What are internal hemorrhoids: how to treat and recognize them

A few words about hemorrhoids

Hemorrhoids occur for various reasons; the main pathophysiological mechanism is stagnation of venous blood in the pelvic vessels. There are a whole host of factors contributing to this, including nutritional obesity, professional sports, heavy lifting, vaginal birth, a sedentary lifestyle and work that requires prolonged sitting. Treatment options include physical therapy, medication, and surgery.

Therapy depends on the severity of the disease and the general condition of the patient. Before starting treatment, a diagnosis should be made. This is what we will talk about below; we will talk about ways to independently suspect hemorrhoids, about the differences among the causes and course of the disease in representatives of different sexes, as well as how a proctologist will confirm the diagnosis.

Hemorrhoids are a pathology accompanied by varicose veins of the rectum

Treatment

Treatment of uncomplicated chronic hemorrhoids includes a comprehensive approach to the cause and pathological symptoms. The choice depends on the severity of the process, as well as the symptoms that bother the patient. The basis is non-drug methods that eliminate risk factors leading to the occurrence of chronic hemorrhoids. The patient is advised to avoid heavy physical activity, constipation, and prolonged sitting.

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It is necessary to change the diet to include a sufficient amount of fiber to facilitate the passage of stool. During heavy physical work, it is important to alternate periods of rest with limited lifting. A sedentary lifestyle requires regular walking and exercise.

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Drug therapy involves the use of systemic and local agents. Non-steroidal anti-inflammatory drugs are used as systemic therapy. They reduce the severity of pain, swelling and inflammation of surrounding tissues.

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Venotonics are used outside of exacerbation. The drugs are used in the form of a course of treatment, with an average duration of up to one month every six months. With regular use, the elasticity of the venous wall is restored, as well as its strengthening. The result is an improvement in blood flow, as well as a decrease in edema and vascular permeability.

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Broad-spectrum antibiotics. Their use is indicated when there is a threat of development of a systemic inflammatory process and possible tissue suppuration. The drugs destroy bacteria, which inhibits inflammation with tissue suppuration. In addition, they can be used for prevention.

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Local remedies are indicated to make you feel better, as within a short time they can reduce the severity of pathological manifestations. The patient's pain is relieved, swelling is relieved, and bleeding stops. They can be used in conjunction with systemic drugs or as monotherapy.

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Surgical treatment is a last resort. The use of these methods is carried out against the background of bleeding, as well as suppuration or thrombosis in the area of the node. If chronic complicated hemorrhoids are identified, treatment is carried out in a hospital setting.

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There are several methods, the selection of which is carried out depending on the severity of the process, as well as changes in general well-being. These include doping or cryodestruction of lesions. The method of laser removal of lesions is widely used. In severe cases, only complete excision of inflamed or thrombosed nodes is possible. These methods are applicable if long-standing severe chronic hemorrhoids are being treated.

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Self-diagnosis of hemorrhoids

In most cases, hemorrhoids are discovered either through self-examination or during regular medical examinations.

Very important is the patient’s ability to listen to problems in his own body and, having paid attention to this, promptly seek help from a specialist.

Hemorrhoids, unlike cardiovascular pathologies, can be detected in young people up to the age of thirty. This makes early diagnosis difficult, since people at this age pay little attention to their health. However, if you follow the recommendations described below, you will be able to detect the development of such an unpleasant pathology as hemorrhoids at the earliest stages.

In order to independently identify any form of hemorrhoids, answer yourself the following questions:

Are there any space-occupying formations in the area of the perianal folds?
Do you notice a feeling of pressure or fullness in your rectum during bowel movements?
How often do you experience constipation?
Do you notice traces of blood on toilet paper?
Have your family members had any cases of hemorrhoids?
Are there any unpleasant sensations such as itching, pain or redness in the anal area?

If you answered yes to some of these questions, you may suspect internal or external hemorrhoids. It is also worth understanding that any disease can be either acute or chronic. Therefore, if after an acute period the symptoms subside slightly or disappear altogether, you should not neglect your own condition, as this may simply be a “quiet period” before the next attack. In order to conduct a more detailed diagnosis, it is advisable to consult a doctor. Only a specialist can establish an accurate diagnosis and, accordingly, prescribe the most effective treatment.

Candles made from natural ingredients

The pharmaceutical market is generously flooded with suppositories for internal hemorrhoids. At the same time, you can prepare equally effective remedies for the effective treatment of hemorrhoids at home. Self-prepared candles contain natural ingredients, whose healing power has stood the test of time and does not require additional recommendations. The basis for suppositories will be shea butter, cocoa or lanolin, which are available in the pharmacy. In addition to the oil base, you will need a mold for the products. You can use plastic packaging from factory-made candles - you will get halves that are easy to fuse by squeezing with your fingers before use.

Propolis suppositories can cure hemorrhoids at home with regular use.

Prepared according to the recipe:

20 ml water;
10 g propolis;
75 ml fat base.

Grate the frozen propolis and pour cold water, drain the floating debris, place the propolis on a sieve and dry. Pour 20 ml of water into pure propolis and simmer in a water bath until smooth. Add the fat base to the melted propolis and mix. Pour the resulting mass into molds and place in the freezer. Propolis is famous for its powerful antibacterial, anti-inflammatory, healing effects. Introduce suppositories in the morning and at night after toilet and hygiene.

Potato candles

At the initial stage of the disease, potato candles are very popular. Its tubers contain a lot of starch and ascorbic acid. Starch envelops and heals. Vitamin C strengthens the walls of blood vessels. The older the tuber, the more starch it contains. Cut a block of washed, peeled potatoes 3 cm long and 1 cm in diameter. Give it a streamlined shape if possible. Store candles in the refrigerator, wrapped in a bandage, for no more than a day. Lubricate with vegetable oil before use. There is no need to remove the candle; it will come out during a bowel movement.

Herbal tea candles

Frozen decoction of chamomile, St. John's wort, sage, yarrow, oak bark will cope with pain and capillary bleeding. The broth poured into ice molds is placed in the freezer and used up to 3-4 times a day. It has no side effects and is used in women during pregnancy and lactation.

How to recognize different forms of the disease

Clinicians have developed special classifications to regulate and standardize treatment methods. In accordance with them, such forms as internal, external and combined are distinguished. The difference lies in the position of the hemorrhoids relative to the dentate line. Saccular protrusions from the vascular wall located inside the rectal ampulla are difficult to identify without the use of digital examination or even visualization of the rectal mucosa.

In order to confirm the presence of internal hemorrhoids, sigmoidoscopy and anoscopy are used; only with their help can this form of pathology be accurately established, as well as the most adequate treatment method selected.

External hemorrhoids are the simplest form in diagnostic terms, since the inflamed nodes literally fall out of the lumen of the rectum when straining or even at rest. For confirmation, a visual inspection and digital examination are performed to identify additional nodes. It is also necessary to carry out a differential diagnosis to establish a complete picture of the pathology. This is due to the fact that the combined form of hemorrhoids is the presence of internal and external nodes. Insufficient diagnosis can lead to the fact that even after identifying external nodes and prescribing treatment, the patient will still note the presence of characteristic complaints, and his general condition will gradually worsen.

Various instrumental and laboratory diagnostic methods will help determine the presence of this disease.

Folk remedies

How to treat if pills are contraindicated? Even in parallel with drug therapy, it is recommended to use folk remedies for the treatment of hemorrhoids. Warm baths of herbal decoctions in a sitting position that have an anti-inflammatory effect (chamomile, sage, rosehip) are effective. Lotions with sea buckthorn oil, suppositories made from peeled potatoes, aloe juice (in the form of lotions), etc. are useful.

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How to recognize internal hemorrhoids

You can suspect the presence of internal hemorrhoids on your own; to do this, you need to carefully monitor the signals given by the body. Since it will not be possible to visualize or independently palpate the anus for the presence of hemorrhoids due to their location deep in the lumen of the rectum, one can rely on clinical manifestations.

With this form of pathology, at the initial stages of its development, there is discomfort during bowel movements. Irritated by internal hemorrhoids, the mucous membrane begins to produce more mucus, which leads to irritation of the skin folds around the anus and the appearance of itching, redness and weeping macerations, causing significant discomfort.

Over time, as the disease progresses, it will lead to the sensation of a foreign body. This is due to the fact that there are no pain receptors in the lumen of the rectal ampulla; the mucous membrane can only feel compression caused by enlarged nodes. Pain syndrome occurs already at fairly late stages of the process, this will indicate that the patient will most likely need surgical treatment. A signal for diagnosis can also be the appearance of bloody discharge on toilet paper after defecation or in the stool itself, which is associated with injury and cracks in the nodes.

Chronic hemorrhoids and methods of its treatment

If chronic hemorrhoids are diagnosed, treatment and techniques can be divided into three areas:

non-surgical (conservative);
minimally invasive;
surgical.

If hemorrhoids are detected at the very initial stages of development, you can limit yourself to the first and second treatment methods. Treatment of chronic hemorrhoids with surgical intervention is used only in the most difficult situations. Early stages of the disease can be cured through measures to strengthen the vascular walls, preventive measures to stop bleeding and prevent constipation.

Medicines from the category of venotonics are prescribed to improve the quality of vascular walls. They are available in the form of tablets for internal use, as well as ointments or gels for external use. Treatment of bleeding and its prevention is well done by local remedies with sodium alginate. However, when nodes fall out, conventional medications become ineffective, so more radical treatment is required, using surgical methods.

How to determine the presence of external hemorrhoids

Confirming guesses about the presence of external hemorrhoids is a simpler task. This is due to the fact that the pathological process in such a situation is localized closer to the anus and this allows it to be visualized.

In addition to characteristic symptoms, such as discomfort during bowel movements, pain when straining, itching and maceration, a soft saccular formation is palpated.

In the early stages, it can be straightened into the lumen on its own, but the lack of necessary treatment will invariably lead to the fact that over time it will no longer be possible to straighten them, and palpation will be sharply painful due to thrombosis of the node and its subsequent inflammation with the involvement of surrounding tissues. You can carry out palpation yourself, after which you should consult a doctor to clarify the diagnosis and make differentiation.

Signs of combined hemorrhoids

Combined hemorrhoids are a real “headache” for proctology doctors. Very often, unskilled workers forget to carry out additional diagnostic procedures to identify internal nodes when identifying external ones. In this regard, the therapy carried out does not improve the patient’s condition; on the contrary, he begins to notice the addition of pain radiating to the groin, increased itching and discomfort even during treatment. In addition to these signs, this form can also be suggested by the loss of significantly enlarged internal nodes from the intestinal lumen. This phenomenon can only be observed in very advanced forms of the disease and provided that the nodes are not located too high in the lumen of the rectum.

Minor symptoms at the beginning of the formation of pathology can indicate mixed hemorrhoids

If an exacerbation occurs

When the disease worsens, the first thing to do is to eliminate inflammatory processes and other obvious signs that cause significant discomfort. To alleviate the condition, effective measures are taken to relieve pain, prevent blood clots in blood vessels and eliminate already formed blood clots. To reduce pain, medications from the categories of antispasmodics, anesthetics and analgesics are used.

Resorption of blood clots is possible due to the action of drugs containing heparin. To stop the inflammatory process, itching and burning, medications based on hormonal substances that have anti-inflammatory properties are prescribed.

An unusual but very effective method is hirudotherapy - the use of leeches. Their saliva contains hirudin, a substance that can dissolve blood clots and prevent their formation. This method of treatment is usually additional to complex therapy.

How to find out the stage of the disease

To decide on the choice of treatment method, the patient’s condition should be assessed and the stage of hemorrhoids should be established.

According to modern classification, four stages are distinguished:

the first stage is the simplest and most favorable in terms of prognosis, it is accompanied by a slight protrusion in the wall of the hemorrhoidal veins, while the patient notes the presence of some discomfort and mild itching in the anus;
the second stage is already more severe and is accompanied by a significant increase in nodes, as well as their loss during emptying. The formations can be reduced into the intestinal lumen on their own; in addition, patients note the presence of a burning sensation, and the appearance of anal fissures that bleed slightly is often observed;
at the third stage, pathological symptoms are severe, requiring specialist intervention to prevent the development of severe complications. The nodes are difficult to reduce into the intestinal lumen; their loss is accompanied by significant pain and itching. The development of pathology is accompanied by the appearance of fistulas, the separation of blood clots along with feces;
The fourth stage of hemorrhoids is the most difficult in terms of treatment, since the surrounding tissues are involved in the inflammation process; it can also be widespread and purulent. The nodes are sharply painful, cyanotic, and cannot be moved into the intestinal lumen due to tension and large size. Treatment at this stage is only surgical, since conservative methods are ineffective in one hundred percent of cases.

Stages of development of hemorrhoids

In the clinical course of chronic hemorrhoids, there are 4 stages of development. Each of them can last for 2-3 years, the deterioration increases slowly and is not obvious to the patient.

The acute form includes 3 stages. At the same time, it is possible to reach the last, advanced stage in 5-7 days.

Do not forget that only a doctor can correctly determine the stage of hemorrhoids, after carrying out diagnostic procedures using a rectoscope or other modern medical devices.

Features of the disease in the stronger and weaker sex

The differences in hemorrhoids between men and women usually lie in the mechanism of its occurrence. In women, the leading cause is pregnancy or frequent constipation due to poor diet. In men, hemorrhoids usually develop as a result of excessive consumption of fatty foods or due to employment in physically demanding work. The number of male athletes with hemorrhoids also exceeds the number of representatives of the fairer sex with a similar problem.

As for the symptoms, methods of diagnosis and treatment of this pathology in representatives of different sexes, there are simply no differences; the same standards are applied all over the world.

Complications

Complications of hemorrhoids that occur due to lack of treatment or incomplete treatment include the following:

thrombosis of hemorrhoids;
inflammatory process in the nodes with the capture of surrounding fiber;
cracks in the rectal mucosa;
paraproctitis;
anemia;
bleeding from nodes.

The main complications of the disease can be: inflammation of hemorrhoids

Diagnosis of hemorrhoids by a proctologist

To establish an accurate diagnosis, you should consult a specialist after identifying the above symptoms.

It is the proctologist who can correctly interpret the data of such diagnostic methods:

complaint survey;
physical examination;
finger examination;
anoscopy;
colonoscopy;
stool occult blood test;
sigmoidoscopy.

Based on the information received, the doctor will conduct a differential diagnosis in order to distinguish hemorrhoids from condylomas, rectal cancer, purulent processes localized in the anal area, fissures and rectal prolapse. Only thanks to the manipulations performed can you choose the most correct method of treatment.