Patient stories after haemorrhoid treatment

Haemorrhoidal disease is a symptomatic enlargement or displacement of the vascular cushions of the anal canal. Calling it only “varicose veins” is inaccurate: supporting tissues are also important. The disease occurs in people of any gender. Estimates of its prevalence vary widely depending on the criteria and method of study; a specific range cannot be attributed to WHO without a verifiable primary source. Read more on the topic: men · women.

The pathology is accompanied by enlargement, prolapse, inflammation and strangulation of haemorrhoids, bleeding, discomfort, itching and pain. Failure to seek medical help in a timely manner leads to the formation of rectal fistulas, paraproctitis, and anemia.

Causes of haemorrhoids

Risk factors for the disease:

• Increased abdominal pressure. Observed during pregnancy and childbirth, with prolonged and frequent constipation, excessive physical activity, professional sports (weightlifting, horse riding).
• Abuse of alcoholic beverages, spicy and fried foods, smoking tobacco.
• Hypodynamia (inactivity), sedentary work (occupational risk for drivers, programmers, teachers, accountants). Promotes stagnation of blood in the pelvic organs.
• Prolonged exposure to high temperatures. Visiting baths and saunas, swimming in a hot bath.
• Increased body weight, stressful situations.
• Inflammatory and infectious processes in the rectum, liver.
• Anal fissures.

The provoking factor is a violation of blood circulation in the vessels of the venous plexus, leading to dystrophic changes in the connective and muscle tissue that holds the nodes in the lumen of the organ.

Classification of haemorrhoids

In clinical practice, the following types of disease are distinguished:

• Osty. Thrombosis of haemorrhoids, accompanied by severe pain, increased body temperature, and a feeling of a foreign body in the rectum. Without treatment, it leads to tissue necrosis.
• Chronic. Inflammation of nodes. The patient notes mild pain, itching and discomfort in the anal area. The time for symptoms to develop is months to years.
• External. Enlargement of haemorrhoids located near the anus. Symptoms: intense pain, discomfort, itching. Thrombosis of nodes requires urgent surgical intervention.
• Internal. Varicose dilation of haemorrhoidal vessels located deep in the anal canal. Diagnosis is based on digital examination of the rectum, anoscopy, and sigmoidoscopy. There are periodic bleedings, prolapse and pinching of nodes during straining or defecation.

Doctors often encounter a combination of enlarged internal and external haemorrhoids.

Symptoms

Pathological changes develop gradually. The patient notes slight discomfort and pain in the anus and rectum, and a tendency to constipation. Symptoms of the disease intensify after eating spicy and fried foods, alcohol abuse, and intense physical activity.

As dystrophic changes in the surrounding tissues increase, the clinical picture is supplemented by prolapse and strangulation of haemorrhoids, periodic bleeding from the rectum. The color of the blood is scarlet, traces are found on stool or toilet paper. Chronic recurrent bleeding leads to anemia (decrease in hemoglobin and red blood cells), accompanied by general weakness, loss of physical strength, pallor of the skin and mucous membranes, and striations of the nail plates.

In the initial stage of the disease, the nodes fall out after an excessive increase in intra-abdominal pressure, provoked by heavy lifting and strong straining during bowel movements. They can be easily adjusted independently or by the patient’s hand. The progression of pathological changes leads to worsening symptoms: nodes fall out when coughing or sneezing. They cannot be corrected on their own; qualified medical assistance is required.

In the final stages, thrombosis of formations occurs, accompanied by intense pain, intoxication and fever. Without adequate treatment, it leads to necrosis of nodes and surrounding tissues, paraproctitis.

In men, the disease develops against the background of excessive physical exertion and sedentary work (taxi drivers, truck drivers, IT sector). The clinical picture is dominated by symptoms of thrombosis of haemorrhoids: severe pain, intoxication, fever. A general blood test reveals anemia mediated by chronic bleeding. This is due to late men seeking medical help.

In women, pathology often develops during pregnancy and prolonged labor, accompanied by a significant increase in intra-abdominal pressure. Symptoms consist of discomfort and pain in the rectal area, periodic bleeding. In women, the disease is detected at stages I-II, which is associated with early referral and attentive attitude to health.

Diagnostics of haemorrhoids

The diagnosis is made by the attending physician based on:

• Collecting a medical history and patient complaints, identifying risk factors.
• Visual inspection.
• Digital examination of the rectum.
• Anoscopy, sigmoidoscopy, irrigoscopy, colonoscopy.
• Fecal occult blood test.
• Coprograms (examination of stool for foreign inclusions, remnants of undigested food).

Additional diagnostic measures:

• General blood test. Determination of the level of red blood cells, hemoglobin, platelets. Detection of anemia, disorders of primary hemostasis.
• Coagulogram. APTT, PT, INR, fibrinogen. Diagnosis of coagulopathies (secondary disorders of hemostasis), bleeding caused by the prescription of medications (warfarin, heparin, LMWH).
• Biochemical blood test. Determination of the level of iron, total protein and albumin, bilirubin, urea and creatinine, electrolytes. Identification of the cause of anemia, systemic complications of the disease.
• Ultrasound of the abdominal organs. Determine the size and structure of the liver and spleen, blood vessels, and portal vein. Diagnosis of portal hypertension, complicated by varicose veins of the rectum.

The scope of research is determined by the attending physician after the initial consultation.

Treatment of haemorrhoids

Patient management tactics – conservative or surgical.

Drug treatment

Justified at stages I-II of the disease:

• Diet. Limit spicy and fried foods. Consumption of foods rich in animal and plant proteins, fiber, vitamins, macro- and microelements. Sufficient drinking regimen – up to 2 liters of fluid per day.
• Quit smoking and drinking alcohol.
• Normalization of stool. For constipation, laxatives are prescribed, for diarrhea, drugs that calm peristalsis are prescribed.
• Local treatment. Suppositories and products with anti-inflammatory, analgesic, strengthening, hemostatic effects, venotonics.

Conservative therapy is aimed at alleviating and relieving symptoms. Medicines are prescribed by the attending physician.

Surgical treatment

Preference is given to minimally invasive procedures:

• Sclerotherapy. Introduction of sclerosing solutions into the haemorrhoid, which leads to cessation of blood flow in the formation.
• Infrared coagulation. Local increase in temperature in the area of ​​the pathological process. The node thromboses, “dies” and is rejected.
• Laser removal. Radical destruction (destruction) of varicose veins with a surgical laser. The technique is characterized by rapid wound healing, restoration of adjacent tissues, minimal trauma, low risk of postoperative complications, and a short rehabilitation period. Combination with sclerotherapy is possible.
• Ligation. Latex rings are used to compress the vessels, stopping the blood flow in the node. It “dies off” and disappears.

Volume surgical interventions are prescribed in the last stages of the disease – III-IV.

Rehabilitation period

The recovery time depends on the severity and extent of pathological changes, surgical technique, and surgeon qualifications. Returning to a full life takes 3-5 weeks.

Recommendations:

• Activity after surgery will be agreed upon with the surgeon. Safe early mobilization is usually sought; Long-term bed rest is prescribed only for specific indications. The load is increased gradually, taking into account your state of health and the type of intervention.
• Postoperative nutrition is selected taking into account the type of surgery and tolerance. There is no universal prohibition on the first day due to the risk of suture disruption. Adequate nutrition, soft regular stools, and a suitable amount of fluids are important; for heart or kidney diseases, the drinking regimen is agreed upon separately. Foods that increase individual discomfort and alcohol are discussed with the doctor.
• Maintain personal hygiene after using the toilet.
• Physical activity is prohibited. Walking, yoga, therapeutic exercises are recommended.
• After surgery, defecation is painful. Local cold exposure (ice packs) relieves symptoms.
• Normalization of stool. It is allowed to take laxatives.
• Limit sexual activity to 3 weeks.

The attending physician will tell you in detail about the rehabilitation period before discharge.