What Are Hemorrhoids? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Hemorrhoid Treatment in a Doctor’s Office, With or Without Surgery

Medical procedures may be needed for hemorrhoids that don’t go away with home treatments.

Painful external hemorrhoids can be excised (cut off) during an office visit following a shot of local anesthetic to numb the area.

For internal hemorrhoids, a few office procedures may be considered. In rubber band ligation, the most common hemorrhoid procedure performed in the United States, the doctor places a small rubber band around the base of the hemorrhoid, cutting off the hemorrhoid’s blood supply. (6) The hemorrhoid typically shrinks and falls off within about a week, though several quick follow-up visits may be required to completely get rid of the hemorrhoid. (1)

Other procedures include sclerotherapy, in which a chemical injected into the hemorrhoid causes scar tissue to form, shrinking the hemorrhoid; and infrared coagulation, in which an intense beam of infrared light causes the scar tissue to form, cutting off the blood supply and shrinking the hemorrhoid. (4)

If you have a large external hemorrhoid, both internal and external hemorrhoids, or an internal hemorrhoid that’s prolapsed (popped out through the anus), a surgical operation called a hemorrhoidectomy may be necessary, though few patients require this procedure. (1)

During a hemorrhoidectomy, the hemorrhoid and surrounding tissue are removed via a small incision, which is usually closed up with stitches afterward. The procedure is performed in an operating room with either localized or general anesthesia, or a spinal block that numbs the bottom half of the body. The procedure is successful in 95 percent of cases, though patients may experience postoperative pain. (6)

Another option that aims to reduce postoperative pain is a stapled hemorrhoidopexy, in which a device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. (The staples fall out over time.) (1)

Learn More About Treatment for Hemorrhoids: Medication, Alternative and Complementary Therapies, Surgery Options, and More

Prevention of Hemorrhoids

Preventing constipation by keeping your stool soft and having regular bowel movements is one of the best ways to help prevent hemorrhoids.

The following tips may help you prevent constipation:

Get plenty of fiber in your diet. A high-fiber diet can make stool softer and bulkier so that it passes easily. According to the Academy of Nutrition and Dietetics, adult men under age 50 should aim for at least 38 grams of fiber a day and adult women under age 50 should aim for 25 grams. For those older than 50, the recommendation is slightly lower: 30 grams for men and 21 grams for women. (8) But be careful to add fiber to your diet slowly to avoid excessive gas or bloating.

There are a number of easy, healthy ways to incorporate more fiber into your diet. Fiber-filled foods include fruits such as berries, avocados, and pears (especially when you eat the skin). Broccoli, artichokes, and Brussels sprouts are among the vegetables that can up your fiber intake. Whole grains, such as brown rice, quinoa, and oatmeal, are also an important source. Legumes, including lentils, various beans, and green peas, are a great way to get fiber. Nuts and seeds make for a great fiber-filled snack, too.

If you’re having trouble getting enough fiber in your regular diet, consider a fiber supplement. (7)

If you experience chronic constipation and suspect that may be contributing to your hemorrhoids, avoid eating too many foods that contain little or no fiber, such as cheese and fast and processed foods.

Drink plenty of water and other fluids. Recommendations for daily water intake vary and depend on the individual, but the Institute of Medicine of the National Academies has set adequate intake levels at 2.7 liters (91 ounces) for men and approximately 3.7 liters (125 ounces) for women. (9) This can come from beverages and food, but caffeinated beverages and alcohol can be dehydrating and should not be counted in reaching this intake goal.

Exercise regularly. Exercise, especially 20 to 30 minutes of moderate aerobic activity a day, can help keep bowel movements regular. (6) And regular exercise may help you lose weight, which may be contributing to the formation of hemorrhoids.

Other tips for preventing hemorrhoids include:

Don’t strain or hold your breath during bowel movements. Straining can put excess pressure on veins and lead directly to hemorrhoid development.

Go to the bathroom as soon as you feel the urge. Letting the urge subside can make your stool harder to pass.

Avoid long periods of sitting. Sitting for too long, especially on the toilet, can stress veins in the anus.

Numbness & Tingling in Buttocks | What You Need to Know

Traumatic causes

Trauma, irritation, or damage to the spine or the sciatic nerve can also result in butt numbness. Spinal trauma can be due to a misalignment of the disks that make up part of your backbone, narrowing of the spinal canal, or irritation due to arthritic processes in the area. Abnormal growths or tumors can also compress or irritate the spine or nerves that leave the spine and travel through the buttocks. The sciatic nerve can be irritated or damaged in similar ways and lead to buttock numbness accompanied by a burning sensation, tingling, numbness, and weakness of the leg(s) and/or thigh(s).

2 butt numbness conditions

The list below shows results from the use of our quiz by Buoy users who experienced butt numbness. This list does not constitute medical advice and may not accurately represent what you have.

Cauda equina syndrome (rapid-onset)

Although leg pain is common and usually goes away without surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord, is a surgical emergency.

Rarity: Ultra rare

Top Symptoms: lower back pain, back pain that shoots to the butt, back pain that shoots down the leg, leg weakness, thigh numbness

Urgency: Emergency medical service

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Don’t Ignore Numbness in Your Hands and Feet! – Vejthani Hospital

Don’t Ignore Numbness in Your Hands and Feet!

Don’t Ignore Numbness in Your Hands and Feet Gradual onset of numbness or tingling in the hands and feet often occurs among working-aged adults from repetitive and forceful activities, e. g. prolonged use of a computer keyboard and mouse. This symptom can have a wide variety of causes including poor nutrition (particularly vitamin B deficiency). But if the numbness and tingling feels worse and associated with pain, it may be a sign of peripheral neuropathy that should not be left untreated.

What is Peripheral Neuropathy and what causes it?

Peripheral neuropathy refers to the condition that occurs when the peripheral nerves has become damaged. Peripheral nerves link the brain, spinal cord and the rest of the body. They carry messages to communicate with the body’s muscles and organs. Damage to the peripheral nerves can affect internal organs, the movement control, and can also result in numbness, tingling, unusual sensation, and pain. Moreover, it can cause paralysis if a nerve is completely lacerated.

Factors that can cause peripheral neuropathy

• Inflammatory neuropathy from abnormal immunity for e.g. GBS, CIDP.
• Hereditary neuropathies or family history of neuropathy.
• Certain infections causing nerves to become inflamed.
• Diabetic people with poorly controlled blood sugar levels.
• Prolonged pressure on a nerve or repetitive motions.
• Chronic diseases, e.g. kidney failure, vitamin B12 deficiency, paraproteinemia.

The treatment for Peripheral Neuropathy

Treatment of numbness or tingling in the hands and feet depends on the underlying cause. For mild cases, the doctor may prescribe medicines to ease symptoms. If patients have neuropathy caused by pressure on the nerves, the doctor may recommend surgery to reduce the pressure.

However, not all numbness is indicative of a serious problem, but it is something you definitely should not ignore. It could be indicative of something more serious; because vitamin deficiency, diabetes, kidney failure, and nerve damage are among the medical causes of these symptoms.

If numbness persists over 2-3 days and is not improving, lifestyle changes and exercise may help improve the symptoms. For those who are not improving after 1 week and numbness spreads to other parts of the body, it is better to consult the neurologist for an evaluation and to receive proper treatment. For further information or making an appointment, please contact Neuroscience Center, Vejthani Hospital.

7 Subtle Signs You’ve Had Hemorrhoids But Didn’t Actually Realize It

Dealing with an issue in your bum area can feel awkward and embarrassing, and you may even be hesitant to speak with anyone about it. But problems in this area can signs of hemorrhoids, and you may even be exhibiting some subtle symptoms without even realizing it. Hemorrhoids, which are swollen veins in your anus and lower rectum, occurs in three out of four adults in their lifetime, so if you have any unexplained symptoms in your behind, there’s a good chance they could be explained by this pesky condition.

“Irritation or inflammation of the hemorrhoids generally occurs with straining, a change in bowel habits (whether constipation or diarrhea), or spending too much time in a squatted position on the toilet,” gastroenterologist Will Bulsiewicz, MD MSCI tells Bustle. “Whether you’re bearing down to lift that barbell or because you’re trying to push out a baby, any increase in abdominal pressure runs the risk of exacerbating these private piles. There are hemorrhoids inside the rectum and also external ones hiding below the surface of the anus.”

Typically, when the external hemorrhoids flare up, they’re generally very painful since the anal area is densely carpeted with nerves, says Dr. Bulsiewicz. “On the flip side, internal hemorrhoids may be causing symptoms from the inside without you even realizing that they’re there and creating problems.”

Since hemorrhoids are so common, it’s possible they have plagued you at least once in your life. Here are seven subtle signs you’ve had hemorrhoids but didn’t actually realize it, according to experts.

1

Anal Itching

Andrew Zaeh for Bustle

It may not be the most subtle symptom, but itching around the anus is a telltale sign of hemorrhoids. “Hemorrhoids can disrupt the anal barrier and allow microscopic leakage of rectal contents that dry out the anal area and cause extreme itching,” says Dr. Bulsiewicz. “When this happens, nearly everyone does the same thing: cleans the area vigorously and excessively. The issue is that the opposite is actually the solution. Itching improves when you stop using soaps, detergents and wipes and allow the bottom to start producing it’s natural oils to maintain the moisture of the tissue.”

2

Painless Bleeding When Going To The Bathroom

Andrew Zaeh for Bustle

Blood on your toilet paper can also be indicative of hemorrhoids. “Generally the bleeding will be painless and often times will continue to drip into the toilet bowl or get on the tissue paper, indicating that the anal canal is involved in the bleeding process,” says Dr. Bulsiewicz. But if the bleeding becomes persistent, be sure to speak with your doctor.

3

Difficulty Cleaning Your Bottom

Andrew Zaeh for Bustle

If you can’t seem to get your butt clean, you might actually have hemorrhoids. “Loose hemorrhoid tissue makes anal cleaning very difficult,” says Dr. Bulsiewicz. “It can constantly feel likes there’s still more work to do.”

4

Skid Marks

Hemorrhoids can lead to leakage, which could cause your underwear to end up with some unwanted stains. “You can’t expect a door to close all the way if you put your foot in the door frame,” says Dr. Bulsiewicz. “Similarly, how can you expect your anal canal to be competent and completely closed if there’s a hemorrhoid sitting in the middle of it?”

5

Incomplete Emptying Or Constipation

Many people with hemorrhoid symptoms feel like they haven’t completely emptied their bowls, or they feel constipated. “It’s a vicious cycle because some people find the the hemorrhoids get in the way and make it difficult to completely empty the rectum,” says Dr. Bulsiewicz. Because constipation can signify other things as well, if this symptom is reoccurring, it could be a good idea to see your doctor.

6

Swelling

Ashley Batz/Bustle

Swelling in the anal area can occur as a result of too much straining. “Many people spend a long time every day on the toilet waiting or straining for their bowel movement,” Navya Mysore, MDCM, CCFP, tells Bustle. “This can put undue pressure on the veins in the area and cause swelling and or irritation.”

7

Skin Tags

Ashley Batz/Bustle

If there’s any excess skin in your anal area, it could be due to hemorrhoids. “Skin tags are associated with hemorrhoids which may be difficult to clean,” gasteroenterologist Samantha Nazareth, MD, tells Bustle. “This leads to fecal material hanging around on the skin for longer than you’d like, and thus local irritation.”

When in doubt, it’s best to see a doctor who can determine whether or not you’ve had hemorrhoids, but if you’re having symptoms in your behind, it may be a result of this condition.

Saddle Anaesthesia: A Red Flag Symptom

Published on: 03 Dec, 2018 – Read Time: 3 minutes Minutes

by: rosalia

The final month’s Red Flag Signs and Symptoms awareness campaign looks at the red flag sign and symptom of saddle anaesthesia. In some circumstances a loss of feeling in the saddle area can be a sign of Cauda Equina Syndrome.

What do we mean by the “saddle area”?

The area of the buttocks, the perineum (the area between the anus and the scrotum or vulva) and the inner surfaces of the thighs.

Why is the saddle area affected?

The nerves at the end of the spinal cord (approximately just above the waist) are called Cauda Equina. These nerves are responsible for the supply of sensation to the skin around the bottom and back passage.

When the Cauda Equina nerves become compressed or squashed they can stop functioning. A loss of function can mean messages of physical sensation in the lower body do not reach the brain. This can potentially cause an individual to suffer from the problems explained below.

You can learn about the potential causes of Cauda Equina Syndrome on our website here.

What sort of problems do people experience with saddle anaesthesia?

Individuals may experience varying degrees of the following problems:

• Loss of feeling between the legs;
• Numbness in or around the back passage and / or genitals;
• Inability to feel the toilet paper when wiping;
• Tingling sensation in the saddle area;
• Weakness in the saddle area.

Daz’s Story

“I had sciatica symptoms for about a week and had never known pain like it. One Friday afternoon I noticed my saddle area had gone numb. I went to bed thinking it was just the zapain and amitriptyline tablets I was on. I woke up on Saturday morning, coughed and noticed urine came out. My wife luckily dragged me to Warrington A & E and I saw a junior doctor who carried out some tests. Three hours later I was transferred to Walton neurological hospital in Liverpool, underwent a scan and I was in the operating theatre by 9 o’clock that evening.

It’s now just over 10 months since this happened and I still have a weak right leg and numbness in my right bum cheek which travels all down the back of my right leg. I am getting stronger albeit slowly as each day passes. I have found that swimming and the gym help and I also do physio based pilates every week.”

What you should do if you experience saddle anaesthesia

Seek immediate medical care from your GP or nearest A&E department. They should be able to diagnose whether you are suffering from symptoms of cauda equina syndrome.

How is Cauda Equina Syndrome treated?

Cauda Equina Syndrome is a surgical emergency.

Surgery must be done quickly to prevent permanent damage. It is best if surgery occurs within 48 hours of the onset of symptoms. You might hear the surgical procedure being called a laminectomy. During a laminectomy part of the vertebra (called the lamina) is removed. The opens up the space surrounding the cauda equina nerves and relieves pressure on the cauda equina nerves.

There are several causes of cauda equina and depending on the cause of an individual’s CES, a patient may also require other treatment, including high doses of corticosteroids to reduce swelling, antibiotics if you are diagnosed with an infection, radiation or chemotherapy if a tumour was the cause.

Can saddle anaesthesia be reversed after surgery?

Everybody is different.

Some individuals may notice an improvement straightaway.

Some individuals may notice an improvement over a period of time – perhaps as long as two years or more.

Unfortunately, there are some individuals that may find the feeling in their saddle area does not improve fully or at all.

If surgery is received before an individual suffers from complete saddle anaesthesia, there is a better chance that the individual may recover some or all of the feeling in the saddle area.

If you would like to know more about any of the other red flag signs and symptoms please view our previous articles.

Are Hemorrhoids, Insomnia, and Back Pain Related?

Could hemorrhoids, insomnia, and back pain all be connected? Yes!

All three of these symptoms are very common effects of poor adaptation to stress. Essentially, they are normal symptoms the body gives off when its health is being compromised. Think of them as alarms, not the problem itself.

I recently had a member of our practice ask me if it was possible that his hemorrhoids could have cleared up because he was getting adjusted to help his low back and insomnia issues.  We had never spoken of his hemorrhoids before, as he did not think they could be related to the nerves affecting his back and sleep issues.

I explained to him that while there are other causes to hemorrhoids, like poor nutrition, many times people will notice the symptom after a very stressful period in life, like a move to a new city, a marital issue, getting let go at work, etc.

The body is very intelligent in its own way, ready to alarm us that our bodies are weak because of poor adaptation to stress. The symptoms may come in the form of low energy, poor sleep, low back or neck pain, headaches, and so on.  Hemorrhoids are no different. The increase in stress from either chemical, physical, or emotional avenues will elevate what is called vagal tone.

The vagus nerve is one of our 12 cranial nerves, which are found in the brain stem. These are essential nerves for survival purposes. You may have heard the phrase “fight or flight” in high school or college biology class.  This increase in vagal tone is to help the body adapt to stress, and should be short lived, then return to a normal level. Unfortunately, in today‘s world of constant texting, email, social media, and hectic schedules, demands are high all day long.  The body never gets the chance to recover, and it starts to accumulate the effects of sustained or prolonged sympathetic tone.

So, when we start balancing the nervous system with chiropractic adjustments and lifestyle changes, people are often surprised when other symptoms, those that they never even told us about, start to clear up.

The particular patient I was talking about earlier was scheduled to have a surgery to remove his hemorrhoids after a year of unsuccessful treatment with other drug methods. He was stunned when they were gone in two weeks of care at our office, helping his back pain and insomnia issue.

That is always one of my favorite reasons to come to work, to hear when people are thankful for issues we helped them with beyond the scope of what we discussed in the beginning of care.  Over-delivering on the goods is a benefit all businesses want to provide to their members, not just healthcare.

Adjustment helps reset the nervous overload in the body.  This not only reduces the “flight or fight” effect, calming the body, but it also decreases the hormone cortisol, and elevates dopamine and seratonin. This is not only great for general anxiety and sleep performance, but it also significantly boosts the immunity of the body.

Long story short? You can be sure that if someone is having low back pain, hemorrhoids, and sleep issues, their immune system is definitely not optimum.

Are Hemorrhoids, Insomnia, and Back Pain Related?2016-07-212016-07-21https://mckinleychiro.com/wp-content/uploads/2017/07/mckinley-rough-draft-logo-1.pngMcKinley Family Chiropractichttps://mckinleychiro.com/wp-content/uploads/2016/07/21July16-HemorrhoidsInsomniaBackPain.jpg200px200px

How to Tell if Your Sciatica is Actually Piriformis Syndrome

If you’re struggling with a chronic pain in the butt, relief can be hard to find—especially if you have piriformis syndrome. The hallmark sign is hip and/or buttock pain on one side of the body along with low back pain that radiates down one or both legs.

Piriformis syndrome can be a real pain in the butt.

The problem is, piriformis syndrome is often mistaken for sciatica. While both conditions interfere with sciatic nerve function, sciatica results from spinal dysfunction such as a herniated disc or spinal stenosis. Piriformis syndrome, on the other hand, occurs when the piriformis muscle, located deep in the buttock, compresses the sciatic nerve.

Your medical provider’s solid understanding of the structure and function of the sciatic nerve and its relationship to the piriformis muscle is key to distinguishing between true or discogenic sciatica and piriformis syndrome.

What Is the Sciatic Nerve? 

The sciatic nerve originates near the base of the spine, where nerve roots at the L4, L5, S1, S2, and S3 vertebrae exit the bony opening of the spine and join into a single, large nerve and exits a bony arch called the sciatic notch. The sciatic nerve travels through the pelvis, passing under the front surface of the piriformis muscle as it travels through the pelvis.

It then cuts into two branches before going down each leg, branching out at the back of the knee to divide into the tibial and peroneal nerves, both of which supply the lower leg and foot. The sural nerves branch off from the tibial and peroneal nerves, terminating in the foot.

The sciatic nerve is responsible for bending the knee, bringing the thighs together (adduction), and flexing and extending the ankles and toes. It also provides sensation to the back of the thigh, the entire lower leg, the ankle, and the sole of the foot.

Piriformis? What’s That?

Visualizing the piriformis muscle and the sciatic nerve

The piriformis muscle originates at the front of the sacrum near the sacroiliac joint capsule and attaches to a bony knob on the femur (thigh bone) at the outermost part of the hip.

The piriformis helps externally rotate and abduct the hip, fancy words for turning your hip outward and bringing your thigh outward to one side while your hip is bent, such as when raising your knee and bringing your leg out when getting out of a car seat. It also offers stability while walking, running and standing.

Usually, the sciatic nerve passes directly underneath the piriformis before continuing down the back of the thigh. But for some, the sciatic nerve passes directly through the piriformis predisposing such people to piriformis syndrome, which may also be referred to as piriformis sciatica (as opposed to true, or discogenic, sciatica).

Piriformis Syndrome Symptoms

While piriformis syndrome doesn’t always present exactly the same way, common symptoms include pain in the buttocks that’s worse when sitting, especially with the legs crossed in a figure of four position. Maintaining that position for long periods can cause pain that radiates down one leg. Other symptoms may include:

• Pain in the opposite sacroiliac joint
• Pain with sitting standing or walking for more than 20 minutes
• Intense pain with sitting or squatting
• Pain and/or paresthesia (pins and needles, numbness, burning, tingling, or itching sensations) radiating from the sacrum down the back of the thigh, usually stopping above the knee
• Pain that improves with movement
• Pain when standing up from seated or squatting
• Foot numbness

That’s why it’s so easy to mistake piriformis syndrome for sciatica; they have many of the same symptoms.

Causes of Piriformis Syndrome

Your anatomy may be behind your piriformis syndrome. This is known as primary piriformis syndrome and occurs when you have a split piriformis muscle, split sciatic nerve, and/or an atypical sciatic nerve path.

Secondary piriformis syndrome is far more common and is caused inflammation of soft tissues, muscle spasm or both, resulting in nerve compression. Direct trauma to the buttock can lead to inflammation, scarring and contractures of the piriformis muscle

This might be the result of a major event like a car accident or a fall. However, the most common cause is likely the gradual tightening of the piriformis muscle due to poor muscle fitness. Activities, such as long distance running or prolonged standing without proper stretching and strengthening of piriformis muscle is a common scenario in patients with piriformis syndrome . 

Testing for Piriformis Syndrome

Because piriformis syndrome symptoms mimic those of sciatica, your medical provider will perform specific tests to determine whether your symptoms are discogenic or caused by an impingement of the sciatic nerve by the piriformis muscle.

Your provider should examine your low back, hip, pelvis and sacroiliac joint and check your gait, posture and leg length. They’ll also test your reflexes, which should be normal if you have piriformis syndrome.

Your provider will manipulate your leg to check for piriformis syndrome.

Other signs of piriformis syndrome include:

• Pain or tenderness when the doctor manipulates your piriformis
• Tenderness to touch around your sacroiliac joint, greater sciatic notch, and piriformis that may radiate to your knee.
• A positive La Seque sign. This means you feel localized pain when pressure is applied to your piriformis muscle and its tendon, especially while flexing your hip at a 90 degree angle and extending (straightening) your knee.
• A positive Freiberg sign. This means you feel pain around the piriformis or reproduction of symptoms in response to putting your hip in extension and internal rotation while externally rotating against resistance.
• A positive Pace’s sign. You’ll experience pain and/or weakness in response to resisting abduction and external rotation of the hip while you’re seated.
• Pain in response to the FAIR test. FAIR stands for flexion, adduction, and internal rotation. This test requires you to lie on your asymptomatic side and relax while your provider guides your painful leg into hip flexion, turns it in toward your body, and then gently turns your lower leg outward.
• A positive Beatty sign. This means you experience pain when, while lying on the asymptomatic side, your provider elevates your flexed symptomatic leg.

When testing for pain or weakness in specific positions, your provider will conduct each test until you experience symptoms or for up to 60 seconds, whichever comes first.

In addition to a physical exam, you might also need imaging to rule out other causes for your symptoms. Your doctor may order X-rays, an MRI, or a CT scan. In addition, injections into the piriformis muscle may be used to confirm the diagnosis, while simultaneously helping with treatment.

Once you pin down the source of your pain, you can move forward with treatment, which typically consists of NSAIDs (nonsteroidal anti-inflammatory drugs) and physical therapy. Although you might be inclined to rest, wait, and see what happens, the sooner you find the root of your issues, the sooner you can get back to pain-free living.

Piriformis syndrome or sciatica? Get a proper diagnosis; find a spine specialist near you who can help.

How to cure chronic hemorrhoids

This problem is so delicate that we are embarrassed to discuss it even with loved ones. As a result, we start the disease. What if you have been suffering from hemorrhoids for a long time?

1. I have been suffering from hemorrhoids for several years now, and I’m still not going to see a doctor. What happens if hemorrhoids are not treated at all?

Almost every third adult has hemorrhoids. If at the 1st stage of this disease conservative treatment is still possible, then at the 2nd, and even more so at the 3rd and 4th stages – only surgical treatment.

At the 2nd stage, the nodes begin to fall out of the anus, but they adjust themselves, at the 3rd stage the patient sets them with his hand, at the 4th stage, when they are set, they immediately fall out again or do not adjust at all.

Hemorrhoids cannot “degenerate” into a malignant disease and, with rare exceptions, are not life threatening. However, the constant prolapse of hemorrhoids and bleeding, which can lead to anemia, thrombosis (inflammation) of the external nodes, excruciating pain associated with the associated inflammatory diseases of the anal canal and rectum – cracks and fistulas, delivers a lot of concern.At the 4th stage, the prolapsed nodes gradually stretch the anal sphincter, and with age, when the compensation mechanisms are exhausted, everything can end in fecal incontinence and complete disability.

If you have hemorrhoids, do not bring it to Stage 4. In the early stages, it can be dealt with with minimally invasive methods. For example, hardening (“gluing”) of internal nodes is a painless, effective operation, performed on an outpatient basis and without anesthesia.

2. How is chronic hemorrhoids operated on?

In advanced cases, when the internal nodes fell out and merged with the external ones, as before, the only way out is hemorrhoidectomy – a radical operation in which hemorrhoids are completely excised.The surgeon needs to find a “golden mean” – to remove hemorrhoids, often merged with each other, and to minimize surgical trauma to such delicate areas as the anal canal and the area around it. It is necessary not to damage the sphincter, to leave the bridges of tissues – the gaps between the wounds, so that there is something for the healing process to take place.

In many federal centers, such operations are now performed with an ultrasonic scalpel. It cuts off, “seals” blood vessels, and most importantly, does not cause great injury to the surrounding tissues, does not leave a burn scab.This allows you to reduce pain, reduce the number of postoperative complications, and accelerate healing.

3. What complications can arise after radical surgery?

During healing, such early complications often occur as:

• Urinary disorders. The operation does not injure the urinary tract, the disorders are reflex in nature and are associated with pain. Such complications are more common in men with prostate problems.
• Bleeding. Failure to comply with the postoperative regime, dense stools and constipation can injure wounds in the anal canal.
• Purulent-inflammatory processes. They occur when defecation is disturbed, wounds are infected with pathogenic microorganisms, and local immunity is reduced. Abscesses may appear – cavities with purulent content or fistulas of the rectum.

Late postoperative complications can develop with an incorrect operation, or if the coloproctologist surgeon does not conduct regular examinations in the postoperative period, if the patient does not follow the doctor’s recommendations.These complications include:

• Narrowing (stricture) of the anus. Complication occurs in 2% of cases. To correct the narrowing of the anus, plastic surgery may be required, often much more complicated than surgery to remove hemorrhoids.
• Insufficiency of the anal sphincter. This formidable complication can develop both due to damage to the obturator of the rectum during the operation, and cicatricial deformity of the anus (the sphincter is intact, but postoperative scars do not allow it to provide hermetic closure of the anus).
• Long-term non-healing wounds – a very common complication, observed in 20-30% of cases, most often associated with infection of wounds with pathogenic and opportunistic flora (chlamydia, Trichomonas). A long-term non-healing wound sometimes brings more suffering to the patient than the hemorrhoid itself.

4. They say that recovery after surgery to remove hemorrhoids is very painful.

The anus is the most sensitive and most painful area of ​​the body.Therefore, after a radical operation, the patient is not immediately released from the clinic, first it is necessary to fix his chair, stop the pain syndrome. All this is to prevent the development of postoperative complications. Previously, when there were no modern technologies, the healing was so painful that patients were kept in the hospital for three weeks, in the first days they were held back to prevent injuries during defecation, they were given antidepressants, I found this in the 90s. And even earlier, after such radical operations, an opium tincture was prescribed, which delayed stool, because opium causes constipation, and anesthetized.

5. How long does the healing take? When can you already lead a normal life?

Healing after radical removal of hemorrhoids lasts, on average, 35 days. If more than 60 days have passed, and the wound has not healed, you need to figure out what the reason is. For several months after the operation, the formation of scar tissue continues. At this time, the patient may be disturbed by various unpleasant sensations: numbness, tingling, twitching. If the stool is too dense, the patient may feel discomfort, burning, and mark traces of blood in the stool.

Can nodes appear again after surgery, for example, after a year or after 5 years? Statistics say that after radical surgery, relapses occur in 4% of cases. Repeated hemorrhoids are caused by the same factors that caused it the first time. It is necessary to abandon a sedentary lifestyle, prevent constipation, increase intra-abdominal pressure, avoid excessive physical exertion.

Numbness of limbs

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct treatment, you should contact your doctor.

Numbness, or paresthesia, is a disorder of the sensitivity of body tissues that occurs as a result of damage to the peripheral nervous system.

It can be accompanied by various sensations: from tingling, goose bumps to a general decrease in the sensitivity of any part of the body, most often the limbs.

The patient feels any tactile effects, as if through a layer of cotton wool.

Varieties

Depending on the duration and location, several types of paresthesias are distinguished. Temporary, or transient, paresthesia may be due to a weakening of blood flow (ischemic). This type of numbness occurs with spasm or compression of the vessels of the limb. Permanent paresthesia is also possible when crossing or compressing nerve fibers during surgery, trauma, cancer and degenerative changes in the musculoskeletal system.

Reasons for the appearance of

An example of transient paresthesias may be sensory impairment in hypertensive crisis . This condition is characterized by a sudden increase in blood pressure and is accompanied by symptoms such as a sharp headache, dizziness, nausea, vomiting, visual impairment, “flies” before the eyes, paresthesia of the extremities.

It should be noted that the clinical symptoms of a crisis can be observed even at low pressure values, the main role is played by the suddenness and the difference in the difference in systolic and diastolic pressure.

Raynaud’s syndrome – an episodic disturbance of blood circulation in the extremities due to a sharp spasm of peripheral vessels in response to cold exposure or emotional stress, quite often causes loss of their sensitivity. Fingers are most often affected, which, from exposure to cold, acquire an almost white or bluish-purple hue and lose sensitivity. After the cessation of the spasm (usually after 15-20 minutes), blood flow in the extremities is restored, as evidenced by the normalization of the color and sensitivity of the skin.

Tunnel or compression syndromes are among the most common causes of limb numbness. Compression (compression) of a nerve fiber located in a narrow space between the bone and muscles of the limb occurs due to edema that occurs with injuries to the joints and ligaments.

The first symptoms of this condition are pain, sometimes a sensation of current flow (electric shock), numbness, weakness and impaired function, which subsequently lead to muscle atrophy and loss of motor ability of the limb.

Compression of the nerve roots ( radiculopathy ) due to herniated intervertebral discs, tumors are also accompanied by numbness of the limb. Depending on the level of the spine where the nerve is pinched, pain and numbness may occur in certain parts of the limb, impaired reflexes, muscle weakness, stiffness in the spine, pain in the projection of the affected root when coughing or sneezing.

With radiculopathies, the pain increases in the upright position of the body and decreases in the supine position.

Numbness of the extremities can be caused by polyneuropathies of various origins. Symmetrical limb involvement is a sign of polyneuropathy. Multiple peripheral nerve damage occurs due to a decrease in the supply of nerve fibers (metabolic polyneuropathy). Diabetic polyneuropathy is a typical example of peripheral nerve damage. It is characterized by slow progression and gradual development of movement and sensory disorders. Alcoholic polyneuropathy develops much faster.

Its characteristic symptoms include numbness and loss of sensation in the lower extremities, starting with the feet, and soreness of the calf muscles. In the future, these symptoms are joined by weakness and paresis (decreased muscle strength) of the limbs.

Paresthesia can occur with drug-induced polyneuropathy when taking certain drugs, with uremic polyneuropathy in patients with chronic renal failure, as well as with other diseases.
Paresthesia, feeling of numbness and goosebumps are the main signs of deficiency of B vitamins . In particular, with a lack of thiamine (B1), polyneuropathy develops, which is manifested by a sensation of “tingling needles”.

Deficiency of cyanocobalamin (B12) leads to degenerative changes in the spinal cord, which are accompanied by a feeling of numbness, tingling in the limbs, impaired gait, loss of memory and loss of tendon reflexes.

Similarly, with hypocalcemia (lack of calcium in the blood), paresthesias and convulsions are the leading clinical manifestations of the disease.Calcium deficiency can develop against the background of pancreatitis, sepsis, hormonal disorders (in particular, with hypoparathyroidism), blood loss during massive operations and injuries.

Multiple sclerosis is referred to as 90,087 demyelinating lesions that cause numbness in the extremities.

With this disease, demyelination (destruction of the myelin sheath) of nerve fibers occurs in various parts of the central nervous system, which significantly disrupts the conduction of impulses through neurons.

Sensory impairment is one of the earliest and most frequent symptoms of multiple sclerosis. The patient has a transient feeling of numbness, “creeping creeps” in various parts of the body, more often in the tips of the toes or hands. This violation of sensitivity is focal in nature.

Sensory disturbances in the limbs, numbness occurs with polymyalgia rheumatica . It is an inflammatory disease of the musculoskeletal system that develops after the age of 50.Severe pain in the symmetrical muscles of the shoulders, hips, neck is combined with an acute inflammatory process. The pains are worse when moving and do not subside even at night. Muscle stiffness is characteristic both in the morning hours and after prolonged immobility. Muscle damage is combined with peripheral arthritis, more often on the one hand, which is accompanied by a slight violation of sensitivity and paresthesias.

Occupational hazards, exposure to ultrasound also lead to sensory and vascular disorders. People who are exposed to vibration for a long time develop hypersensitivity of the hands to cold, periodically there is numbness of the fingers. The skin becomes cyanotic, marbled in color, cold and damp to the touch. Over time, dystrophic changes spread to nerve fibers, muscles, bones.

Diagnostics and examination

Diagnosis of a disease accompanied by numbness begins with a patient interview, which allows clarifying the location and nature of the sensitivity disorder.To exclude the metabolic nature of the disease, blood tests (general clinical and biochemical), determination of the level of glycated hemoglobin, blood urea, liver enzymes), calcium, vitamin B12 and methylmalonic acid, C-reactive protein and general urinalysis are required.

How to choose the right mattress firmness

The most difficult task when choosing a mattress is to determine the required level of firmness. This is one of those parameters that cannot be estimated with standard measuring instruments.

Misconceptions about the firmness of the mattress

Many buyers are mistaken, believing that the harder the mattress, the more useful it is for the spine and back as a whole. This is one of the myths that formed in our country back in the Soviet years. At that time, a very hard mattress was actively opposed to a soft sleeping place with pressed springs, creating the so-called hammock effect. In fact, both the first and second options are harmful to the health and condition of the spine in particular, since they exclude the possibility of resting in a natural position for the body.

Let’s turn to physiology. The spine is not an even line, like a string; in its shape, it is more like a wave. Accordingly, sleeping on a very hard surface will lead to the fact that the shoulders and hips will receive the maximum load – they simply cannot sink into the soft layers of the mattress. At the same time, the space around the lumbar spine will remain unfilled, it will not receive the necessary support, which will lead to overstrain of muscle tissues. A too hard surface can disrupt the work of the circulatory system due to excessive compression of individual vessels, which provokes problems with blood circulation.This can cause numbness in the limbs, muscle stiffness, and general fatigue after sleep.

Too soft a mattress is no less harmful to health, but for other reasons. On such a surface, the spine bends too much and takes the shape of a crescent. And again, muscle overstrain occurs, the lungs are compressed, and the respiratory process becomes difficult.

When choosing the rigidity of the mattress, one should take into account the weight and age of the person, the anatomical features of his body, medical indications based on diseases of the musculoskeletal system and internal organs.

How to determine the optimal firmness of the mattress

1. For newborns from the first days of life. The first few months of its existence, the child is going through a stage of permanent formation of the spine and the musculoskeletal system as a whole. Therefore, pediatricians recommend putting babies to sleep on the most rigid springless mattresses.

2. For children from 2 to 13 years old.
   During this period, the baby moves from a crib to a teenager.The mattress chosen for her should take into account the characteristics of the child’s development and significant changes in his body weight over several years. For this purpose, models of medium rigidity, both spring and springless, are suitable.

3. For adolescents and young people under 25. The formation of the spine lasts a quarter of a century. Therefore, it is undesirable to use soft mattresses for sleeping until the age of 25. Models of medium and high (if there are problems with excess weight) rigidity will be relevant.

4. For people from 25 to 50 years old. During this period of life, you can stop the choice on a mattress of any firmness, depending on personal preferences and weight category:

• up to 55 kg – soft models without coconut coir or with a thick layer on top of it;
• from 55 to 90 kg – medium firm mattresses. In this case, pay attention to the maximum permissible load for the selected model. If it is above 140 kg, the product will seem too dense and uncomfortable to sleep;
• over 90 kg – mattresses with the maximum hardness parameter.Here, models with a reinforced spring block or with a double layer of coconut coir will prove themselves well. If the mattress is used for sleeping by a couple, it is necessary to focus on the weight of the heavier partner.

5. People over 50 years old. Very hard mattresses are contraindicated for them – this can lead to serious problems with intervertebral discs. The optimal choice for them will be soft and medium-hard models.

6. For people with musculoskeletal problems.

   If a person has diseases of the spine, you should first consult with your doctor. In each case, the selection of the mattress should be carried out individually. But there are general recommendations:

• in the case of problems in the thoracic or cervical regions, models of medium hardness are suitable;
• in the presence of diseases in the lumbar spine, soft mattresses are most relevant;
• for osteochondrosis and problems with posture, rigid models are recommended.