Hemorrhoids – Reflux, Stomach Pain, Ulcers

Hemorrhoids are engorged, often painful veins located in your anus.

Hemorrhoids can build up in 2 different places. There are 2 distinct branches of veins that drain the blood from the lower rectum and anus.

The internal veins can become swollen to form internal hemorrhoids. Internal hemorrhoids, unless they are severe, cannot be seen or felt, unlike external hemorrhoids.

Similarly, the external veins can enlarge to form external hemorrhoids. External hemorrhoids can be seen around the outside of the anus and, often, can be felt.

Causes

Hemorrhoids are associated with constipation, straining at bowel movements, and pregnancy. Many physicians believe that these conditions lead to increased pressure in the hemorrhoid veins, thus causing them to swell. Hemorrhoids are very common and have been estimated to occur in up to half the general population by age 50.

Symptoms

The symptoms are fairly straightforward. The most common is painless rectal bleeding. You will see bright red blood on the outside of your bowel movement, on toilet tissue, or dripping into the toilet. The bleeding usually is self limited and does not last long.

Hemorrhoids may become prolapsed.

• This occurs when the internal hemorrhoids swell and then protrude through the anal canal.
• You then can feel the hemorrhoids, at your anus, from the outside.
• Often a simple push of the hemorrhoids back into the rectum can solve the problem.
• If the hemorrhoids cannot be reduced back into the rectum, then they will continue to inflame and can become trapped outside of the anus.
• If your hemorrhoids become prolapsed and cannot be reduced, then you will need to see a doctor.
• You may develop itching in your anus from prolapsed hemorrhoids. This condition is called pruritus ani.

External hemorrhoids may become quite painful when they get thrombosed.

• This occurs when blood clot (thrombus) forms in the hemorrhoid; the hemorrhoid will become even more engorged. This swelling leads to increased discomfort or pain.
• The pain usually worsens with straining during bowel movements or with sitting.
• This too is a condition that may require a doctor’s examination and treatment.

When to call the doctor

If you notice recurrent bleeding between bowel movements or have a moderate amount of bleeding, you should consult with your doctor.

If you have a family history of colon cancer or are over age 40 you should see your doctor for evaluation of the recurrent rectal bleeding.

If you have prolapsed hemorrhoids that will not go back into the anus, or you have significant anal or rectal pain, you should consult your doctor.

There are numerous other medical causes of rectal bleeding that are much more serious than hemorrhoids. These will require a doctor to further evaluate he cause so that serious conditions such as colon cancer and colitis are not overlooked

When to go to the hospital

Most of the time hemorrhoids can be managed by your primary care physician. A few situations exist that may require that instead you to go to the hospital emergency department.

If you have considerable pain, bleeding, or a prolapsed hemorrhoid and are unable to get in touch with your doctor, then you should be evaluated in the emergency department.

If you have a large amount of bleeding from your rectum, become weak, or experience lightheadedness you should be evaluated in the emergency department.

Exams and Tests

The number one tool that the doctor will need is a medical history and physical exam to evaluate your hemorrhoids. Occasionally your doctor may need to evaluate your hemorrhoids by looking directly at them by performing an anoscopy.

During an anoscopy, a small, lighted scope is placed into the anus and rectum to fully view the anal canal and lower rectum. This procedure is a bit uncomfortable but is easily performed in a doctor’s office and does not require sedation, usually a local anesthetic gel is applied.

If there has been significant bleeding or symptoms of severe blood loss, then your doctor may order a simple blood test to ensure that you have notdeveloped anemia.

Hemorrhoid Treatment

Self-Care at Home

The treatment varies depending on the severity of the problem. Most of the time, conservative treatment can be performed at home.

Hot sitz baths

• For a sitz bath, sit in a few inches of warm water in a tub. Epsom salts can also be added to the bath water.
• A sitz bath is recommended 3 times a day and after each bowel movement for 10 to15 minutes.
• This is the best way to reduce the inflammation and the discomfort.
• Thorough drying of the skin around the anus after each bath is extremely important so that it doesn’t rub and become torn.

Dietary changes

• Drinking more liquids and eating a diet rich in fiber, such as leafy green vegetables and fruits, will make the stools bulkier and softer, helping to relieve constipation.

Stool softeners

• Stool softeners can also be advantageous.
• If you use a laxative and it leads to watery, or runny stools, it could cause an infection in the anus and should not be avoided.

Sitting restrictions

• Some doctors also recommend people with hemorrhoids not sit for a prolonged periods of time.
• Some people have reported feeling more comfortable when they sit on an air doughnut.

OTC medications

• These medications help only minimally and at times even lead to longer healing, so consult with your physician first.

Medical Treatment

Thrombosed hemorrhoids

• If a hemorrhoid with a clot develops (thrombosed hemorrhoid), you will feel some pain.
• If the pain is not severe and the swelling is minimal, often this can be treated with hot sitz baths and stool bulking agents.
• If the pain is intolerable or there is a large amount of swelling present, it might be necessary to remove the blood clot. This procedure can be done in a doctor’s office or emergency department but must not be attempted at home.
• Almost universally there is great relief of the pain after the clot is removed and any residual discomfort can be easily treated with acetaminophen (Tylenol) or ibuprofen (Advil/Motrin) for pain.

Prolapsed internal hemorrhoids

• If you have prolapsed hemorrhoids, which you are unable to introduce through the anus, then your doctor will need to reduce them.
• Many times the doctor is able to gently push the hemorrhoids back into place.
• If the hemorrhoids are too swollen to be reintroduced back, then a surgical procedure to relieve the swelling may be called for.
• If the hemorrhoids remain trapped through the anal canal and nothing is done, then the hemorrhoid will become strangulated, not receive enough blood and start to die.
• If this occurs, the hemorrhoid will become infected, and this can lead to a more serious generalized infection in the blood.

Surgery

The surgeon can elect to inject the hemorrhoids with a medicine to shrink them or place small rubber bands around the hemorrhoids to cut off the blood supply so they will die. These procedures are usually done in the office and don’t require you to be put to sleep or admitted to a hospital.

Sometimes, it is necessary for the surgeon to actually remove the hemorrhoids. In this case you will need to be put to sleep or have a spinal anesthetic.

Follow-up

Warm sitz baths 3 times a day and after each bowel movement along with increasing the amount of dietary fiber is beneficial.

Any pain associated to the surgery can be easily managed with over-the-counter pain relievers.

Prevention

There is no scientifically proven method for avoiding the development of hemorrhoids. Eating a high-fiber diet and avoiding straining is believed to aid in preventing hemorrhoids, but there is no way to completely eliminate the risk.

Outlook

Most people with hemorrhoids have an excellent outcome. There cab be flare-ups of bleeding or slight discomfort from time to time, but they don’t last long and can be relieved with care at home, typically with sitz baths.

Hemorrhoids | Gastrointestinal Society

Click here to download a PDF of this information.

Hemorrhoids, also called piles, are enlarged or varicose veins of the anus and rectum. They are a common health ailment, particularly in developed countries, affecting nearly 5% of the population. There are two types of hemorrhoids, external and internal, which can occur separately or in combination. A person could have a single hemorrhoid, or have several at the same time.

Symptoms/Complications of Hemorrhoids

External hemorrhoids develop under the skin just outside the opening of the anus. They are usually painful if they develop a clot (thrombose), in which case they appear as very tender, circular, purplish bulges around the anal opening.

Internal hemorrhoids are often present without causing any discomfort or even awareness of their existence. This is because there is rectal lining (mucous membrane) around internal hemorrhoids, rather than nerve-rich skin. You might experience a feeling of fullness in the rectum, as if you need to have a bowel movement. You might not even know you have them unless they clot (thrombose) or bleed, resulting in passing bright red blood during and/or following a bowel movement. However, if a hemorrhoid loses its blood supply (strangulates) it can become very painful. Sometimes an internal hemorrhoid pushes down or stretches until it bulges outside of the anus (prolapse). This could manifest as a pinching sensation in the anal area, or you may notice a painless lump when you wipe after a bowel movement.

The extra bumps and crevasses of hemorrhoids could lead to improper cleaning of the area, resulting in anal itching.

Hemorrhoids have a number of predisposing causes but, in most cases, increased pressure in the abdomen plays a key role. Some of the most common underlying factors for developing hemorrhoids include constipation and straining during bowel movements, repeated lifting of heavy objects, frequent diarrhea, prolonged sitting or standing, obesity, and pregnancy. Excessive abdominal pressure can cause the small veins around the anus and rectum to stretch. As the veins lose their elasticity, they become distended with blood and more likely to thrombose and become more fragile. Pregnant women are particularly prone to hemorrhoids, partially because the enlarging uterus sits directly on the blood vessels that drain veins near the rectum and anus. Hemorrhoids affect up to 38% of women in the third trimester of pregnancy.

Diagnosing Hemorrhoids

Your physician might diagnose hemorrhoids following a physical examination of the anus and rectum. This can include a rectal exam performed with a gloved, lubricated finger, or with a small instrument that will allow your physician to visualize the rectum more closely.

Rectal bleeding could be a symptom of other, potentially more serious, conditions. One source of bleeding could be anal fissures, which are tears in the lining of the anus causing pain when passing a bowel movement. Some types of inflammatory bowel disease can also cause rectal bleeding, as can tumours of the rectum and colon. If you pass blood from the anus, then you should consult with your physician to determine if further testing is required.

Management of Hemorrhoids

It is very important to avoid straining while having a bowel movement, as this puts extra pressure on the anal area. The management of hemorrhoids typically involves a number of moderate dietary and lifestyle changes to ensure soft and formed stools, which help to avoid pressure in the rectal area.

Dietary Modifications

Recommendations for ongoing dietary management include consuming well-balanced meals and snacks and ensuring adequate fibre and fluid intake as outlined in Canada’s Food Guide, available from Health Canada. Fibre and fluid help soften stool, allowing it to move more quickly and easily through the colon, rectum, and anus, which reduces strain.

Aim for 20-35 g of fibre daily, consumed evenly throughout the day. To help monitor your fibre intake, check the nutrient content on the labels of packaged foods. Make gradual changes while increasing fibre intake, as this approach could help you to avoid the bloating, gas, and general abdominal discomfort that could occur as your body adapts to the dietary modifications.

There are also some commercial fibre supplements available. These include bran, psyllium seed, or ispaghula husk derivatives (e.g., Metamucil®) and inulin (Benefibre®), which is soluble vegetable fibre. For more information on fibre, visit our website or contact our office.

Most hemorrhoid sufferers will find good results with the use of a basic fibre supplement; however, if constipation continues to remain a problem, then products containing the herb senna could offer additional relief. Be sure to check the labels as some of these products contain different substances depending on their format (e.g., powders are different from caplets). Also note that products marked ‘plus’ could contain additional unwanted substances that increase their laxative effect.

Resist the Urge to Scratch

The area around your hemorrhoid might feel itchy. Don’t scratch, as you could damage delicate vein walls.

Clean Carefully

It is extremely important to clean yourself properly and gently following a bowel movement. Use only non-perfumed, non-coloured toilet paper and try dampening it under the faucet before each wipe. Some varieties of toilet paper are softer than are others and some facial tissues contain moisturizing cream, which you may find to be more soothing. Using pre-moistened flushable wipes might also increase cleaning comfort.

Have a Sitz bath

This is a type of therapeutic bath that involves sitting in very warm water with your knees raised. The warm water helps lessen the pain while increasing blood flow to the area. This helps to shrink the swollen veins and promote healing. Adding Epsom salts to the bath water might also help.

Push it Back Inside

If your hemorrhoid protrudes from the anal canal, try gently pushing it back inside. A hemorrhoid left hanging out of the anus is at a greater risk of developing clots or strangulating.

Hemorrhoids During Pregnancy

To help prevent or manage hemorrhoids if you are pregnant, try lying on your left side for about 20 minutes every 4-6 hours, as this decreases pressure on the main vein draining the lower half of the body.

Ointments and Creams

Hemorrhoidal symptoms often subside within a few days, even with no specific treatment. Topical hemorrhoid treatments usually contain one or more active ingredients including a local anesthetic, mild anti-inflammatory compounds, or astringents.

Local anaesthetics temporarily relieve pain, burning, and itching by numbing the nerve endings. Analgesic products relieve pain, itching, and burning by depressing receptors on pain nerves.

Witch hazel is a widely used plant-based astringent; when applied to the rectum with a cotton ball, this product can offer relief. Several other products have stronger ingredients that focus on reducing inflammation and these may require a prescription.

Surgery

If significant hemorrhoidal symptoms persist despite conservative measures, a number of minor surgical options are available and a physician may perform many of these in the office. Treatment for internal hemorrhoids includes application of rubber bands (ligation), injection of a material (sclerosant) that blocks the vein, stapling, cryosurgery, laser, or electro-coagulation techniques. Surgical excision that is more extensive might be required for large, permanently prolapsed hemorrhoids or strangulated hemorrhoids. Thrombosed external hemorrhoids generally respond promptly to surgical incision and clot removal.

Hemorrhoids Outlook

Some individuals can have a single hemorrhoid while others have ongoing hemorrhoids throughout life. Most hemorrhoids completely resolve within a week or so. Maintaining adequate intake of dietary fibre, drinking plenty of water, avoiding abdominal strain, and getting regular moderate exercise might help to avoid the recurrence of hemorrhoids.

Want to learn more about hemorrhoids?

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Hemorrhoids – Reflux, Stomach Pain, Ulcers

On this page:

What are hemorrhoids?

The term hemorrhoids refers to a condition in which
the veins around the anus or lower rectum are swollen and inflamed.

Hemorrhoids may result from straining to move stool.
Other contributing factors include pregnancy, aging, chronic constipation
or diarrhea, and anal intercourse.

Hemorrhoids are either inside the anus (internal) or
under the skin around the anus (external). (See figure.)

[Top]

What are the symptoms of hemorrhoids?

Many anorectal problems, including fissures, fistulae,
abscesses, or irritation and itching (pruritus ani), have similar symptoms
and are incorrectly referred to as hemorrhoids.

Hemorrhoids usually are not dangerous or life threatening.
In most cases, hemorrhoidal symptoms will go away within a few days.

Although many people have hemorrhoids, not all experience
symptoms. The most common symptom of internal hemorrhoids is bright red
blood covering the stool, on toilet paper, or in the toilet bowl. However,
an internal hemorrhoid may protrude through the anus outside the body,
becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful
swelling or a hard lump around the anus that results when a blood clot
forms. This condition is known as a thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning
around the anus may cause irritation with bleeding and/or itching, which
may produce a vicious cycle of symptoms. Draining mucus may also cause
itching.

[Top]

How common are hemorrhoids?

Hemorrhoids are very common in both men and women. About
half of the population have hemorrhoids by age 50. Hemorrhoids are also
common among pregnant women. The pressure of the fetus in the abdomen,
as well as hormonal changes, cause the hemorrhoidal vessels to enlarge.
These vessels are also placed under severe pressure during childbirth.
For most women, however, hemorrhoids caused by pregnancy are a temporary
problem.

[Top]

How are hemorrhoids diagnosed?

A thorough evaluation and proper diagnosis by the doctor
is important any time bleeding from the rectum or blood in the stool occurs.
Bleeding may also be a symptom of other digestive diseases, including
colorectal cancer.

The doctor will examine the anus and rectum to look
for swollen blood vessels that indicate hemorrhoids and will also perform
a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires
an exam with an anoscope, a hollow, lighted tube useful for viewing internal
hemorrhoids, or a proctoscope, useful for more completely examining the
entire rectum.

To rule out other causes of gastrointestinal bleeding,
the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy
or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are
diagnostic procedures that also involve the use of lighted, flexible tubes
inserted through the rectum.

[Top]

What is the treatment?

Medical treatment of hemorrhoids is aimed initially
at relieving symptoms. Measures to reduce symptoms include

• warm tub baths several times a day in plain, warm
  water for about 10 minutes
• application of a hemorroidal cream or suppository
  to the affected area for a limited time

Preventing the recurrence of hemorrhoids will require
relieving the pressure and straining of constipation. Doctors will often
recommend increasing fiber and fluids in the diet. Eating the right amount
of fiber and drinking six to eight glasses of fluid (not alcohol) result
in softer, bulkier stools. A softer stool makes emptying the bowels easier
and lessens the pressure on hemorrhoids caused by straining. Eliminating
straining also helps prevent the hemorrhoids from protruding.

Good sources of fiber are fruits, vegetables, and whole
grains. In addition, doctors may suggest a bulk stool softener or a fiber
supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

In some cases, hemorrhoids must be treated endoscopically
or surgically. These methods are used to shrink and destroy the hemorrhoidal
tissue. The doctor will perform the procedure during an office or hospital
visit.

A number of methods may be used to remove or reduce
the size of internal hemorrhoids. These techniques include

• Rubber band ligation. A rubber band is placed
  around the base of the hemorrhoid inside the rectum. The band cuts off
  circulation, and the hemorrhoid withers away within a few days.
• Sclerotherapy. A chemical solution is injected
  around the blood vessel to shrink the hemorrhoid.
• Infrared coagulation. A special device is
  used to burn hemorrhoidal tissue.
• Hemorrhoidectomy. Occasionally, extensive
  or severe internal or external hemorrhoids may require removal by surgery
  known as hemorrhoidectomy.

[Top]

How are hemorrhoids prevented?

The best way to prevent hemorrhoids is to keep stools
soft so they pass easily, thus decreasing pressure and straining, and
to empty bowels as soon as possible after the urge occurs. Exercise, including
walking, and increased fiber in the diet help reduce constipation and
straining by producing stools that are softer and easier to pass.

[Top]

The U.S. Government does not endorse or favor any specific
commercial product or company. Trade, proprietary, or company names appearing
in this document are used only because they are considered necessary in
the context of the information provided. If a product is not mentioned,
this does not mean or imply that the product is unsatisfactory.

Understanding Minor Rectal Bleeding – Reflux, Stomach Pain, Ulcers

This information was developed by the Publications Committee of the American Society for Gastrointestinal Endoscopy (ASGE). For more information about ASGE, visit www.asge.org.

This information is intended only to provide general guidance. It does not provide definitive medical advice. It is important that you consult your doctor about your specific condition.

To evaluate minor rectal bleeding, your doctor may perform a digital rectal examination. In addition, an endoscopic procedure such as anoscopy, flexible sigmoidoscopy or colonoscopy may be recommended.

Minor rectal bleeding refers to the passage of a few drops of bright red (fresh) blood from the rectum, which may appear on the stool, on the toilet paper or in the toilet bowl.

This brochure addresses minor rectal bleeding that occurs from time to time. Continuous passage of significantly greater amounts of blood from the rectum or stools that appear black, tarry or maroon in color can be caused by other diseases that will not be discussed here. Call your doctor immediately if these more serious conditions occur. Because there are several possible causes for minor rectal bleeding, a complete evaluation and early diagnosis by your doctor is very important. Rectal bleeding, whether it is minor or not, can be a symptom of colon cancer, a type of cancer that can be cured if detected early.

What are hemorrhoids?

Hemorrhoids (also called piles) are swollen blood vessels in the anus and rectum that become engorged from increased pressure, similar to what occurs in varicose veins in the legs. Hemorrhoids can either be internal (inside the anus) or external (under the skin around the anus). Hemorrhoids are the most common cause of minor rectal bleeding, and are typically not associated with pain. Bleeding from hemorrhoids is usually associated with bowel movements, or it may also stain the toilet paper with blood. The exact cause of bleeding from hemorrhoids is not known, but it often seems to be related to constipation, diarrhea, sitting or standing for long periods, obesity, heavy lifting and pregnancy. Symptoms from hemorrhoids may run in some families. Hemorrhoids are also more common as we get older. Fortunately, this very common condition does not lead to cancer.

Hemorrhoids and rectal polyps are common causes of minor rectal bleeding.

How are hemorrhoids treated?

Medical treatment of hemorrhoids includes treatment of any underlying constipation, taking warm baths and applying an over-the-counter cream or suppository that may contain hydrocortisone. If medical treatment fails there are a number of ways to reduce the size or eliminate internal hemorrhoids. Each method varies in its success rate, risks and recovery time. Your doctor will discuss these options with you. Rubber band ligation is the most common outpatient procedure for hemorrhoids in the United States. It involves placing rubber bands around the base of an internal hemorrhoid to cut off its blood supply. This causes the hemorrhoid to shrink, and in a few days both the hemorrhoid and the rubber band fall off during a bowel movement. Possible complications include pain, bleeding and infection. After band ligation, your doctor may prescribe medications, including pain medication and stool softeners, before sending you home. Contact your doctor immediately if you notice severe pain, fever or significant rectal bleeding. Laser or infrared coagulation and sclerotherapy (injection of medicine directly into the hemorrhoids) are also office-based treatment procedures, although they are less common. Surgery to remove hemorrhoids may be required in severe cases or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy.

What are anal fissures?

Tears that occur in the lining of the anus are called anal fissures. This condition is most commonly caused by constipation and passing hard stools, although it may also result from diarrhea or inflammation in the anus. In addition to causing bleeding from the rectum, anal fissures may also cause a lot of pain during and immediately after bowel movements. Most fissures are treated successfully with simple remedies such as fiber supplements, stool softeners (if constipation is the cause) and warm baths. Your doctor may also prescribe a cream to soothe the inflamed area. Other options for fissures that do not heal with medication include treatment to relax the muscles around the anus (sphincters) or surgery.

In a colonoscopy, the physician passes the endoscope through your rectum and into the colon to examine the tissue of the colon wall for abnormalities such as polyps.

What is proctitis?

Proctitis refers to inflammation of the lining of the rectum. It can be caused by previous radiation therapy for various cancers, medications, infections or a limited form of inflammatory bowel disease (IBD). It may cause the sensation that you didn’t completely empty your bowels after a bowel movement, and may give you the frequent urge to have a bowel movement. Other symptoms include passing mucus through the rectum, rectal bleeding and pain in the area of the anus and rectum. Treatment for proctitis depends on the cause. Your doctor will discuss the appropriate course of action with you.

What are colon polyps?

Polyps are benign growths within the lining of the large bowel. Although most do not cause symptoms, some polyps located in the lower colon and rectum may cause minor bleeding. It is important to remove these polyps because some of them may later turn into colon cancer if left untreated.

What is colon cancer?

Colon cancer refers to cancer that starts in the large intestine. It can affect both men and women of all ethnic backgrounds and is the second most common cause of cancer deaths in the United States. Fortunately, it is generally a slow-growing cancer that can be cured if detected early. Most colon cancers develop from colon polyps over a period of several years. Therefore, removing colon polyps reduces the risk for colon cancer. Anal cancer is less common but curable when diagnosed early.

Most colon cancers develop from colon polyps over a period of several years. Therefore, removing colon polyps reduces the risk for colon cancer.

What are rectal ulcers?

Solitary rectal ulcer syndrome is an uncommon condition that can affect both men and women, and is associated with long-standing constipation and prolonged straining during bowel movement. In this condition, an area in the rectum (typically in the form of a single ulcer) leads to passing blood and mucus from the rectum. Treatment involves fiber supplements to relieve constipation. For those with significant symptoms, surgery may be required.

How is minor rectal bleeding evaluated?

Your doctor may examine the anus visually to look for anal fissures, cancer or external hemorrhoids, or the doctor may perform an internal examination with a gloved, lubricated finger to feel for abnormalities in the lower rectum and anal canal.If indicated, your doctor may also perform a procedure called colonoscopy. In this procedure, a flexible, lighted tube about the thickness of your finger is inserted into the anus to examine the entire colon. Sedative medications are typically given for colonoscopy to make you sleepy and decrease any discomfort. As an alternative, to evaluate your bleeding, your doctor may recommend a flexible sigmoidoscopy, which uses a shorter tube with a camera to examine the lower colon and rectum. To examine only the lower rectum and anal canal, an anoscope may be used. This very short (3 to 4 inch) tube is especially useful when your doctor suspects hemorrhoids, anal cancer or anal fissures.

What can I do to prevent further rectal bleeding?

This depends on the cause of the rectal bleeding. You should talk to your doctor about specific management options.

Haemorrhoids (piles) – Illnesses & conditions

Haemorrhoids (piles) often clear up by themselves after a few days. However, there are many treatments that can reduce itching and discomfort.

Making simple dietary changes and not straining on the toilet are often recommended first.

Creams, ointments and suppositories (which you insert into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort.

If more intensive treatment is needed, the type will depend on where your haemorrhoids are in your anal canal – the lower third (closest to your anus) or the upper two-thirds. The lower third contain nerves which can transmit pain, while the upper two-thirds do not.

Non-surgical treatments for haemorrhoids in the lower part of the canal are likely to be very painful, because the nerves in this area can detect pain. In these cases, haemorrhoid surgery will usually be recommended.

The various treatments for haemorrhoids are outlined below. 

Dietary changes and self care

If constipation is thought to be the cause of your haemorrhoids, you need to keep your stools soft and regular, so that you don’t strain when passing stools.

You can do this by increasing the amount of fibre in your diet. Good sources of fibre include wholegrain bread, cereal, fruit and vegetables.

You should also drink plenty of water and avoid caffeine (found in tea, coffee and cola).

When going to the toilet, you should:

• avoid straining to pass stools, because it may make your haemorrhoids worse
• use moist toilet paper, rather than dry toilet paper, or baby wipes to clean your bottom after passing a stool
• pat the area around your bottom, rather than rubbing it

Read more about preventing constipation.

Medication

Over-the-counter topical treatments

Various creams, ointments and suppositories (which are inserted into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort.

These medicines should only be used for five to seven days at a time. If you use them for longer, they may irritate the sensitive skin around your anus. Any medication should be combined with the diet and self-care advice discussed above.

There’s no evidence to suggest that one method is more effective than another. Ask your pharmacist for advice about which product is most suitable for you, and always read the patient information leaflet that comes with your medicine before using it.

Don’t use more than one product at once.

Corticosteroid cream

If you have severe inflammation in and around your back passage, your GP may prescribe corticosteroid cream, which contains steroids.

You shouldn’t use corticosteroid cream for more than a week at a time, because it can make the skin around your anus thinner and the irritation worse.

Painkillers

Common painkilling medication, such as paracetamol, can help relieve the pain of haemorrhoids.

However, if you have excessive bleeding, avoid using non-steroid anti-inflammatory drugs (NSAIDs), such as ibuprofen, because it can make rectal bleeding worse. You should also avoid using codeine painkillers, because they can cause constipation.

Your GP may prescribe products that contain local anaesthetic to treat painful haemorrhoids. Like over-the-counter topical treatments, these should only be used for a few days, because they can make the skin around your back passage more sensitive.

Laxatives

If you’re constipated, your GP may prescribe a laxative. Laxatives are a type of medicine that can help you empty your bowels.

Non-surgical treatments

If dietary changes and medication don’t improve your symptoms, your GP may refer you to a specialist. They can confirm whether you have haemorrhoids and recommend appropriate treatment.

If you have haemorrhoids in the upper part of your anal canal, non-surgical procedures such as banding and sclerotherapy may be recommended.

Banding

Banding involves placing a very tight elastic band around the base of your haemorrhoids to cut off their blood supply. The haemorrhoids should then fall off within about a week of having the treatment.

Banding is usually a day procedure that doesn’t need an anaesthetic, and most people can get back to their normal activities the next day. You may feel some pain or discomfort for a day or so afterwards. Normal painkillers are usually adequate, but your GP can prescribe something stronger, if needed.

You may not realise that your haemorrhoids have fallen off, as they should pass out of your body when you go to the toilet. If you notice some mucus discharge within a week of the procedure, it usually means that the haemorrhoids have fallen off.

Directly after the procedure, you may notice blood on the toilet paper after going to the toilet. This is normal, but there shouldn’t be a lot of bleeding. If you pass a lot of bright red blood or blood clots (solid lumps of blood), go to your nearest accident and emergency (A&E) department immediately.

Ulcers (open sores) can occur at the site of the banding, although these usually heal without needing further treatment.

Injections (sclerotherapy)

A treatment called sclerotherapy may be used as an alternative to banding.

During sclerotherapy, a chemical solution is injected into the blood vessels in your back passage. This relieves pain by numbing the nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about 4 to 6 weeks, the haemorrhoid should decrease in size or shrivel up.

After the injection, you should avoid strenuous exercise for the rest of the day. You may experience minor pain for a while and may bleed a little. You should be able to resume normal activities, including work, the day after the procedure.

Electrotherapy

Electrotherapy, also known as electrocoagulation, is another alternative to banding for people with smaller haemorrhoids.

During the procedure, a device called a proctoscope is inserted into the anus to locate the haemorrhoid. An electric current is then passed through a small metal probe that’s placed at the base of the haemorrhoid, above the dentate line. The specialist can control the electric current using controls attached to the probe.

The aim of electrotherapy is to cause the blood supplying the haemorrhoid to coagulate (thicken), which causes the haemorrhoid to shrink. If necessary, more than one haemorrhoid can be treated during each session.

Electrotherapy can either be carried out on outpatient basis using a low electric current, or a higher dose can be given while the person is under a general anaesthetic or spinal anaesthetic.

You may experience some mild pain during or after electrotherapy, but in most cases this doesn’t last long. Rectal bleeding is another possible side effect of the procedure, but this is usually short-lived.  

Electrotherapy is recommended by the National Institute for Health and Care Excellence (NICE), and has been shown to be an effective method of treating smaller haemorrhoids. It can also be used as an alternative to surgery for treating larger haemorrhoids, but there’s less evidence of its effectiveness.

Surgery

Although most haemorrhoids can be treated using the methods described above, around 1 in every 10 people will eventually need surgery.

Surgery is particularly useful for haemorrhoids that have developed below the dentate line because, unlike non-surgical treatments, anaesthetic is used to ensure you don’t feel any pain.

There are many different types of surgery that can be used to treat haemorrhoids, but they all usually involve either removing the haemorrhoids or reducing their blood supply, causing them to shrink.

Read more about surgery for haemorrhoids.

Hemorrhoids: Gotham Gastroenterology: Gastroenterology

Hemorrhoids and how to handle them:

By Dr. Kati Glockenberg

What are Hemorrhoids?

Hemorrhoids, also known as piles, are enlarged veins in the lower rectum and anus. They are one of the most common causes of rectal bleeding. Hemorrhoids come in two varieties, internal, which occur in the lower

rectum, and external, which develop around the anus. 

What are the most common causes of hemorrhoids?

Hemorrhoids often result from chronic constipation. They can also result from sitting too long on the toilet, being pregnant, having liver disease or obesity.

What are the symptoms of hemorrhoids?

Hemorrhoids often cause blood on the toilet paper or in the bowl. Depending on the location, they can be painful or painless and may cause anal itching. Patients may also note a bulge or lump protruding from the anus. Occasionally, hemorrhoids can become thrombosed or strangulated leading to sudden and severe anal discomfort.

How do I prevent hemorrhoids?

Use the following tips to prevent hemorrhoids from occurring:

• Maintain an active lifestyle to help keep your body moving stools
• Eat plenty of fiber
• Drink plenty of water
• Avoid sitting on the toilet for long periods
• Avoid straining to pass stools
• Use the restroom as soon as you have the urge

How do I treat hemorrhoids?

Some hemorrhoids are self-resolving. However, others require either homecare or minorprocedures. The first line of treatment is usually dietary modifications and medicated creams/ointments.First line treatment includes:

• High fiber diet: Aim to have around 20-35g of fiber a day through the diet and/or addition of a fiber supplement such as psyllium husk, wheat dextrin or methylcellulose.
• Stool softeners or gentle laxatives may also be helpful in managing hemorrhoids related to chronic constipation.
• Over the counter remedies such as PrepH or witch hazel may be helpful. Your doctor may also prescribe an ointment or cream.
• Sitz baths: soaking the area in warm water for 10-15 minutes, 2-3 times a day may be helpful.

If these treatments are not effective, your doctor might recommend one of the following hemorrhoid medical treatments:

• Sclerotherapy
• Hemorrhoidectomy
• Band ligation
• Infrared coagulation

When Should I See a Doctor for Hemorrhoids?

You should see a doctor for hemorrhoids if you experience bleeding with bowel movements, significant pain with bowel movements or if the hemorrhoids fail to get better after a week of care at home. You should seek immediate attention if you have severe rectal bleeding or lightheadedness. For more information or to book an appointment with Gotham Gastroenterology, contact our office at 212-794-0240. Our team of experts strives to provide excellence in gastroenterology for patients in NYC. You can also make an appointment by filling out a form.

External Hemorrhoids: Causes, Symptoms, and Treatments

Aug 23, 2019

Articles

Just the term hemorrhoid can make most people squirm. And while hemorrhoids are a very  common gastrointestinal issue, they can be uncomfortable and painful, not to mention irritating, embarrassing, and disruptive to the daily functioning of our lives.

Hemorrhoids are simply enlarged veins in the lower rectum, most often caused by straining during bowel movements. Rectal bleeding, irritation, itching, and pain are some of the most common complaints with hemorrhoids. The good news is that internal hemorrhoids, external hemorrhoids, or any combination of the two, are typically very treatable. Many people think they are limited to only the most extreme options—living with hemorrhoids, or undergoing surgery called a hemorrhoidectomy. But most hemorrhoids will go away on their own, and relief is available through a number of doctor-prescribed or over-the-counter treatment options. Even something as simple as a sitz bath can help.

It’s a good idea for anyone who thinks they may have hemorrhoids to talk with a doctor. A gastroenterologist can review your symptoms, perform a physical exam, and help you make a treatment plan, while ruling out other more severe conditions. 

What Exactly is a Hemorrhoid Anyway?

A hemmorhoid is a swollen blood vessel in the anal or rectal area. The veins often swell due to constipation and pushing too hard during bowel movements.

There are two basic types of hemorrhoids, also commonly called piles: internal hemorrhoids and external hemorrhoids. Just as the name suggests, internal hemorrhoids are inside the rectum. They are typically painless and are not visible but may cause some bleeding. They can sometimes be pushed through the anus creating a protruding hemorrhoid, which can be painful. External hemorrhoids can be seen from the outside. They occur under the skin around the anus and are typically more painful and irritating than internal hemorrhoids. Blood clots can also form inside hemorrhoids creating what is called a thrombosed external hemorrhoid.

Symptoms of External Hemorrhoids

One of the first symptoms people may notice with external hemorrhoids is bright red blood in their stool. The bright red blood is typically seen in the toilet or on toilet paper after a bowel movement. Any amount of bleeding can feel scary, but this rectal bleeding is often painless and doesn’t typically involve a large amount of blood. Dark blood or blood that appears to be formed in the stool should be reported to your doctor.

A bulge or small lumps of tissue can often be felt around the anus with external hemorrhoids. You may also experience painful bowel movements, itching, and irritation. In some cases hemorrhoids can also cause leakage of feces making it difficult to wipe or clean the area. While all of these symptoms are uncomfortable, hemorrhoids are very treatable and are not usually medically concerning.

What Causes External Hemorrhoids?

The main cause of external hemorrhoids is constipation (hard or irregular stools). Too much straining can make hemorrhoids you already have worse and increase the risk of new hemorrhoids. Other types of straining such as lifting heavy objects or sitting for long periods of time can contribute.

Who is at Risk for Hemorrhoids?

Hemorrhoids are one of the most common gastrointestinal illnesses. They affect both males and females of all races, in all age groups. But there are some factors that can put you at higher risk including:

• Genetics—A family history of hemorrhoids puts you at higher risk. Doctors will often ask whether family members suffer from hemorrhoids in order to identify a genetic tendency.
• Aging—The risk of hemorrhoids increases with age. While children and young adults do experience hemorrhoids, they are most common in adults 45-65 years old.
• Obesity—Body weight can contribute to the risk of hemorrhoids since heavier weight can cause additional strain on the body and contribute to a more sedentary lifestyle.
• Nutrition—A poor diet that lacks fiber often leads to constipation and straining during bowel movements. 
• Pregnancy—The weight of carrying a baby during pregnancy can put increased pressure on the pelvic area. Thankfully, these will often resolve completely after delivery of the baby.

Can I Prevent Hemorrhoids?

Benjamin Franklin’s phrase, “An ounce of prevention is worth a pound of cure,” was made in reference to fire prevention, but the same wisdom applies to health and specifically to hemorrhoids. Making proactive lifestyle choices can help prevent hemorrhoids from occurring or recurring.

Most important? Eat a high-fiber diet. Consuming lots of fruits, vegetables, and other high-fiber foods including nuts, seeds, and whole grains will help produce normal bowel movements. Drinking plenty of water (6-8 glasses a day) is central to a high-fiber diet. Hydration works together with the fiber to help keep you regular. And don’t forget to exercise! Keeping the body moving helps keep everything inside the body moving as well. 

Two more tips for prevention: First, when you feel the urge to go, go! Allowing bowel movements to happen regularly will help prevent constipation. Second, limit the time you spend sitting on the toilet to reduce pressure on the rectal area.

How to Treat External Hemorrhoids

The best ways to treat external hemorrhoids are through conservative measures like adopting the lifestyle changes mentioned above. You may also find over-the-counter or prescribed stool softeners and laxatives helpful. 

Other treatment options are all about reducing the discomfort of the symptoms. Applying ice packs or cold compresses to the area can help with swelling and relieve irritation. A sitz bath provides relief by soaking the rectal area in warm water for 15 minutes three or four times per day. You can use your bathtub filled with two-to-three inches of warm water, or a shallow plastic basin available at drug stores, specifically designed for this. The basin fits over the toilet and allows you to soak only the rectal area.Remember, don’t add anything to the warm water unless directed by a doctor. A sitz bath is an excellent first treatment option because it is non-invasive and can bring immediate, frequent relief.

Over-the-counter pain relievers such as Ibuprofen and Tylenol can also be used to reduce pain. Ointments, pads, or suppositories that contain medications can also temporarily relieve itching and pain. While you can self-administer many of these treatments, please note that creams with hydrocortisone shouldn’t be used for more than a week. If your symptoms haven’t improved, you should stop using the cream and talk with your doctor about other treatment options.

If your symptoms don’t respond to lifestyle changes and initial treatment, your doctor may recommend other options. External and internal hemorrhoids can be removed through surgery called a hemorrhoidectomy. A less invasive procedure, offered at GI Associates, is available for internal hemorrhoids, called hemorrhoidal banding or rubber band ligation. Rubber band ligation involves a doctor placing rubber bands or small rings around the hemorrhoids. With a restricted blood supply, the hemorrhoids will shrink and fall off, usually within a few days. While some patients report a feeling of tightness, rubber band ligation is painless and has a high success rate, making it an excellent option for treating internal hemorrhoids.

When to Call Your Doctor

It’s always a good idea for anyone with hemorrhoids to consult with his or her doctor. However, you should call your gastroenterologist right away if you experience a lot of blood in the stool, dark tar-colored stool, or excessive pain. While most cases of hemorrhoids are not medically concerning, some of the same symptoms can point to more serious conditions including anal fissure, anal cancer, colorectal cancer, perianal abscess, and inflammatory bowel disease. A GI doctor will help you access your symptoms and make an accurate diagnosis.
If you are experiencing the symptoms of external hemorrhoids, request an appointment at GI Associates and Endoscopy Center today. As the largest gastroenterology group in Mississippi, we have three convenient locations to serve you. Our doctors can provide options and help you decide on a treatment plan.

Symptoms signaling referral to a coloproctologist

ANXIETY SYMPTOMS WHICH REQUIRE IMMEDIATE CONTACT OF THE PATIENT TO A DOCTOR – COLOPROCTOLOGIST:

1. PAIN AND ITCHING IN THE AREA OF THE BACK PASS AND RECT Intestine:
Arising during walking, prolonged sitting, constant or recurrent acute or dull aching pains. Also pain during bowel movements.

2. DISCHARGE OF BLOOD FROM THE RECTAL Intestine:
“Streaks” of blood on toilet paper or blood that drips onto the toilet, traces of blood on the linen.Anemia in diseases of the colon often develops as a result of chronic or acute blood loss. In cancer localized in the right sections of the colon, anemia is often observed and is caused by both chronic blood loss and impaired hematopoiesis due to intoxication, which develops early and rapidly at this localization of the tumor.
Refusal to visit a doctor increases the number of cancer patients.

3. CONSTRUCTION AND DIFFICULTY DURING DEFECTION:
Difficulty emptying the intestines, frequent constipation, feeling of incomplete release after stool or, conversely, frequent stools, diarrhea, incontinence of feces and gas, unreasonably loose stools, false urge to defecate, as well as alternation states of constipation and loose stools.Such symptoms in the future can lead to the development of the disease and the need for surgery.

4. PAINNOTES, SEALS, “Nipples”, “COMBINATIONS” IN THE REGION OF THE ANUS AND AROUND THE ANUS:
Appearance after defecation of swelling or a round formation from the anus. With hemorrhoids, complications come suddenly, without warning, and if the hemorrhoidal node has become tense, hard and sharply painful or bleeding has developed from the node, a proctologist should be consulted immediately! The appearance of a painful formation may be the first sign of the development of acute purulent inflammation (paraproctitis).
In the postpartum period in women, hemorrhoids are a fairly common problem. Typical early symptoms of this disease are itching, anal discomfort, soreness during bowel movements, mucous membranes, and then bloody discharge from the rectum. Do not be afraid to consult a doctor, effective treatment of hemorrhoids is possible with breastfeeding.

5. TRAUMA IN THE ANORECTAL REGION AND AESTHETIC CHANGES IN THE PERIPHERAL ZONE AND ANCIENT PASSAGE:
Foreign bodies in the rectum. Bruises, tears, cuts and other damage to the anus with or without a violation of the integrity of the skin and mucous membranes.The appearance in the zone of genital warts, papillomas, fringes, cracks. In the event that bumps or seals are found in the anus, it is possible that foreign bodies enter the rectum that cannot come out naturally. You should not try to remove them yourself, as this can lead to disastrous consequences. Proctological diseases are easier to prevent than to cure. If you find at least one of the listed symptoms in yourself, discard excessive bashfulness, refuse self-medication and consult a proctologist in a timely manner.

6. Mucous and purulent discharge from the anus:
which are observed in paraproctitis, cryptitis, chronic anal fissure, proctosigmoiditis, ulcerative and granulomatous colitis, as well as in villous tumors and cancer of the rectum and sigmoid colon.

7. ABDOMINAL PAIN:
Cramping pains usually indicate limited narrowing of the intestine as a result of various pathological processes (cicatricial strictures in ulcerative colitis and Crohn’s disease of the colon, adhesive disease as an outcome of the inflammatory process in the intestinal anastomosis, benign and malignant tumors) …Less commonly, they are noted with intestinal dyskinesia with a predominance of the spastic component.
Persistent or recurrent aching, “dull” abdominal pains are more characteristic of progressive inflammatory lesions, they are observed in Crohn’s disease, ulcerative colitis, irritable bowel syndrome, bowel tumors with perifocal inflammation, diverticulosis with diverticulitis and the formation of inflammatory infiltrate or the development of peritonitis.

8. Bloating:
Bloating can occur not only with constipation and intestinal obstruction.Bloating can accompany chronic and acute pancreatitis, colon dysbiosis, irritable bowel syndrome, cystic fibrosis, and the abuse of flour, sweet foods.

9. Diarrhea:
Occurs in: ulcerative colitis, Crohn’s disease, familial juvenile polyposis, infectious enterocolitis. Often combined with tenesmus (urge to defecate).

10. Tenesmus:
Tenesmus – frequent false urge to defecate (without excretion of feces or with the separation of a small amount of mucus, blood or liquid intestinal contents).Tenesmus is a consequence of reflex excitation of motor activity in the distal colon.

11. Incontinence of feces and gases:
Incontinence of feces and gases is observed with congenital or acquired anatomical lesions of the sphincter apparatus of the rectum or violation of its reflex regulation.

LET’S SOLVE YOUR DELICATE PROBLEMS COMMUNICATION, MY FRIENDS. Every organ of the human body must be healthy. Every part of the body should be beautiful)

90,000 Hemorrhoids are hazardous to health! The author of the article: doctor-hirudotherapist Suslova Margarita Vasilievna.

03 December 2019

Family Health Magazine

HEMORRHOUS is one of the most common diseases in all age groups.
groups. Suffer from hemorrhoids most often
in middle age, but it also occurs in
early childhood, and among the elderly.It is more common in men (77.2%) than in women.
This disease is based on dysregulation of the outflow and flow of blood.
in the cavernous veins of the rectum, leading to stagnation of blood in them. As a rule, the occurrence of enlargement of hemorrhoids is one of the manifestations
general venous insufficiency. This
primarily contribute to the features of the venous system of the rectum,
sedentary lifestyle, heavy
physical labor, alcohol abuse, pregnancy, inflammation in the rectum and adjacent pelvic organs, constipation.For chronic
constipation, as the cause of hemorrhoids, indicates
more than half of the patients (50.5%). Constipation
cause hemorrhoids, and hemorrhoids increase
constipation. Accumulating in the rectum
fecal masses press on the surrounding venous vessels, causing blood stagnation and vasodilation in them. The course of hemorrhoids is always chronic with periodic
exacerbation.
Chronic hemorrhoids with exacerbation
delivers a lot of trouble due to pain, inflammation, bleeding, prolapse of swollen or strangulated thrombosed nodes.In the acute stage of the disease
independent stool in patients is difficult
or completely impossible. A sharp swelling of the surrounding tissues, spasm of the rectal sphincter and sharp pain interfere with
defecation. A complex of local
and general procedures to reduce venous congestion.
One of the oldest and most effective treatments is the use of leeches. Leeches are very useful
with acute phlebothrombosis of hemorrhoids. Alleviation of the condition occurs after the first session of hirudotherapy.Leeches eliminate venous
stagnation in the pelvic organs, normalize blood circulation and bowel function,
have anesthetic and anti-inflammatory effect, destroy already
existing blood clots and prevent the formation of new ones. In the acute period, sessions
hirudotherapy is carried out daily until
the disappearance of all signs of the disease.
After relieving acute pain, hirudotherapy
supplemented by techniques that reduce
venous congestion of the pelvic organs:
gymnastics, medicinal enemas, massage, “cleansing” the liver and fighting
constipation.

Almost every second inhabitant of our country today suffers from constipation. Refined food, quick snacks,
ill-considered diets and other attributes of modern nutrition – these are the main
causes of constipation. And their consequences? How
it would be nice if a person never
did not grow old, remained until the end of his life
as young and beautiful! Few
it is known that premature aging
is often a consequence of the most common constipation. Poor bowel function
very strongly affects the appearance.If a person suffers from constipation, especially for several years, a lot of toxins accumulate in the body. it
leads to the fact that the exchange is disrupted
substances; almost no vitamins are absorbed
and minerals; oxygen starvation develops.
The face is the first to react. On
purulent eruptions appear on it. By
in fact, these are the same toxins that are not
being able to come out naturally
way (through the intestines), “break through”
out through the pores and sebaceous glands.If a person has been constipated for years,
the rash can appear on the back and on
breasts. Signs of premature aging appear. Due to the strong “slagging” of the body, the skin quickly loses its tone. She becomes lethargic and
very wrinkled. Exfoliate and break
nails. What’s more, chronic constipation
often cause early baldness. Therefore, before buying
expensive cosmetics, pay attention to
the work of your intestines. Start on a special diet and get rid of
from constipation! Chronic constipation causes
irreparable harm to our liver.One
of the main functions of the liver – to neutralize and remove toxins from the body
and other harmful substances. When will their
accumulates a lot (which is
due to constipation), the liver is overloaded and ceases to cope with its
tasks. Constipation is especially dangerous in those
cases when the liver is already sick. Poisonous substances enter the bloodstream, begin
poison all organs, damage the nervous system and even the brain. Therefore, chronic constipation sometimes causes such seemingly distant
from him states, like strong headaches
pain, memory lapses, excessive irritability and even senile dementia.There is a lot of research today
causes of colon cancer, but observations show that people
with chronic constipation more often than others
susceptible to cancer. The fact is that during our entire life, about one and a half thousand carcinogens pass through the gastrointestinal tract. For constipation
these harmful substances are retained in
the body. And the longer they are in it, the higher the likelihood of developing
cancer. This is confirmed by the fact that most often a cancerous tumor occurs in
places of accumulation of feces: in the blind
and the sigmoid colon, hepatic angle,
splenic corner, etc.The elderly are especially at risk. After all, they are more likely to suffer from chronic constipation, and therefore
more at risk of getting sick
cancer. Constipation is caused by many
various reasons, among which inactivity is of great importance,
chronic stress, elongated sigmoid colon, eating disorders and many, many others.
Intestinal health and regularity
work is directly related to the fact that we
eating. Nutrition of modern people in
much the same.These are mostly refined, refined foods. Few
which of us eats brown rice, cooks on
water oatmeal, buys coarse bread, daily adds to his diet
not less than 1-2 kg of vegetables, fruits. All these
foods contain vegetable dietary fiber. It has been found that food
fibers promote peristalsis and
the appearance of soft stools, serve as “food”
beneficial to the body bifidobacteria, prevent the processes of decay and
fermentation in the intestines, eliminate dysbiosis.Vegetable dietary fiber is an excellent sorbent. They
bind and remove heavy metals and toxic elements from the body. V
daily diet of an adult
there should be at least 30-40 g of plant fibers. Hirudotherapy is
an auxiliary method for the treatment of constipation, but absolutely necessary in the presence of signs of venous congestion
abdominal organs, if present
constipation against the background of acute or chronic hemorrhoids, as well as for senile constipation associated with malnutrition,
atrophy of the mucous membrane and weakening of the contractile activity of the thick
intestines.Hirudotherapy should be accompanied by bowel cleansing, including a sufficient amount in the diet
fiber, restoration of microflora
intestines, abdominal massage and herbal medicine. Here are the “secrets” to gut health
and his regular work!

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90,000 Large intestine, symptoms of diseases – Clinic Health 365, Yekaterinburg

Signs of diseases of the colon and rectum are very diverse, however, a number of important symptoms can be distinguished, when they appear, we strongly recommend that you make an appointment with a coloproctologist in Yekaterinburg.Proctologists Kuzmin S.N. (the highest category, Honored Doctor of the Russian Federation) and Ryamov Yu.S. (head of the surgical department, the highest category) are receiving appointments in the clinic “Health 365”.

Pain in the abdomen is a fairly characteristic symptom of diseases of the colon and ampullar rectum, but they cannot be considered an early manifestation. Pain can be constant or cramping and radiate to the lumbar region, back, supraclavicular space (more often with irritation of the diaphragm peritoneum).Cramping pains usually indicate a limited narrowing of the intestine as a result of various pathological processes (cicatricial strictures in ulcerative colitis and Crohn’s disease of the colon, adhesive disease as an outcome of the inflammatory process in the intestinal anastomosis, benign and malignant tumors). Less commonly, they are noted with intestinal dyskinesia with a predominance of the spastic component.

Persistent abdominal pain is more characteristic of progressive inflammatory lesions, they are observed in granulomatous and nonspecific ulcerative colitis, irritable bowel syndrome, intestinal tumor with perifocal inflammation, diverticulosis with diverticulitis and the formation of inflammatory infiltrate or the development of peritonitis.Dull pain in the epigastric region is often the first manifestation of diffuse familial colon polyposis and can be explained by a violation of the secretory and motor activity of the stomach.

Pain in the anus and perineum is often constant, bursting or twitching and burning. With an acute anal fissure, acute thrombosis of hemorrhoids, acute paraproctitis after an act of defecation, they can become unbearable.A number of diseases of the rectum (benign tumors, chronic fistulas, cancer, etc.) can proceed for a long time without pain. With the most common disease of the rectum – uncomplicated hemorrhoids – pain usually does not occur or they are mild (a feeling of swelling).

The discharge of mucus and pus from the anus can be noted only during bowel movements or be permanent (with rectal fistulas and anus sphincter insufficiency).In the latter case, maceration of the perianal skin often occurs, multiple erosions and poorly healing deep cracks occur, which is accompanied by itching, burning and sharp pain. An admixture of mucus and pus to feces is usually observed in chronic and acute proctitis, proctosigmoiditis, ulcerative and granulomatous colitis, as well as in villous tumors and cancer of the rectum and sigmoid colon. The secretion of mucus and pus in these cases is often combined with an admixture of blood. Excretion of mucus in the feces often accompanies pathology such as irritable bowel syndrome.

Bleeding or admixture of blood in stool is one of the most common symptoms of diseases of the rectum and colon. Discharge of drops of scarlet blood or even jet bleeding, more often at the end of the act of defecation, is characteristic of hemorrhoids and anal fissures. Sometimes such hemorrhage leads to a loss of 100-200 ml of blood per day and, with frequent repetitions, causes the development of anemia.

Blood streaks and blood clots visible in feces are commonly seen in inflammatory processes (colitis), diverticulosis and tumors.The more proximal is the source of bleeding in the colon, the more homogeneous the admixture of blood to the feces and the darker their color. With bleeding from the cecum and the ascending intestine, the blood can be so strongly changed under the influence of intestinal enzymes that the feces take on a typical tarry appearance, as with bleeding from the upper gastrointestinal tract.

Slightly altered blood in a liquid state or in the form of clots can be released during bowel movements in patients with ulcerative colitis and Crohn’s disease of the colon, with diverticulosis, as well as with disintegrating and ulcerated villous and cancerous tumors.Profuse bleeding is rarely observed in diseases of the colon. They can occur with diverticulosis of the colon, less often with ulcerative colitis and Crohn’s disease of the colon.

Anemia in diseases of the colon develops more often due to chronic or acute blood loss. In cancer localized in the right sections of the colon, anemia is often observed and is caused by both chronic blood loss and impaired hematopoiesis due to intoxication, which develops early and rapidly at this localization of the tumor.

Constipation – difficulty in defecation and stool retention until it is absent for several days and weeks – is a common symptom of both functional and organic diseases of the colon.

Functional constipation can be atonic and spastic and, depending on this, proceed with less or more severe pain syndrome. With organic narrowing of the colon (cicatricial strictures, tumors, external compression, etc.), constipation usually precedes or is one of the symptoms of partial intestinal obstruction, often progressing to complete obstruction.The alternation of constipation and diarrhea is often a symptom of irritable bowel syndrome.

Colon obstruction – a syndrome of violation of the passage of contents through the colon, manifested in the absence or delay of stool, difficulty in passing gas, bloating and distension of the abdomen, constant and cramping pains, the growth of other dyskinetic phenomena (impaired appetite, nausea, vomiting, etc.). NS.). Obstruction can be partial or complete and is more often observed with organic lesions of the colon, but it also occurs with functional (atonic and spastic constipation, coprostasis, etc.)NS.).

With the progression of colon obstruction, both local (bloating, signs of inflammation of the peritoneum) and general (symptoms of intoxication and metabolic disturbances) increase. Partial obstruction of the colon is characterized by periodic but incomplete passage of stool and gas, sometimes a change of constipation with diarrhea, temporary cessation of pain and bloating, short or long periods of remission with an improvement in general condition, especially under the influence of therapeutic measures (enemas, light laxatives).

Bloating can occur not only with constipation and intestinal obstruction. It is often associated with flatulence caused by alimentary disorders, congenital or acquired enzymatic insufficiency (especially in the upper gastrointestinal tract), as well as colon dysbiosis, irritable bowel syndrome. In modern conditions, dysbiosis occurs especially often due to the widespread use of various antibacterial and antiseptic drugs.There is also reason to believe that dysbiosis and associated bloating are largely determined by inappropriate nutrition, especially among the urban population (the predominance of high-calorie animal products with a high content of fats and proteins, a small amount of vegetable fiber).

Diarrhea – frequent loose stools – is a characteristic symptom of a number of non-infectious diseases of the colon (colitis, diffuse polyposis). In nonspecific ulcerative and granulomatous colitis, diarrhea is often accompanied by tenesmus.Diarrhea can be a symptom of dysbiosis, irritable bowel syndrome.

Tenesmus – frequent false urge to defecate (without excretion of feces or with the separation of a small amount of mucus, blood or liquid intestinal contents) – exhaust patients and may be accompanied by maceration of the perianal skin, the formation of cracks and erosions. Tenesmus is a consequence of reflex excitation of motor activity in the distal colon, especially the rectum, as a result of inflammatory changes in the sensory zone of the mucous membrane of the anal rectum.

Fecal and gas incontinence is observed with congenital or acquired anatomical lesions of the sphincter apparatus of the rectum or a violation of its reflex regulation of the central, including psychological, or peripheral nature. Most experts distinguish between three clinically determined degrees of insufficiency of the sphincter of the anus: I degree – incontinence of gases, II degree – incontinence of gases and liquid feces, III degree – incontinence of gases, liquid and solid feces.

Related articles:

Medical Center “ELIF”

GUARANTEE FOR HEMORRHOUS TREATMENT – 5 YEARS!

What is this?

Hemorrhoids, in the form in which it is already considered a disease, are enlarged, often bleeding and causing a lot of inconvenience hemorrhoidal (vascular) plexuses. Hemorrhoidal plexuses are normally present in the terminal rectum.Moreover, they are entrusted with an important function – together with the muscles of the anal sphincter (sphincter), they expand, retaining feces and intestinal gases. As long as the process of their expansion and reverse contraction is regulated and operates automatically, they are our assistants. But the lifestyle and food addictions of a modern person seriously test them for strength. As a result, due to periods of prolonged stagnation of blood in the pelvic organs, due to stool disorders (both in the direction of its strengthening and liquefaction), the plexus, having expanded, no longer decrease to normal size.In parallel with this, the ligaments are weakened, which hold the hemorrhoidal plexus in the desired position, which also contributes to its loss. This is how a hemorrhoid is formed. And then it’s a matter of time. The node will grow. Its mechanical injury will lead to the addition of bleeding and other unpleasant complications.

Who is sick?

Both men and women get sick. In young people, hemorrhoids are rare, further, with age, its frequency increases, reaching a maximum at 45-65 years, and then again its occurrence decreases.

How does it manifest?

The main symptoms of hemorrhoids:

• Bleeding from the anus or smearing with blood, especially after a bowel movement;
• Pain, sometimes only during bowel movements, with the addition of complications – constant;
• “Falling out” of nodes outward;
• Itching, weeping, mucus secretion, discomfort (often “throbbing”) in the anal area.

Why is there blood?

Enlarged nodes are injured by feces with constipation or irritated by the aggressive environment of the intestine with loose stools.Sooner or later, such an effect on them leads to bleeding.

What does it look like?

The symptoms of hemorrhoids described above are not unique to him. Other diseases can be accompanied by similar manifestations. Along with hemorrhoids, most often these are rectal fissures. A sharp crack may heal on its own. A chronic fissure usually does not heal on its own. These can be bowel diseases such as Crohn’s disease or ulcerative colitis, which will be dealt with by rheumatologists.It can also be Anal warts caused by viruses, the treatment of which will be dealt with by venereologists. The most dangerous diseases that can be accompanied by bleeding from the anus are malignant neoplasms – cancer of the rectum or the overlying parts of the large intestine.

Will it pass by itself?

Most likely no. Many go to the doctor as a last resort. Having previously tried all the advice of friends or “folk remedies”.The dispute between supporters and opponents of such tactics is a perennial topic. It will never end. And each side has a lot of arguments. We will not try to judge the disputants. But we will give advice: before you take a wait-and-see attitude or self-medicate – consult a doctor! Eliminate those diseases where the loss of precious time can turn into an irreparable tragedy!

What to do?

No matter how banal the answer is, it is the only correct one – to consult a proctologist.If the diagnosis “Hemorrhoids” is confirmed, you will be offered various ways of treating this pathology.

In our medical center, the treatment of hemorrhoids is possible with less traumatic methods, such as ligation, the introduction of sclerosing solutions into the nodes, and bandaging of the nodes at the base. The use of these techniques will allow you to get rid of the disease without interrupting work and with minimal correction of the usual way of life. For medical reasons, the attending physician can issue a certificate of temporary disability (sick leave).

90,000 Colon disease symptoms: nature of pain and manifestation

Diseases of the large intestine do not always manifest themselves unambiguously and clearly. More often, the initial phase is accompanied by blurred symptoms that people do not attach importance to. It can be a burning sensation, discomfort in the intestines, periodic mucus secretion. The specificity of the intestine is that it may not give such signs for a long time, which will indicate the need to visit a proctologist.
Even when a person begins to worry about pain, bloating, discharge from the anus and other symptoms, he does not rush to see a doctor. At first, the patient stubbornly tries self-medication and the means that modern advertising obtrusively offers. Meanwhile, the symptoms change, become more noticeable, pain appears and are often aggressive.

Sometimes symptoms may not indirectly indicate bowel disease, symptoms may be specific:

• dramatic weight loss;
• weakness in the body;
• disorders in metabolic and hormonal processes;
• hair loss.

These signs are accompanied by the most severe intestinal lesions: cancer, malignant tumors, polyposis. The intestine is the only organ that simultaneously belongs to two important systems of the body: the immune and the gastrointestinal tract. For a full life and health, it is important to be able to recognize those symptoms and signs that suggest a pathological process in the large intestine:

• constipation;
• pains of varying intensity in the abdomen;
• Bloody discharge during bowel movement;
• discharge of clear or purulent mucus;
• anemia;
• flatulence;
• intestinal obstruction;
• Stool Disorder;
• tenesmus;
• incontinence.

Intestinal constipation
With constipation, difficulties with defecation are observed, up to the complete exclusion of stool for several days. Constipation can be persistent and stubborn, not succumb to the action of laxatives. Stool disorder can replace constipation – this is a common picture in irritable bowel syndrome, dysbiosis, and functional disorders.
The intensity of the pain depends on the type of constipation: atonic and spastic.In the first case, the pain is aching, often not aggressive. With spastic constipation, there may be cuts in the groin area of ​​an intractable nature. The presence of frequent constipation indicates the possibility of fecal blockages or intestinal obstruction. Conditions are extremely dangerous in nature, capable of threatening life.

Abdominal pain
Pain in the abdomen and groin often accompanies organic and functional disorders in the large intestine. So, with Crohn’s disease and ulcerative colitis, the pain is in the nature of spastic contractions.Such pains often radiate to the lumbar region, radiating to the outside of the legs. It is difficult to determine the locality, since the pain “spreads” along the lower abdomen, often involving the perineum in the process.

Constant pain is a sign of a progressive inflammatory process. Such pains are aching, pulling, persistent. Manifested with IBS, various colitis, diverticulosis. The nature of the pain indicates the likelihood of developing peritonitis or a purulent lesion.

Bloody discharge and bleeding
Bleeding occurs in diseases of the rectum and colon.Usually, the location of the lesion is visually determined by the color of the blood: the brighter the blood, the closer to the exit the lesion. So, the appearance of pure and brightly scarlet blood indicates internal or external hemorrhoids. Sometimes blood loss can be significant and cause weakness, dizziness.

If the feces are homogeneous and have uniform bloody impurities in their composition, then this is a symptom of the formation of a tumor in the upper parts of the intestine. Sometimes such masses are with nonspecific colitis and diverticulosis.The higher the section of the lesion, the more uniform the blood clots in the stool will look and the darker their color.

In Crohn’s disease, blood can be excreted in pure form or in abundant clots. In some cases, scarlet blood can be a sign of a disintegrating tumor in the intestine.

Discharge of mucus or pus
Such discharge is either constant or appears during bowel movement. Most often, this becomes a sign of fistula formation in the anus.With constant mucus and pain, sphincter insufficiency can be assumed. In this case, numerous erosions and cracks are formed, which brings itching and pain.

Such discharge is characteristic of irritable bowel syndrome, proctitis, with the formation of tumors in the sigmoid colon. Often, the discharge is combined with blood, the appearance of clots.

Pain in the anus
The pains can be aching and periodic, bursting with the area of ​​the passage. This happens with deep cracks, they are difficult to heal, especially in the presence of constipation.Twitching and unbearable pain occurs when hemorrhoids rupture or there are multiple nodes in the intestine. Ordinary hemorrhoids without complications do not cause such pain, it is felt only by bursting and swelling in the anus.

Anemia
Anemia develops when a person has lost a lot of blood. This occurs with severe intestinal lesions, cancers, and rapid tumor progression.

Bloating and flatulence
Bloating is a common symptom for almost any pathology in the gastrointestinal tract.The feeling of bloating and copious gas is characteristic of constipation, intestinal obstruction, fecal obstruction. Often flatulence is the result of enzyme deficiency and can talk about disturbances in the work of other internal organs.
Often bloating and flatulence accompany those who suffer from dysbiosis and eat poorly. In some cases, bloating occurs with a feeling of discomfort and heaviness in the stomach, but with an excess of gas, severe abdominal pain may appear.

Intestinal obstruction
Intestinal obstruction can be complete or partial.More often you have to deal with a partial, which is characterized by:

• blisters;
• pain;
• flatulence;
• prolonged constipation;
• the appearance of impurities and blood;
• vomiting;
• Loss of appetite.

More often this indicates a severe lesion of the large intestine of organic origin. The condition is extremely painful and dangerous to human health. With the progression, there are signs of body poisoning, inflammation of the peritoneum.With partial obstruction of the intestine, stools are rare, scanty, often replaced by profuse disorder. Temporary improvement occurs under the influence of laxatives or cleansing enemas.

Stool disorder
Diarrhea accompanies milder bowel disease, a common sign of dysbiosis. Stool disorder can also be combined with other symptoms, such as constipation or various secretions. This happens with exacerbation of colitis, IBS.

Tenesmus
Tenesmus is a false urge to empty the bowel.With such urges, a small amount of mucus is separated, sometimes together with diarrhea. Tenesmus is usually frequent, persistent, tiring a person with its frequency. They are characteristic of excited rectal motility and result from inflammation of the anal mucosa.

Incontinence
Fecal incontinence of separated gases is manifested with congenital or acquired changes in the sphincter. Another reason may be dysregulation due to psychological factors.

90,000 The relationship between diseases of the spine, intestines and rectum

The health of the spine, and in particular the lumbosacrococcygeal region, plays a huge role in the normal functioning of the abdominal organs of the small pelvis. The innervation, which provides all the functions of the organs of this area, comes from these parts of the spinal column. Accordingly, inflammatory, destructive-degenerative diseases of the spine can lead to dysfunctions of the intestines , , , of the bladder , of the rectum , provoke the development of diseases of these organs or simulate them.

If you already have problems with the spine

In the presence of existing diseases of the spine and bowel diseases (for example, hemorrhoids , rectal fissure , rectal prolapse ) several factors can cause the development of exacerbations of these diseases. These factors can include physical activity . For example, lifting weights without proper preparation (work on a land plot), heavy physical activity without preparation during classes in the gym without supervision from professional trainers, long-term hard physical work in the air, and others.

A special condition occurs in women during pregnancy . The growing uterus creates additional stress on the spine, strengthening the physiological curves, and contributes to the appearance of lower back pain. During pregnancy, the tone of the vessels of the small pelvis and abdominal cavity changes, the internal organs are compressed, making it difficult for them to work. Poor outflow of blood from the pelvic organs and lower extremities contributes to the development of congestion in soft tissues. It can also provoke an exacerbation of hemorrhoids, the appearance of cracks in the anus, prolapse of the rectum, etc.

People whose work is related to the forced position of the body (drivers, office workers, teachers, turners, tailors) have a predisposition to diseases of the spine (more often it is the cervical and lumbar spine) and congestion in the small pelvis (diseases of the prostate gland, uterus, intestines, constipation, hemorrhoids, anal fissures). This is due to impaired blood supply to these organs due to overstrain of the musculo-ligamentous apparatus and insufficient motor load on the muscles of the legs, back, and abdominal muscles.

Prevention of complications

In order to reduce the harmful effect of static loads (prolonged forced position of the body) on your body, it is enough to follow a few simple rules: stretch your legs and back: make several smooth bends of the body to the sides, back, forward, several squats. Even a simple ascent and descent by stairs from one floor to another will be useful to you.

2. Visit the pool 1-2 times a week. Swimming on the back and abdomen with active leg work will have a beneficial effect on the work of the gastrointestinal tract, cardiovascular system, strengthen the muscles of the back, and strengthen the nervous system.

3. Try not to lift weights. If necessary, tie the lower back and the anterior abdominal wall with an elastic belt or a wide strip of cloth, start lifting from a squatting position, distribute the load more on the legs, and not on the lower back and abs.Do not refuse assistance or the use of various devices for moving heavy objects.

4. Follow your diet. If you are prone to constipation, you need to eat more vegetable fiber (vegetables, fruits, bran).

5. Do gymnastics in the morning or evening every day. Even the simple exercises that we once learned in school during physical education lessons will be helpful.

Consider examining the spine, as the innervation of the abdominal and pelvic organs suffers in the pathology of the thoracic and lumbar regions.The consequence of this is the disruption of their normal work and the appearance of complaints that gastroenterologists, proctologists, urologists and gynecologists do not always manage to cope with.

If you start to be bothered by pain in the intestines, rectum, or a feeling of discomfort in the anus, do not hesitate and hope that “it will pass by itself.” Contact specialists. At the Clinic of Dr. Vojta, you will be examined by a coloproctologist, if necessary, a vertebroneurologist and other experienced specialists.The clinic of Dr. Vojta will help you cope with pain and determine the cause of your ailments.

In this article we have tried to answer your questions:

• What is hemorrhoids?
• How is osteochondrosis and bowel problems related?
• What is the danger of osteochondrosis of the lumbar spine for the body?

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Blood in the stool – Coloproctology – Day (surgical) hospital – Departments

Blood in stool

The appearance of blood in the stool is one of the most serious and alarming signs of bowel disease. Blood in the feces is a signal of a violation of the integrity of the intestinal mucosa and blood vessels. Tentatively, when questioning the patient and by the nature of the complaints, one or another disease can be assumed.

Scarlet blood, not mixed with feces.
Typical for internal hemorrhoids, anal fissures.

Scarlet blood on toilet paper.
Typical for internal hemorrhoids, anal fissures, rectal cancer.

Blood and mucus on linen.
Typical for late stages of hemorrhoids, rectal prolapse.

Blood on linen without mucus.
Specific to rectal cancer.

Blood and mucus mixed with feces.
Typical for ulcerative colitis, proctitis, polyps and rectal tumors.

Massive bleeding.
May be with colon diverticulosis, ischemic colitis.

Black feces (melena).
Characteristic for bleeding from dilated veins of the esophagus with cirrhosis of the liver, ulcers and stomach cancer.

In most cases, the causes of blood in the stool are relatively benign – with hemorrhoids, cracks in the anus.