In coloproctological practice, haemorrhoids are one of the most common diseases. Pathology can occur in both men and women. For every 1 thousand adult population, there are at least 100 patients suffering from discomfort, itching and burning in the anus. Currently, there are effective drug and minimally invasive treatment methods.
Causes of haemorrhoids
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Enlargement of haemorrhoids is a common reason for a patient to seek medical help at the clinic. When collecting anamnesis, the doctor focuses on the presence of risk factors, including:
- overweight;
- sedentary lifestyle;
- smoking and drinking alcohol;
- sedentary work;
- lifting weights;
- excessive consumption of foods that irritate the mucous membrane of the stomach and intestines;
- presence of diseases that are accompanied by chronic constipation or diarrhea;
- vascular pathologies, venous outflow is impaired.
Under the influence of the above reasons, haemorrhoids increase in size over time, becoming dense and voluminous. In the chronic course of the disease, they may fall out of the anus. That is why treatment of haemorrhoids is aimed not only at eliminating the consequences, but also at combating the cause of the development of the pathology.
Main symptoms
The clinic distinguishes between external and internal haemorrhoids. In the first case, enlarged haemorrhoids can be found in the area of the anus; they are located outside. With internal haemorrhoids, they are located in the rectal canal. There is also a combined version, in which dilated corpora cavernosa are found both outside and in the final part of the digestive tract.
Internal haemorrhoids are characterized by the appearance of the following clinical signs:
- discomfort in the anal area;
- itching and burning around the anus;
- pain during defecation, when coughing;
- drops of blood on toilet paper;
- a stream of blood at the time of defecation.
In addition, upon examination and palpation, enlarged lump-shaped haemorrhoids are determined. In the later stages of the disease, complications arise: haemorrhoidal bleeding, thrombosis, irreducibility and strangulation of prolapsed nodes. If they are present, emergency medical care is required, as the patient’s condition sharply worsens.
For treatment, the doctor must determine the stage of the disease. The following stages are distinguished:
- enlarged nodes, an admixture of scarlet blood in the stool;
- prolapse of haemorrhoids and their self-reduction;
- loss of nodes, which requires manual assistance by the patient;
- prolapse of nodes without their further reduction with a high risk of entrapment of the loops.
In the acute course of the disease, thrombosis is observed, which can be complicated by the transition of inflammation to surrounding tissues and subcutaneous tissue. In this case, an inflammatory syndrome with a sharp increase in temperature and chills is often associated.
Diagnostics
If the first signs of the disease appear, you should immediately seek medical help from a specialist. Diagnosis and treatment of haemorrhoids is carried out by a coloproctologist. In most cases, making a correct diagnosis does not cause any difficulties for a specialist.
To do this, the coloproctologist must collect an anamnesis. After the conversation, the patient is examined, and additional instrumental studies are often required. Among them are anoscopy, sigmoidoscopy, colonoscopy and irrigoscopy.
During the examination, the specialist pays attention to the condition of the skin around the anus and assesses the condition of prolapsed internal haemorrhoids. The doctor must conduct a digital examination and also check the anal reflex.
Treatment
The coloproctologist prescribes treatment in accordance with the individual characteristics of the patient (course of the disease, presence of concomitant pathologies). In practice, there is conservative therapy for haemorrhoids with the active use of medications and surgical methods.
In this case, the patient undergoes treatment both on an outpatient basis and in a hospital. In acute cases of the disease with node thrombosis and massive bleeding, hospitalization is required. In case of complications associated with chronic haemorrhoids, it is also recommended to undergo treatment under the close supervision of doctors.
It is necessary to follow a diet to restore the microflora of the gastrointestinal tract. Add foods high in fiber to your diet and take medications to prevent constipation.
Conservative
In the initial stages of the disease, it is possible to use medications. Among them, the following groups of drugs are distinguished:
- analgesics for pain relief;
- anticoagulants for the formation of thrombosis;
- non-steroidal anti-inflammatory drugs (NSAIDs);
- hemostatics for massive bleeding.
The duration and frequency of taking medications are determined by the doctor if indicated. The main advantage is the relief of symptoms, prevention of complications and progression of the disease. The disadvantage is low efficiency due to the individual characteristics of the patient.
Drugs for the treatment of haemorrhoids
Modern pharmacological drugs for the treatment of haemorrhoids help relieve disturbing symptoms. Among them are:
- procto-glivenol (improves vascular tone, has an anesthetic effect);
- detralex (venotonic and angioprotector);
- suppositories with sea buckthorn (stimulates healing);
- dicloberl suppositories (have anti-inflammatory and analgesic effects).
The listed drugs are effective only in the initial stages of the disease; they give short-term results. For complex treatment of haemorrhoids, coloproctologists recommend minimally invasive operations.
Surgical
Sclerotherapy, photocoagulation, ligation and other methods are used to treat haemorrhoids. Laser vaporization is considered a highly effective and safe method. In this case, a thin beam hits the damaged vessel. The liquid inside evaporates. As a result, a small dense scar remains, which prevents the node from re-enlarging.
Our clinic also performs the following operations for the treatment of haemorrhoids:
- HAL-RAR disarterization, which is performed under ultrasound control;
- laser thrombectomy;
- minimally invasive Longo surgery;
- transanal Doppler-controlled disarterization;
- haemorrhoidectomy according to Milligan-Morgan using the Liga Sure device.
For postoperative pain relief, our clinic uses spinal-epidural anesthesia with the installation of an epidural block. It relieves pain; the installed catheter ensures prolongation of the effect.
In addition, our specialists diagnose and treat other diseases: anal fissure, pararectal fistulas, epithelial coccygeal ducts, presacral cyst. The operation takes place under the careful supervision of doctors, the patient does not feel pain. Thanks to the extensive experience of practicing surgeons, complications in the postoperative period are rare.