The relevance of the problem

Although published data on the prevalence of hemorrhoidal disease among the population of developed countries differ, 1,2 can be said that it is one of the most common diseases in surgical practice. In the United States, more than 2.2 million new cases are registered annually on an outpatient basis. A large variety of clinical symptoms, which may be incorrect to be interpreted by doctors and patients as a manifestation of hemorrhoidal disease. Thus, it is necessary to accurately establish that hemorrhoids is the cause of symptoms before the treatment of the disease. These recommendations are devoted to both diagnostic methods and modern approaches to the treatment of hemorrhoids.

Diagnosis of hemorrhoidal disease

1. Anamnesis and physical examination should be taken, taking into account the degree and duration of symptoms, as well as risk factors. Level of recommendations 1C.

Hemorrhoids is diagnosed in most cases, confirmed clinically. The survey should begin with the collection of anamnesis of the disease, much attention should be paid to symptoms that allow you to suspect the presence of hemorrhoids, as well as risk factors, such as constipation, 6 followed by physical inspection. Painless bleeding during defecation with periodic loss of nodes are key signs of internal hemorrhoids. It is necessary to pay special attention to the severity, degree of gravity and duration of symptoms, both during bleeding and in the loss of nodes, on the observance of the crotch hygiene and the presence of pain syndrome.

It should also be clarified by the amount of fiber consumption, the frequency and character of the chair, difficulties in defecation, since the constipation is one of the most important risk factors for the occurrence of hemorrhoids. The physical inspection must be produced in the knee-elbow position or in the position lying on the side with a visual inspection of the anal hole, as well as a finger rectal study to eliminate other diseases and estimating the integrity of the sphincter. In addition, spending testing can help in the diagnosis of hemorrhoidal nodes and makes it possible to eliminate the prolapse of the rectum. To estimate the topography of affected hemorrhoidal nodes, it is necessary to perform anoscopy.6 The classification of the internal hemorrhoids located above the gear line is presented in Table 1. This classification allows you to choose the desired treatment method. To make a diagnosis, laboratory tests are most often not required.

Identification of a source of rectial bleeding

1. The conduct of endoscopic studies of the colon is shown in individual patients with symptomic hemorrhoids and bleeding from the rectum. Level of recommendation iv.

Despite the fact that the hemorrhoidal disease is the most common cause of blood in the chair (hematohesis), there are many diseases such as colorectal cancer, inflammatory diseases of the intestine, various types of colitis, diverticular disease and angiolasis, which can also cause bleeding. 7 in most Patients Colon cancer is not the cause of hematosysis, while many doctors neglect this symptom and miss the ability to diagnose the tumor.8

Data personal and family history, as well as a physical inspection, which may include proctoscopy and / or flexible sigmoidoscopy, will detect high-risk patients requiring a more thorough diagnostic search. Previous entries of endoscopic studies can be revised if possible. Table 2 shows the criteria of patients who need to carry out a full study of the colon with a colonoscopy or other method of coloring colorectal cancer.9 If the colonoscopy is not possible for one or another reasons, it is necessary to consider the conduct of flexible sigmoidoscopy in combination with other diagnostic methods given in recommendations By screening colorectal cancer.10

Hemorrhoid treatment

1. Modification of diet with sufficient fluid consumption and inclusion in diet of dietary fibers, as well as the formation of regular defecation habits - all this is the main methods of treating patients with symptomic hemorrhoids. Level of recommendation iv.

Constipation and bad habits (for example, excessive strain, long stay in the toilet and frequent defecates) can play an important negative role in patients with symptomic hemorrhoids.4.5 Increased dietary fiber consumption and fluid should be recommended to all patients - it helps to reduce the symptoms when falling out nodes and bleeding light and moderate severity. An overview that includes 7 randomized studies (378 patients) demonstrated the superiority of a dieting containing fiber. It has improved the results of the treatment of symptomic hemorrhoids (risk reduction (CP) \u003d 0.47, 95% di, 0.32-0.68), also reduced the risk of bleeding (cf \u003d 0.50, di 95%, 0.28-0.89), while The diet did not affect the symptoms of the leaps of hemorrhoidal nodes, pain syndrome and itch.11

2. The conservative therapy of hemorrhoidal disease is represented by various groups of drugs with minimal risk of developing complications and sufficient efficiency. Level of recommendations 2b.

Phlebotonics include various groups of drugs used to treat both acute and chronic hemorrhoids. It is not clear that the mechanism of their action is not clear, but it is assumed that it is associated with the strengthening of the walls of blood vessels, an increase in the tone of the venous bed, the normalization of the lymphottock and the permeability of the capillaries. Overview of 24 randomized controlled studies (RCI), in which the effectiveness of drugs compared with the control group, demonstrated that phlebotonics significantly reduce itching (the ratio of chances (OSH) \u003d 0.23 (95% di, 0.07-0.79) , p \u003d 0.02), bleeding frequency (OSH \u003d 0.12 95% di, 0.04-0.37, p \u003d 0.0002), symptoms of incontinence (OSH \u003d 0.12, 95% di, 0, 04-0.42, p \u003d 0.0008), and also contribute to the overall decrease in symptoms (OSH \u003d 15.99, 95% Di 5.97-42.84, P<0,00001). Несмотря на это, степень болевого синдрома статистически не различалась по сравнению с контрольной группой (ОШ = 0,11 95% ДИ, 0,01-1,11, p = 0,06).14 Мета-анализ 14 РКИ, проводящий сравнение различных классов флавоноидов (диосмин, микронизированная фракция диосмина и рутозиды) выявил, что флавоноиды оказывают положительное влияние на симптомы зуда, а также на частоту кровотечений и рецидивов (СР= 0,53).15

Despite the routine use of oranges containing anesthetics, steroids, emolents, and / or antiseptics, their long-term use can lead to allergic reactions or sensitization, and there is no sufficient evidence base for remote outcomes of therapy.

Ambulatory treatment

1. In most patients with the I and II stage, as well as individual patients with the III stage of the internal hemorrhoids, it is possible to carry out ligation of latex rings, sclerosis, infrared photocoagulation. Latex rings ligation is the most efficient method. Level of recommendation 1A.

The purpose of surgical intervention in outpatient conditions is the relief of symptoms by reducing the size or vascularization of hemorrhoidal plexuses, as well as fixing the hemorrhoidal tissue to the wall of the rectum to reduce the risk of loss. These procedures are not accompanied by pronounced pain syndrome and are well tolerated by patients.

However, patients should be informed about the high probability of recurrence, which may require re-intervention.16.17

Lagging by latex rings

The most common and effective method of treatment with hemorrhoids is the ligation of latex rings (LLK), which is superior to the efficiency of sclerotherapy and infrared photocoagulation.18 The ligation of hemorrhoidal tissue leads to its ischemia and necrosis, followed by the fixation of the necrotic portion to the rectal wall. The technique is well tolerated by patients, since ligation is performed significantly above the gear line, where there is no sensitive innervation. In one study, among 750 patients suffering from hemorrhoids of stage II and III, the effectiveness was 93%, and the frequency of recurrences is 11% for 2 years, regardless of the hemorrhoidal disease stage.

In RKKI among patients with hemorrhoidal disease II and III stages that have been treated with the help of LLK, during 1 year of observation, in 49% of patients, there was a relapse of the disease, most of them needed re-ligation. 195 in the review compared the effectiveness of LLK compared with hemorrhoidsomy, taking into account Stages of the disease. The results of the analysis demonstrated that hemorrhroids exceeded LLK at the III stage of hemorrhoidal disease (2 studies, 116 patients, cf \u003d 1.23, 95% di, 1.04-1.45); p \u003d 0.01). At the same time, a reliable difference in outcomes was found in the treatment of the II stage of the disease (1 study, 32 patient, cf \u003d 1.07, 95% di, 0.94-1.21; p \u003d 0.32). However, after radical hemorrhroidism, a smaller number of patients was required by re-intervention (3 studies, cf \u003d 0.20, 95% di, 0.09-0.40; p< 0,00001).20 Несмотря на то, что имеются ограниченные данные относительно безопасности ЛЛК у пациентов, принимающих антикоагулянты, применение латексного лигирования у этой группы больных противопоказано. В крупном ретроспективном исследовании среди 805 пациентов, которым суммарно было выполнено 2114 процедур ЛЛК, кровотечение в послеоперационном периоде отмечалось у 25.0% больных, принимающих варфарин, и у 7,5% пациентов, принимающих аспирин или нестероидные противовоспалительные препараты. Следует отметить, что только в 2,9% случаев кровотечение встречалось среди пациентов, которые не принимали какую-либо антитромботическую терапию.21

Sclerotherapy

For the treatment of internal hemorrhoids I-III degree uses various techniques and sclerizing agents. The most commonly used sclerosis - 5% solution of phenol in almond oil and sodium tetradecyl sulfate - sclerosis, approved by the FDA only for the treatment of small varicose veins of the lower limbs (Sotradecol, Elkins-Sinn, New Jersey). The mechanism of action lies in the sclerosis of the submucosal shell, followed by fixing the hemorrhoidal tissue to the wall of the rectum. The injection is carried out into the submembratus shell in the apical region of the hemorrhoidal node (0.5-2.0 ml of 1% sodium tetradecyl sulfate or 1.0-3.0 ml of 5% of the oil solution of phenol). Injection complications can be: ulceration or necrosis of the mucous membrane, as well as more rare complications - prostate abscess and retroperitoneal sepsis.22 Transient bacteremia after execution of sclerotherapy is observed in 8% of patients, the use of antibacterial therapy needs to be considered only for persons with increased risk of septic complications.

In one study, the effectiveness of the sclerotherapy in the treatment of hemorrhoids of stage III after a year amounted to only 20% .24. Higher results are demonstrated in relation to the hemorrhoids of the stage I, in a polydocanol study (FDA approved, registered in the Russian Federation) in 88% of patients did not have a relapse Diseases after 12 observation weeks.25 Despite the absence of rocks, in which the outcomes of sclerotherapy would be estimated in patients receiving anticoagulants, there are data from "case-control" type studies among 37 patients. In this work, the study participants received antiagregative therapy (aspirin, tickopidine, clopidogrel, and cylostazol (not registered in the Russian Federation), or anticoagulant therapy (warfarin), or combined therapy (anti-aggregant + anticoagulant), and differences in the three groups were not identified postoperative bleeding frequency.26 new sclerosing agents available in some Asian countries and Europe (for example, ZiOhn drug is not registered in the USA and the Russian Federation), have a higher efficiency in the treatment of hemorrhoids II-III stage.27.28 until New data will not be obtained, the role of sclerotherapy in the treatment of hemorrhoidal disease remains quite limited.

Infrared photocoagulation

In infrared photocoagulation (IFC) infrared waves lead to coagulation and necrosis of hemorrhoidal tissue. Most often, this technique is used in hemorrhoids of the I and II stage. Despite the high degree of recurrence according to early studies, especially among patients with III and IV stages of hemorrhoidal disease, 29 recent data from the RCA speak of comparable outcomes of IFC and LK.30.31 among patients with I and II stages of internal hemorrhoids after 6 months of observation Efficiency amounted to 81% after IFC, 28% of patients needed a re-procedure.32

Complications of outpatient procedures

In general, serious complications occur quite rarely. Nevertheless, when performing outpatient procedures or operational intervention in the rectum, it is necessary to remember this life-inner complication as a perianal sepsis. The perianal septice can manifest in the form of urination disorders, the increase in pain syndrome or the appearance of fever, which requires urgent search for the causes of symptoms.33 Bleeding is the most frequent complication of outpatient procedures, and more often than with other types, occurs after LLK.

As a rule, these complications arise on the first day after the intervention, which can be due to the ulceration of the hemorrhoidal node. The exact data on the prevalence of postoperative pain syndrome is currently absent. In some patients, after the LLC, pain syndrome occurs as a result of a ligature displacement below the gear line, which may cause ligature removal. Patients should be informed about these rare complications.22,34,35

Thrombosis of external hemorrhoidal nodes

1. In some patients with thrombosis of hemorrhoidal nodes, advantages are noted in the early excision of thrombic nodes. Level 2C Recommendation.

A few research data on trombosis of hemorrhoidal nodes does not allow to provide recommendations for high-grade evidence. Surgical treatment can exceed non-upheater treatment methods, and the optimal duration of conservative therapy is not defined. In a prospective study of CavCic with colleagues37 150 patients randomized into 3 groups, in the first one locally 0.2% nitroglycerin ointment, in the second thrombectomy and in third hemorrhoidsomy. On the 4th day after the start of treatment, the most pronounced decrease in pain syndrome was noted in the hemorrhroid group, then in the group of local treatment, thrombecomy was the least effective method. However, differences in the intensity of pain syndrome in a month were insignificant. Greenspon with co-authors38 retrospectively analyzed the data 231 patient data with thrombosis of external hemorrhoidal nodes. Among them, 48.5% of patients were surgical intervention (in this group, 97.3% was carried out local excision of the thrombied node, the remaining thrombecomy).

Conservative treatment included a modification of the diet, the use of means, softening chair, oral and local analgesics and baths. Symptoms (pain, bleeding and / or sensation of volumetric education) were completely regressed on average 24 days in a conservative treatment group compared with 3.9 days when performing operational intervention.

Surgical treatment of hemorrhoidal disease

1. Hemorrhidectomy is a method for selecting patients with symptomic outer hemorrhoids or in cases of combinations of internal and outer hemorrhoids with nodes losing (III-IV stage). Level of recommendations 1A.

Hemorrhidetcomy

Hemorrhroid optomy remains the most effective method of treatment among patients who have an outpatient intervention ineffective or their execution is impossible, at the III - IV stage of hemorrhoidal disease or in the presence of polyps anal channel. In a meta-analysis of 18 randomized studies, an outpatient procedure and hemorrhroidism was compared, the latter demonstrated the greatest effectiveness in patients with the III hemorrhoid stage. At the same time, after hemorrhroid optomy, a pronounced pain syndrome was noted and more often complications were met.18 open, as well as closed hemorrhoids, can be carried out using various surgical techniques. According to the results of the meta-analysis 11 of the RCC (total number of patients 1326), closed hemorrhimetomy demonstrated the best results for postoperative pain, wound healing time, and risks of postoperative bleeding.

The frequency of all postoperative complications, the recurrences of hemorrhoids and infectious complications did not differ statistically. The use of a bipolar electrocoagulator reduces the execution time of the operation and has a positive effect on the postoperative pain syndrome, which was demonstrated by a meta-analysis of 5 studies in which this technique was compared with a closed hemorrhroidism.40 Another meta-analysis 8 studies (468 patients) showed that the use of an ultrasonic scalpel is positive influenced the duration of disability, pain syndrome and postoperative complications when comparing hemorroid outcomes.

Stapler hemorrhoids

The staple hemorrhoidification (LONGO operation) is an operation at which mucous-submembered anastomosis is created using a circular crosslinking apparatus with resection of the submembraty layer for a proximal to the toothed line. As a result, blood supply and hemorrhoids lifting are discontinued. This technique is effective only in relation to internal hemorrhoids. The first neranger studies of staples hemorrhoids demonstrated a smaller severity of pain syndrome and a faster recovery of patients compared to hemorrhoidsomy. In the Watson study with colleagues43 randomized 777 patients, of which 389 patients were carried out stapler hemorrhoids, and 388 patients are radical hemorrhoids. In the early postoperative period, after performing hemorrhoids, a less pronounced pain syndrome was observed, the number of complications in two groups was not statistically different. At the same time, the hemorroid group had higher quality quality indicators than in the hemorrhoid group.

In the group of hemorrhoids, there was a larger number of recurrences of 32% against 14% (OR \u003d 2.96, 95% di 2.02 - 4.32; p< 0,0001), эта разница сохранялась на протяжении 24 месяцев наблюдения. Кроме того, у пациентов после операции Лонго чаще встречались симптомы выпадения (ОР = 2,65, 95% ДИ 1,45-4,85; p = 0,002).43 Мета-анализ 12 исследований (955 пациентов) продемонстрировал более высокий риск рецидива после проведения степлерной геморроидопексии по сравнению с геморроидэктомией на протяжении всего периода наблюдения (ОР = 3.22, 95% ДИ 1.59-6.51; p = 0.001). После операции Лонго чаще требовалось повторное вмешательство, по сравнению с геморроидэктомией (8 исследований, ОР = 2,75, 95% ДИ, 1,31-5,77; p = 0,008), послеоперационный период чаще протекал бессимптомно (12 исследований, ОР = 0,59, 95% ДИ, 0,40-0,88). Положительная тенденция после геморроидопексии отмечалась в отношении болевого синдрома, симптомов зуда и случаев внезапных позывов к дефекации. Все остальные показатели продемонстрировали преимущество геморроидэктомии.44 По результатам мета-анализа среди всех методов хирургического лечения геморроидальной болезни у степлерной геморроидопексии отмечался самый высокий показатель рецидивирования симптомов геморроя.45

The Long surgery has several characteristic complications: the formation of a rectovaginal fistula, bleeding or stricture at the place of performing hemorrhoids.

According to a systematic review of 784 articles (14,232 patients), the incidence of complications on average is 16.1%, while 5 patients have led to death 46 in the period from 2000 to 2009. 40 cases of rectal perforations after stapler hemorrhoids were published. Thirty-five patients required the fulfillment of laparotomy with the evacuation of carts, in one case there was a low front resection of the rectum. Despite surgical treatment and intensive therapy 4 patients died.

Digitalization of hemorrhoidal nodes.

When leaging hemorrhoidal arteries under the control of ultrasonic dopplerometry (dezerization of hemorrhoidal nodes, Hal), a special anososcope is used, equipped with an Doppler sensor. It allows you to identify arteries associated with hemorrhoidal plexuses, and to perform their ligation. At the same time, there is no need for the excision of the fabric, and the painful syndrome is minimally expressed. In addition to ligation, hemoroidal plexus lifting can also be performed. In general, studies of this technique demonstrate positive short-term results. It occurs among patients with IV hemorrhoids. Anesthesia in the postoperative period required 0-38% of patients. Complications occurred quite rarely, bleeding was noted in 5.0% of patients, repeated interventions were required in 6.4% of cases. The average duration of the operation ranged from 19 to 35 minutes.49

In a randomized prospective study when comparing LLC with HAL in the treatment of hemorrhoidal disease II and III stage, the frequency of relapses within 1 year after LLK amounted to 49% (87/176) and 30% (48/161) in the dezerization group (OR \u003d 2.23, 95 % Di, 1.42-3.51, p \u003d 0.0005). The number of additional procedures necessary for the full regression of symptoms (32% in the LLK group and 14% in the HAL group), consider the main cause of more frequent recurrences of the disease after LLK.

In another study, the frequency of recurrences and complications, the severity of symptoms, the quality of life on the EQ-5D scale and the incontinence scales are not different between the LLK and HAL groups. At the same time, in the early postoperative period, Hal was accompanied by a more pronounced pain syndrome. According to the results of the clinical and economic assessment of additional costs, with amendments to the outcomes, HAL is recognized less efficient than LLK.50

Complications of hemorrhidectomy

The frequency of complications after hemorromidectomy according to the literature varies from 1% to 2% .39. Acute urine delay occurs in 1-15%. 51 This complication is more common when using spinal anesthesia and after HAL procedure. Reducing infusion therapy and the use of local anesthesia can significantly reduce the risk of developing these complications.52

2. Multicomponent therapy of pain syndrome with minimal use of narcotic anesthetic means allows you to accelerate the recovery of patients after hemorrhoidsomy. Level of recommendations ІВ.

According to a review of 115,775 patients who were performed by various surgical procedures, hemorroids took the 23rd place out of 529 by the severity of postoperative pain syndrome.53 Various modifications of surgical intervention and postoperative patient management make it possible to reduce the degree of pain syndrome.54 local use of 2% computers containing diltia , reduces pain syndrome and the need to use narcotic analgesics after hemorrhroids. 55.56 meta-analysis 12 studies (1095 patients) demonstrated a significant decrease in the degree of pain syndrome when using nitroglycerin ointment after hemorrhroidism, as well as a reduction in patient recovery period. 57

Surgery Sphincterotomy (LIS) reduced the degree of pain syndrome and the need for analgesics after hemorrhoids. Lis reduced the frequency of the postoperative retention of urination and the risk of developing anal stenosis. However, when using hemorrhroid optomy, in combination with LIS, the risk of developing transient incontinence of Cala.58 in 3 RCA The use of botulinum toxin after hemorrhroidity was accompanied by a decrease in pain in the early postoperative period (<1 недели), а частота недержания газов оказалась сопоставима с группой плацебо.59 По данным мета-анализа метронидазол не снижал степень болевого синдрома в плацебо-контролируемых исследованиях.60 Оценка эффективности липосомального бупивакаина (ЛБ) проводилась в 2 РКИ. В первом случае 189 пациентов после геморроидэктомии рандомизировались в группы ЛБ и плацебо. В группе ЛБ интенсивность боли отмечалась значительно ниже (141,8 против 202,5; р < 0,0001). В группе ЛБ через 12 часов после операции у 59% пациентов не требовалось дополнительного применения опиоидных анальгетиков и у 28% через 72 часа по сравнению с пациентами, получавшими плацебо (14% и 10%; р < 0,0008 для 72ч).61 В другом исследовании 100 пациентов случайно рандомизировались в группы, однократно получающие 175 мг 0,25% бупивакаина гидрохлорида или ЛБ в дозе 66 мг, 199 мг, или 266 мг после выполнения геморроидэктомии. ЛБ значительно превосходил бупивакаин гидрохлорид по степени снижения интенсивности болевого синдрома через 72 часа после операции независимо от дозы ЛБ (р < 0,05). В послеоперационном периоде (12-72 часа) в группе бупивакаина гидрохлорида опиоиды назначались чаще, чем в группе ЛБ 266 мг (p = 0,019). Среднее время до первого применения опиоидов составило 19 часов для ЛБ 266 мг против 8 часов для бупивакаина гидрохлорида (р = 0.005). В группах ЛБ 266 мг и бупивакаина гидрохлорида в 4% и 35% случаев соответственно отмечались побочные эффекты, связанные с использованием опиоидов (р = 0.007).62

What is hemorrhoids?

Hemorrhoids - pathological expansion of veins in the area of \u200b\u200bthe rectum and the rear pass. Weak vessels form discomfort units during a fence or in sports. At an early stage of manifestation of the disease, insignificant: itching and gravity in the area of \u200b\u200bthe rear passage is weakly exposed and eliminate the use of special candles from hemorrhoids.

At the later stages, a person suffers from severe burning, gravity and soreness even at rest. Timely appeal to the doctor helps to cure pathology at an early stage. However, in Russia only a small part of the inhabitants of the country are ready to inform a specialist about the symptoms of the disease, to undergo a survey and receive medical care.

Hemorrhoids is the inflamed state of the veins inside and (or) outside the rectum, their varicose extension. The disease occurs as a result of an increase in the volume of "cavernous" tissues located around the exit from the rectum, the ligaments retaining these tissues are also destroyed. Hemorrhoids is a chronic, progressive disease with periodic exacerbations. People's treatments of hemorrhoids stop the progression of the disease and allow you to avoid or minimize the exacerbation.

Hemorrhoids is not a dangerous disease, but before it is treated, it is necessary to put an accurate diagnosis. Hemorrhoids is diagnosed only in 40% of patients with proctological diseases. Under the larger hemorrhoids, colitis, polyps, tumors of the rectum can be hidden. Causes of hemorrhoids: chronic constipation, sedentary lifestyle, obesity, pregnancy. The reasons for hemorrhoids can be associated with the profession - it may occur if you have long stand (sellers, hairdressers), lift weights (movers, excavations), sit (drivers, operators) symptoms and signs of hemorrhoids: feeling itching, burning, heat in the rear pass , pain in defecation, bleeding, blood traces in the wheel masses, loss of venous nodes from the rear passage, loss of part of the rectum with its pinching.

When hemorrhoids, the following recommendations should be followed: constipation; alcoholic beverages and acute, saved food; supercooling the bottom of the body, do not sit on cold; severe physical exertion, strong voltage;

Anus drawing in the sitting and lying position, "Walking" on the buttocks sitting on the heels, pump the body from side to the side of 2-5 minutes all exercises

Exercises can not be performed under the exacerbation of diseases

Hemorrhoids is known since a long time, therefore there are many folk remedies and treatment methods hemorrhoids.

narodn-sredstva.ru.

Scientists associate this violation with the ability to shine. The nodes are formed under the influence of reinforced blood flow in arteries and increased pressure in venous rectum vessels.

A number of factors lead to this:

• hereditary predisposition. The features of the structure of the vessels and the degree of their strength are laid in the body genetically. In patients of different generations with hemorrhoids, similar violations can be revealed. The most common example is the varicosemost limbs;
• constipation. Networking under detergent leads to an increase in pressure in the intra-abdominal zone, due to this, noded veins are pushed out;
• severe physical work. Abnormal loads contribute to damage to the ligament apparatus of a small pelvic and rectum, which leads stagnant, stretching veins and twisting vessels into nodes;
• sedentary lifestyle. Sitting work and hemorrhoids are concepts that are inextricably connected with each other. If a person sits in one place for a long time, the "warming compress" operates on the crotch area. Under the action of elevated temperatures, the vessels are constantly expanding, and blood is stirred;
• unhealthy food. The abuse of smoked, salty, oily and acute food stimulates a strengthened blood flow and irritation of the mucous membrane of the rectum. As a result of this, the veins are gradually expanding and become noded;
• alcohol abuse. The high content of alcohol leads to reflex extension of vessels, stagnant phenomena and inflammation of hemorrhoidal nodes.

Irritation of mucosa and heavy diarrhea - additional factors leading to inflammation and footprint. Often there is an exacerbation of hemorrhoids during or after childbirth.

narodn-sredstva.ru.

Hemorrhoids - exclusively human disease that scientists connect with the ability to shine. The formation of nodes occurs when the pressure in the venous rectum system and the local enhancement of arterial blood flow for a number of reasons.

• Heredity. The literature describes the cases of hemorrhoids in five generations in a row. We are talking about the structure and strength of venous vessels and their walls. Often, with hemorrhoids, other diseases are determined related to the pathology of the venous system, for example varicose veins.
• Popps can be the main reason. Due to the constipation when there is an intra-abdominal pressure, and the hemorrhoidal nodes from the anus occurs.
• Pregnancy, childbirth. During pregnancy, as the fetus increases, an increase in intra-abdominal pressure occurs, it makes it difficult for venous blood flow and increases the pressure in the veins, it leads to venous stagnation. At the time of birth, these factors may exceed critical values \u200b\u200band lead to the formation of non-commissioned nodes. After giving birth, hemorrhoidal veins are dramatically narrowed, and symptoms of the disease, if there are no other predisposing factors, often disappear.
• Heavy physical work. Loads arising from raising and transferring gravity, especially unprepared person, can lead to damage to the ligament apparatus of the rectum and a small pelvis.
• Passive lifestyle. With a duty of the seat on the soft, hemorrhoids are expanding, and they are stagnant. Heat to the crotch area acts as a kind of warming compress.
• Diet violation - abuse of acute, oily, salt and smoked food, chronic overeating. The sharp seasonings are irritated by the mucous membrane of the gastrointestinal tract, which leads to an increase in blood flow, so prolonged abuse of sharp and spicy dishes contributes to excess blood flow and irritation of the mucous membrane.
• Harmful habits (tobacco, alcohol). The high concentration of alcohol in the gastrointestinal tract causes a resistant reflex extension of the vessels that extends to all parts of the digestive tract, including the rectum. In extended vessels, blood flow slows down, a blood stagnation is formed in hemorrhoidal nodes and their inflammation.
• Heavy diarrhea. Directly damaging effect on fabrics - frequent enemas, not neat spinning, candles, laxatives, anal sex, excessively intense anus hygiene.

Prohibited sports

And those people who are professionally engaged in sports, if this disease is found, it is best to switch to a more sparing mode of classes, so as not to lead to serious consequences and do not tighten the disease for a long time. Therefore, it is advisable to just reduce the load - not to lift gravity, do not make sharp turns. So it is impossible to do with the exacerbation of hemorrhoids? Do certain sports that can increase pressure in the pelvic area.

• delay the breath when physical exertion is performed;
• close up to the mountains, as well as make hiking lifts to the mountainous area.

In addition, in no case can we wear close underwear or clothing, tighten the belt on the waist and sit for a long time on soft sofas, chairs and more.

Causes and Risk Factors Hemorrhoids

Basically, for physiological reasons, such a disease occurs when the walls of the vessels begin to lose their elasticity. And so at the same time it is strictly forbidden to provoke any stagnation of blood.

This state can also lead the position of the body, which is no longer changing. Therefore, people who are for a long time in the same position most often suffer from hemorrhoids. Such a category include people of such professions:

• truckers;
• scientists, and people who give knowledge to others - teachers;
• hair stylists;
• people who spend working hours in the office;
• bartenders.

And those who occupy such posts, it is advisable to change their position in a few hours, and it is best to make an easy gymnastics. What can not be done with hemorrhoids? First of all, there is a long time in the same position. Therefore, it is necessary to get up as often as possible, caking, you can make slopes, make circular movements of the thighs.

Hemorrhoids: Prevention in children

The prevention of the disease in children does not have fundamental differences from measures to prevent the disease in adults. So that you do not have to start treating hemorrhoids at home at the kid, observe the basic recommendations:

• provide your child quality and healthy nutrition;
• do not allow a long session of the child at a table or computer. Be sure to send your child to walk or arrange moving games right at home;
• little children do not leave for a long time in the same position. Be sure to turn them out, take it on your hands, type.

Scheme for the prevention of hemorrhoids in men

For women, three risk factors are the most relevant: a sedentary lifestyle, pregnancy and childbirth. We will deal with each of them in turn. Most of the works offered to women are characterized by finding within 8 hours in the sitting position.

If you add to this eight o'clock the time on the road, then we get 9-10 hours of a sedentary position per day. In the absence of physical activity, such a day of the day will sooner or later become the cause of hemorrhoids. What to do?

First, it cannot but please the trend towards a regular visit to the fitness centers. The benefits that can be learned from sports is invaluable. In addition, you are in the form, also take measures to prevent hemorrhoids.

Secondly, very often in a set with sports women are fond of diets and healthy nutrition. This is another most important factor in how to avoid hemorrhoids during sedentary work. What should a diet be?

The reason for the occurrence of hemorrhoidal nodes is constipation and chalk problems. Therefore, it is necessary to adhere to the power mode, which contributes to the formation of a healthy chair.

The diet must contain fiber (cereals, vegetables, fruits), and also exclude irritating intestines: alcohol, sharp, marinades.

Products of this category cause fermentation and rotting processes in the intestines. If there is no funds to allocate funds to the subscription to the gym, then you will have a big service, to acquire healthy habits like morning gymnastics or jogging.

The more active in your lifestyle, the more successful the prevention of hemorrhoids at home.

Among the men's half of humanity, no disaster is spread even more. It is very often caused by improper nutrition or overeating, a sedentary lifestyle and unexpected power loads.

If the issue with nutrition, we have already considered in detail in the female question, then in men's will pay more attention to preventive exercises.

In general, the best gemorrhoid prevention during sedentary work is a sport. But on the way to Sports, the other health problems that are common among the population can be an obstacle. Therefore, there is a simpler way. To prevent hemorrhoids, there is physical prophylaxis in the form of exercises:

1. Without changing the initial position, go to the second popular exercise - "BIKE". Varically twist pedals in both directions.
2. Last exercise in this position - as close as possible press the knees to the stomach.
3. Turn over to the stomach and be fixed in the hands, elbows and knees. Then he alternately turn the pelvis so as to touch the floor buttocks.
4. We move to the chair. Sitting, crossed hands on the back of the head and strain the anus, slightly pulling it. Enough to make 6-7 repetitions.

Such exercises for the prevention of hemorrhoids with regular execution will help you forget about this disease until the end of life. At the same time, do not forget about personal hygiene and compliance with a balanced diet.

We also do not advise men to heroge with weight lifting. Know your measure and do not be too much. Adhering to all these simple rules, you will make sure that the sitting work and hemorrhoids may be incompatible.

Among men, no disaster is even more common. It is very often caused by improper nutrition or overeating, a sedentary lifestyle and unexpected power loads.

In general, the best prophylaxis of hemorrhoids in men with sedentary work is a sport. But on the way to Sports, the other health problems that are common among the population can be an obstacle. Therefore, there is a simpler way. To prevent hemorrhoids, there is physical prophylaxis in the form of exercises that can be performed at home:

1. The first exercise that strengthens the muscles around the pelvis, as well as the blood dispersing blood in the organs of the small pelvis, are well-known "scissors". Lokia on his back, alternately cross straight legs.
2. Without changing the initial position, go to the second popular exercise - "BIKE". Varically twist pedals in both directions.
3. Last exercise in this position - as close as possible to press the knees to the stomach.
4. I turn over the stomach and become focusing on the hands, elbows and knees. Then he alternately turn the pelvis so as to touch the floor buttocks.
5. We move to the chair. Sitting, crossed hands on the back of the head and strain the anus, slightly pulling it. Enough to make 6-7 repetitions.

Hemorrhoid Preventive Pregnancy

Entering the fetus, especially in the later stages, has a negative effect on blood circulation in the organs of the small pelvis. Also during this period, estrogen and progesterone levels are elevated, it can also affect the occurrence of hemorrhoidal nodes.

Statistics says that 50% of women in a position, somehow, symptoms of pathology are manifested. In order to avoid this, hemorrhoids need prevention in pregnant women. The disease can behave tricky, and the woman can sometimes do not guess about her until the first check by the doctor. Therefore, we advise not to tighten with hikes to the clinic, being in a position.

The prevention of hemorrhoids in pregnant women lies in proper nutrition and a specific exercise complex:

1. First exercise. In the initial position of the leg on the width of the shoulders, and the hands are elongated forward. Movement: Turn the torso to the right, keeping the feet on the spot, and maximize the right hand back. This movement is done on the breath. In exhalation, we return to the starting position. For each movement allocated five seconds.
2. The same initial position As in the first exercise, but the hands are clips. Turn the housing in different directions, with the effort we assign your hands back.
3. Source position: Sit on the floor and go on the hands of the back. Do not take off the heels, bend the legs in the knees. Return to starting position on the exhale. Just run five times.
4. In the initial position, sitting to divert legs to the side, without bending. Then stretch the case to each of the legs, trying to reach the stop. ATTENTION! Exercise is allowed only in the first and second trimester.
5. For the third trimester recommended next exercise: Sit at home on the chair. Take the right hand, the left foot bent in the knee, try to reach the bell of the belly, you can help your left hand. This movement is carried out on exhalation, and in the breathe, go back to its original position. Repeat the action for the right leg and five times for each.

These are such simple physical exercises for the prevention of hemorrhoids will help dispersed the blood and strengthen the necessary muscles.

The prevention of hemorrhoids in women waiting for a child involves the occupations of Aqua Aerobics for pregnant women, the implementation of daily hiking, performing specially designed gymnastics exercises. It is important to comply with the diet and prevent an excessive weight gain.

During the rest, it is necessary to put a special pillow under the stomach, which reduces the pressure on the abodes of the small pelvis and prevents the development of stagnation.

During pregnancy, the risk of developing hemorrhoids increases many times. This is due to excessive pressure of the uterus on hemorrhoidal nodes. During the baby tooling, it is necessary to refrain from using excessively tight, piercing belts and bandages, as well as from carrying narrow clothing and high heels.

During the period of tooling the child on a small pelvis vessels, there is a huge pressure. This leads to the influx of blood, stagnant phenomena and deformation of hemorrhoidal vessels. The situation is exacerbated at the moment when a woman begins to give birth - the limit loads can lead to the fact that the extended veins will fall out. The next day, the woman born will move and walk to the toilet with great difficulty.

Knowing it, future mothers are often wondering how to avoid hemorrhoids after childbirth. Doctors recommend doing the following:

• to prevent unpleasant pathology when entering the fetus or shortly before childbirth, a woman is prescribed special means: creams, ointments and candles for the prevention of hemorrhoids. In the first trimester, doctors prescribe the following drugs with future mothers: Naltseris, candles and ointments based on propolis, posts. In the second trimester: neo-anusol, ichthyol. In the last trimester: hepathersbin, seeding forte, sea buckthorn candles;
• the best prophylaxis of hemorrhoids during childbirth is to trust the doctor who takes them and comply with all its recommendations. Control of their behavior and fence in the process of childbirth will help to avoid the formation and rupture of hemorrhoidal nodes and cones;
• the prevention of hemorrhoids during pregnancy includes maintaining normal weight. Contrary to popular belief that it is necessary for two, unhealthy food and overeating pregnant women are categorically contraindicated.

The manifestation of hemorrhoids during pregnancy and childbirth is an unpleasant process that aggravates and without the difficult position of the young mother. To avoid this, keep preventive procedures and carefully follow the health of health.

In order to avoid this, hemorrhoids need prevention in pregnant women. The disease can behave tricky, and the woman can sometimes do not guess about her until the first check by the doctor. Therefore, we advise not to tighten with hikes to the clinic, being in a position.

Symptoms and complications hemorrhoids

narodn-sredstva.ru.

The manifestations of the disease depends on the stage. Initially, they can disturb the feeling of gravity, itching, burning in the area of \u200b\u200bthe rear pass. The unpleasant sensations are enhanced after taking alcohol and excessive physical exertion. As the disease progressing, the main feature of chronic hemorrhoids appears - the loss of hemorrhoidal nodes, often accompanied by the appearance of scarlet bloody discharge at the end of the act of defecation on feces or toilet paper.

In addition to the discomfort, hemorrhoids leads to the development of hazardous complications. Hemorrhoidal nodes can be inflamed, it leads to thrombophlebitis. This complication is manifested in the form of a sharp pain and edema, the hemorrhoidal node is compacted, the temperature rises. The inflammatory process can go to the surrounding vein fatty tissue. There is no less danger of loss and infringement of internal nodes, in which they become dense and very painful. In both cases, contact a specialist immediately.

Diagnosis of hemorrhoids

The diagnosis of hemorrhoids does not represent much difficulty. This is a visual inspection of the skin of the anal area, the presence of bleeding and its degree.

Be sure to be carried out a finger rectal study of the rectum. However, with pronounced pain syndrome, it may be impossible. Then, against the background of admission of painkillers, anoscopy is carried out.

To examine the mucous membrane of the rectum and the lower segment of the sigmoid intestine, it makes it possible to see the presence of even highly located internal hemorrhoids and estimate the state of the internal nodes, or fibrocolonoscopy.

It is not necessary to beat the alarm ahead of time if I discovered the symptoms of this disease. The treatment for treatment is sold in publicly available in almost any pharmacies without a doctor's prescription. We are talking about this medicine from hemorrhoids like candles.

Active substances have healing anti-bodying, wound-healing and painful qualities. In addition to treating, candles are used to prevent hemorrhoids. Therefore, suppositories must be present in any family aid kit, because there is a reason for their application, and the tool may be needed at any time.

In general, preventive measures for hemorrhoids will have a general positive impact on your body and health. It is difficult to overestimate the benefit of regular exercises and balanced nutrition. The total muscle tone, as well as a specifically digestive system not only protects you from the occurrence of unpleasant diseases, but also will bring your overall condition to the optimal one.

Be healthy!

It is not necessary to beat the alarm ahead of time if I discovered the symptoms of this disease. The treatment for treatment is sold in publicly available in almost any pharmacies without a doctor's prescription. We are talking about this medicine from hemorrhoids, like candles for men and women.

In general, preventive measures for hemorrhoids will have a general positive impact on your body and health.

It is difficult to overestimate the benefit of regular exercises and balanced nutrition. The total muscle tone, as well as a specifically digestive system not only protects you from the occurrence of unpleasant diseases, but also will bring your overall condition to the optimal one.

Be healthy!

Greetings to you, dear readers of my blog!

Despite the enormous amount of information about the hemorrhoids and its treatment, there are very few information on the practical ways to combat hemorrhoids from ordinary citizens.

Below, I suggest familiarizing yourself with the practical recommendations of Yevgeny on the prevention of hemorrhoids and the warning of hemorrhoid exacerbations. The text of the letter is literally, almost without editing, is written well, the person's experience is felt in this matter. It is nice to receive such useful letters from readers.

Eugene wrote me a letter about his experience in the treatment of hemorrhoids. With his consent, I decided to post this information on my blog, hoping that my readers would be interested and useful to explore this letter.

The main thing that I was able to understand, hemorrhoids is not a disease, but a symptom of imbalance in the body.

As cystitis, for example, indicates an infection in the urogenital system and hemorrhoids indicates problems in the gastrointestinal tract - the gastrointestinal tract. Therefore, it is necessary to treat, as I understood, the stomach, intestines and other digestive organs.

The wife came up with a diet for me, in which there is no oily, fried, smoked, sharp and salted.

In the morning, porridge, the day of cottage cheese, then vegetables on a pair or boiled meat, and even in the evening there is still a reception of vegetables for example. It turns out 4 times a day.

I noticed that it is important to eat these four times, and a small portion so that the stomach and intestines do not overload and have not been pressed on the rectum, as well as the blood supply to be impaired due to the intestinal overcrowding.

It is also important very very very well to chew food so that the stomach and intestines can easily cope with her. Enzymes, pancreatin and Creon (pharmacy, for example - there enzymes are also suitable for improving digestion.

In general, with digestion it is necessary to cope first in order for the tract machine to start working well.

Hemorrhoid treatment is prescribed depending on the stage of the disease. Accordingly, conservative or minimally invasive methods or surgical operations can be used ...

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In the treatment of hemorrhoids, it is possible to apply as common (herbal fees with anti-inflammatory, painkillers, laxative, hemostatic, healing and removing spasms by action) ...

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What drugs can be used to prevent prevention?

Excessive and regular use of laxatives can cause hemorrhoids. Frequent constipation must be treated, eliminating, first of all, the reason for their appearance. Laxative funds cannot cure constipation, but only provide temporary relief.

For prevention, various drugs that promote venotonic effects can be used. Selection of drugs must implement a doctor. Can be used:

• Detralex tablets for internal reception are used both with exacerbations and in order to prevent the development of the disease.
• Venarar is an analogue of detection, is used by courses several times a year. Regular use of the drug in combination with the observance of the diet and the motor activity gives an excellent result.
• Homeopathic candles that prevent the development of the inflammatory process and have a strengthening effect on the walls of the vessels are widely used. Separage or propolis based suppositories can also be used.

Folk methods are used in the course of treatment and prevention of chronic hemorrhoids.

1. In order to prevent the exacerbation of the disease, it is recommended to insert a candle from raw potatoes into the area of \u200b\u200bthe rear opening. The course of treatment is from 30 days and can be extended in the event of a proper medical impact.
2. For the prevention of the outer form of the disease, the applying of the compress of the saber grass to the hemorrhoidal nodes is recommended. To prepare a decoction of 3 tablespoons of raw materials poured with cold water and bring to a boil. Then cozzle and use to implement the procedure. The course of treatment is 2-3 weeks, then you need to take a short break.
3. Sitting baths with the addition of essential oils and beams of healing plants have a good healing and prophylactic effect. In the course of treatment, you can use the bark of oak, St. John's wort, the Calendula and Chamomile Inflorescences, Melissa.

Folk medicine funds must be used for a long time: in some cases from several months to six months. It all depends on the degree of development of the disease and tolerance of a means.

varikoznic.ru.

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Hemorrhoid treatment at home

Be healthy!

Be healthy!

It is very important to consult with the attending physician about the reception of various medicinal herbs, both inside and externally (in the form of a bath, compresses, etc.). After all, the treatment of herbs, if they take them inside, affects the whole organism as a whole. Therefore, it is necessary to take into account all the indications and contraindications of these healing plants. And those herbs that may have the properties of stopping blood, you need to take in certain doses and is generally better limit. After all, with such a disease, thrombus may form. This eventually leads to serious consequences.

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Bad habits

It is worth stop smoking, because after only an hour after a burned cigarette in capillaries, blood circulation worsens by 30%. If there is an inclination to hemorrhoids, then this factor can provoke its development. And if there is already a disease, smoking contributes to thrombosis.

Alcohol is recommended to use rarely, ideally - refuse him. The fact is that alcohol metabolism products contribute to excess blood flow. This applies to the rectum vessels. And the red wine so strongly increases the pressure that if there is a hemorrhoids, it may even provoke real bleeding.

Methods of prevention

It is quite difficult to take some measures during the childbirth themselves. The best and most facilitating means will be timely cough and the fulfillment of the councils of the obstetrician. Much depends on how the last months of pregnancy occurred when the fruit weighs the most.

It puts pressure on the vessels, so to prevent the appearance or exacerbation of hemorrhoids during childbirth, you need to adhere to the rules throughout the term.

The methods of treatment of varicose veins of hemorrhoids mass, and the earlier it starts, the earlier it will end. Preparations for treatment - ointments and candles from hemorrhoids - will help get rid of it during pregnancy.

People leading a sedentary lifestyle are in the risk group. If you have on professional or other reasons, you have to be in the same position, we recommend complying with a few simple rules:

• during operation every 30-50 minutes, get up and knew. If possible, go around the room or go out into the street;
• exercise. To maintain the body and intestines in the tone, cardion loads are suitable: aerobics, running, swimming and dancing. Raising the rods, dumbbells and weights with a lot of weight gives the opposite effect: hemorrhoidal nodes are formed due to high pressure;
• with long-term finding at home, make charging and show activity when performing classic home duties. Get the dog - with the advent of a pet you will not have time to sit in the evenings in front of a computer or TV.

If the time for additional activity is not enough, combine the road to work with hiking. This is an excellent hemorrhoid prevention with sedentary work, which does not take a lot of time and safe for health.

Food

Hemorrotype patients suffer from frequent constipation, as a result, for defecation, such women have to make a lot of time, physical effort. Therefore, food is an important part of the prophylaxis of hemorrhoids, it is important to cope with constipation.

A special diet helps to build a diet so that the emptying of the intestines takes place regularly (daily, preferably at the same time), without much physical effort.

It is important to drink at least about a pair of liters of water a day, especially the mineral water, for example, Essentuki.

It will be necessary to refuse from any smoked foods, acute foods, any marinated products and, of course, semi-finished products, Fastfud.

It is important to use enough vegetables, fruits, cereals, for they are rich in fiber. There are also dried fruits, fermented dairy products. They beneficially affect the gastric mucosa, and also normalize the work of the intestine. Excellent soft laxatives:

• pumpkin;
• kissel cooked from rhubarb;
• beet;
• prunes;
• equal milk products, namely - kefir, prokobvash.

Also worth to give preference to bread with rzhan either with bran. If the fiber is still not enough in nutrition, the proctologist will write special medicines containing it.

RCRZ (Republican Center for Health Development MD RK)
Version: Clinical Protocols MOR RK - 2013

Hemorrhoids without complications Uncomfortable (I84.9)

Proctology

general information

Short description

Approved by the minutes of the meeting
Expert Commission on Health Development Mort RK
№23 dated 12.12.2013

Hemorrhoids - acute or chronic disease, characterized by noded (varicose veins) expansion of veins (cavernous television) of the lower part of the rectum. Hemorrhoids is equally common in men and women of middle and old age. The prevalence of hemorrhoids is approximately 120 cases per 1000 adult population, which allows it to be considered the most frequent disease. Among the proctological diseases, hemorrhoids accounted for from 34 to 41%. Abroad hemorrhoids suffer 75% of the population. The average age of patients is 45-65 years. In the UK, hemorrhoid suffers from 4.4% to 24.5% of the population. The disease predispose factors such as a sedentary lifestyle, pregnancy and childbirth, long constipation, severe physical work, associated with weight lifting, habit of drinking acute and spicy foods, diseases of the small pelvis, causing compression of discharge veins, as well as the absence of valves Disposal veins of a straightworm plexus.

Protocol name:Hemorrhoids

Classification

Clinical classification:

Classification of hemorrhoids (by A.N. Ryzhich, 1956)

By etiology:
1. Regenerate (hereditary)
2. Accommodated: primary
3. Security (symptomatic)

Localization:
1. Internal
2. Outdoor
3. Combined

By clinical flow (Thomson W 1975):

Chronic hemorrhoids (4 stages)
I. Stage - manifested by bleeding, hemorrhoids do not fall out
II.stadia- hemorrhoidal nodes fall out when there is a straightened and eventual (with or without bleeding)
III.stadia- hemorrhoidal nodes fall out and eventual only by manual benefits (with or without bleeding)
IV.Stadia- Hemorrhoidal nodes fall alone and do not fail or fall out immediately after ordering (with or without bleeding)

Acute hemorrhoids (3 degrees) (GNS Coloproctology) (A.M. Ameninee, 1977)
1.Trombosis of hemorrhoidal nodes, without inflammatory process
2.Trombosis complicated by inflammation of hemorrhoidal nodes
3.Trombosis, complicated by inflammation of subcutaneous tissue, edema of perianal skin, necrosis of the mucosa of hemorrhoidal nodes

The clinical course of acute hemorrhoid has three stages (Vorobiev G.I. et al., 2001).
1. Thrombosis of outdoor and internal hemorrhoidal nodes without an inflammatory process.
2. Thrombosis complicated by inflammation of hemorrhoidal nodes.
3. Thrombosis of hemorrhoidal nodes complicated by inflammation of subcutaneous fiber and perianal skin.

Diagnostics

List of basic and additional diagnostic events

Main diagnostic measures:
1. Protecting a proctologist (collection of complaints, history, inspection, rectal research)
2.Inacopia
3. DeterminoCopy.
4. Colonoscopy
5. Ryrigoscopy.

Diagnostic criteria:

Complaints and history:
Bleeding and loss of hemorrhoidal nodes. Anal itching, a sense of discomfort in an anal channel, the excretion of mucus.

physical examination
Hemorrhoidal nodes are determined in the form of blowout in the lumen of the anal channel, dark cherry blossom, soft-elastic consistency, covered with mucous membrane. Passenger internal nodes are distinctly roasted from the rear pass during the stretching. External hemorrhoids are visible with external inspection. In the finger study, the pains of the walls of the anal canal are determined, their pathological mobility. Explore the functional state of the locking apparatus of the rectum

Laboratory research:
General blood analysis
Gregersen reaction
With chronic hemorrhoids with frequent bleeding, there are signs of chronic anemia, a decrease in indicators (the norm of men HB- 140-160 g / l, women HB- 120-130 g / l, Husband ER-4.1-5.1x10 12, 3.7-4.7x10 12)
In case of acute hemorrhoids, signs of inflammation are possible, raising the level of leukocytes in the blood, ESO (norm L-4-9x10 9, ESO husband 1-10, wives 2-15 mm / h)

Tools:
Anoscopy.
RectorOnososcopy.
Fibrocolonoscopy.
Irrigoscopy

Indications for consultation of specialists
Consultation oncologist for the identification of neoplasms of the distal large intestinal department
Consultation of the dermatologist for the elimination of dermatological diseases of the perianal region

Differential diagnosis

Differential diagnosis of pain in the rear pass and the perianal region

Treatment abroad

Treat treatment in Korea, Israel, Germany, USA

Get advice on medical examination

Treatment

Treats of treatment:
In acute thrombosis: the achievement of the regression of the clinic of thrombosis
In chronic hemorrhoid: prevention of complications, removal of varicose veins of the rectum

Tactics of treatment
Acute hemorrhoids treatment conservative
Chronic hemorrhoids, aggravation stage:
1. Blood-treatment conservative: hemostatic therapy
2. With the ineffectiveness of conservative therapy
and. Minimally invasive treatment methods
b. Operational treatment Operation of milligan morgana, Ferguson
Chronic hemorrhoids with frequent exacerbations
1.Maline treatment methods
2. Operation of milligan morgana, Ferguson

Non-media treatment

Acute hemorrhoids
Bedding mode or semi-noar 7-14 days
Diet Sless: protein omelet, meat beef broth, boiled meat, checked through a meat grinder, rice mucous or tidy porridge (on water with a small piece of oil), White crackers (3-4 crusher per day) and abundant drinking (4-6 glasses barely sweetened tea).

Chronic hemorrhoids
Diet Peshalkova
Regulation of intestinal function, diet, lifestyle change, application of laxatives.

Medicia treatment

Acute thrombophlebitis of hemorrhoids

Outpatient stage:
1. Rectal candles with local anticoagulants: heparin sodium + prednisolone acetate + laureomacrologol (hepathersbin B), heparin sodium + benzocaine (Nigepan)
2. Outflows with anticoagulants: Troxerutin (Troksevazin), Sodium heparin.
3. Water soluble ointment with anti-inflammatory properties: chloramphenicol + methyluracil (levomecol), levomycetin + sulfadimetoxin + methyluracil + trimecain (Levosin)
4. Elimination of pain syndrome: NSAIDs, spasmodics
5. Labiting
- based on lactulose

Hospital treatment
1. Perianal blockade
2. Required candles with local anticoagulants: heparin sodium + prednisolone acetate + laureomacrologol (hepathersbin B), heparin sodium + benzocaine (Nigepan)
3. Mazi with anticoagulants: Troxerutin (Troksevazin), Sodium heparin.
4. Water soluble ointment with anti-inflammatory properties: chloramphenicol + methyluracil (levomecol), levomycetin + sulfadimetoxin + methyluracil + trimecain (Levosin)
5. Salads
- based on lactulose
- based on dietary fiber: planting seed sheath oval + excipients (Mukofalc)

Hospital treatment

Chronic

I-II Art. Chronic hemorrhoids are treated by conservative methods
1. Replacement of phlebotonics (Detralex, Phlebodia 600), rectal candles (ultrafrokt, Nigepan, Natal Calid, Relief, Proktosan, Anusol)
2.Productions of iron
3. Angioprotectors

II - III STOkelotherapy, ligation of latex rings, proximal ligation, infrared photocoagulation, radio frequency coagulation

Used medicines

Other types of treatment
With the II-III stages of chronic hemorrhoids
Multinavasive treatments hemorrhoids:
Sclerotherapy
Lagging by latex rings
Proximal ligation
Infrared photocoagulation
Radio frequency coagulation

Surgical intervention
I-IV Art. Chronic hemorrhoids - operational treatment in the inefficiency of conservative therapy: Operation of Milligan-Morgan, Ferguson

Preparations (active substances) used in the treatment

Prevention

- Prevention of chronic anemia
- Prevention of the development of anal inconstantiation

Further maintenance: observation of a proctologist or surgeon at the place of residence

Information

Sources and literature

1. Protocols of meetings of the Expert Commission on Health Development Mort RK, 2013
   1. List of references: 1. Guidelines for the classification of diseases T4, Karaganda, 2009, p. 115-116 2. Hemorrhoids. A.I. Parfenov Medical Council, No. 9-10, p. 13-18. Moscow, 2010, 3.Baker H. Hemorrhoids. In: Longe JL, ED. GALE ENCYCLOPEDIA OF MEDICINE. 3rd ed. Detroit: Gale; 2006: 1766-1769. 4.Chong PS, Bartolo DCC. Hemorrhoids and Fissure in Ano. Gastroenterology Clinics of North America. 2008; 37: 627-644. 5.Nice Technology Appraisal Guidance 128 Stapled HaemorrhoidPEXY FOR THE TREATMENT OF HAEMORRHOIDS 6. The modern tactics of the treatment of acute hemorrhoids. Charge E.A. Surgery. T6. №2. 2004. From 25. 7.U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2005. 8. Cochrane Database Syst Rev. 2012 Aug 15; 8: CD004322. DOI: 10.1002 / 14651858.cd004322.pub3.phlebotonics for haemorrhoids.perera n, Liolitsa D, Iype S, Croxford A, Yassin M, Lang P, Ukaegbu O, Van Issum C. Source General Medicine, Addenbrookes Hospital, Cambridge, UK. [Email Protected] 9.INDRU Khubchandani, Nina Paonessa, Azimuddin Khawaja Editors Surgical Treatment of Hemorrhoids. SECOND EDITION. Springer, 2009. 459 pp. 10.Vorobyev G. I. Medicamentous and minimally invasive methods of treating hemorrhoids / G. I. Vorobyev, Yu. A. Shelygin, L. A. Grant // Russian Medical Journal. - 2001. - volume 9, N 13/14. - P. 551-555. - ISSN 1382-4368. 11. Tactics of the rapid treatment of patients with chronic hemorrhoids. Kolmakov P. N. Dissence Abstract. For competition Ph.D. St. Petersburg, 2007. P. 30 12.Current Status of Surgical Treatment for Hemorroids Systematic Review and Meta-Analysis. Jinn-Shian Chen, MD, FACS, Jeng-Fu You, MD. Chang Gung MED J Vol.33№5 September-October 2010, P.488 13. Carapeti E.A., Phillips R.K.S. Treatment of Hemorrhoids. In: j.beynon, n.d.carr (EDS): Recent Advances in ColoproCTology, Springer-Verlag London Limited, 2000, 155-166. 14 The Hubble Trial: Haemorrhoidal ARTERY LIGATION (HAL) VERSUS RUBBER BAND LIGATION (RBL) for haemorrhoids.tiernan j, Hind D, Watson A, Wailoo AJ, Bradburn M, Shephard N, Biggs K, Brown S.Source Cruk Clinical Research Fellow , St James "University Hospital, Leeds, UK.BMC Gastroenterol. 2012 Oct 25; 12: 153. DOI: 10.1186 / 1471-230X-12-153. 15. Stapled Haemorrhoidopexy vs. Milligan-Morgan Haemorrhoidectomy for Grade III Haemorrhoids: A Randomized Clinical Trial. Ammaturo C, Tufano A, Spiniello E, Sodano B, Iervolino Em, Brillantino A, Braccio B.Sourcedepartment of Surgery, "Dei Pellegrini" Hospital, Naples, Italy.Sourcedepartment of Surgery, "Dei Pellegrini" Hospital, Naples , Italy.g Chir. 2012 Oct; 33 (10): 346-51. 16. Charúa Guindic L, Fonseca Muñoz E, García Pérez NJ, Osorio Hernández RM, Navarrete Cruces T, Avendaño Espinosa O, Guerra Melgar Lr. Hemorrhoidal DesaRialization Guided by Doppler. A Surgical Alternative in Hemorrhoidal Disease Management. Rev Gastroenter MEX. 2004 APR-Jun; 69 (2): 83-7. 17. Faucheron JL, Gangner Y. Doppler-Guided Hemorrhoidal Arttery Ligation For the Treatment of Symptomatic Hemorrhoids: Early and Three-Year Follow-Up Results In 100 Consecutive Patients. Dis Colon Rectum. 2008 Jun; 51 (6): 945-9. 18. Faucheron JL, Poncet G, Voirin D, Badic B, Gangner Y. Doppler-Guided Hemorrhoidal ARTERY LIGATION AND RECTOANAL REPAIR (HAL-RAR) for the Treatment of Grade IV Hemorrhoids: Long-Term Results in 100 Consecutive Patients. Dis Colon Rectum. 2011 Feb; 54 (2): 226-31. 19.Festen S, Van Hoogstren MJ, Van Geloven AA, Gerhards MF. Treatment of Grade III and IV Haemorrhoidal Disease with PPH or THD. A RANDOMIZED TRIAL ON POSTOPERATIVE COMPLICATIONS AND SHORT-TERM RESULTS. Int j colorectal dis. 2009 DEC; 24 (12): 1401-5. 20. Giordano P, Nastro P, Davies A, Gravante G. Prospective Evaluation of Stapled Haemorrhoidopexy Versus Transanal Haemorrhoidal Deartersation for Stage II and III Haemorrhoids: Three-Year Outcomes. Tech ColoproCTOL. 2011 MAR; 15 (1): 67-73. 21. SOHN N, ARONOFF JS, COHEN FS, WEINSTEIN MA. Transanal Hemorrhoidal Dearterialization IS An Alternative to Operative Hemorrhoidectomy. Am j Surg. 2001 Nov; 182 (5): 515-9.

Information

List of developers:
1. Nurbekov A.A.- D.M., Professor of the Department of Surgical Diseases No. 2 of the RGP on the PCB "Karaganda State Medical University" MR RK, head. Department of Coloproctology KGP "Regional Clinical Hospital" of the Health Department of the Karaganda region.
2. Kaliya D.K.- Magister of Medical Sciences, Assistant Department of Surgical Diseases №2 RSP on PVV "Karaganda State Medical University" MR RK

Indication for the absence of conflict of interest: There is no conflict of interest

Reviewers:

Note Protocol Review Conditions: The deviation from the protocol is permissible in the presence of concomitant pathology, individual contraindications for treatment. This protocol is subject to revision every three years, or when new proven data on the conduct of patients with acute and chronic hemorrhoid form appear.

Attached files

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Many believe that hemorrhoids is a frivolous disease. But it is not so. And all because such a disease has a lot of complications (venous bleeding, paragreus abscess), which are very dangerous for a person. And so that the disease does not develop and various complications appear, each patient should know that it is impossible to do with hemorrhoids.

Sauna with disease

Many are interested, is it possible to go to the sauna or bath with such a disease? To this question, most doctors say that it is categorically impossible. This is due to the fact that the temperature is very high. Under such circumstances, the walls of the vessels are greatly expanding. Such an effect is high temperatures and on Vienna, which are in the rectum. In this case, blood begins to pass into a small pelvis. Then the patient may have severe pain, and the disease will develop further.

In the event that hemorrhoids bleed, then strong bleeding can begin with increasing temperature. If you do not knock down the temperature and stop the blood, then the patient may have shock. Such a state may even lead to death. It becomes clear from this that when hemorrhoids can not overheat.

In addition, under such conditions, a person increases sweating. And this in turn can lead to dehydration. And therefore blood becomes curly, and the permeability is broken. In this case, thrombose formations are formed. Therefore, this method of alternative medicine is categorically prohibited for hemorrhoids.

Sports in the disease

Now it has become fashionable to play sports. But is it allowed when there are education in the rectum? What physical exercises can not do with hemorrhoids?

If you do easy exercises, they will have a beneficial effect on the course of the disease. The vessels are strengthened, and the blood enters the sick zone better. Therefore, stagnant blood in the rectum is eliminated. Then the disease does not develop. But during exercise, it is necessary to closely monitor its condition. And if there is an aggravation, it is best to avoid sports. When such a state appears, it is best to wait a few days until the aggravation pass.

But you need to remember that there are exercises that can not be done with hemorrhoids. It is best to go for a walk. So what exercises can not do with hemorrhoids? And if there is still a desire to play sports, it is worth avoiding lifting weights, as well as exercises, where you need to take a sedentary position - squatting. If there are some doubts, it is better to consult a doctor and find out what exercises are contraindicated, and which the state of the vessels will improve. After all, sport is one of the methods of treating many diseases.

What people are subject to the development of hemorrhoids?

Basically, for physiological reasons, such a disease occurs when the walls of the vessels begin to lose their elasticity. And so at the same time it is strictly forbidden to provoke any stagnation of blood.

This state can also lead the position of the body, which is no longer changing. Therefore, people who are for a long time in the same position most often suffer from hemorrhoids. Such a category include people of such professions:

• truckers;
• scientists, and people who give knowledge to others - teachers;
• hair stylists;
• people who spend working hours in the office;
• bartenders.

And those who occupy such posts, it is advisable to change their position in a few hours, and it is best to make an easy gymnastics. What can not be done with hemorrhoids? First of all, there is a long time in the same position. Therefore, it is necessary to get up as often as possible, caking, you can make slopes, make circular movements of the thighs.

Prohibited sports

And those people who are professionally engaged in sports, if this disease is found, it is best to switch to a more sparing mode of classes, so as not to lead to serious consequences and do not tighten the disease for a long time. Therefore, it is advisable to just reduce the load - not to lift gravity, do not make sharp turns. So it is impossible to do with the exacerbation of hemorrhoids? Do certain sports that can increase pressure in the pelvic area. Before the ban is cycling, riding a motorcycle, horseback. Also impossible:

• delay the breath when physical exertion is performed;
• close up to the mountains, as well as make hiking lifts to the mountainous area.

In addition, in no case can we wear close underwear or clothing, tighten the belt on the waist and sit for a long time on soft sofas, chairs and more.

What is impossible to eat with hemorrhoids?

What can not be done with hemorrhoids from physical exertion, it was described above, and now you need to know that it is impossible to eat with this disease. After all, with improper nutrition, constipation develops, which ultimately leads to the development of hemorrhoids. If some unusual sensations appear in the rectum area, it is best to start well eat. First of all, it is worth excluding bakery products from the diet, which contains easily durable carbohydrates, we include sweet pastries, confectionery products.

And it is best to replace with fruit and vegetables that contain a lot of fiber and lead to a better passage of feces, without delay. But besides carbohydrates, you need to stop eating fatty food, fried, fast food, semolina, rice porridges and fatty dairy products. It is best to replace them with fermented milk.

But when this disease appears, there is not only contraindications, but also mandatory conditions. The patient needs to eat balanced and observe the mode. You need to eat gradually and small portions.

If there are constipation, in which he began to develop hemorrhoids, it is best to reconsider the power and begin to introduce products that contribute to a soft laxative action into the diet. But at the same time, if it is difficult to go to the toilet, it is impossible to overdo the laxative so that in the end the diarrhea does not appear. If there is constipation, it is possible to get rid of it with the help of special exercise, which are made from the morning on an empty stomach.

It is very important when hemorrhoids drink more liquid, namely clean water. But strong alcoholic beverages, coffee and tea, kislets and soda are contraindicated.

Excess weight

In addition to the listed, negatively affects the course of the disease and excessive weight. In the treatment of hemorrhoids, many patients pay more of their attention precisely the main disease, and not the weight control. What ultimately leads to the fact that a person begins to suffer from overweight. But those people who, in connection with the hereditary predisposition, or because of a low-propelled lifestyle associated with labor activity, better carefully follow themselves. With the appearance of unnecessary kilograms, it is better to sit on the diet (it is also worth specifying with the attending physician) so as not to lead to big health problems.

Candles

Some patients discharge special creams with outer hemorrhoids. It is best to use those that gently affect.

And what can not be done with hemorrhoids outdoor? In this case, candles cannot be applied. Since they can injure and so thin vessels in the thick intestine and lead to bleeding. Therefore, it is best to take special creams that the attending physician will advise.

Clear

Why it is impossible to do this due to why you should not put and candles. Since such a procedure may damage the walls of the hemorrhoid assembly, which will lead to serious consequences.

In addition, such treatment is not quite effective. But some doctors still prescribe such a procedure if there are no serious contraindications. In this case, the enema should be introduced very slowly and the tip must be lubricated.

Grass

It is very important to consult with the attending physician about the reception of various medicinal herbs, both inside and externally (in the form of a bath, compresses, etc.). After all, the treatment of herbs, if they take them inside, affects the whole organism as a whole. Therefore, it is necessary to take into account all the indications and contraindications of these healing plants. And those herbs that may have the properties of stopping blood, you need to take in certain doses and is generally better limit. After all, with such a disease, thrombus may form. This eventually leads to serious consequences.

Conclusion

Now you know what you can not do with hemorrhoids, and what can be achieved to achieve better treatment and not worsen the patient's condition. We also touched a little the topic of balanced nutrition. After all, in the diet of a patient with data, there are some limitations.

Only integrated disease therapy will help

Hemorrhoids are a disease that were painful in ancient times. In those days, pathology was called "bleeding from the intestine" and got rid of the illness by radical ways. Popular was considered to be a hot metal. Today, in most cases, the therapy of proctological disease is carried out by minimally invasive methods. They are painless, small-acting and safe.

What is the most effective treatment of hemorrhoids? Disputes are still on this question. A number of authors argue that the removal of hemorrhoidal nodes is the key to successful prevention of complications. Others believe that medication therapy can be struggling with pathology.

Effective treatment methods

If the disease is diagnosed in the initial stages of development, then the use of conservative therapy is sufficient. To do this, you need to visit a proctologist. Depending on pronounced symptoms, the doctor individually selects medicines. During this period, it is recommended to refrain from bad habits. It is useful to establish the right diet.

If hemorrhoidal nodes constantly fall out or have a large form, the question is raised about their removal. What method to apply in a particular case the doctor decides after careful diagnosis.

Conservative treatment

Conservative treatment of hemorrhoids implies the use of general and local drugs. In the first case, doctors prescribe, so-called phlebotonic agents. These are drugs that strengthen the walls of blood vessels and improve blood flow.

All preinselves must be coordinated with a proctologist! Independent use of powerful tools may aggravate the situation.

A much broader spectrum of action at local agents. These are anti-inflammatory ointments, creams and candles.

Medicines of this kind are intended for:

1. relieving pain;
2. reduction of inflammation;
3. elimination of waste;
4. stopping itching;
5. acceleration of regeneration processes;
6. prevent allergic reactions.

Efficiency even the best drugs may not be particularly high without adjusting the power and establishing a normal defecation mode.

means an exception from the diet of sharp, salty, acidic dishes. Abstinence from alcohol, very oily food. Restriction of canned and smoked. Be sure to use fresh fruits and vegetables, greenery, as well as fermented milk products. The doctor may also prescribe drugs that regulate intestinal peristalsis and normalizing intestinal flora.

All these measures along with drugs allow you to cope with the initial manifestations of pathology. If the disease reached the second stage, conservative methods may not be enough. In this case, doctors offer their patients more serious therapy.

Minimally invasive treatment methods

Minimally invasive techniques of treating hemorrhoids today almost completely displaced radical surgical intervention. The word "minimally invasive" means that the intervention in the body will be gentle. It does not require long stay in the hospital and bed restoration period.

Table: Popular minimally invasive methods for removing hemorrhoidal nodes

The method can stop abundant bleeding

A syringe with a long needle filled with a special sclerosing preparation is introduced into the rectum through ancop.

The medicine, penetrating the hemorrhoidal node, actually gluits the blood vessels. The blood supply to the cavernous cavities is stopped, as well as the manifestation of hemorrhoids.

The technique is very effective, but only in the early stages of the disease. Adverse effects usually arise due to the inexperience of the coloproktologist and the incorrect procedure. In the third and fourth stage, the hemorrhoids of sclerotherapy is practically not able to give the desired result.

Laser coagulation

Another progressive method. Lies in the causing hemorrhoidal nodes directed thermal beam. Impact goes directly to the node. Does not leave wounds, scars and passes painlessly.

Laser coagulation Maloveraumatic and safe method of treating hemorrhoids

This method is more suitable for 1-2 stages of the disease. Doctors warn that if hemorrhoidal nodes are significantly increased in size, repeated sessions may be required.

Transanal ligation

It implies putting on the leg of each hemorrhoidal node of the tight latex ring (washers). The blood supply to the nodes stops. After some time, they die and remove, like rings, through the rear passage with the carte masses.

The technique is possible only in the second or third stage of hemorrhoids. It is very important that only one hemorrhoidal node is processed in one session. Otherwise, it is possible to develop serious pain syndrome and complications. The interval between sessions is usually two weeks. Single ligation in rare cases does not give a full effect, and then the procedure has to be repeated.

Of the three described minimally invasive methods, the most effective is considered. At the same time, it is the most expensive.

Surgical removal of nodes

For a long time, the only method of removing hemorrhoids existed in Surgery. This is a technique of hemorrhidectomy in milligu-morganu. Regarding soon she will celebrate its century, although since the development of such a method of treatment has enriched with new tools and options.

Methods of milligan-morgana radical way to quickly get rid of the problem

The operation involves excision and removing hemorrhoidal nodes. Depending on the version of the execution, open wounds and seams remain. And in some cases, the cultures of the nodes are placed in the submembiatrous shell of the anal channel, followed by the reduction of the mucous layer.

Approximately two cases of the three operation leads to the complete disappearance of all problems associated with the manifestations of hemorrhoids. The duration of the favorable period is determined mainly by the behavior of a person after surgery. Proper lifestyle, diet, good intestinal work, recommended physical exertion, allow you to almost forget about the disease.

The only hemorrhoidomy alternative is the Longo operation. This method appeared relatively recently. During the operation of the Longo, the mucous membrane of the rectum is in a special way. After that, hemorrhoidal nodes turn out to be on their anatomical places and decrease in size.

The technique, according to the responses of the patient operations, is very effective. However, not everyone is available because of its high cost.

The best folk ways

One of the most effective folk methods at home is the potato treatment of hemorrhoids. The method is based on several properties of raw tubers and juice. Starch, due to enveloping action, reduces itching, pain and irritation of the anal area. Vitamin C strengthens blood vessels.

The easiest way to use potatoes with hemorrhoid is the manufacture of rectal candles.

Cut them from a raw tuber with a diameter near a centimeter and a length of three to eight centimeters.
Ideally, candles, pre-lubricated with vegetable oil or vaseline, are introduced into the rear pass overnight. In the morning after defecation, it is necessary to get a cool water.

Treatment should last 10 days. No less effective microclides in potato juice (30 ml per night).

Konsky and ordinary chestnut, oak bark, daisy flowers, nettle leaves - all these are components of various braveraging, infusions and fees. They effectively reduce bleeding, improve the overall condition of blood vessels, struggle with inflammation, itching and pain.

People's methods of treating hemorrhoids are a lot. It is important to remember that phytotherapy sometimes requires long use. In addition, it does not give a positive effect in the launched forms of the disease.

Symptoms and signs

It is customary to allocate four stages of chronic hemorrhoids. Separate the disease in the acute phase, with complications or without them. The manifestations of the disease are determined by its stage.

The initial stages are amenable to drug treatment, launched forms are only operational way.

At the first stage of the disease, blood strokes are characterized on hiding masses or toilet paper. As a rule, the discharge of scarlet and is small in quantity. After defecation, it is often a feeling that the intestine is still full. Also felt burning, itching in the anal area.

In the absence of therapy, new symptoms are added to the listed symptoms. If hemorrhoidal nodes fall out from the rectum during emptying, and then retracted back, hemorrhoid reached its second stage.

At the third stage, the nodes are no longer refilled by themselves. They have to be trapped manually. In addition, the loss of hemorrhoidal nodes occurs not only during defecation, but after any tension.

At the fourth stage of chronic hemorrhoid, the loss of nodes can occur at any time, even without much muscle tension (for example, when walking). Their right is almost impossible. Anal bleeding can achieve such an intensity that provoke anemia (anemia). At the same time, various complications are developing, usually inflammatory character.

Acute hemorrhoids manifests itself with pain in the field of anus. Internal hemorrhoidal nodes fall out and infringe upon, and the outdoor is inflamed.

Causes of development

Lifelong lifestyle One of the main sources of disease development

Why is hemorrhoids developing? Problems of blood circulation arise in two main reasons. Due to a sedentary lifestyle or, on the contrary, due to excessive physical exertion.

All sorts of diseases of the small pelvis organs often provide stagnation of blood, and then carries out hemorrhoids. Permanent constipation or diarrhea is another frequent reason. Also in the disease is a love of alcohol and acute food.

In the latter case, we are not only about constant impairment of blood flow, but also about irritation and damage to the mucous membranes of the intestinal tract. A similar adverse effect occurs as a result of anal sex.

Pregnancy and childbirth provoke the development of the disease

Two more extensive risk groups are pregnant women and. The bakingbind of the child generates a serious overload of the circulatory system, and the sweeps are comparable with severe physical exertion. People aged are often incapable of an active lifestyle or neglect them. In addition, the elderly tend to consider hemorrhoids with something natural for their years. As a result, the disease has time to develop and give a number of complications.

Sometimes hemorrhoidal disease is diagnosed even in young children. In the rarest cases, this is a congenital pathology. In the rest, the consequence of constipation, improperly teaching to the pot, permanent and long crying.

Hemorrhoids does not give fatal outcome, but it is able to seriously worsen the general state of a person. Minor discomfort once turned into a mass of inconvenience, pain and various complications.

However, the ailments at an early stage quite quickly "surrender" thanks to quite simple prevention at home.

Here are key measures that will not give diseases to develop:

• it is necessary to eliminate or maximize dishes and drinks (especially alcohol) that irritate the gastrointestinal tract;
• in constipation and diarrhea need to be traced which products cause such an unfavorable reaction, and abandon them;
• in sedentary and standing work need breaks. Change of body position, at least a short walking, if possible, elementary exercise;
• lovers sit in the position of "foot leg" it is desirable to learn from this habit to not worsen blood circulation;
• after defecation, it is recommended to fed an anal area with cool water to improve blood flow.

Timely prevention and on time, hemorrhoids began to develop and take serious and complicated forms.

It is important to understand that the launched form of the disease is seriously treating and without surgical removal in such cases can not do. The correct lifestyle and compliance with general recommendations will reduce the development of a proctological pathology to a minimum.

Important materials