Hemorrhoids are painful enlargement of the cavernous cavities of the venous plexus of the rectum. These cavities are filled with blood when straining, performing the function of a kind of “pillow” that protects tissues from the traumatic effects of solid feces during the act of defecation.
Hemorrhoids are an urgent problem of mankind, about 60% of the Earth’s citizens suffer at least one episode of painful enlargement of hemorrhoids during their life. I must say that this percentage is much higher in countries that are commonly called civilized.
Anatomically distinguish between internal hemorrhoids – hemorrhoids in the distal (terminal) rectum, and external hemorrhoids, when the nodes are located outside in the anal area.
By the nature of the course, hemorrhoids are acute, associated with thrombosis of hemorrhoidal veins, and chronic – caused by the constant overflow of distended veins with blood.
The reasons for the development of hemorrhoids in women
Chronic hemorrhoids in women, as a rule, develop after 30 years, with age, the risk of developing the disease increases. Women suffer from enlarged hemorrhoidal veins four times less often than men. However, the risk increases in the presence of resolving factors:
• chronic constipation;
• prolonged sitting on the toilet;
• obesity;
• sedentary work, sedentary lifestyle;
• diseases occurring with chronic cough;
• diseases of the pelvic organs.
The typical cause of acute hemorrhoids in women is pregnancy or childbirth. In such cases, adequate conservative treatment leads to the disappearance of the problem. However, if the therapy was untimely or inaccurate, the disease becomes chronic.
Symptoms of the acute form of the disease
Symptoms of acute hemorrhoids in young women are most often associated with pregnancy or childbirth. The appearance of an enlarged hemorrhoid in the first trimester of pregnancy is preceded by constipation characteristic of this period.
Acute dilatation of hemorrhoidal veins manifests itself as a sharp pain that becomes unbearable during bowel movements. In addition, the pain syndrome can increase during walking, as well as with an increase in intra-abdominal pressure during straining, coughing, laughing, hiccups.
Another characteristic symptom of the acute form of the disease is bleeding from the dilated veins of the rectum. This symptom manifests itself with fresh blood on the surface of the feces.
Often, hemorrhoids in women are combined with an anal fissure. In such cases, blood stains on toilet paper and on underwear appear even more often after a bowel movement.
One important thing to mention here is: many people confuse anal skin tags as anal fissure or something like that. But they are not that serious. You can easily shrink hemorrhoid skin tags at home.
Stages of development of chronic pathology
In chronic hemorrhoids, the pain syndrome is much weaker. Often, the only signs of chronic pathology are itching around the anus and blood from time to time appearing on the surface of the stool.
The stages of development of internal hemorrhoids differ with the help of the most objective symptom – the degree of stretching of the dilated veins:
I. The hemorrhoid is constantly in the intestinal cavity
II. The knot falls out when straining and adjusts back on its own
III. The patient has to set the knot with his hands
IV. One or more hemorrhoids are constantly outside and cannot be corrected
At any stage, thrombosis of the enlarged veins of the rectum may occur, in which case a pronounced pain syndrome characteristic of an acute attack occurs.
With a prolonged course of the disease, the risk of complications (anemia, neurasthenia, anal fissure, etc.) increases.
Diagnostics and choice of treatment tactics
Hemorrhoids are diagnosed by a proctologist using a digital examination. Symptoms such as bleeding, pain, foreign body sensation in the rectum are found in cancer, as well as in other pathologies of the lower intestine.
Therefore, the general list of examinations may include sigmoidoscopy or colonoscopy, as well as laboratory tests.
At the final stage of diagnosis, treatment tactics are selected. Acute hemorrhoids are treated conservatively, and in case of a chronic form of the disease, they turn to surgery, giving preference to minimally invasive methods of treatment.
An exception is made when the operation is temporarily contraindicated. In women, this is pregnancy, the postpartum period, as well as situations when it is necessary to stabilize the general condition of the patient. This situation can occur in acute infections or during exacerbation of severe chronic diseases.
Methods for treating hemorrhoids without surgery
Conservative treatment of painfully enlarged hemorrhoids should be carried out in a comprehensive manner, influencing all the factors that contribute to the development of the disease. Stool should be normalized, because constipation and diarrhea equally traumatize the inflamed node.
If the cause of hemorrhoids is an attack of diarrhea, every effort is made to heal from the disease that caused the stool disorder. Constipation is fought with a diet that includes a large amount of dietary fiber (prunes, dried apricots, oranges, apples). With a persistent course of constipation, mild laxatives (duphalac) are prescribed.
In order not to irritate the intestines, spices, salt, vinegar, smoked foods, as well as carbonated drinks and alcohol are excluded from the diet.
The pain intensifies the spasm of the internal sphincter, which contributes to the congestion of blood in the veins. To relieve pain and spasm, use warm baths with potassium permanganate or herbal decoctions.
As a drug therapy, pain relievers, antispasmodics, blood-thinning drugs, as well as drugs that promote tissue regeneration are prescribed. The advantage is given to “local” therapy: with the external location of the nodes, ointments are used, with the internal – candles.
Attention! Prescription of drugs depends on the location of the hemorrhoid, the stage of development of the disease, the phase of the process, the presence of concomitant diseases and the general condition of the body. Therefore, we recommend not to self-medicate, but to consult a doctor in a timely manner.
Radical treatment of pathology
Minimally invasive methods
Doctors treat chronic hemorrhoids with surgical methods. At the initial stages of the development of the disease, preference is given to minimally invasive techniques, which are carried out on an outpatient basis (without placing the patient in a hospital) and provide for a short rehabilitation period.
An important advantage of low-traumatic operations is a short list of contraindications.
The list of methods that are suitable for most patients includes:
• sclerotherapy (injection of substances into the dilated veins that cause the walls of the dilated veins to “weld”);
• infrared coagulation (cauterization of the leg of the node);
• ligation of the internal hemorrhoid with latex rings.
Sclerotherapy and infrared coagulation are used at stages I – II of the development of internal hemorrhoids. The effectiveness of these methods at stage I is 85%, and at stage II – about 72%. If the knot is ligated with latex rings, the efficiency is greater than 93%.
Hemorrhoidectomy operation
Hemorrhoidectomy is the removal of enlarged hemorrhoids by surgical methods, that is, with a scalpel.
Such treatment must be carried out in a hospital. The rehabilitation period is much longer and is worse tolerated by patients. Therefore, surgical removal of nodes is carried out only in the last stages of the disease, when minimally invasive techniques are no longer effective.
Hemorrhoidectomy can be combined with dearterization of hemorrhoids under ultrasound control. This method is often used for stage III internal hemorrhoids.
The choice of the method of surgical intervention depends on the number of enlarged nodes, their location, as well as the presence of complications and concomitant pathologies.
Treatment during pregnancy and after childbirth
Treatment of hemorrhoids in pregnant women and in the early postpartum period does not involve surgical intervention. The fact is that the reasons for the expansion of rectal veins during this period are of a physiological nature:
• changes in hormonal levels;
• increased intra-abdominal pressure;
• an increase in the volume of circulating blood;
• straining during childbirth.
After childbirth, the hormonal background gradually normalizes, which leads to the disappearance of the tendency to constipation. The volume of circulating blood decreases, intra-abdominal pressure decreases, the body’s defenses are restored and all conditions are created for recovery.
Therefore, in most cases, the painful node that arose during pregnancy or after childbirth disappears on its own under the influence of standard methods of conservative treatment.
Attention! With the conservative treatment of hemorrhoids in pregnant women, as well as in women during lactation, caution should be exercised. A certain amount of the active ingredients of topically applied drugs still gets into the bloodstream and can harm the child. Therefore, it is necessary to be treated under the supervision of the attending physician.
Relapse prevention
If you have had to remove hemorrhoids before, there is an increased risk of the disease returning. To protect yourself from relapse, you should follow the recommendations of doctors:
1. Watch your stools (preferably to achieve daily morning bowel movements).
2. Be careful with diets “for weight loss” (see point 1).
3. If you have a sedentary job, do gymnastics regularly.
4. Timely treat diseases of the gastrointestinal tract and pelvic organs (gastroenterology, urology, gynecology).
5. Avoid physical and nervous strain.
Nature has prepared a woman for childbirth, therefore the venous vessels of the rectum in women are more resistant to stress than in men. If you stick to the rules, the disease will not return.
Can chronic hemorrhoids be cured with folk remedies?
Unfortunately, chronic hemorrhoids cannot be cured with conservative methods. “Folk” methods give a short-term effect. Similar results will be obtained with “home” medication.
The unpleasant symptoms of the disease may disappear for a while, but the disease will develop unnoticed by you. In the future, the following complications may develop:
• anal fissure;
• anemia;
• nervous exhaustion;
• infectious processes (proctitis, paraproctitis, etc.).
It should also be noted that under the guise of hemorrhoids such a deadly disease as rectal cancer can be hidden. Therefore, if alarming symptoms appear, you need to urgently consult a doctor in order to find out the exact diagnosis and start adequate treatment.
Do not waste time on self-medication, come to an appointment with a proctologist!
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