.
- By increasing the pressure of the abdominal press, we impede the venous outflow from the anus, which causes enlargement of the hemorrhoids and the circle closes. Another symptom is slight bleeding, most often during a bowel movement (a mark on the toilet paper).
- Over time, the lump falls out - after defecation, it can be felt around the anus. At the beginning it regresses spontaneously, in the later stages of the disease it is necessary to help it return to its place to avoid edema and thrombosis.
- It's finally stuck outside the anus the whole time. Pain occurs when hemorrhoids are accompanied, for example, by inflammatory and thrombotic complications.
Necessary tests for haemorrhoids
It is difficult to get rid of resistance to exposing "a certain" part of the body, so we usually delay the visit to the doctor. This is a mistake! The disease progresses slowly, so the sooner it is treated, the better.
Rectal bleeding requires immediate consultation. This may indicate hemorrhoids, but also other serious diseases, such as anal cancer, which must be ruled out.
What doctor treats hemorrhoids? You can go to your GP without a referral - you need a referral to a proctologist (a surgeon dealing with anus and rectal diseases).
The examination is often associated with an embarrassing, and for the elderly also quite dangerous, knee-elbow position with buttocks sticking out. Today, they are most often made in the position on the left side. This position does not cause any discomfort.
Testing for hemorrhoids:
- The doctor can usually recognize hemorrhoids on the basis of the history, the appearance of the anus area and digital rectal examination.
- At the end of the basic diagnostic examination, an anoscopy awaits you - the doctor carefully examines the final section of the rectum with the help of a speculum (anoscope). Both tests are short-lived, require no special preparation, and are painless.
Classification of hemorrhoids (haemorrhoids)
The Park's four-point scale is used to classify altered haemorrhoids and assess their enlargement.
Parks scale:
- I - the hemorrhoids are enlarged but do not fall out. They can be visualized during endoscopic examination
- II - haemorrhoids fall out during defecation (defecation) and regress spontaneously into the anal canal after defecating
- III- haemorrhoids fall out during defecation, do not regress spontaneously after defecation, but can be drained manually
- IV- haemorrhoids remain outside regardless of defecation and cannot be drained manually
Treatment of hemorrhoids
What to use for hemorrhoids? Treatment of hemorrhoids depends on the severity of the disease.At each stage, it is recommended to drink 2-2.5 liters of fluids a day and a balanced diet , which includes vegetables, fruits and coarse products. But it's better not to overdo the seeds as they can mechanically irritate the anus. Eliminating them from the diet in the case of anal itching reduces the discomfort.
Restrict chocolate, strong tea, coffee, spirits, red wine, nuts, products that cause gas, animal fats, spicy spices.
Tablets, ointments, suppositories onhemorrhoids
In all forms of the disease, the doctor may recommend drugs for hemorrhoids - anti-inflammatory pills that reduce itching and swelling and delay the development of nodules, as well as ointments for hemorrhoids, creams, suppositories for hemorrhoids and gels with a similar effect.
OTC drugs for hemorrhoids usually contain natural substances, e.g. horse chestnut extract, Peruvian balm, preparations from poplar buds and many others.
Relief is brought by sitz baths, e.g. with the addition of oak bark or a marigold flower, warm baths (the water must not be hot) with herbs, e.g. chamomile.
When haemorrhoids are constipated, drugs that swell and relax the stool help. These methods are most effective in the early stages of the disease, and support treatment in advanced stages. You need to use them for several weeks, as recommended by your doctor.
When conservative treatment does not bring improvement or the disease is advanced, the nodules can be removed using one of the modern methods. As a rule, they do not require anesthesia because the hemorrhoids are located in the part of the anus that is not sensitive to pain.
Unfortunately, you have to pay for such a procedure out of your own pocket (but the operation can be performed under the National He alth Fund).
Erasing for hemorrhoids
"Rubbing" or the Barron's method is the most frequently used treatment today in the treatment of 2nd and 3rd degree hemorrhoids, consisting in placing a rubber band (ring) on the root of the nodule, which cuts off the blood supply to it.
As a result, the nodule dies and falls off within 7-10 days. The procedure takes a few minutes. You can return to work immediately afterwards. Sometimes a slight pain lasts for a few days (the sitz bath helps).
Avoid bowel movements for 24 hours (risk of slipping the bandage). For 2 weeks, you must not take medications that reduce blood clotting. 1-2 rubber bands are put on during one treatment.
The next ones can be put on after about 4 weeks. The method gives very good results and is safe. Complications are sporadic, such as superficial inflammation that is easy to heal. One session costs about PLN 400.
Sclerotherapy for hemorrhoids
Sclerotherapy is a method of treating mainly small hemorrhoids. A special preparation (e.g. in the form of foam) is injected under the mucosa around the enlarged nodule, which causes the formation of a blood clot at the site of drug administration.
The malnourished nodule comes off. After the procedure, most people do not feel any discomfort, some - slight discomfort.
In the first 2-3 days there may be a scanty bleeding that stops on its own.
You immediately go back to your daily activities. The risk of complications is thereminor - bleeding due to vessel damage, minor ulceration in the area of the injection that passes by itself, drug allergy.
The cost of the session is PLN 150-300.
Laser therapy for hemorrhoids
The treatment involves irradiating the nodule with a laser beam. Under the influence of high temperature, the vessels contract and close, and consequently the tissue of the nodule is destroyed.
The procedure is performed on an outpatient basis and takes 15 minutes. The only ailment after the procedure is the feeling of a foreign body in the anus. The cost is PLN 600-800.
DGHAL method, called Morinaga method
This is a non-invasive alternative to traditional surgery. It can be used in all phases of the disease.
The procedure is performed on an outpatient basis or as part of a one-day stay in the hospital, usually without anesthesia (except for the use of a gel).
It is based on the selective closure of hemorrhoidal vessels. Under the control of a Doppler probe, the doctor places sutures on the arteries (they absorb themselves). It is a safe method, it does not cause complications and minimizes the risk of relapse.
Patient returns home and working within 24 hours.
This mini-operation costs PLN 1500-2000. Some centers perform it under the National He alth Fund.
Excision of nodules
In a minority of patients, nodules need to be surgically removed. This is done in many ways. However, traditional methods are most often used.
The classic Milligan-Morgan method involves excision of the nodules, leaving the wounds open, which prevents narrowing of the anus. The procedure is performed under lumbar or general anesthesia.
After the surgery, painkillers and sitz baths with the addition of antiseptics are used.
The next day the sick person returns home, after a week to work. Wounds heal in 7-10 days.
The Ferguson method is equally effective, which differs from the previous one in that the wound is sutured after the tubercle is removed. It heals faster, and postoperative pains are also smaller.
Large hemorrhoids cannot be operated on with this method, because extensive defects of the mucosa and skin prevent safe wound closure. Both surgical procedures are reimbursed.
Longo method
It consists in circular removal and sewing of a fragment of the mucosajwith a special device (hemorrhoidal stapler). This allows the nodules to be "pulled" into place to prevent falling out.
The treatment is recommended in the 2nd and 3rd degree of the disease.
It is performed in the system of "one-day surgery", under local or general anesthesia. If there are no complications, after a few hours the patient does not feel any more symptoms.
The cost of the operation is 2000-3000PLN.
Complications after haemorrhoids surgery
Unfortunately, surgical removal of hemorrhoids carries the risk of postoperative complications.
- Pain may be an early complication. Doctors believe that it may be related to the pull-up of the anoderm, which is the skin around the anus, which is strongly innervated. Another cause may be the reflex contraction of the anal sphincter and urethral muscles. The spasm is painful but also leads to trouble passing urine and stools.
- Another complication is bleeding, which is eliminated e.g. by electrocoagulation. To avoid such troubles, patients are given topical and general painkillers. Warm (not hot) sockets are recommended to relax the sphincters.
- There may be slight bleeding three weeks after the operation. The problem concerns about 1 percent. operated and the cause of bleeding is usually local infection of the wound. But minor bleeding can also be caused by taking medications that reduce blood clotting (aspirin). All you have to do is set them aside for the bleeding to stop.
- Post-surgery constipation or the complete absence of bowel movements are caused by dietary errors or may be psychological. A mild laxative is recommended if changing your diet and keeping your body hydrated does not help. The treatment must be agreed with the doctor, because some preparations, even those available without a prescription, act rapidly, which is not beneficial for the irritated anal mucosa.
Late complications , which may appear even several years after the procedure, are the most dangerous. These include:
- fecal incontinence
- anal stricture
- mucosa eversion
- anal fistula
Stool incontinence is associated with damage to the internal anal sphincter muscle or the sensory nerves. Treatment is difficult. Patients are usually recommended anti-diarrheal medications and biofeedback therapy.
More about complications from hemorrhoids surgery here.
How to prevent hemorrhoids?
In order to prevent the development of a hemorrhoidal disease, you need to follow a few rules:
- avoid constipation;
- lead an active lifestyle (the point is not to get tired, but to include gymnastics, walks, runs, and swimming in your daily activities);
- do not sit long, and if work requires it, choose a firm chair and take short breaks to stretch your bones;
- perform buttocks squeezing exercises, like when holding a bowel movement;
- spend as much time on the toilet as necessary - tensioning too longabdominal muscles overloads the venous system;
- take care of hygiene;
- wear cotton underwear;
- avoid anal sex - this protects against various anal and sexually transmitted diseases.