Hemorrhoids: educational program for current and potential patients

How to get rid of hemorrhoids?

Vadim Kirillov, a doctor. Magazine "60 years is not an age"
Published in the online magazine "Third Age"Every year people suffering from hemorrhoids,http://vechnayamolodost.ru/pages/vashezdorovye/zachevamjetogemfa.html it's getting bigger.

It is especially common in middle and old age. How does modern medicine treat this disease, what are the preventive measures? You will learn about this from the article.

How does hemorrhoids develop?In the lower part of the rectum (anal canal) there are vascular formations – hemorrhoids.

In a healthy person, they are not enlarged. However, when exposed to adverse factors, such as a sedentary lifestyle, prolonged constipation, heavy physical work associated with lifting weights, the use of spicy and spicy food, diseases of the pelvic organs and others, blood stagnation occurs in the nodes, and they increase. This is hemorrhoids, the most common proctological disease. It is manifested by pain and bleeding from the rectum.

In most cases, this disease begins unnoticed. Its course is rather "unhurried" – the transition from one stage to another can take months or even years. Modern medicine distinguishes four main stages of hemorrhoids.

• Stage one – internal hemorrhoids. At this stage of the disease, the symptoms are minimal, and sometimes the disease can occur without external manifestations at all. Usually, if something bothers the patient, it is most often itching near the anus or unpleasant sensations during defecation. Quite often, the first stage of hemorrhoids is recognized completely by accident when contacting the hospital for another reason. It is almost impossible to diagnose the disease independently at this stage. This can only be done by a doctor. Treatment of the first stage of hemorrhoids usually proceeds successfully with the use of conservative therapy or methods such as photocoagulation or sclerotherapy.
• The second stage. The manifestations of the disease are more pronounced: itching or burning in the anus appears, there is a clear connection of pain with defecation and quite frequent bleeding, which almost does not happen at the first stage. It is worth noting a rather important symptom – the loss of hemorrhoids during defecation, then they are retracted independently. With such symptoms, it is necessary to consult a doctor in a timely manner. He may prescribe conservative therapy, ligation, sclerotherapy or combination treatment.
• The third stage is external hemorrhoids. It is characterized by the loss of hemorrhoids even without defecation, for example, when lifting weights or other physical exertion. Unlike the second stage, the nodes do not retract on their own: they need to be adjusted by hand. Expanded nodes are quite easily identified by touch and visually during inspection. Treatment of the second stage of the disease already presents some difficulties, so preference is given to surgical methods. At this stage, node resection, ligation or complex therapy using both conservative and operative methods can be used. It is important to remember that at the third stage of the disease, self-correction of nodes can lead to complications, so contacting a doctor is mandatory!
• The fourth stage is acute hemorrhoids. This stage is an exacerbation of a process that had been going on chronically before. Its important difference lies in the fact that the nodes are not set at all, and if they can be set, they almost immediately fall out again. At the fourth stage, the disease can be complicated by thrombosis, so first of all surgical or combined treatment is used. Self-medication at this stage is categorically contraindicated!

Getting rid of knots without a scalpelAll methods of treatment of hemorrhoids can be divided into conservative and operative.

Let's first consider minimally invasive methods, which, being essentially surgical manipulations, make it possible to remove hemorrhoids with minimal traumatization, practically without depriving the patient of working capacity. Surgical removal of nodes today is resorted to only at the third and fourth stages of the process, when other methods are ineffective, and with thrombosis of hemorrhoids.

• Photocoagulation. The method is operative, although a scalpel is not used in this operation. Hemorrhoids are affected by a focused beam of thermal (infrared) radiation, which stops bleeding. Photocoagulation is used mainly in the early stages of the disease or as part of complex therapy in the third and fourth stages.
• Sclerotherapy. This method is used at all stages of the disease, except the fourth. It is similar to the treatment of varicose veins on the legs: a special substance, sclerosant, is injected into hemorrhoidally dilated veins, which contributes to their "gluing" and, as a consequence, stopping bleeding. Acute hemorrhoids are a contraindication to sclerotherapy.
• Latex ligation. Its essence is that during the procedure, the hemorrhoid node is "squeezed", and after 12-14 days it is simply rejected. Currently, latex rings are used for ligation of nodes, which are completely inert against body tissues. This method can be used in the second and third stages of the disease.
• Suture ligation. Despite the similar names, this method has little in common with the above. Suture ligation is the stitching of arteries that provide blood flow to hemorrhoids with a special arthroscope under ultrasound control. It is used in the second and third stages of the disease.
• Mucosal resection by the Longo method. During this operation, parts of the rectal mucosa above the hemorrhoid node are removed, followed by suturing of the resulting defect. As a result, the node seems to be "pulled up", and its blood supply is sharply reduced. The Longo method is used mainly in the third stage of hemorrhoids.
• Hemorrhoidectomy. This method is the modern gold standard in the treatment of acute hemorrhoids. The essence of the manipulation consists in surgical removal of the hemorrhoidal node and suturing of the defect of the rectal mucosa formed after this. Hemorrhoidectomy is used at the fourth stage of the disease. It has strict indications and contraindications, so the decision to perform the operation should be made only by a highly qualified doctor.

Candles against hemorrhoidsConservative methods of treating hemorrhoids currently rely on the "three whales" – analgesic, anti-inflammatory and thrombolytic (preventing thrombosis) effect.

Previously, drugs for the treatment of hemorrhoids included one or two components and therefore were not effective enough. Modern medicines have all of the above properties, so they give a fairly good result in the treatment of the initial stages of hemorrhoids or as part of combination therapy. For internal hemorrhoids, candles are used, for external hemorrhoids - ointments.

The peculiarity of modern rectal candles against hemorrhoids is that they contain three main active ingredients:

• heparin, which prevents the formation of blood clots (this is one of the main complications of hemorrhoids);
• lidocaine, which has a local analgesic effect;
• prednisone, which relieves such manifestations as itching and burning, due to its pronounced antiallergic effect.

The complex action of these components allows the use of drugs based on them not only in the treatment of hemorrhoids, but also in diseases such as fistulas in the anal area, eczema (which may manifest as itching in the perianal area), as well as as part of combination therapy in the pre- and postoperative periods. Of course, like any medicine, they have contraindications and side effects, so before using them, it is necessary to consult with your doctor.

The conservative methods of treatment include hirudotherapy. The enzyme hirudin, contained in the saliva of medical leeches, dilutes blood, dissolves blood clots and prevents their formation. Hirudotherapy is usually used in combination with other methods.

Sedentary baths In case of exacerbation of external hemorrhoids, sedentary baths with a warm solution of potassium permanganate (potassium permanganate) of pale pink color help.

They are taken 3 times a day. The baths have a soothing and bactericidal effect. In addition to the solution of potassium permanganate, baths are made with decoctions of medicinal herbs (nettle, peppercorn, clover, horse chestnut bark) or with a ready-made anti-hemorrhoidal collection. The temperature of the water in the bath is 33-35 ° C. A sedentary bath is taken no more than 15-20 minutes. Part of the infusion can be frozen – you will get a phytoleed, which is applied to the anus. With internal hemorrhoids, baths are not effective.

Herbal preparations can be used for baths.

1. Oak bark (5 parts), horsetail grass (3 parts), field steelworm root (2 parts). Pour two tablespoons of the mixture with 0.5 liters of boiling water, boil for 5 minutes.
2. Oak bark (5 parts), horse chestnut seeds, chamomile flowers, medicinal sage grass (all 3 parts). Pour four tablespoons of the collection with 3 cups of boiling water, insist in a thermos for 2 hours, strain and dilute with boiled water to 2 liters. Take for 15 minutes with external hemorrhoids and loss of nodes.

Strengthen the musclesTherapeutic gymnastics strengthens the abdominal muscles, buttocks and perineum, normalizes blood flow in the rectum.

Here is an approximate set of exercises, each exercise of which must be repeated 10 times.

1. Walk around the room, raising your knees high and crossing your legs (putting one leg in front of the other). At the same time, rhythmically strain the muscles of the anus and buttocks. Exercise improves blood circulation.

2. Lying on your back:

• lift the straightened legs by 45°, spread them apart and bring them together, crossing (exercise "scissors");
• bend your knees and place them shoulder-width apart, feet on the floor, arms extended along the trunk. Leaning on the feet and shoulders, lift the pelvis;
• in the same position, slowly squeeze the buttocks and pull in the rectum, counting to 5, then also slowly, counting to 5, relax;
• simulate cycling;
• alternately raise straight legs;
• bend your knees, press them tightly to your stomach and screw into the starting position;
• put your hands behind your head, bend your knees, at the same time slowly spread your knees apart and connect the soles (exercise "frog").

3. Lying on your stomach: focusing on your knees, elbows and palms, alternately turn the pelvis to the sides so that the buttocks touch the floor.

4. Sitting on a hard chair: straighten your back, tilt your body forward, squeezing the muscles of the anus.

Now you know about modern medical methods of treating hemorrhoids. They make the patient's condition easier. But you can and should help yourself. The use of baths, candles and other means at home, the performance of special gymnastics will help to significantly improve well-being and avoid exacerbation of the disease.

Portal "Eternal youth" http://vechnayamolodost.ru02.12.2013