Hemorrhoids - causes, symptoms, complications, treatment and prevention.

Diseases of the colon and rectum have recently become increasingly widespread. There are many reasons for this - a sedentary, sedentary lifestyle, the dietary habits of modern people, the influence of environmental changes.

Many patients, out of false modesty, hide their illness, hesitate to see a doctor for a long time and continue to suffer from various unpleasant sensations in the anus and rectum; Naturally, this cannot but affect the state of their nervous system and ability to work. Meanwhile, proctology has recently received extremely wide development. According to V.D. Fedorov and co-authors, diseases of the rectum and colon occur on average in 306 out of 1000 examined. Precancerous diseases of the colon account for 37.3%, cancerous diseases - 2.6% (out of 1 million proctological patients).

Hemorrhoids are one of the most common diseases; they occur in 100–120 people per thousand adults. Previously, it was generally believed that its cause was varicose veins of the distal rectum. Modern theories interpret this disease as a pathology of the arteriovenous corpora cavernosa with hyperplasia and various clinical manifestations, such as bleeding, prolapse of internal nodes, thrombosis, necrosis, inflammation, maceration, itching, etc.

In the submucosal layer of the rectum, there are normally cavernous vascular structures from which hemorrhoids can form (cavernous bodies are located in the distal part of the rectum). Hemorrhoids are caused by a violation of the outflow of blood from the cavernous bodies, which leads to their overflow and increase in size. There is no single producing cause, but rather a combination of several factors, such as congenital insufficiency of connective tissue and disruption of nervous regulation, increased pressure due to constipation and prolonged work in a sitting or standing position. Among the causes of hemorrhoids, consumption of alcohol and spicy foods is also important, which increases blood flow to the rectal area. Long-term exposure to unfavorable factors in combination with the body's predisposition leads to the transformation of cavernous bodies into hemorrhoids.

The hemorrhoid clinic is varied. Two main syndromes can be distinguished - acute attack of the disease and chronic hemorrhoids. These are two stages of the disease.

A typical symptom complex of the chronic course of the disease consists of pain in the anus that occurs during and after defecation, small intermittent bleeding, usually also associated with defecation, and prolapse of internal hemorrhoids; Quite often, all these signs are combined with anal itching, a burning sensation, weeping, and rawness in the anus.

In the early stages of the disease, patients complain of discomfort in the anus (compared to the sensation of a foreign body), especially with dietary disorders, constipation and diarrhea. Bleeding occurs during the act of defecation or immediately after it, less often the blood flows in a trickle. Pain with hemorrhoids does not always occur, but only when the node becomes inflamed or pinched. As the disease progresses, hemorrhoids begin to fall out of the rectum. And if in the early stages of hemorrhoids the nodes fall out only during bowel movements and are reduced on their own, then later protrusion occurs even at rest without returning to their original position. It is important to remember that during the period of remission the patient may not have any complaints, while drinking alcohol or eating incorrectly can provoke an exacerbation of hemorrhoids with a typical clinical picture.

In the modern classification, there are four stages of hemorrhoids:

– the first stage is characterized by bleeding and discomfort. During anoscopy, hemorrhoids are visible, but they are not prolapsed;

– in the second stage, itching also occurs. There is a prolapse of hemorrhoids from the anal canal when straining, but they are reduced on their own;

– at the third stage, the nodes fall out and require manual reduction, but after manual reduction they are retained in the anal canal; clothing is soiled;

– in the fourth stage, pain also occurs. Prolapsed irreducible hemorrhoids are noted.

The most common complications of hemorrhoids are bleeding, strangulation of the hemorrhoid and its thrombosis (the severity of acute thrombosis is distinguished I, II, III), itching, loss of the ability to control the release of feces, swelling of the anus.

In the early stages of the disease, conservative treatment is possible. With this patientYou must follow a certain diet and avoid constipation. With the development of new technologies, minimally invasive treatment methods are widely used. With timely treatment of patients, they allow outpatient and inpatient treatment of up to 80% of patients with hemorrhoids. These methods include infrared photocoagulation of nodes, sclerotherapy, ligation with latex rings, electrocoagulation, which are used in the initial stages of hemorrhoids. Alas, the frequency of recurrence of hemorrhoids and complications after such manipulation is much higher than with surgical treatment. The operation is performed under anesthesia and consists of removing hemorrhoids.

Among minimally invasive methods for removing hemorrhoids, the most common is laser coagulation. As a result of temperature exposure, their destruction or transformation occurs. Anesthesia can be local or spinal. Depending on the size and location of hemorrhoids, both external laser cutting and exposure to high-temperature radiation on the internal part of the cavernous formations are used. The last option is less painful and gentle. Powerful laser radiation evaporates the liquid from the tissue and degenerates into connective tissue with a decrease in volume. The duration of the procedure is about 10-25 minutes. The recovery period very much depends on the degree of intervention, as well as on the individual characteristics of the patient’s body. It can range from 5 to 20 days before returning to full life and ability to work.

Compared to traditional hemorrhoidectomy, laser surgery has the following advantages:

Reducing the duration of surgery;

· significant reduction in blood loss during the operation and the morbidity of the incision;

· reduction of pain and swelling of soft tissues in the postoperative period;

· significant reduction in the period of epithelization of the surgical wound;

· reduction in the number of postoperative complications and relapses of the disease;

· reducing the period of patients' incapacity for work;

· the operation can be performed even in the presence of pararectal fistulas, inflammatory processes, and anal fissures.

The VITAMED MEDICAL clinic provides a unique opportunity to perform laser coagulation and vaporization of hemorrhoids, ligation of hemorrhoids with latex rings. In the postoperative period, the patient is under the supervision of qualified medical personnel in a comfortable inpatient environment.

To prevent hemorrhoids, it is recommended to avoid dietary errors and limit alcohol consumption. When sitting for a long time, you need to take breaks for walks. Using laxatives will help prevent constipation. By eliminating the causes of hemorrhoids in this way, you will significantly reduce the risk of the disease.

I would like to note once again that there is no need to be ashamed of your ailments and consult a doctor in a timely manner.

With respect and wishes of good health, proctologist of the highest category, candidate of medical sciences, Khodzhimukhamedova Nigora Abdukamalovna.