Do they give sick leave for hemorrhoids and for how long? 5 features

Diet for exacerbation of hemorrhoids

Exacerbation of hemorrhoids with adequate treatment usually goes away within a week.
In case of acute hemorrhoids, it is necessary not only to fully comply with the doctor’s instructions for drug treatment, but also to adhere to a strict diet. The diet during an exacerbation is aimed at regulating intestinal function. The diet should not contain smoked meats, mayonnaise, canned food, sugar, or baked goods made from premium flour. You should include seaweed, coarse cereals, bran, dried fruits, fruits and vegetables rich in fiber in your food. You can also eat lean meat, nuts, and pomegranates. It is better to replace tea or coffee with herbal drinks. Relief from hemorrhoids during an exacerbation period will benefit from dishes such as chicken broth, slimy rice porridge, chopped boiled meat, and protein omelet. In addition, drinking plenty of water will help you cope with the inflammatory process faster.

During periods of exacerbation, it is not recommended to use:

hot and spicy seasonings;
coffee, tea, alcohol;
fatty, pickled, fried foods;
canned food;
smoked meats;
Sahara;
mayonnaise;
products made from premium flour.

The diet must include:

seaweed;
fruits and vegetables with a lot of plant fiber;
dairy products.

It is recommended to drink enough fluids - about two liters of water per day. You need to eat often, in small portions.

gemors.ru

Hemorrhoids affect people from a variety of professions, but especially often those who spend most of their time in a sitting position or are exposed to great physical activity. It is these 2 types of seemingly opposite activities that contribute to the development of this disease and its aggravation.

It should be noted that conservative treatment of hemorrhoids is quite long, and it is quite difficult for patients to work and combine visits to the doctor and other therapeutic measures, so they often have a question: is sick leave given for hemorrhoids?

Sick leave for hemorrhoids is given because during an exacerbation a person can neither walk nor sit normally. The sick leave is issued by a proctologist. There are no exact lengths of stay on sick leave for hemorrhoids. The doctor, taking into account such factors as the course of the disease, the nature of the patient’s work and the speed of recovery, decides what period of rest to provide the patient, based on the severity of the disease.

If such a set of measures does not bring the desired result, then the patient may be recommended surgical treatment. In this case, the patient will be provided with sick leave for the entire period of stay in the hospital, also taking into account the time required for rehabilitation after discharge from the hospital.

The duration of sick leave after hemorrhoid removal largely depends on several factors:

selected type of operation;
degree of disease at the time of removal;
presence of complications after surgery;
the nature of the patient's work.

For example, after removal of chronic hemorrhoids of the 2nd degree, provided that the operation is gentle, there are no complications and the nature of the main activity does not provoke further development of the disease, the patient, if desired, will be able to return to work within 4 days after discharge. The patient who had a fourth-degree disease removed will return to his workplace no earlier than 4 weeks after hospitalization.

On average, the recovery period after hemorrhoidectomy, which took place without complications, ranges from 20 to 30 days. In this case, a certificate of temporary disability is issued by the hospital where inpatient treatment took place during the period of stay there, as well as by the clinic for the necessary period of rehabilitation after the patient is discharged from the hospital.

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Features of the disease

Will the diagnosis be made public?

Payment for sick leave

Do they give sick leave for hemorrhoids?

Stage 1

Stage 2

Stage 3

Stage 4

In what cases is a certificate of incapacity for work not issued?

How many days

Will the diagnosis be made public?

Cases of issuing a certificate of incapacity for work

Which specialist should I contact?

Hemorrhoids - what is it?

Causes of the disease

Stages of hemorrhoids

Do they give sick leave for hemorrhoids?

For how long is sick leave issued for conservative treatment?

For how long is sick leave issued after surgery?

With radical surgery

For minimally invasive surgery

Disability payment

Hemorrhoids are a disease that affects people of different ages and professions, but people who are most susceptible to it are those who spend the working day in a sedentary position or whose activities involve heavy physical exertion, which can subsequently cause aggravation.

Hemorrhoids occur in various forms: external, internal and combined. It should be remembered that external hemorrhoids are not an advanced stage of the internal form of the disease.

The cause of hemorrhoids in any form of the disease is primarily the congenital weakness of the venous walls. Some provoking factors contribute to the development and exacerbation of the disease, such as:

sedentary lifestyle;
unhealthy diet (abuse of fatty, fried, salty, spicy foods, low amount of plant fiber);
problems with stool – constipation or prolonged diarrhea;
bad habits (alcohol, smoking);
regular hard physical work;
strength sports;
pregnancy, childbirth.

Any of these factors can cause a rush of blood to the pelvic organs and congestion in this area, which leads to dilation of hemorrhoidal veins and the formation of nodes.

In the external form of hemorrhoids, nodes are formed due to protrusion of the walls of the subcutaneous vessels localized around the sphincter. The plexuses grouped near the anus can be of different shapes and sizes. During the period of remission they are painless. During an exacerbation, the hemorrhoidal plexuses become inflamed and increase in size, causing a feeling of discomfort, sharp pain and itching in the anal area. Minor bleeding may occur during bowel movements.

The internal form of hemorrhoids is characterized by the localization of hemorrhoids in the rectum. There are four stages of severity of hemorrhoidal disease, which are characterized by the size of the nodes and the severity of symptoms.

At the first stage, the nodes are small and do not cause the patient any discomfort.
The second stage is characterized by enlargement of the nodes and their bleeding. The nodes may fall out during bowel movements and then return to the rectum on their own.
At the third stage, hemorrhoids fall out during defecation or any heavy physical activity and cannot be reset on their own.
At the fourth stage, the nodes may fall out even with slight tension or constantly hang out of the anus. This is the most advanced stage of hemorrhoids. The patient has persistent severe pain. There may be heavy bleeding after bowel movements.

The internal form of hemorrhoids is very difficult to diagnose independently; during the period of remission, hemorrhoids can only be detected by instrumental methods or by digital examination. The only symptom that may give rise to suspicion of internal hemorrhoids is bleeding after bowel movements.

At the first stage of hemorrhoids, it is not necessary to take out a document of incapacity for work, if the work does not involve heavy physical labor, which can adversely affect the patient’s condition. In case of exacerbation of hemorrhoids, a sick leave certificate must be issued to the patient, however, he is recommended to be transferred to an easier job.

In the second and third stages of hemorrhoids, the patient requires long-term drug treatment and bed rest, therefore, after examination by a doctor, a sick leave certificate is issued, the period of which is usually 7 days.

Stage four usually requires surgery. After the operation, the patient must be given a sick leave certificate for the entire period spent in the hospital, and the time required for rehabilitation at home - at least 10 days.

Conditions for issuing sick leave

One of the main conditions for the treatment of hemorrhoids is a timely visit to the doctor. Factors contributing to the formation of hemorrhoids are minimized or eliminated completely. The proctologist has the right to issue a certificate of incapacity to the patient. First of all, the doctor assesses the patient’s condition. The stage and form of the disease matters. Vividly present symptoms contribute to making a decision about the impossibility of a person’s work activity. The situation is aggravated by the presence of concomitant diseases

The doctor takes into account the type of person’s work activity. For hemorrhoids, sick leave is given based on the stage of the disease

The patient is prescribed bed rest. Compliance with the recommendations and prescriptions of the attending physician. Diet and hygiene are shown. In the absence of a proctologist, the therapist can give sick leave for hemorrhoids.

After the specified time, the clinical symptoms weaken. If there is no effect, the person is transferred to an inpatient stay. The sick leave is extended. It includes the duration of actual presence in the hospital. The rehabilitation period may be included in the sick leave. If the patient’s activity involves heavy physical labor, the doctor may recommend changing his specialty or profession.

The disease in the first stage does not cause much discomfort to the patient. In its presence, rare bursts of pain can bother a person. In this case, the sick leave certificate is not opened.

The second and third stages are subject to long-term drug therapy. Visiting the doctor becomes regular. Additional medical procedures may be prescribed. Combining work and visiting a doctor is problematic, but the employer can accommodate the employee halfway. However, if the disease worsens, bed rest is prescribed. Severe pain can directly affect the performance of job duties. In this case, the proctologist can issue sick leave for up to seven days.

The fourth stage is the most difficult. External hemorrhoids constantly hurt and cause severe discomfort. The patient has difficulty with the simplest movements. Bed rest becomes a necessary component in the treatment of stage 4 hemorrhoids. People with the specified stage of development of the disease are hospitalized, and surgical intervention is prescribed.

Periods of incapacity for work

It is difficult to say how many days sick leave for hemorrhoids is issued. The duration of treatment is influenced by many factors. The decision on the timing of release from work is made by the doctor.

The length of time a person will be disabled depends on:

his condition;
forms, stages of hemorrhoids;
presence of complications;
the success of the selected treatment regimen;
human living conditions;
concomitant pathologies;
severity of symptoms;
the patient's work schedule.

For uncomplicated hemorrhoids, if therapy is started in a timely manner, a certificate of incapacity for work is issued to the person for 7-10 days. During this period, outpatient treatment is carried out. This time is quite enough to relieve acute symptoms and restore performance.

If there is no improvement within 7-10 days of therapy, then the patient is sent to the hospital. In the hospital, an examination is carried out and an operation is performed. Hospitalization and rehabilitation take about ten days.

The length of hospital stay depends on:

stages of hemorrhoids;
type of operation performed;
the success of the surgical intervention.

If the operation was performed by doping with latex rings, infrared photocoagulation, then the rehabilitation period will be short and will take no more than three days.

In advanced cases, hemorrhoidectomy is indicated. Recovery after such surgery lasts about a month.

Expert opinion

Irina Vasilyeva

Civil law expert

Sick leave for a period of more than 15 days for outpatient treatment is issued only on the basis of a decision of a special medical commission.

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Treatment and prevention

Getting rid of the problem begins with contacting a specialist. The doctor will conduct a thorough examination and then determine what kind of treatment is necessary in a particular case. As for how many days sick leave is given if hemorrhoids have reached a serious stage, this is, as a rule, the entire period of treatment.

If you contact a specialist in a timely manner, you can do without surgery. The doctor may prescribe conservative methods to get rid of inflammation and prolapse of nodes. Most often these are gels and ointments, which consist of antiseptic, analgesic and antispasmodic components.

A good way to restore the body with hemorrhoids are baths, but you need to be careful with them, since incorrect use of this method or excessively high temperature can only aggravate the situation.

In addition, drugs from the phlebotonic class will also be useful. These include Phlebodia and Detralex. Intestinal dysfunction can be removed with the help of Duphalac and Mucofalk.

All this will eliminate the symptoms of exacerbation of the disease, but then you will have to adhere to the right diet and lead a healthy lifestyle to prevent a relapse.

If the patient consults a doctor at an early stage of the disease, this disease should recede quickly with proper treatment. Already on the 3-4th day a person can go to work. But with severe progression of hemorrhoids, surgery may be necessary. It cannot be called difficult, but the period of sick leave in this state of affairs is always extended by at least a week.

Hemorrhoids are not only an unpleasant disease, but also often recurrent. Therefore, a person who has already encountered a similar problem or is at risk needs to more closely monitor their health and not forget about preventive measures:

have sufficient physical activity;
prevent blood stagnation in the pelvic area;
eat right to strengthen the walls of blood vessels and avoid constipation;
give up alcohol and nicotine, as they can also affect the formation of hemorrhoids.

When the first symptoms of the disease appear, you should not hesitate to consult a doctor and undergo examination with further treatment. For this entire period, you can take sick leave, which is necessarily issued in case of hemorrhoids.

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Duration of treatment

Hemorrhoids are a very serious disease that requires proper treatment and complete rest for the patient. Therefore, it is necessary to work and even walk less while getting rid of an acute illness.

Accordingly, a working person needs sick leave. It is issued without problems for the period until the problem is completely resolved.

The duration of treatment for hemorrhoids directly depends on the stage at which the necessary measures began. The sooner the patient begins to receive the correct treatment, the higher his chances that recovery will be complete and quick.

Hemorrhoids should not be allowed to become severely aggravated, otherwise numerous complications cannot be avoided, including bleeding, infection and even thrombosis. As a rule, an exacerbation with proper treatment goes away within a week. However, a person can be given sick leave for a longer period of time if there are compelling reasons for this.

Traditional methods that speed up recovery

Along with drug therapy, patients often use traditional methods, which are not contraindicated when used in combination with medications.
All this is due to the naturalness of the components used and their low cost. At the initial stage of hemorrhoids, you can make candles from potatoes yourself. Take one root vegetable and peel it. Candles of 1.5 - 2.5 cm in size and small diameter are cut out of it. The main rule is an absolutely smooth surface of the potato suppository, without the slightest notches.

Use rectally at night; it is recommended to cool the suppositories before use. This way they can also remove swelling from painful nodes. How long does it take to treat hemorrhoids at the initial stage with potato suppositories? The course of treatment is 7–10 days.

One of the popular folk methods is baked onions. You need to take a small onion, cut it in half and divide it into pieces. Place in a hot frying pan, cups up, and bake over low heat for 20 minutes.

How is sick leave paid?

In order for sick leave to be paid, according to the law, the patient must provide it to the employer within 6 months after closure.

According to the law, the employer must accrue sick leave benefits within ten days after it is provided and pay with the first advance or salary. But in most cases, the patient receives the money later.

The amount of the benefit depends on the patient's average daily salary over the past 24 months and professional experience. If the patient’s work experience is less than five years, then he will receive 60% of the average salary, if from five to eight years - 80%, and if more than eight years - 100%. Moreover, the employer pays benefits only for the first three days of sick leave, and then sick leave is paid for by the social insurance fund.

Disability payment

How is sick leave paid for hemorrhoids? The certificate of incapacity for work is presented to the personnel department of the organization in which the operated person works. Submission of sick leave occurs on the first working day after the sick leave is closed. Based on this document, it is reported that the person’s absence from work was not unauthorized, after which a decision is made to pay for sick leave.

There is no exact amount for sick leave; payment depends on the salary and length of service of the worker in this position. According to the Labor Code, there are payment amounts:

Sick leave payment

8 years of work experience at this enterprise - payment of 100 percent of the salary.
5-8 years of experience in this organization - 80 percent of the payment.
Up to 5 years of work in this organization - 60 percent of the salary.

If after the operation the worker decides to change jobs and quits his previous job, then sick leave is paid within 30 calendar days after submitting the sick leave. In this case, sick leave is paid in the amount of 60 percent of wages.

When a person was on vacation and had surgery to remove hemorrhoids, sick leave is paid by the employer only for 3 days, the rest of the amount is paid by the social insurance fund.

Sick leave for surgical treatment

Extension of the sheet is allowed for 10 days after discharge. Thus, a sick leave assumes that the patient is in a hospital setting, and is also given 10 days after discharge for outpatient rehabilitation.

But when issuing the form, you must take into account the severity of the illness; sometimes the period can be extended to a month. All these nuances are taken into account by the doctor upon discharge.

The sheet is issued by the proctologist after passing the required examinations.

If no improvement is observed, the restoration period is extended by a special commission. She can extend her sick leave for another 10 days. In this case, the patient with hemorrhoids is given a certificate stating that he needs to be examined and consult with the treating doctor every two weeks.

Payments are made for the entire duration of therapy in a medical institution, with an additional 10 days of outpatient stay.

The duration of the certificate of incapacity for work depends on the treatment of hemorrhoids in the hospital. The duration of treatment is affected by:

Type of surgery.
Clinical stage of the disease.
The presence of complications of the pathological process.
The nature of the patient’s work activity.

If the disease occurs with severe complications, the patient returns to work a month after the operation to remove hemorrhoids.

On average, sick leave after surgery to remove hemorrhoids is issued for a period of 20 to 30 days. Patients stay in the hospital for 10 to 14 days, then are transferred to outpatient treatment. The certificate of incapacity for work is opened by the medical institution where the patient is hospitalized. After discharge from the hospital, the patient goes to the outpatient facility. If necessary, sick leave is extended and a new one is opened. At a clinic appointment, doctors determine the patient’s rehabilitation period after removal of a hemorrhoid and open a certificate of incapacity for work.

Initial treatment involves conservative therapy. Anti-inflammatory ointments and gels are used, which contain analgesic and antispasmodic substances. Phlebotonics and drugs to improve intestinal function are also prescribed.

If conservative therapy does not lead to a successful result, or the disease is of the third degree of complication, surgical treatment is used. In this case, after localizing the inflammation, one of the following types of operations is performed:

Thrombectomy - the hemorrhoid is opened and the blood clot is removed.
Resection of external hemorrhoidal node. The cause of the disease is directly removed, which allows further relapses to be avoided.

How many days of sick leave is given after hemorrhoid surgery?

The duration of temporary disability after surgical treatment of hemorrhoids also depends on a number of factors, namely:

type of operation;
stage and severity of the disease;
presence of postoperative complications;
type of work activity of the patient.

Temporary disability after minimally invasive surgical interventions

Minimally invasive surgeries have a number of advantages, including:

speed of operation;
low-injury;
painlessness;
carried out on an outpatient basis;
short recovery period (up to three days);
low risk of complications.

Considering these advantages, we can say that recovery after minimally invasive surgical treatment is easy and quick. In most cases, sick leave is issued for only one day (the day of surgery), and the patient can start working the next day. Sometimes, if the patient’s work activity involves lifting weights or other types of heavy physical labor, a certificate of incapacity for work may be issued for 2-3 days.

Temporary disability after extensive surgery for hemorrhoids

Hemorrhoidectomy is a surgical procedure during which hemorrhoids and part of the rectal canal mucosa are removed. This operation is the only effective method for treating advanced forms of hemorrhoids.

This type of surgical treatment of hemorrhoids also has a serious drawback - a long and difficult recovery period, during which the patient is unable to work. Therefore, a sick leave certificate is issued for the entire period of the patient’s stay in the hospital, as well as for 15 days of outpatient treatment.

A certificate of incapacity for work for the period of inpatient treatment is issued by the hospital where the patient was operated on. The duration of inpatient treatment takes on average 7-10 days.

After discharge from the surgical department, the sick leave is extended by a proctologist, who will see the patient on an outpatient basis. At the end of this period, the patient undergoes a follow-up examination; if the recovery is successful, there are no complaints or complications, then the sick leave is closed and the patient must begin work the next day.

If after 15 days of outpatient treatment the patient has any complaints and complications that require correction have developed, then the medical advisory commission decides on extending the sick leave until the patient fully recovers - for a maximum of 10 months. But the patient must visit the treating doctor and a medical commission every 15 days for an examination, based on the results of which the sick leave will be extended or closed.

Thus, with a successful operation and with an uncomplicated postoperative period, sick leave is issued for the entire stay in the surgical department and 15 days of outpatient treatment. In case of a complex operation, difficult recovery or referral to sanatorium treatment, a certificate of incapacity for work is issued for a maximum of 24 days.

How to recognize an exacerbation of hemorrhoids

A person whose hemorrhoidal lump is inflamed will know about it immediately.

Main features:

severe pain, which sometimes makes it impossible to walk and sit normally, is the main sign of exacerbation of hemorrhoids;
bleeding may occur, which sometimes becomes very heavy;
sensation of a new growth in the anal area (bump);
this lump can be very painful, cause a burning sensation and itching;
Often the pain radiates to the groin or affects the perineum.

Sometimes the sensations become simply unbearable and impossible to endure. Therefore, it is necessary to use special emergency medicines.

Considering all the symptoms that are associated with an exacerbation of the disease, there should be no question as to whether sick leave is given for hemorrhoids. This even needs to be done in order to undergo full treatment and get rid of the problem before it becomes chronic.

Acute hemorrhoids severity

Hemorrhoids are divided into several stages of development, each of them characterized by its own clinical manifestations. At the first stage, no particular discomfort is felt, so sick leave will not be issued. The exception is professional activities that involve carrying heavy objects.

At the second stage of the disease, severe symptoms appear and bleeding may occur, so you should contact a medical specialist on the same day. After the examination, the doctor decides whether to issue a sick leave certificate.

The third and fourth degrees of the disease are advanced. For treatment, bed rest and the use of medications are mandatory. The document must be issued.

Formation of blood clots in hemorrhoids without an inflammatory process.

In this case, the external nodes located at the level of the dentate line are small in size, have a tight-elastic consistency and moderate pain. The patient complains of burning and itching, which intensifies after defecation. There is redness of the skin and moderate swelling around the sphincter. Discomfort increases when eating salty and spicy foods, alcohol, or sitting on a hard surface.

Thrombosis of nodes, complicated by inflammation.

The perianal area is compacted, hyperemic, edematous, and sharply painful. A strong spasm of the sphincter is clearly expressed. Severe pain occurs when sitting and walking. Patients try to delay bowel movements as much as possible. Diagnostic instrumental studies are difficult due to severe pain.

Thrombosis with inflammation of the subcutaneous tissue.

The inflammatory infiltrate occupies almost the entire circumference of the anus. Strangled hemorrhoids that have fallen out of the anal canal are dense, non-reducible, purple with a hint of cyanosis. If urgent measures are not taken, the external prolapsed nodes may become necrotic, which threatens the development of paraproctitis. Acute third degree hemorrhoids require immediate medical intervention.

Hemorrhoids are a dangerous and insidious disease associated with varicose veins of the rectum. In the early stages, the disease develops almost asymptomatically inside the rectum and rarely causes mild discomfort when visiting the toilet. Visible signs and tangible symptoms occur in the later stages of development, when hospital treatment or even surgery is required.

Experts distinguish four degrees of development of hemorrhoids:

First. It has no pronounced signs or symptoms. When visiting the toilet, mild itching and burning in the anal area are sometimes observed. The doctor prescribes the use of special suppositories and ointments. And also in following a diet and quitting smoking and drinking alcohol.
Second. It is characterized by the appearance of compactions (bumps) in the anus, which sometimes come out. However, these tumors are very easily set back. Pain and discomfort intensify, so you should immediately visit a specialist and undergo a comprehensive examination.
Third. Significantly enlarged nodes fall out with minor physical exertion. Severe pain during bowel movements is accompanied by bleeding. The patient is prescribed bed rest and conservative treatment (often in a hospital setting under the supervision of the attending physician.)
Fourth. The person suffers from severe pain, going to the toilet is accompanied by profuse bleeding. In this case, there is a danger of thrombosis and strangulation of the nodes that come out. In most cases, the use of medications does not bring results, and the doctor is forced to resort to surgery. In this case, the patient is entitled to sick leave for the entire period of rehabilitation (both in a hospital setting and at home).

This disease has 4 stages:

In the first stage, hemorrhoidal cones are located internally, they do not fall out. After defecation, a person experiences itching and burning, which occurs after spicy, salty foods, alcohol, or after sitting for a long time on a hard surface.
In the second stage, the cones fall out when emptied. And then they return to their place. Often a person delays bowel movements due to fear of pain.
At the third stage, it becomes possible to set the hemorrhoids back only with your hands. Evacuation is accompanied by bleeding and pain.
At the fourth stage, it becomes impossible to reduce hemorrhoids on your own. Health is in great danger; the mucous membrane becomes susceptible to infection. Treatment is possible only through surgery.

Proctologist Igor Domoratsky: “If you don’t get rid of bleeding hemorrhoids, they can...

Low-traumatic operations performed by surgeons today last no more than 20 minutes, and the patient can immediately go home

People say that hemorrhoids are a sore that is difficult to see for yourself and embarrassing to show to others. This is why patients tend to put off visiting a doctor.

But this ailment may be a sign of more serious pathologies... What studies should be carried out if hemorrhoids are suspected? Is it necessary to remove polyps that have arisen in the intestines? How often should the condition of the gastrointestinal tract be checked so as not to miss dangerous diseases? Proctologist Igor Domoratsky, deputy head of the military medical department of the Security Service of Ukraine, answered these and other questions from our readers during the FACTS direct line.

“Hemorrhoids also happen to young guys who do weightlifting, kettlebell lifting, and pump up their muscles on exercise machines.”

— Hello, Igor Eduardovich! Vladimir, a resident of the city of Lokhvitsa, Poltava region, is worried. Over the past few months, after going to the toilet, I sometimes have blood in my stool, and then it hurts to sit. What could be causing this?

— I advise you to be examined by a proctologist - a doctor who treats diseases of the large intestine, or a surgeon (in regional hospitals, as a rule, there are no proctologists). Burning, itching, pain, and bloody discharge from the intestines may indicate inflammation of the hemorrhoids. In general, the appearance of blood is a dangerous symptom; it occurs not only with hemorrhoids or fissures, but also with cancer in this area. If a tumor is detected at an early stage, it can be treated.

*Igor Domoratsky: “Hemorrhoids are an occupational disease of those who sit for a long time: motorists, programmers, accountants, secretaries and bosses”

— Sergey is calling from Kyiv. Is it possible to use traditional recipes to treat hemorrhoids? My father advised me to take chamomile baths...

- First we need to clarify the diagnosis. If a person really has hemorrhoids and the disease is not advanced, then careful hygiene, diet, light exercise and the use of simple folk remedies can slow down the pathology. At the beginning of the disease, it is good to take warm baths with a solution of soda or laundry soap for 15-20 minutes. You can add an infusion of chamomile or other antiseptic herb.

For many years, the disease will rarely bother you, but will not disappear, because anatomical changes have occurred in the area of hemorrhoids, which can appear at any time. At the stage when hemorrhoids fall out of the rectum and cannot be reduced, baths will no longer help. Swelling develops, the venous valve is damaged and the vein swells up like a bag.

The vessel will never be able to pass blood normally; this area has to be removed.

It must also be remembered that swollen hemorrhoids are sometimes an indirect sign of serious diseases - cirrhosis and liver cancer. When a diseased liver is unable to process the venous blood flow coming from below, disorders occur in the pelvic organs, varicose veins in the legs and hemorrhoids in the intestines.

- Are these “FACTS”? Mikhail, resident of Nizhyn. Is it true that hemorrhoids only occur in older people?

- Many are sure that this is so. In fact, young guys also suffer, even schoolchildren who do weightlifting, kettlebell lifting, shot put, and pump up their muscles on exercise machines. Hemorrhoids are an occupational disease of those who sit for a long time: motorists, programmers, accountants, secretaries and bosses. I believe that people of working age need to check the condition of their intestines, as well as the heart, blood vessels, stomach, and other organs, at least once a year, and do general tests so as not to miss incipient diseases.

“Analysis of tissue taken during intestinal probing will help identify a malignant tumor”

— Tatyana from Kyiv. How does a proctologist conduct an intestinal examination?

— We start with the simplest: visual examination and endoscopic examination, for example, using a proctoscope. This device allows you to see from the inside all changes in the lower rectum (up to 30 centimeters). But a person can have more than just hemorrhoids. For example, bleeding occurs if there are polyps or intestinal cancer.

Therefore, with such a symptom, it is very important to conduct an in-depth examination in order to identify the tumor at an early stage and treat the patient in time. Your doctor may order an examination using a flexible probe (fiber colonoscopy). For this device, a zone of approximately one and a half meters in length is available (almost up to the cecum).

If, during probing, the doctor finds a suspicious area in the intestine, he can carefully separate a piece of the formation with tweezers (do a biopsy). Then the specialist examines the cells under a microscope, determines their composition and gives a conclusion.

To clarify the diagnosis, blood tests must also be performed. If hemorrhoids bleed even a little, a person's red blood cell and hemoglobin levels may decrease. Anemia causes oxygen starvation of organ tissues. The heart muscle and brain are most sensitive to it. If bleeding hemorrhoids are not treated, they can eventually lead to a heart attack or stroke.

Causes and mechanism of development of hemorrhoids

Hemorrhoids are a disease of the rectum, leading to deformation of blood vessels and the appearance of hemorrhoids in this area of the body. There are several causes for this disease. Here are some of them:

inactive lifestyle, physical inactivity;
constipation or diarrhea;
physical overload;
“sedentary” office work;
Unbalanced diet, bad habits.

In addition, pregnancy and childbirth can lead to the appearance of hemorrhoids in a woman.

For a number of reasons, an inflammatory process begins in the intestines, blood circulation is disrupted and hemorrhoids appear. Enlarged vessels make it difficult for feces to pass out; when trying to cleanse the intestines, severe pain occurs, the vessels become inelastic, and in some cases there are traces of bleeding in the anal area. Failure to see a proctologist in a timely manner leads to progression of the disease and various complications. For example, the appearance of lumps in the anus, intoxication of the body, thrombosis and malignant formations.

Sick leave for surgery

If conservative therapy fails, surgery is indicated. The patient is transferred from outpatient treatment to inpatient treatment. Sick leave is extended for a period of more than 10 days. This may include a hospital stay and rehabilitation period.

Disability lasts depending on:

Type of surgical manipulation performed.
Presence of complications after surgery. Purulent formations on the sutures are considered negative consequences.
Stages of hemorrhoids.
The conditions under which the patient works.

If a person comes late and the stage of hemorrhoids is advanced, then the doctor performs a hemorrhoidectomy. With this manipulation, the rehabilitation time can be up to one month. At the end of the manipulation, a sick leave certificate is issued by the clinic at the place where the patient is registered with the doctor. According to the law, sick leave lasting more than two weeks can be issued only after a decision of a special commission.

The scheme for issuing a certificate of incapacity for work is as follows:

A proctologist or therapist has the right to issue a document during an outpatient stay for up to seven days.
In case of hospitalization, sick leave includes the entire period of stay in the hospital. Lasts from ten days.
After a successful operation, the sick leave is extended by the clinic or a special commission. The duration depends on the type of surgery and can be up to one month.
In the severe stage of the disease, when a person goes straight to the ward and requires surgery to remove hemorrhoids, the sick leave is opened by a health care facility, and the clinic extends it.

If you have hemorrhoids, you should immediately consult a specialist after the first signs appear, and not wait for the situation to worsen. It is possible to take sick leave for hemorrhoids. The effectiveness of therapy depends on the degree of the disease. Hemorrhoids are a sedentary disease. With a constant exacerbation of the disease, you need to think about changing your profession.

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Do private clinics and proctology offices issue sick leave certificates?

Since 2020, private clinics and proctology offices that have permission and license from the Ministry of Health can issue sick leave certificates to their patients. The maximum duration of such a sheet should not exceed 15 days. In cases where it is necessary to extend sick leave for a longer period, the doctor of a private medical institution refers the patient to a public clinic at the place of residence.

As a result, we can conclude that exacerbation of hemorrhoids is almost always an indication for issuing a sick leave for a period of 1 to 15 days, depending on the severity of the disease. Also, a certificate of temporary incapacity for work is issued to all patients who have undergone surgery for hemorrhoids for the period of hospital stay and up to 15 days of outpatient treatment.

A mandatory condition for issuing sick leave is to contact a specialist at a public or private medical institution at the first symptoms of the disease, since sick leave is not issued retroactively. To receive sick leave benefits, they must be provided to the employer within six months of the closure date.

Symptoms of acute hemorrhoids

The most common symptoms of hemorrhoids are:

discomfort in the anal canal;
itching and burning in the anus;
pain during bowel movements, which can radiate to the perineum, groin, lower abdomen and even lower back;
bleeding from hemorrhoids, which occurs during bowel movements and when hemorrhoids are injured.

Also, when hemorrhoids worsen, hemorrhoidal cones fall out of the anus. Depending on the stage of the disease, prolapse of nodes can be provoked by defecation, lifting a heavy object, sneezing, intense laughter, coughing, etc.

If the fallen nodes are not put back in time, they become swollen and very painful. In addition, blood clots can form in the inflamed lump nodes, which is accompanied by unbearable pain.

Also, during an exacerbation, anal fissures often appear in the anus, which can become infected with pathogens, which will lead to the formation of ulcers in the perirectal tissues.

Development of acute hemorrhoids

Hemorrhoids can be cured in the initial stages without much difficulty. But most people do not dare to consult a doctor in time, as a result of which the disease enters a more complex stage of development.

There are three degrees of severity of complications of the disease.

In the initial stage, blood accumulates in hemorrhoids and blood clots form, but no inflammatory process is observed. The nodes are small in size, with moderate pain. The patient complains of burning and itching in the anal area, which intensifies after defecation. Soreness, redness and swelling of the perianal area intensify after ingesting spicy and salty foods and alcohol.
The next stage in the development of complications is thrombosis of the nodes and the onset of the inflammatory process. In this case, the area around the sphincter thickens and swells. Due to the strong spasm of the sphincter, patients try to delay the moment of emptying as much as possible. Pronounced pain does not allow instrumental examination of the patient.
A severe complication is thrombosis of hemorrhoids with inflammation of the entire anal area. Stagnant blood thickens, a blood clot forms inside the node, compressing its nerve endings. The patient is in severe pain. Due to infringement in the anus, the hemorrhoidal plexus becomes purple in color with a bluish tint. In this case, immediate surgical intervention is necessary before the prolapsed nodes become necrotic and purulent paraproctitis develops.

When can they refuse to receive sick leave?

A patient may be denied a sick leave certificate if:

an examination by a doctor and computer diagnostics confirmed the satisfactory condition of the patient and conditions that prevented the performance of work were not identified;
the patient categorically refuses diagnosis, demanding sick leave only on the basis of his complaints;
the patient does not follow the recommendations given by the doctor;
the person is studying by correspondence, but does not have official employment.

If a person believes that he was unreasonably refused, he can contact the head doctor of the clinic. If the situation is controversial, a consultation is held to decide whether or not to issue sick leave to the patient.

Symptoms of exacerbation of hemorrhoids

Treatment of thrombosis of hemorrhoids usually begins with conservative therapy. Among the medicinal methods is the use of multicomponent anti-inflammatory ointments and gels, which contain analgesics and antispasmodics. Steam or sitz baths are also recommended. In parallel, the patient is prescribed phlebotonics, such as Detralex or Phlebodia, as well as drugs to normalize intestinal function: Lactulose syrup (Duphalac), psyllium husk (Mukofalk). After the acute phase of inflammation has been relieved, surgical thrombectomy (opening of the hemorrhoid and evacuation of the blood clot) can be performed if indicated.

An exacerbation of the disease is characterized by swelling and pain of hemorrhoids with increased itching and burning in the anus. The pain may radiate to the perineum and groin. In this condition, the patient needs immediate treatment before thrombosis of the hemorrhoids develops, which indicates a complication of acute hemorrhoids.