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Hemorrhoids without bleeding: How to tell if you Have a Hemorrhoid

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Hemorrhoids and what to do about them

What causes internal and external hemorrhoids and simple ways to treat them

Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, hemorrhoids often become an ongoing complaint. By age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse (hemorrhoids that protrude through the anal canal). Although hemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion. Fortunately, there’s a lot we can do about hemorrhoids.

What are hemorrhoids?

In one sense, everyone has hemorrhoids (or piles), the pillow-like clusters of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and the anus. The condition most of us call hemorrhoids (or piles) develops when those veins become swollen and distended, like varicose veins in the legs. Because the blood vessels involved must continually battle gravity to get blood back up to the heart, some people believe hemorrhoids are part of the price we pay for being upright creatures.

There are two kinds of hemorrhoids: internal hemorrhoids, which occur in the lower rectum, and external hemorrhoids, which develop under the skin around the anus. External hemorrhoids are the most uncomfortable, because the overlying skin becomes irritated and erodes. If a blood clot forms inside an external hemorrhoid, the pain can be sudden and severe. You might feel or see a lump around the anus. The clot usually dissolves, leaving excess skin (a skin tag), which may itch or become irritated.

Internal hemorrhoids are typically painless, even when they produce bleeding. You might, for example, see bright red blood on the toilet paper or dripping into the toilet bowl. Internal hemorrhoids may also prolapse, or extend beyond the anus, causing several potential problems. When a hemorrhoid protrudes, it can collect small amounts of mucus and tiny stool particles that may cause an irritation called pruritus ani. Wiping constantly to try to relieve the itching can worsen the problem.

Internal and external hemorrhoids

Hemorrhoids are distended blood vessels that form either externally (around the anus) or internally (in the lower rectum).

What causes hemorrhoids?

Traditionally, hemorrhoids are associated with chronic constipation, straining during bowel movements, and prolonged sitting on the toilet — all of which interfere with blood flow to and from the area, causing it to pool and enlarge the vessels. This also explains why hemorrhoids are common during pregnancy, when the enlarging uterus presses on the veins.

More recent studies show that patients with hemorrhoids tend to have a higher resting anal canal tone — that is, the smooth muscle of the anal canal tends to be tighter than average (even when not straining). Constipation adds to these troubles, because straining during a bowel movement increases pressure in the anal canal and pushes the hemorrhoids against the sphincter muscle. Finally, the connective tissues that support and hold hemorrhoids in place can weaken with age, causing hemorrhoids to bulge and prolapse.

Diagnosing hemorrhoids

Hemorrhoids can usually be diagnosed from a simple medical history and physical exam. External hemorrhoids are generally apparent, especially if a blood clot has formed. Your clinician may perform a digital rectal exam to check for blood in the stool. She or he may also examine the anal canal with an anoscope, a short plastic tube inserted into the rectum with illumination. If there’s evidence of rectal bleeding or microscopic blood in the stool, flexible sigmoidoscopy or colonoscopy may be performed to rule out other causes of bleeding, such as colorectal polyps or cancer, especially in people over age 45.

Hemorrhoid treatment

Dramatic relief for most hemorrhoid symptoms can be found with simple, home remedies for hemorrhoids. To avoid occasional flare-ups, try the following.

Get more fiber. Add more fiber to your diet from food, a fiber supplement (such as Metamucil, Citrucel, or Fiber Con), or both. Along with adequate fluid, fiber softens stools and makes them easier to pass, reducing pressure on hemorrhoids. High-fiber foods include broccoli, beans, wheat and oat bran, whole-grain foods, and fresh fruit. Fiber supplements help decrease hemorrhoidal bleeding, inflammation, and enlargement. They may also reduce irritation from small bits of stool that are trapped around the blood vessels. Some people find that boosting fiber causes bloating or gas. Start slowly, and gradually increase your intake to 25–30 grams of fiber per day. Also, increase your fluid intake.

Exercise. Moderate aerobic exercise, such as brisk walking 20–30 minutes a day, can help stimulate bowel function.

Take time. When you feel the urge to defecate, go to the bathroom immediately; don’t wait until a more convenient time. Stool can back up, leading to increased pressure and straining. Also, schedule a set time each day, such as after a meal, to sit on the toilet for a few minutes. This can help you establish a regular bowel habit.

Sitz. A sitz bath is a warm water bath for the buttocks and hips (the name comes from the German “sitzen,” meaning “to sit”). It can relieve itching, irritation, and spasms of the sphincter muscle. Pharmacies sell small plastic tubs that fit over a toilet seat, or you can sit in a regular bathtub with a few inches of warm water. Most experts recommend a 20-minute sitz bath after each bowel movement and two or three times a day in addition. Take care to gently pat the anal area dry afterward; do not rub or wipe hard. You can also use a hair dryer to dry the area.

Seek topical relief for hemorrhoids. Over-the-counter hemorrhoid creams containing a local anesthetic can temporarily soothe pain. Witch hazel wipes (Tucks) are soothing and have no harmful effects. A small ice pack placed against the anal area for a few minutes can also help reduce pain and swelling. Finally, sitting on a cushion rather than a hard surface helps reduce the swelling of existing hemorrhoids and prevents the formation of new ones.

Treat the clot. When an external hemorrhoid forms a blood clot, the pain can be excruciating. If pain is tolerable and the clot has been present for longer than two days, apply home treatments for the symptoms while waiting for it to go away on its own. If the clot is more recent, the hemorrhoid can be surgically removed or the clot withdrawn from the vein in a minor office procedure performed by a surgeon.

Rubber band ligation of hemorrhoid

To perform a rubber band ligation, the clinician places a ligator over the hemorrhoid to position a rubber band around its base.

Procedures for hemorrhoids treatment

Some hemorrhoids can’t be managed with conservative treatments alone, either because symptoms persist or because an internal hemorrhoid has prolapsed. Fortunately, a number of minimally invasive hemorrhoid treatments are available that are less painful than traditional hemorrhoid removal (hemorrhoidectomy) and allow a quicker recovery. These procedures are generally performed in a surgeon’s office or as outpatient surgery in a hospital.

Band it. The most commonly used hemorrhoid treatment in the United States is rubber band ligation, in which a small elastic band is placed around the base of a hemorrhoid (see box above). The band causes the hemorrhoid to shrink and the surrounding tissue to scar as it heals, holding the hemorrhoid in place. It takes two to four procedures, done six to eight weeks apart, to completely eliminate the hemorrhoid. Complications, which are rare, include mild pain or tightness (usually relieved with a sitz bath), bleeding, and infection. Other office procedures include laser or infrared coagulation, sclerotherapy, and cryosurgery. They all work on the same principle as rubber band ligation but are not quite as effective in preventing recurrence. Side effects and recurrence vary with the procedure, so consult your physician about what’s best for your situation.

Hemorrhoidectomy. You may need surgery if you have large protruding hemorrhoids, persistently symptomatic external hemorrhoids, or internal hemorrhoids that return despite rubber band ligation. In a traditional hemorrhoidectomy, a narrow incision is made around both external and internal hemorrhoid tissue and the offending blood vessels are removed. This procedure cures 95% of cases and has a low complication rate — plus a well-deserved reputation for being painful. The procedure requires general anesthesia, but patients can go home the same day. Patients can usually return to work after 7–10 days. Despite the drawbacks, many people are pleased to have a definitive solution to their hemorrhoids.

Staples. An alternative to traditional hemorrhoidectomy is called stapled hemorrhoidopexy. This procedure treats bleeding or prolapsed internal hemorrhoids. The surgeon uses a stapling device to anchor the hemorrhoids in their normal position. Like traditional hemorrhoid removal, stapled hemorrhoidopexy is performed under general anesthesia as day surgery.

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Bawaseer-e- Aamiya (Non Bleeding Piles/ Non Bleeding Haemorrhoids)


Bawaseer-e- Aamiya (Non Bleeding Piles/ Non Bleeding Haemorrhoids)


Introduction


It is a mass developed in the vessels of anal canal. In non-bleeding type of piles there is swelling near anus, it does not bleed but pains a lot. In other words It is swollen and inflamed vein in the rectum or anus. It occur very commonly in most of the people at some stage during their live span.Non Bleeding Piles tend to occur more frequently at later stage in life due to stretching of the tissues supporting the veins in the rectum and age-related weakening.  


As per Unani philosophy it is caused by thick melancholic sanguine (Dam-e- ghaleez saudavi). In Unani classical books, it is characterized by presence of yellowish green mass, pain and itching in the anus. The mass may be of different shape such as mulberry, grape and wart.


Causes


Bawaseer-e- aamiya (Non Bleeding Piles/ Non Bleeding Haemorrhoids) are caused by an increase of pressure in the lower rectum from any of the undermentioned reason: 


  • Sitting for long periods of time, especially on the toilet seat

  • Straining during bowel movements or defaecation

  • Being overweight or obese

  • Chronic (long lasting) constipation or diarrhoea

  • Anal intercourse

  • Regular use of low-fibre diet

  • Pregnancy

  • Poor posture

  • Spinal cord injury


Signs and symptoms of Bawaseer-e- aamiya (Non Bleeding Piles)


  • Pain or discomfort, especially at sitting posture

  • Pain during bowel movements/ defaecation

  • Irritation or itching around the anal region

  • Swelling (Waram) around the anus

  • One or more lumps near the anus, which might be painful or tender.

  • Along with above mentioned signs and symptoms, non-appearance of blood mixed with stools


When to Consult a Doctor in this type of piles?


One should consult a doctor if his haemorrhoids:


  • do not respond to self-treatment

  • if their symptoms have been accompanied by an obvious change in bowel habits

  • if patient is passing black or maroon-coloured stools


Management


It can be treated by Unani medicine very effectively. Treatment and prevention will often involve local application of an ointment, other home treatments and lifestyle changes/ modifications.


Usool-e- Ilaaj (Principles of treatment)


  • Evacuation (Istifraagh)

  • Laxation (Talyin)

  • Removal of obstruction (Tafteeh-e- sudud)

  • Analgesia (Taskeen-e- alam)

  • Resolution of swelling (Tahleel-e- waram)

  • Ilaaj bil yad (Surgery)


Ilaaj bil dawa (Pharmacotherapy)


  • Joshanda-e- Halela

  • Joshanda-e- Aftimoon

  • Local application of bone marrow

  • Local application of undermentioned Unani formulation for analgesia


Pods of Trigonella uncata, Boiss. (Naakhoona), Althaea officinalis, Linn. (Khatami), dried latex of Papaver somniferum, Linn. (Afiyoon) and Crocus sativus Linn. (Zaafran)


Sitz bath (Aabzan)


Fruit rind of Punica granatum, Linn. (Post-e- Anaar), Quercus infectoria, Oliv. (Maazu), stamens of Rosa damascene, Mill. (Zar-e- ward) and flower of Punica granatum, Linn. (Gulnaar)


Use of 2 spoons of ghee along with lukewarm milk at night will help more.


Compound Unani Formulations


  • Itreefal Sagheer

  • Habb-e- Rasaut

  • Habb-e- Muqil

  • Itreefal Muqil mulayyin

  • Roghan-e- Zard

  • Murabba-e- Halela


Ilaaj bil Tadbeer (Regimenal therapy)


  • Bloodletting through saphenous vein (Fasd-e-Saafin) is very effective

  • Sitz bath (Aabzan): Take sitz bath of joshanda-e- triphala (Had, Bahed and Aamla) two times in a day


Dietary Recommendations


  • Aghziya-e- lateefa martooba is recommended

  • Always keep stools soft by using green leafy vegetables, other fibrous food e. g. psyllium husk or ispaghula husk, linseed/rapeseed/flaxseed 2 – 4 table spoonful with lots of fluids (yoghurt, fruit juice, water). 

  • Use of butter milk is important in the diet of an individual suffering from it.


Dietary Restrictions


  • Avoid black bile producing diets (Muallid-e- sauda aghziya).

  • Patient must avoid baked, fried and spicy food, curd, pickle, non-vegetarian diet and green chili etc.


Prevention


Keeping stools soft by avoiding constipation is the best way to prevent noon bleeding haemorrhoids/ non bleeding piles. These undermentioned precautions can help to prevent haemorrhoids from occurring. Also they may reduce symptoms of existing haemorrhoids:


  • Always avoid being constipated. Also avoid medication that causes constipation.

  • Eat high-fibre foods and fibre supplements

  • Increase your fluids intake

  • Avoid straining when on the toilet

  • Avoid sitting for long periods.

  • Always go the toilet when feel the urge

  • Black bile procreative regimens (Muwallid-e- sauda tadaabeer) to be avoided

  • lose weight, if you’re overweight

  • Exercise regularly, it can help in preventing constipation, reducing blood pressure. It will also help in losing weight.


Note


  • Along with medicine the patients have to follow strict regimen as per the concept of Unani system. The patients are therefore, strongly advised to avoid self-medication.

  • They are advised to visit the nearest authorized Unani treatment centre for advice and treatment.


References


http://ayush.gov.in/sites/default/files/1378112724-Essential%20Unani%20Medicines%20LR%20%204.pdf


https://www.articlez.com/articles/?What-Is-The-Best-Treatment-Of-Non-Bleeding-Piles%3F&article_id=8174


https://www. southerncross.co.nz/group/medical-library/haemorrhoids-causes-symptoms-treatment-prevention


https://healthissuesnaturaltreatments.wordpress.com/2016/10/03/best-natural-treatment-for-non-bleeding-piles-hemorrhoids/


https://food.ndtv.com/health/6-excellent-home-remedies-for-piles-1659736


 


 

  • PUBLISHED DATE : Apr 18, 2018
  • PUBLISHED BY : NHP Admin
  • CREATED / VALIDATED BY : Dr. Mahtab Alam Khan
  • LAST UPDATED ON : Apr 18, 2018
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How to Treat Bleeding Hemorrhoids

Though it’s not a very pleasant topic to think about, the fact is that hemorrhoids are one of the most common gastrointestinal problems. The National Institutes of Health (NIH) estimates that about 1 in 20 Americans will develop hemorrhoids at some point during their life. For most people, though, getting hemorrhoids is a temporary problem that isn’t much of a cause for concern. Sometimes the problem is more severe and the hemorrhoids cause rectal bleeding; in those cases, a more proactive treatment approach is usually necessary. 

What Are Hemorrhoids?  

Most people only associate the negative symptoms of hemorrhoids with the words, but the truth is that they are normal vascular structures that everyone has in their body. Also known as piles, hemorrhoids are located in and around the anus and anal canal. Under normal circumstances, these pillowy clusters of blood vessels function as a sort of cushion that makes it easier for stool to pass through the rectum and out the anus. It’s only when something goes wrong that they actually become a problem. 

So when people complain about having hemorrhoids, what they really mean is that the vein clusters in or around the anus have become inflamed or swollen. This kind of distension and inflammation can actually be very painful, and it also makes defecation and regular hygiene practices more difficult and additionally painful. The medical term for this condition is hemorrhoid disease, and it is somewhat similar to having varicose veins in that both conditions involve veins that have become swollen or inflamed. 

The two main types of hemorrhoids are classified as internal and external. Internal hemorrhoids, as the name implies, are located inside the lower rectum and are therefore not visible on the body. This type is usually not painful, and many people don’t even know that a problem exists. External hemorrhoids, by contrast, are located just under the skin surrounding the anus; this is the type with the symptoms most people associate with the condition. 

Sometimes, when external or internal hemorrhoids become swollen, blood begins to pool in the vein clusters. In this situation, a blood clot known as a thrombus can form in the hemorrhoid; that is why this third type is called a thrombosed hemorrhoid. Beyond the typical discomfort that goes with swelling and inflammation, thrombosed hemorrhoids are identifiable by the significantly higher pain they cause. Over time, the thrombosed hemorrhoid may also cause a hard lump to form in the tissue around the anus. 

Hemorrhoid Symptoms 

As noted above, internal hemorrhoids are not visible outside the body and tend not to cause much pain or discomfort; the main symptom is occasional rectal bleeding (which will show up on toilet paper or in the toilet bowl as bright red blood). External hemorrhoids, on the other hand, tend to cause anal itching in addition to aches or pain; it is also possible for hard lumps to form. Thrombosed hemorrhoids begin as “regular” hemorrhoids, and they can quickly become noticeable because of a sharp increase in the amount of pain as well as a related discomfort with sitting down. If bleeding occurs with external or thrombosed hemorrhoids, the blood will usually be darker than with the internal type.  

Why Do Hemorrhoids Bleed?  

Even though internal, external, and thrombosed hemorrhoids are all slightly different, one of the commonalities between them is possible bleeding as a symptom. Bleeding can occur for a variety of reasons, but the main reason is due to straining during a bowel movement; when swollen, inflamed hemorrhoids are subjected to excessive straining, the surface of the hemorrhoid can become damaged and start to bleed. This can also happen when a person is constipated and has dry, hard stools. Because of pressure from pooling blood, thrombosed hemorrhoids can actually burst and cause significant bleeding as well. 

Bleeding Hemorrhoids Treatment    

In almost all cases, the potential bleeding associated with hemorrhoids is due to damage of the swollen tissue; in other words, the bleeding can be traced to an action like straining during defecation or aggressive wiping. In that sense, bleeding hemorrhoids are treated in much the same way as any other hemorrhoid. Differences in treatment options have more to do with severity and duration of the inflammation. Below are some common at-home treatment options that can help ease the symptoms until the hemorrhoids go away: 

  • sitz bath with warm water and epsom salt 
  • wiping with moist towelettes rather than dry toilet paper 
  • sitting on ice packs wrapped in a towel can ease discomfort 
  • stay hydrated and ensure sufficient dietary fiber to help keep stools soft
  • stay physically active to help reduce the chances of constipation 
  • high fiber foods or fiber supplements (Metamucil) to make defecation easier 
  • over-the-counter pain medication like ibuprofen 
  • suppositories or stool softeners 

Sometimes, though, the hemorrhoids won’t really go away on their own and require medical care and more extensive treatment. This kind of greater care is usually needed for thrombosed hemorrhoids or hemorrhoids that are causing extreme, constant severe pain or significant bleeding. If you have symptoms like that, you should make an appointment with a gastroenterologist. Below are some medical treatment options doctors may employ to treat hemorrhoids: 

  • Rubber Band Ligation: Hemorrhoid banding ligation is one of the most effective treatments for hemorrhoids. This procedure involves placing a small elastic band around the base of the swollen vein cluster so that its blood supply is cut off. After about a week, the withered hemorrhoid will fall off. 
  • Sclerotherapy: Sclerotherapy seeks to achieve a similar effect as rubber band ligation, but it is done with a medicated solution. This solution is injected directly into the hemorrhoidal tissue, causing the vein walls to collapse and the hemorrhoid to shrink. In 7-10 days, the shrunken hemorrhoid will similarly fall off. 
  • Coagulation Therapy: Typically reserved for internal hemorrhoids, coagulation therapy uses infrared light to lase the hemorrhoid; the heat from the laser causes scar tissue to form that will eventually destroy the hemorrhoid. Only one hemorrhoid can be treated at a time, however, and the procedure can only be performed every 10-14 days. 
  • Electrocoagulation: Electrocoagulation is similar to coagulation therapy in that the goal is also to cut off blood flow so that the hemorrhoid will fall off. In this case, though, an electric current is sent into the hemorrhoid.  
  • Hemorrhoidectomy: When other methods are unsuccessful, the doctor may turn to surgical treatment. A hemorrhoidectomy involves surgically removing any hemorrhoid that has prolapsed or is especially large or complicated. 
  • Hemorrhoidopexy: Also known as hemorrhoid stapling, this procedure involves using surgical staples to return a prolapsed hemorrhoid to its normal position in the wall of the anal canal. Because the hemorrhoid isn’t actually being removed, it can be less painful and have a faster recovery time. 

Contact a Gastroenterologist 

Hemorrhoids can be nothing more than a mild nuisance, but sometimes they can turn into an incredibly painful malady that requires rapid treatment. Even though hemorrhoids are rarely dangerous, the disruption to daily life can become significant enough that medical intervention is the only path. 

If you have hemorrhoids that are bleeding or extremely painful, you should contact a gastroenterologist soon. At Cary Gastro, we are passionate about promoting good digestive health and helping improve the quality of life when a gastrointestinal problem arises. If you’d like more information about hemorrhoid banding ligation, or hemorrhoid treatments in general, reference our Hemorrhoid Center for more information, or request an appointment. 

Symptoms & Causes of Hemorrhoids

What are the symptoms of hemorrhoids?

The symptoms of hemorrhoids depend on the type you have.

If you have external hemorrhoids, you may have

  • anal itching
  • one or more hard, tender lumps near your anus
  • anal ache or pain, especially when sitting

Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.

If you have internal hemorrhoids, you may have

  • bleeding from your rectum––bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement
  • a hemorrhoid that has fallen through your anal opening, called prolapse

Internal hemorrhoids that are not prolapsed most often are not painful. Prolapsed internal hemorrhoids may cause pain and discomfort.

Although hemorrhoids are the most common cause of anal symptoms, not every anal symptom is caused by a hemorrhoid. Some hemorrhoid symptoms are similar to those of other digestive tract problems. For example, bleeding from your rectum may be a sign of bowel diseases such as Crohn’s disease, ulcerative colitis, or cancer of the colon or rectum.

When should I seek a doctor’s help?

You should seek a doctor’s help if you

What causes hemorrhoids?

The causes of hemorrhoids include

  • straining during bowel movements
  • sitting on the toilet for long periods of time
  • chronic constipation or diarrhea
  • a low-fiber diet
  • weakening of the supporting tissues in your anus and rectum that happens with aging
  • pregnancy
  • often lifting heavy objects


This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

ASGE | Understanding Minor Rectal Bleeding

What are the possible causes of minor rectal bleeding?

  1. Hemorrhoids
  2. Anal fissures
  3. Proctitis (inflammation of the rectum)
  4. Polyps
  5. Colon or anal cancer
  6. Rectal ulcers

Understanding Minor Rectal Bleeding

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.

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 officebased 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.

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 alone.

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 more rare but curable when diagnosed early.

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. 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.

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

 

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Prolapsed Hemorrhoids: Symptoms, Causes, and Treatment

Prolapsed hemorrhoids are located inside the rectum, and protrude out of the anus. (External hemorrhoids in the anus could also bulge outside the anal opening, but they are not called prolapsed hemorrhoids.)

Prolapsed hemorrhoids are not usually painful. They do cause discomfort, bleeding, and itching that can interfere with sitting, using the bathroom, and going about daily life comfortably.

In many cases, prolapsed hemorrhoids may shrink on their own or with the use of at-home treatment. Medical or surgical treatment may also be required. Here’s a closer look at the symptoms, risk factors, diagnosis, and treatment for prolapsed hemorrhoids.

Illustration by Cindy Chung, Verywell 

Symptoms

`The most common symptoms include:

  • Lump: You may feel a bump on your anus when you wipe after a bowel movement. This is the swollen vein, and it may be tender to the touch, tender all the time, or painless.
  • Bleeding: You may notice blood in the toilet, on the toilet paper when you have a bowel movement, or even on your underwear in between bowel movements. The blood is typically bright red and very watery. Blood that comes from the stomach or from intestinal bleeding is usually dark, black, or tarry.
  • Itching: The skin around your anus may be very itchy when you have a prolapsed hemorrhoid.
  • Discomfort: Large prolapsed hemorrhoids may trigger a general feeling of discomfort or a sense of incomplete evacuation of your bowels, or feeling like you need to go to the bathroom even when you don’t have to release stool. There may be tenderness when a bowel movement or anything else touches your hemorrhoid. The pressure of sitting down may also irritate it.

Pain is unusual with prolapse of internal hemorrhoids.

Complications

A prolapsed hemorrhoid may become severely swollen, obstructing your bowel movements. Internal hemorrhoids can sometimes bleed quickly and profusely on occasion, causing severe blood loss which can be life-threatening in some cases.

Prolapsed hemorrhoids are more likely to bleed or become thrombosed or strangulated than hemorrhoids that are not prolapsed.

See your doctor immediately if you have severe pain or heavy bleeding from your rectum, especially if you have abdominal discomfort, diarrhea, or a fever.

Causes and Risk Factors

The underlying cause of hemorrhoids that form in the anus or rectum is still a matter of debate. One theory is that it is due to the deterioration of the supporting tissues of the anal cushions in the anal canal.

When hemorrhoids are untreated, last for a prolonged period of time, or are under more physical pressure, they can become prolapsed and protrude out of the anus or rectum.

There are several risk factors for prolapsed hemorrhoids, including:

  • Advanced age
  • Constipation
  • Dehydration
  • Diarrhea
  • High-fat/low-fiber diet
  • Lack of physical activity
  • Obesity
  • Overuse of anti-diarrhea medications
  • Pregnancy (especially during the postpartum period)

Sometimes, placing something in the anus, such as during sexual activity, or for medical treatment, can also cause pressure, resulting in prolapse of hemorrhoid.

Diagnosis 

A hemorrhoid is considered to be prolapsed when there is protrusion beyond the rectum. Prolapsed hemorrhoids can be identified by your physician during a physical examination.

Internal hemorrhoids are classified depending on the level of protrusion:

  • Grade I: These internal hemorrhoids are prominent but do not protrude into the anal canal. Bleeding may occur.
  • Grade II: These internal hemorrhoids prolapse out of the anal canal during a bowel movement, but spontaneously retract back inside.
  • Grade III: These internal hemorrhoids prolapse during a bowel movement or other forms of exertion and have to be manually returned inside.
  • Grade IV: These internal hemorrhoids have prolapsed out of the anal canal. They cannot be pushed back in, nor do they remain inside the rectum. Grade IV hemorrhoids may become strangulated if the blood supply becomes been blocked due to pressure from the anal sphincter.

Treatment

Most prolapsed hemorrhoids spontaneously reduce, but you may need at-home remedies, medication, or surgery if your hemorrhoid does not improve on its own. 

Self-Care

The following self-care strategies can help shrink or prevent the worsening of a prolapsed hemorrhoid.

  • Apply ice packs. Icing the area can reduce swelling.
  • Take a sitz baths. Soaking in a warm bath for 10 to 15 minutes can help ease discomfort.
  • Avoid straining during bowel movements. Keep your stools soft by eating foods high in fiber and drinking plenty of water.
  • Stay active. Walking regularly can help increase blood flow to your rectal area to prevent constipation.
  • Limit or avoid alcohol and caffeine. These can both be dehydrating and can cause dry stool that exacerbates the hemorrhoid.

Medication

If your hemorrhoids do not spontaneously reduce, or if they recur, there are a variety of medical treatments you can use.

  • Over-the-counter topical ointments
  • OTC stool softeners
  • Prescription stool softeners

Interventional Procedures

Several procedures can shrink, remove, or decrease blood flow to a prolapsed hemorrhoid that cannot be treated with more conservative measures.

The most common procedure for the treatment of a prolapsed hemorrhoid is a rubber band ligation, which cuts off blood flow to the vein by wrapping a band around it. This results in the shrinking of the hemorrhoid.

Other options include:

  • Sclerotherapy: Injection of a material that causes the vein to shrink
  • Coagulation: Use of infrared light to cut off blood supply to the vein, causing it to shrink

Surgery is a more invasive way to tie off or remove a prolapsed hemorrhoid. Surgery may be necessary if your prolapsed hemorrhoid can’t be treated with the other options.

Summary

The most common symptoms of prolapsed hemorrhoids include lumps on the anus, discomfort, itching, and bleeding. These symptoms are not painful but can interfere with daily activities like sitting and using the bathroom. A high-fat/low-fiber diet, dehydration, lack of physical activity, diarrhea, constipation, overuse of anti-diarrhea medications, advanced age, and pregnancy can all cause hemorrhoids to prolapse. While treatment can vary depending on the grade of your internal hemorrhoid, it may include self-care strategies, medications, interventional procedures, or surgery.

A Word From Verywell

Hemorrhoids are very common, and prolapsed hemorrhoids are also not unusual. They typically improve on their own, but they can persist, necessitating medical or surgical intervention. Healthy lifestyle habits can help prevent prolapsed hemorrhoids from developing in the first place, and often, adopting healthy habits can shrink them permanently.

Bleeding Hemorrhoids: When to See a Doctor

Although most cases of hemorrhoids are mild and can be treated with home care, sometimes they need professional attention. Here are some tips on deciding when to treat at home and when to see your doctor.

Symptoms of a mild condition

Hemorrhoids are swollen veins in and around the anus and rectum, very similar in nature to the varicose veins commonly seen in the legs. Only around 5% of individuals with hemorrhoids experience troubling symptoms. The most common symptom of a mild condition is seeing a few drops of bright red blood after a bowel movement. The blood may be visible in the toilet, streaked on the stool itself, or simply apparent on the toilet paper. Other symptoms may include:

  • Itching and irritation around the anus
  • A small lump or bulge on or near the anus
  • It feels like some stool was retained after a bowel movement
  • Feeling pressure around the anus

Sometimes an internal hemorrhoid will protrude through the anus and become trapped. This may feel uncomfortable. Usually, it can be manually pushed back in and does not require medical treatment.

Pain

If a hemorrhoid bleeds internally, a blood clot can form inside the hemorrhoid, creating a bluish colored lump. This is referred to as a thrombosed hemorrhoid and requires medical treatment. Thrombosed hemorrhoids can cause significant levels of pain. Sometimes a thrombosed hemorrhoid will rupture and release the clot and bleed heavily, and this condition also requires treatment. Ideally, a thrombosed hemorrhoid, whether it ruptures or not, should be removed within 72 hours of the onset of the thrombosis. If not removed, the pressure from a thrombosed hemorrhoid can damage the surrounding tissues.

Bleeding: Should I See a Doctor?

Generally, if there is only minor bleeding, namely a few drops of blood seen after a bowel movement, the hemorrhoids can be managed at home. If the hemorrhoid is regularly bleeding in between bowel movements and you frequently notice blood in your underwear or a fairly large amount of blood in the toilet after each use, definitely seek medical care.

Conclusion

Hemorrhoids can generally be treated at home unless one or more of these symptoms occur:

  • Pain, particularly if it is intense or has a sudden onset
  • Losing more than a drop or two of blood after a bowel movement
  • Bleeding in between bowel movements
  • A new lump forms on or near the anus that is bluish in color

Hemorrhoid treatment without pain and blood

Hemorrhoids are enlarged veins of the hemorrhoidal plexus.

Both women and men face this disease. Not every patient consults a doctor. This is especially true when the symptoms are mild.

Most patients with hemorrhoids have complaints such as pain and bleeding. Each patient has an individual manifestation of the disease. When symptoms are present, many patients seek medical attention.But in the absence of pain, even if bleeding from the anus, patients often prefer to lead a normal life and do not think about their health and the consequences that the disease can provoke.

Are there painless hemorrhoids?

Varicose veins of the hemorrhoidal plexus are not always painful. When a patient notices an admixture of blood in the stool, he begins to wonder if hemorrhoids are pain-free and at the same time doubts that he is sick.In this case, the patient should monitor his condition with special care. In addition to pain and bleeding, other symptoms may also be present, such as discomfort during bowel movements, difficulty in emptying the bowels, constipation, and others.

Also, hemorrhoidal disease may not be accompanied by prolapse of nodes. This is especially true of internal hemorrhoids, in which an increase in blood vessels occurs inside the rectum. External hemorrhoids are much less common without pain.

At the initial stage of the disease, the lesion of hemorrhoids is not strong.Feces, moving along the rectum, do not damage them. That is why the patient does not experience pain. After some time, an admixture of blood appears in the feces. This suggests that hemorrhoidal disease is progressing. This process is accelerated in the presence of predisposing factors:

  • weight lifting;
  • constipation;
  • 90,015 sedentary lifestyles;

  • pregnancy and childbirth;
  • improper nutrition;
  • bad habits;
  • hereditary predisposition….

Hemorrhoids also happen without bleeding. The absence of pain and blood continues until the disease progresses to the next, more severe stage. In advanced cases, only an operation to remove hemorrhoids will relieve the disease.

If there is no pain, this does not mean that the patient is not experiencing complications. Over time, hemorrhoids begin to bleed. Without timely medical care, a severe stage of combined hemorrhoids develops, in which, over time, the nodes cannot be adjusted on their own.

What other symptoms are there for hemorrhoids without pain?

With a painless course, the patient does not notice immediately that he has hemorrhoids. At the initial stage of inflammation of hemorrhoids, bleeding may also be absent. Over time, an admixture of blood appears in the feces. Along with this, the following symptoms may be present:

  • itching in the anus;
  • the presence of edema in the perineal area;
  • feeling of a foreign body in the anus;
  • stool disorder;
  • painful bowel movements;
  • swelling and redness near the anus;
  • the appearance of inflamed nodes.

The absence of pain does not mean that internal hemorrhoids should not be treated. Treatment at the initial stage is much more effective, therefore, a proctologist should be consulted if there are even the most insignificant symptoms in the patient’s opinion.

How are hemorrhoids treated?

Have signs of hemorrhoids? Protect yourself from complications, seek medical attention. Experienced proctologists are receiving appointments at the On Clinic medical center in Almaty. You will undergo diagnostic procedures and prescribe a therapeutic course that is effective in your case.Depending on whether hemorrhoids are bloody or not, treatment regimens are different.

Treatment of hemorrhoids without pain should be immediate. In On Clinic, the disease is treated with non-surgical methods. One of them is latex ring ligation. The technique consists in squeezing the knot with a latex ring. The blood supply to the node is interrupted, as a result of which it dies and is excreted during bowel movements. Latex ring ligation is more commonly used to treat internal hemorrhoids.

External hemorrhoids are eliminated in other ways.Combination treatments are often used, such as ligation in combination with infrared photocoagulation. The method of treatment is selected individually for each patient.

Can hemorrhoids go away on their own?

Even if the disease does not manifest itself as severe pain, it must be treated. Enlarged hemorrhoids cannot go away on their own. Sooner or later, the symptoms will start to bother you. With a late visit to the doctor, treatment is more complex and lengthy.Preventive measures will help to suspend the progression of the disease.

  1. Balanced nutrition. The daily diet should not contain too spicy, fatty foods. Patients are shown vegetable soups, cereals, fresh vegetables and fruits, low-fat dairy products.
  2. Quitting bad habits. Alcohol abuse contributes to the adhesion of red blood cells and vasodilation. Nicotine, tar and combustion products negatively affect blood vessels.
  3. Compliance with the correct drinking regime.The use of herbal teas, unsweetened compotes and homemade fruit drinks will be beneficial.

According to the doctor’s prescription, the patient can use medications. Often, the treatment of bleeding hemorrhoids is not complete without the use of medication.

Make an appointment with a proctologist at the first sign. Fill out the registration form through the clinic’s website, become the owner of a discount on medical services!

City Clinical Hospital №31 – Treatment of hemorrhoids without surgery: methods, methods, therapy

Is it possible to radically get rid of hemorrhoids with a bloodless method?

How to choose a way to eliminate hemorrhoids

The tactics of medical measures for hemorrhoids are determined by the attending physician at a full-time consultative appointment.It will be necessary to undergo diagnostics: external examination, anoscopy, and in some cases – sigmoidoscopy or colonoscopy.

Answer to the question “Is it possible to cure hemorrhoids without surgery?” depends on the following factors:
___ • the nature of the course of the disease (acute or chronic pathology),
___ • the stage of development of the process,
___ • the presence of complications,
___ • the general condition of the patient (age, concomitant diseases).

Doctors turn to traditional surgical intervention relatively rarely, in advanced cases. Preference is given to non-surgical methods: conservative therapy in combination with low-traumatic techniques (sclerotherapy, ligation of nodes, laser coagulation, etc.).

Which method is the most reliable?

Hemorrhoids – a disease that occurs as a result of the expansion of the arterial collectors of the rectum.

In addition to a hereditary predisposition to the development of hemorrhoids, lead to:
___ • stool disorders (constipation, diarrhea),
___ • sedentary lifestyle,
___ • sedentary work,
___ • overweight,
___ • heavy physical exertion,
___ • diseases digestive system,
___ • pathologies that increase intra-abdominal pressure (ascites, pulmonary emphysema, chronic cough, etc.)),
___ • pregnancy.

The duration of the relapse-free period with hemorrhoids does not depend on the method of eliminating the enlarged node. To prevent the disease from returning, it is necessary to eliminate all factors contributing to the development of pathology – this is a necessary and sufficient condition for maintaining your health.

When is treatment without surgery prescribed?

1. Acute hemorrhoids

It is possible to cure hemorrhoids without surgery using conservative methods of therapy when it comes to exacerbation of the disease. Acute hemorrhoids, , as a rule, develops in response to the influence of a resolving factor:
___ • errors in diet (spicy food, alcohol),
___ • stool disorders (constipation or diarrhea),
___ • hard physical labor.

Thrombosis of the hemorrhoid clinically manifests itself in the appearance of a subcutaneous painful formation in the projection of the anus. The pain syndrome increases with bowel movement, and in severe cases, when walking, coughing and sneezing.

Pain may radiate to the leg and / or be accompanied by a sensation of a foreign body in the rectum.Another characteristic complaint of patients with acute hemorrhoids is blood on the surface of the stool during bowel movements. In severe cases, severe bleeding is possible.

2. Pregnancy

Methods of conservative therapy are used to treat hemorrhoids during pregnancy. The expansion of hemorrhoidal veins during childbearing is associated with physiological changes in the body of the expectant mother.

The enlarged uterus compresses the rectum, as a result, blood circulation is disturbed and conditions are created for stagnation of blood in the hemorrhoidal vessels.The situation is aggravated by the hormonal background of pregnant women provoking chronic constipation.

After the birth of a child, all factors contributing to the development of hemorrhoids are safely eliminated – intra-abdominal pressure decreases, hormones stabilize, and stool normalizes. All conditions are created to eliminate hemorrhoids by conservative methods.

But, if the process was started even before pregnancy, the doctor may offer treatment with minimally invasive methods.

3. If the operation is contraindicated

Conservative therapy in the later stages of the development of hemorrhoids is prescribed if the patient’s health condition does not allow for radical surgery:
___ • acute infection,
___ • exacerbation of chronic pathology,
___ • acute vascular accidents,
___ • general weakened state of health,
___ • oncological diseases.

In such cases, conservative therapy successfully solves the following tasks:
___ • improving the patient’s quality of life (eliminating pain, anal itching and other discomfort),
___ • preventing further development of the disease,
___ • combating complications (iron supplements for anemia and etc.).

However, the prognosis for getting rid of the disease remains dubious, and the risk of complications is quite high. Therefore, proctologists recommend that the intervention be carried out immediately after the patient’s state of health has stabilized.

Methods of conservative therapy

1. Conservation regime and non-drug methods of treatment

A protective regime and physiotherapy are prescribed in the general complex of measures for conservative therapy of hemorrhoids, as well as in preparation for surgical intervention and during the rehabilitation period after a traditional operation or low-traumatic procedures.

The essence of the protective regime is to eliminate all factors that increase intra-abdominal pressure and contribute to stagnation of blood in the veins of the small pelvis:
___ • prohibition on heavy physical labor and prolonged sitting in a sitting position,
___ • dosed loads (walking on level ground),
___ • limitation of thermal procedures (baths, saunas),
___ • fight against excess weight,
___ • treatment of chronic diseases that aggravate the process (pathologies of the digestive tract, lungs, genitourinary system),
___ • refusal to take alcohol and spicy food …

To relieve pain, proctologists prescribe baths with potassium permanganate and / or decoctions of medicinal herbs, which have an astringent, antimicrobial and anti-inflammatory effect.

In the subacute period, as well as as anti-relapse treatment, special complexes of physiotherapy exercises are recommended, which strengthen the muscles of the pelvic floor, have a beneficial effect on intestinal motility and restore blood circulation in the small pelvis.

2. Fight against stool disorders

Violation of stool regularity (constipation, diarrhea, and constipation alternating with diarrhea) is the main cause of exacerbations of hemorrhoids.To stimulate the intestines, a diet with a high fiber content (apples, oranges, wholemeal bread, prunes) is recommended. Foods that help strengthen stool are excluded from the diet:
___ • potatoes,
___ • rice,
___ • semolina,
___ • pears,
___ • quince,
___ • pomegranate,
___ • wheat products: white bread, pasta.

The ban also includes dishes that irritate the intestines:
___ • pickles and smoked meats,
___ • spices, onions, garlic,
___ • carbonated and alcoholic drinks,
___ • strong coffee.

Food must be soft, sufficiently heat-treated (steamed, boiled or baked food). It is recommended to include a sufficient amount of liquid foods and drinks in the diet, which will ensure the body is saturated with water (more than 2 liters per day).

If the diet does not help to achieve a regular stool, natural laxatives are prescribed, the principle of which is to soften the stool (for example, Forlax).

3. Drug treatment: suppositories and ointments

Treatment of hemorrhoids without surgery involves the use of drugs for external use.With the nodes located outside, ointments are prescribed, and with the localization of pathological elements inside the intestine, suppositories.

The drugs used for hemorrhoids may contain one or more active substances:
___ • pain relievers,
___ • antispasmodics,
___ • anti-inflammatory,
___ • antimicrobial,
___ • blood thinners,
___ • strengthening capillaries,
__ drying, etc.

Some patients believe that the more actions a drug produces simultaneously, the better, but a large number of components means an increased risk of side effects and a longer list of contraindications.Therefore, we recommend that you contact a proctologist who will select the drug individually, based on your specific situation.

Minimally invasive methods

Mechanism of action of low-traumatic interventions

Minimally invasive (less traumatic) methods of treatment involve the elimination of hemorrhoids without the use of a traditional surgical scalpel. Such procedures are well tolerated by patients, therefore they are often called treatment of hemorrhoids without surgery.
___1. Sclerotherapy of hemorrhoids is the introduction of a chemical substance into the lumen of the vessel feeding the node, which burns the inner lining of the vessel. As a result, the pathological element decreases in size.
___2. At coagulation of hemorrhoids “gluing” of the inner walls of the vein feeding the node occurs under the thermal effect of wave radiation.
___3. Ligation of nodes with latex rings is a mechanical ligation of the feeding arteries.

Thus, the mechanism of action of minimally invasive methods is the same: the pathological element is “disconnected” from the vascular network, becomes dead and excreted from the body with feces.

Advantages and disadvantages of low-traumatic methods

The advantages of low-traumatic methods of hemorrhoid treatment are expressed in the name itself. An injury that is insignificant for the body does not provide for increased requirements for the state of health of the patient, therefore, such treatment can be carried out even in old age in patients aggravated by many chronic diseases.

In addition, minimally invasive intervention assumes:
___ • outpatient nature (does not require hospitalization),
___ • short recovery period with minor restrictions (prohibition of physical activity and thermal procedures),
___ • mild postoperative pain syndrome, easily relieved standard pain relievers.

Minimally invasive methods have one single, but serious drawback : they are not effective for all patients. At the IV and V stages of the development of the process (uncontrolled nodes), as well as in cases of complicated hemorrhoids, one has to resort to traditional surgery to remove hemorrhoids

Treatment with folk remedies

It is necessary to be very careful with the advice distributed on the Internet, and do not prescribe treatment yourself! Only the doctor, after the examination, will be able to say which stage of hemorrhoids will have to be dealt with, whether there are any accompanying complications and prescribe the most appropriate treatment.
Do not self-medicate! Contact the specialists!

Methods for the treatment of hemorrhoids without surgery at City Clinical Hospital No. 31 (Moscow)

Surgical operations in Moscow City Clinical Hospital No. 31 are carried out under the compulsory medical insurance policy. The list of services included in the Territorial program of state guarantees of free medical care in the city of Moscow can be found in the document.

You can also make an appointment and undergo the procedure of non-surgical treatment of hemorrhoids on a paid basis.You can find out about the rules for the provision of paid services here.

Remember that the treatment of hemorrhoids without surgery is possible only with timely referral to the proctologist!

Don’t miss your chance! We are waiting for you, come.

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A repeated consultation of one specialist is considered within 30 days from the date of the previous appointment.On the 31st day from the previous visit to a specialist of this profile, the consultation will be primary.

90,000 all treatments ranging from minimally invasive. Laser treatment for hemorrhoids. Medical center “Medyunion”

Hemorrhoids are a delicate problem faced by every second modern person.If you delay treatment and do not consult a specialist in time, the situation may worsen. Medyunion knows how to solve your unpleasant problem. Hemorrhoids are formed as a result of inflammatory processes that occur in the vessels of the rectum. As a consequence: thrombosis, varicose veins, venous sclerosis. This leads to severe bleeding and pain.

What triggers the appearance of hemorrhoids?

  • sedentary lifestyle, resulting in congestion in the pelvic region;
  • violation of venous circulation;
  • dysfunction of the rectum;
  • chronic inflammation of the pelvic organs;
  • period of pregnancy and childbirth;
  • congestion in the pelvic region;
  • Genetic predisposition to dysfunction of the venous valves.This results in arterial blood flow and venous congestion.

How to understand that it is hemorrhoids?

  • Heavy bleeding during bowel movements;
  • prolapse of nodes from the anal canal;
  • 90,015 anal itching;

  • mucus secretion;
  • pain in the anus;
  • constipation;
  • Cracking.

Disease degree

  • At the earliest stage of the disease, there is bleeding, cracks in the anus without loss of nodes.
  • Loss of knots with the possibility of self-indentation.
  • The third degree is accompanied by the prolapse of nodes not only during bowel movements, but also with any intra-abdominal pressure. For example, when coughing, lifting heavy objects.
  • The fourth degree is the most dangerous. Since in this case, the disease is accompanied by profuse bleeding, discharge, incessant pain in the anus. It is impossible to correct the knots manually.Removal of hemorrhoids is carried out using an operation.

Diagnostics

After visual examination and digital examination of the rectum, the coloproctologist will definitely prescribe anoscopy or rectaromonoscopy. The methods are used to study the state of the rectal mucosa. This test helps to rule out or confirm the presence of neoplasms and polyps in the colon. If the diagnosis is confirmed, the proctologist will order a colonoscopy.

Treatment

Therapeutic therapy depends on the degree of manifestation of the disease. In the early stages, it is possible to restore stool, get rid of pain in the anus and stop frequent bleeding. The most important thing in the fight against hemorrhoids is frequent bowel movements and avoidance of constipation. Diet. Our coloproctologist recommends consuming foods that are sources of dietary fiber (wheat bran, seaweed, flaxseed oil / seed). They stimulate stool normalization. Also, do not forget to drink plenty of clean, non-carbonated water, which will restore the mineral balance in the blood.Dietary fibers swell, feces soften. Fried and smoked foods are not recommended. Special sports exercises. Strengthen the muscles of the rectal canal, train the vascular system, improve blood circulation, saturate the body with oxygen.

  • Walking or walking;
  • swimming;
  • 90,015 running;

  • skiing.

Local treatment of hemorrhoids.

The doctor will prescribe you drugs that increase the tone of the veins, stimulating the normalization of blood flow.With the formation of large anal fissures and infringement of the hemorrhoid, anesthetic ointments / creams / gels are prescribed. The laxative stimulates the release of feces, enhances peristalsis, softens feces.

Minimally invasive methods

  • Ligation of hemorrhoids. The treatment takes place under local anesthesia. The proctologist places latex rings on the vascular pedicle of the node. The rings squeeze the base and the blood supply to the processes stops. After 2 weeks, they die off.This method is not suitable in the presence of anal fissures, indistinct borders of nodules, exacerbation of hemorrhoids.
  • Sclerotherapy. Removes nodules and stops bleeding. During the procedure, a solution is used that glues the walls of the vessels. The nodules are no longer fed with blood, and they subside over time.
  • Laser removal. The light beam burns out neoplasms. Over time, they decrease in size, then disappear completely, leaving the connective tissues intact.The procedure is especially effective at stages 2 and 3 of development.
  • Desarterization. This is the constriction of the arterial canals that feed the nodules. A treatment session is performed using a special ultrasound sensor and is indicated at any stage of the disease.
  • Cryodestruction. Freezing of formations with liquid nitrogen down to -200 degrees. Due to this, the nodules die off and go out in the feces.

Operating Methods

One of the painful complications of hemorrhoids is thrombosis.With this disorder, a blood clot forms. The disease is accompanied by:

  • Enlargement and tenderness of the hemorrhoidal nodule;
  • Edema of the anal canal;
  • The beginning of the inflammatory process;
  • High temperature.

How to get rid of painful sensations? In the case of thrombosis, the only effective method will be thrombectomy of the hemorrhoidal node – removing a blood clot from a blocked vessel. With the help of an operation, a coloproctologist will restore blood flow in the affected vein.

How is the operation going? The doctor makes a small incision, allowing himself access to the damaged vessel and removes the blood clot with a surgical instrument.

Surgery is indicated for external hemorrhoids when local treatment has failed.

If you have found signs of hemorrhoids, contact the specialists of the Medunion Medical Center. Hemorrhoids not only bring discomfort, but can also be dangerous to your overall health.Entrust your delicate problem to doctors and start living life to the fullest!

Blood from the anus – causes, diagnosis and treatment of bleeding from the anus

Blood from the anus is a sign of diseases of the rectum or colon, indicating the presence of a source of blood secretion in these parts of the intestine. The color and nature of bleeding plays an important role in the diagnosis.

In the event of the appearance of such a symptom as blood from the rectum, both a man and a woman need to urgently consult a coloproctologist.Coloproctologist, proctologist will conduct an examination and make a preliminary diagnosis. If you need more detailed diagnostics, for example, anoscopy or sigmoidoscopy, you can carry it out on the same day. For women, at the Clinic of Proctology, women-proctologists are receiving appointments.

Prices for an appointment with a proctologist

Initial appointment with a proctologist (assessment of patient complaints, taking anamnesis, external examination of the anus, digital examination of the rectum, anoscopy according to indications)

Initial appointment – a visit to a doctor of a specific specialty for the first time.

To make an appointment

Causes of bleeding from the anus

If you notice blood on toilet paper after a bowel movement, even if the process of bowel movement is painless, you should definitely consult a proctologist for advice in order to establish the cause of bleeding, start treatment in a timely manner and avoid possible complications.

Why does blood appear from the anus after stool, both in men and women:

  • A fairly common factor – hemorrhoids (enlargement of the veins of the rectum). Red blood appears from the anus during bowel movements.
  • Anal fissure is the second most common cause of rectal (rectal) bleeding. The disease is characterized by a burning sensation during bowel movements, sometimes accompanied by acute pain (patients describe it as cutting, and then squeezing).Bloody discharge is manifested in both small and abundant portions.
  • Inflammatory diseases of the colon.
  • Presence of benign lesions (polyps). A characteristic symptom is the discharge of blood from the rectum after a bowel movement. The blood is darker, often with mucus.
  • Presence of a malignant tumor of the rectum. Blood of various colors may be released. Quite often, the secreted blood does not differ in any way from the blood that is secreted, for example, from hemorrhoidal tissue.And if the presence of hemorrhoidal disease worsens only the quality of life (hemorrhoidal tissue never degenerates into a malignant tumor), then the presence of a benign tumor or malignant tumor can be harmful to health and danger to life, which is why you should not try to establish the source yourself.

Only a coloproctologist can determine the true cause of bleeding from the anus and choose the appropriate treatment. Timely diagnosis allows for effective conservative and minimally invasive treatment.

Discharge color and disease

  • bright red, scarlet blood from the anus on toilet paper or underwear, drops at the end of the act of defecation (bowel movement) – hemorrhoids or anal fissure;
  • red color of blood with anal bleeding – cancer, intestinal polyp;
  • dark-colored blood clots – tumors of the distal colon, diverticulosis;
  • cherry color of blood from the anus – colon pathology;
  • black, tarry stools – diseases of the stomach, duodenum and small intestine.

IMPORTANT! Bleeding is a serious symptom, after the appearance of which the visit to the doctor cannot be postponed. Unfortunately, blood from the anus can cause diseases such as swelling of the rectum or colon. And in the worst case, this tumor can turn out to be malignant. Blood can also occur as a result of an injury to a polyp – a benign tumor. Long-standing polyposis can be a sign of bowel cancer.

The nature of bleeding and disease

  • Regular profuse blood, not associated with bowel movement – diverticulosis, polyposis, Crohn’s disease, ulcerative colitis, rectal or colon cancer;
  • Blood mixed with feces – cancer of the rectum and colon;
  • Bleeding with diarrhea – dysbiosis, irritable bowel syndrome;
  • Discharge of blood with mucus or pus – internal hemorrhoids, prolapse of the rectum or polyp;
  • Heavy bleeding with mucus – proctitis, colitis, rectal cancer.

Make an appointment

Diagnostics and treatment

When faced with an intimate problem, especially such as bleeding from
anus during bowel movements, you can get confused, especially not knowing about the methods of diagnosing and treating such ailments or not understanding which doctor to turn to.

A proctologist or coloproctologist is a doctor who diagnoses and treats diseases of the colon, rectum and anus, as well as problems of the sacrum, coccyx and perineum.You should not postpone a visit to this specialist if there is blood from the anus after stool.

The proctologist will listen to complaints and the history of their appearance, and to establish the cause of the appearance of blood from the rectum, he can carry out the following procedures:

Digital rectal examination: the primary research method that makes it possible to assess the condition of the anus, identify possible pathologies in the form of neoplasms, anal fissures, uncharacteristic discharge, bleeding.

After a digital examination, the coloproctologist, if necessary, prescribes further diagnostic methods using special equipment:

  • Anoscopy. This is an examination of the last 3-7 cm of the rectum, it is in this area that almost half of the sources are located with visible bleeding. There are several types of anoscopes (straight, conical, with and without notch, transparent and non-transparent), each of them is used strictly according to indications, but any of these types allows you to perform a full examination of the anal canal and lower ampullar rectum.Anoscopy is used when performing minimally invasive methods of treating hemorrhoids (ligation, sclerotherapy), as well as performing a number of surgical interventions (bipolar coagulation). Preparation is generally not required to perform diagnostic anoscopy; preparation is required for therapeutic anoscopy.
  • Sigmoidoscopy or rectoscopy (RRS or RRS) – diagnostic manipulation using a special device with a camera. It makes it possible at the initial admission to quickly and without pain visually assess the state of the rectal mucosa, identify the presence of mucosal formations and intestinal compression.With rectoscopy, up to 20 cm of the intestine is examined (the entire straight line and the place of its transition to the sigmoid one). Preparation is required for rectoscopy.
  • Colonoscopy is the most informative, in comparison with others, method for examining the large intestine. It is performed using a flexible fibrocolonoscope equipped with a high-resolution camera that will show even the smallest sources of bleeding. The procedure is also prescribed for the purpose of endoscopic removal of colon masses. Colonoscopy is performed by an endoscopist.

The appropriate treatment for the disease is determined and prescribed by the physician. You should not engage in self-treatment and neglect contacting a coloproctologist.

How to prepare for the examination?

The own research of the specialists of the proctology department of the Altermed clinic made it possible to make a visit to the proctologist as easy and comfortable as possible. You no longer need to fast the day before and schedule your procedure in the morning. In the proctology departments of Altermed, a way has been found that allows you to successfully cope with all these difficulties.This is Microlax bowel preparation.

The use of Mikrolax microclysters makes fasting unnecessary, does not require special equipment and premises, and saves a lot of time. The laxative effect occurs within 5-15 minutes after drug administration. The quality of bowel cleansing is such that treatment can be started immediately after rectoscopy and anoscopy. If necessary, use during pregnancy and lactation Microlax does not require special precautions.

The Proctology Clinic carries out diagnostics using the most modern equipment.The best doctors of St. Petersburg – both men and women – and a delicate approach are at your service.

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Hemorrhoid treatment

Hemorrhoids – pathological enlargement of hemorrhoids (internal nodes – internal hemorrhoids, external nodes, external hemorrhoids). Combined hemorrhoids – a simultaneous increase in internal and external nodes.The urgency of the problem is indisputable – the prevalence of the disease is 140-150 people per 1000 adult working-age population, its share in the structure of colon diseases ranges from 34 to 41%.

Causes and development of the disease

Anatomy of hemorrhoids

Hemorrhoids are a venous plexus located in the submucosal layer of the distal rectum above the anorectal line in the anal canal under the skin of the perineum, held by muscle and ligamentous apparatus.

Predisposing factors for the development of hemorrhoids are:

  • Elderly and senile age;
  • Sedentary lifestyle, sedentary work;
  • Incorrect food;
  • Chronic and acute constipation;
  • Alcohol abuse;
  • Pregnancy and childbirth.

The cause of the pathological increase in hemorrhoids is acute or chronic circulatory disorders (blood stasis) in the cavernous formations.A weakening of the ligamentous apparatus of hemorrhoids plays a certain role in the development of the disease.

Clinical observations show that at the onset of the disease, hemorrhoids can be reduced for a long time and reappear with unfavorable factors. Loss of nodes at later stages is associated with a violation of the elasticity of the ligamentous apparatus and muscle structures that hold the hemorrhoidal nodes in the anal canal.

Clinical manifestations

The most common reason for going to a doctor is the appearance of red blood in the anus.In 80% of patients, this is the release of scarlet blood during or after an act of defecation, less often there is a release of blood between acts of defecation .. In 24-27% of patients, constant bleeding from the anus leads to a decrease in hemoglobin, which affects the general condition. Also, hemorrhoids are characterized by constant dull pain, itching in the anus.

So, summarizing the above clinical symptoms of hemorrhoids :

  • Scarlet blood during or immediately after the act of defecation;
  • Anal itching;
  • Pain in the anus;
  • Feeling of a “foreign body” in the anus;
  • Presence of subcutaneous formation on the skin of the anus.

Complications

The constant release of scarlet blood is simultaneously the main symptom and complication of hemorrhoidal disease, leading to profound anemia up to a decrease in hemoglobin to 40 g / l.

The second most important complication of hemorrhoids is the inflammatory process in the surrounding tissue as a result of thrombosis of the nodes, which during its development can lead to the formation of purulent paraproctitis (purulent inflammation of the tissue surrounding the anal canal).

It should be noted that prolonged prolapse of hemorrhoids in the elderly leads to a weakening of the anal sphincter and, as a result, incontinence of gases and feces.

Diagnosis of the disease

Recognizing hemorrhoids is usually easy. The diagnosis is made by the doctor during the questioning of the patient and the first examination. During the examination, the doctor assesses the condition of the skin of the anal region, the degree of prolapse of hemorrhoids, the possibility of their independent reduction of the anal canal and the severity of bleeding.Then a digital examination of the rectum is carried out, the state of the obturator canal of the rectum is assessed, the presence of compacted hemorrhoids, the presence of polyps or anal papillae is determined.

With severe bleeding, a general clinical blood examination is prescribed by a doctor. In the presence of concomitant problems with the stool, an analysis of feces is prescribed, including for dysbiosis, a biochemical blood test. Examination of smears from the anal canal to determine the presence of fungal or other specific lesions of the mucous membrane of the anal canal.

In some cases, the diagnosis requires instrumental research methods – anoscopy, sigmoidoscopy and colonoscopy, including for differential diagnosis with other diseases of the colon.

Classification

Hemorrhoids, like many diseases, are characterized by a recurrent course and have 2 clinical forms – acute and chronic.

In the development of acute hemorrhoids , there are 3 stages:

Stage 1 – characterized by thrombosis of external and internal hemorrhoids without inflammation.

Stage 2 – characteristic signs are the attachment of local inflammation of the hemorrhoids.

Stage 3 – against the background of thrombosis and inflammation of the hemorrhoids, it develops by inflammation of the subcutaneous tissue and the perianal region.

In the development of chronic hemorrhoids there are 4 stages:

Stage 1 – the allocation of only scarlet blood from the anus during bowel movements without prolapse of hemorrhoids.

Stage 2 – prolapse of hemorrhagic nodes, but with their independent reduction into the anal canal.

Stage 3 – periodic prolapse of nodes from the anal canal with the need for manual reduction (with or without bleeding).

Stage 4 is a constant prolapse of hemorrhagic nodes from the anal canal together with the rectal mucosa, the impossibility of their reduction into the anal canal using manual assistance.

Treatment

Conservative treatment of hemorrhoids is indicated in the initial stages of chronic, with acute hemorrhoids, in the perioperative period.

In the treatment of all forms and stages of hemorrhoids, an important component is the treatment of irritable bowel syndrome, which is a companion of hemorrhoidal disease. It is necessary to seek the normalization of the intestines. A diet with a high content of plant fiber is prescribed, in violation of microflora – pro – and prebiotics, enzyme preparations.

Treatment consists of local and systemic drugs. As a systemic therapy at all stages of hemorrhoids, veno-currents are prescribed, preference is given to preparations containing a micronized purified fraction of flavonoids. Their effectiveness has been proven, they reduce the likelihood of recurrence of exacerbations of hemorrhoids by 70%, reduce bleeding, etc.

For local treatment, various ointments and applications, suppositories are used, depending on the stage of the disease.

And yet, despite a wide variety of systemic and local drugs for the treatment of the acute stage of hemorrhoids, which in most cases lead to a positive result, the resumption of physical activity, diet disorders and other factors leads to another exacerbation of the disease.

With the ineffectiveness of conservative measures for the treatment of acute hemorrhoids and in the late stages of chronic hemorrhoids, surgical treatment is indicated.

Surgical treatment of chronic hemorrhoids has come a long way in its development.In recent years, the so-called minimally invasive surgical methods of treatment, which are quite suitable on an outpatient basis, have become increasingly common. These include photocoagulation of hemorrhoids, ligation with latex rings, dearterization of hemorrhoids, combined techniques, sclerotherapy. Each method of treatment has its own indications and contraindications.

You can sign up for a consultation and find out more at the administrator by phone +7 (495) 356-30-03.

Clinical Hospital | Hemorrhoids

Hemorrhoids is one of the most common human diseases. The frequency of hemorrhoids reaches 135-140 people per 1000 adult population, and the proportion of patients in the structure of coloproctological diseases ranges from 34 to 41%.

Pathogenesis

There are two leading pathogenetic links in the development of hemorrhoidal disease: vascular and mechanical.Vascular disorders occur due to changes in the local regulation of blood circulation: an increase in the flow of arterial blood into the cavernous tissue of the hemorrhoid and a decrease in outflow through the veins, which leads to an increase in the size of internal hemorrhoids and stretching of their ligamentous-muscular apparatus. The mechanical theory is based on stretching and rupture of the fixation apparatus of the internal hemorrhoid.

Signs of illness:

  • Appearance of blood during bowel movements, in the toilet, on toilet paper or on clothes,
  • itching, wetness, discharge,
  • foreign body sensation,
  • feeling of incomplete emptying during bowel movements,
  • prolapse of the hemorrhoid during bowel movements and physical exertion,
  • pain in the anus.

Classification

The first stage – the release of blood from the anus without prolapse of hemorrhoids.

Second stage – prolapse of hemorrhoids with self-reduction into the anal canal, with or without bleeding.

The third stage – prolapse of hemorrhoids with the need to reposition them into the anal canal using manual assistance, with or without bleeding.

Fourth stage – constant prolapse of hemorrhoids together with the rectal mucosa and the impossibility of their reduction into the anal canal, with or without bleeding.

Treatment

At the initial stages of the disease, conservative methods of treatment are possible: ointments, suppositories, physiotherapy. Minimally invasive methods of treatment of hemorrhoids are used: coagulation with infrared color, injections of sclerosing drugs, ligation of hemorrhoids.These techniques are painless, do not require hospitalization, are easily tolerated, but are effective only in the initial 1-2 stages of hemorrhoids.

Complete removal of hemorrhoids (hemorrhoidectomy) is the most common and one of the most radical surgery, used for 2-4 stages of hemorrhoids. Currently, these operations are performed using the latest modern equipment: ultrasonic scalpel, high-frequency coagulation, radio-frequency scalpel. Such surgical interventions are easier to tolerate, less traumatic, are accompanied by minimal pain syndrome, and can shorten the time of wound healing, the days of hospital stay and subsequent rehabilitation.Modern operations with the use of innovative technologies in the used disposable stapling devices are even easier for patients.

Operation Longo

Operation Longo – mucous and submucosal resection of the lower ampullar rectum. The operation is performed using a modern disposable circular stapler. The operation simultaneously affects two leading pathogenetic links in the development of hemorrhoidal disease (vascular and mechanical) due to the strengthening and fixation of the ligamentous and muscular apparatus of the internal hemorrhoidal plexuses, as well as blockade of the terminal branches of the superior rectal artery.This method is organ-saving because does not require removal of internal hemorrhoids. All the symptoms of hemorrhoids are eliminated with the preservation of nerve and reflex connections, which play a role in the retention of feces, in the postoperative period there is no discomfort and pain, the ability to work is restored after 3-5 days. The experience of our clinic has more than 300 operations with good treatment results.

Before surgery After operation

Laser vaporization of hemorrhoids ( LHP)

Hemorrhoid Vaporization Procedure (LHP) is a new method of hemorrhoid treatment.Vaporization is literally vaporization, vaporization of tissue under the influence of a laser beam without physical impact. It is the contactless elimination of the disease without excision and stitches that is the main advantage of the technique. As a result, it provides a minimal risk of bleeding during and after surgery, a low level of pain after surgery, and a quick recovery.

Advantages of laser vaporization of hemorrhoids over other methods of treatment:

  • Non-contact method, elimination of nodes without excision.
  • Absence of postoperative wounds and sutures in the anal canal, without the formation of scars on the inner surface of the rectum.
  • Pain after the procedure is weaker and shorter in duration by half, due to low trauma.
  • Healing is faster than after surgical excision of the nodes.
  • After 5-10 days, you can return to your normal lifestyle, but the final recovery occurs in 3 weeks.
  • No bleeding due to coagulation, laser sealing of blood vessels.
  • Low relapse rate. After laser vaporization of hemorrhoids, a scar frame is formed at the site of exposure, which protects against further development of the disease.