What Is It, Tests & Diagnosis

Overview

What is a flexible sigmoidoscopy?

A gastroenterologist, or healthcare provider specializing in the gastrointestinal system, performs a flexible sigmoidoscopy to view the inside of the lower (sigmoid) part of your colon and rectum. Your healthcare provider uses a sigmoidoscope, a flexible lighted tube with a camera. The procedure helps your healthcare provider diagnose, and sometimes treat, bowel disorders and cancer.

Who might need a flexible sigmoidoscopy?

Your healthcare provider may recommend a flexible sigmoidoscopy if you experience:

• Abdominal pain.
• Chronic diarrhea.
• Rectal bleeding.
• Unexplained weight loss.

Why do healthcare providers perform flexible sigmoidoscopies?

Healthcare providers use flexible sigmoidoscopies to diagnose:

• Colon cancer.
• Colon polyps (groups of cells in the colon that can become cancer).
• Inflammatory bowel disease (IBD), namely ulcerative colitis or Crohn’s disease.
• Rectal ulcers.

What’s the difference between a flexible sigmoidoscopy and a colonoscopy?

Both procedures are screening tools for colon cancer. A sigmoidoscopy is less invasive. It allows your healthcare provider to see only the lower part of the colon. With a colonoscopy, your healthcare provider can examine all of the large intestine. If the flexible sigmoidoscopy procedure reveals polyps in your lower colon, your healthcare provider can remove them. You’ll need a colonoscopy next. During a colonoscopy, your healthcare provider can remove additional polyps before they turn cancerous.

Test Details

How should I prepare for a flexible sigmoidoscopy?

Your bowels (stomach and intestines) must be completely empty before this examination. Your healthcare provider might have you use an enema in the office just before the procedure, or they’ll have you do the following at home:

• Stick to a clear liquid diet (water, broth) for up to 24 hours before the procedure.
• Use a prescribed bowel preparation, a laxative or an enema to soften stool and empty the bowels.

Note that your own healthcare provider’s office might have different instructions for you to follow.

How is a flexible sigmoidoscopy performed?

A flexible sigmoidoscopy takes place as an outpatient procedure at your healthcare provider’s office or medical center. You can go home the same day. Because flexible sigmoidoscopy isn’t as involved as a colonoscopy, you shouldn’t need medicine that puts you to sleep (anesthesia). The procedure may feel a bit uncomfortable, but it’s usually done in less than 30 minutes.

You’ll lie on your left side on an exam table. During the procedure, your healthcare provider:

• Slides a thin, lubricated sigmoidoscope through the rectum into the lower intestine.
• Pumps air through the scope into the large intestine for a better view. If you have cramps, try taking a few deep breaths.
• Examines the inside of the rectum and lower intestine using video images sent from the scope’s camera.
• Inserts small instruments through the scope to remove tissue samples or polyps to biopsy, if needed.
• Gently removes the scope.

What should I expect after a flexible sigmoidoscopy?

You may have belly pain, bloating or cramps for an hour or so after the procedure. You should feel better after you pass gas. If your provider removed polyps or tissue, you may have some light rectal bleeding. You should be able to resume activities and a normal diet after the procedure.

What are the potential risks or complications of a flexible sigmoidoscopy?

Potential complications of a flexible sigmoidoscopy are rare but include:

• Colon perforation (a tear in the colon lining that may require surgery).
• Delayed bleeding (up to two weeks after the procedure).

Results and Follow-Up

When should I get my test results?

Diagnostic results may be available immediately at your provider’s office. Often, providers send biopsy (tissue) samples to a lab. It can take up to two weeks to get biopsy results.

When should I call the healthcare provider?

You should call your healthcare provider if you experience:

• Continued bloody bowel movements or heavy rectal bleeding.
• Dizziness or weakness.
• Extreme abdominal pain.
• Signs of infection, such as fever or chills.

Screening, Procedure Details & Preparation

Overview

Tips to Prepare for Your Colonoscopy

What is a colonoscopy?

A colonoscopy is an outpatient procedure that is done to examine the inside of the large intestine (colon and rectum). The examination uses an instrument called a colonoscope (sometimes called a scope). This flexible instrument, is very long and includes a camera and the ability to remove tissue (you do not feel tissue being removed). A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as bleeding, abdominal pain or changes in bowel habits (how often you poop, how easily you poop, and the color and consistency of your poop).

A colonoscopy can be used to detect many different types of conditions.

Some people may avoid the procedure due to embarrassment or a reluctance to do the preparation. There are many bowel preparations available, and they come in different sizes and tastes. Also, the colonoscopy team respects your privacy during the entire procedure. Colonoscopies are done to check for colorectal polyps or cancer. Removing polyps early means they can’t turn into cancer.

The medical community recommends that anyone who does not have risk factors for colorectal cancer should get a screening colonoscopy starting at age 45. The timing of your colonoscopies varies depending on the findings of your test. You may need to have a colonoscopy at a younger age if you have an increased risk of colon cancer. These risk factors can include:

• Having familial polyposis syndrome (a condition that runs in your family and is linked to an increased risk of forming polyps).
• Having a genetic condition associated with colon cancer.
• Having inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis.
• Having first-degree relatives with colon cancer (that is, your mother or father, brother or sister, or child).
• Having multiple relatives with colon cancer.

Test Details

Large intestine, rectum & anus

What should I know or tell my doctor before a colonoscopy?

Be sure to tell your doctor exactly what medicines you take on a daily basis. This includes prescription and over-the-counter products like supplements. Your doctor can tell you which medications to avoid and what changes might be necessary. It is possible that you might have to reschedule your medications if you have diabetes or need blood thinners.

You will need a driver. Most facilities will not let you check in or perform the exam at all if you do not bring a responsible driver with you.

To have a successful colonoscopy, you will have to do your part. This means following all the instructions about what to eat and drink in the days before the procedure. It also means making sure that your colon is empty so your doctor can see clearly when the scope is inside the colon. This involves what is known as ‘bowel preparation.’

Bowel preparation. Colonoscopy prep. Cleaning out your colon. What does this mean?

Your healthcare team will give you plenty of time to prepare. You will get instructions at least two weeks before the procedure. It is important to read and follow all of the instructions given to you. If your bowel is not empty, your colonoscopy will not be successful and may have to be repeated. The cleaner your colon, the better chance your provider will have at finding all of your polyps and cancer, which sometimes can be small or hidden.

What can you eat and drink in the days before a colonoscopy?

Some providers may ask you to avoid corn, nuts, seeds and popcorn for at least three days before the procedure. Others might suggest a low-fiber diet for two days before the colonoscopy. The day before the procedure you will not be able to eat solid food or drink alcohol

You will be able to drink clear liquids, including water, black coffee, tea, ginger ale, apple juice, white grape juice and clear broths. You can have JELL-O® and Popsicles®, but only those that are not red, blue or purple. Drinking extra fluid will help you not become severely dehydrated.

You should not drink or eat anything at all for at least four hours before the colonoscopy. Be sure to drink plenty of fluids the day before while you are doing your bowel prep. If you are having your colonoscopy with general anesthesia, then you cannot drink anything after midnight on the night preceding your test.

What exactly does bowel preparation mean?

There are a few different kinds of bowel preparations, almost all of them liquid. Your doctor will tell you what kind is best for you based on your medical history and their particular preference. Some of these products are prescription-only, while others are available over-the-counter. They all have the same goal — to get rid of everything in your colon by causing watery diarrhea.

The time of day or night that you will have to start drinking the solution will depend on when your procedure is scheduled. You will be asked to consume the entire amount of liquid within a specific time period. There is also something called “split-dosing.” In split dosing, you will be asked to drink half of the bowel preparation the night before and then stop. You will get up in the morning and do the other half of the dose in the morning, finishing up at least four hours before the procedure itself. In general, split dosing results in cleaner bowel preparations. If you are having a colonoscopy with conscious sedation or twilight, and you have not been given split dosing instructions, ask your provider if you can do the split dosing.

What can you do to make a colonoscopy preparation easier?

There are things that might help you to drink the solution more easily. These include using a straw to drink the liquid and cooling the solution in the refrigerator before drinking it. You can add lemon drops or chew ginger candy. You will need to stay close to the bathroom during bowel preparation period. A split-dose might make the preparation easier. You will know you have done a good job when your diarrhea looks clear and yellowish, like urine.

You may experience skin irritation around the anus due to the passage of liquid stools. To prevent and treat skin irritation, you should:

• Apply Vaseline® or Desitin® ointment to the skin around the anus before drinking the bowel preparation medications. These products can be purchased at any drug store.
• Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
• Sit in a bathtub filled with warm water for 10 to 15 minutes after you finish passing a stool. After soaking, blot the skin dry with a soft cloth. Then apply Vaseline or Desitin ointment to the anal area, and place a cotton ball just outside your anus to absorb leaking fluid.

What happens on the day of a colonoscopy?

Take a shower in the morning if you like, but do not use lotions, perfumes, or deodorants. Leave your jewelry, other valuables and contact lenses at home.

During the procedure itself:

• You are asked to wear a hospital gown and an IV will be started.
• The procedure can be done with conscious sedation, often referred to as “twilight,” or deeper sedation referred to as “general anesthesia.” You are given a pain reliever and a sedative intravenously (in your vein). You will feel relaxed and somewhat drowsy. This step means that the colonoscopy will not hurt.
• You will lie on your left side, with your knees drawn up towards your chest.
• A small amount of air is used to expand the colon so the doctor can see the colon walls.
• You may feel mild cramping during the procedure. Cramping can be reduced by taking slow, deep breaths.
• The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
• The procedure lasts about 30 minutes. It takes about 12 minutes to move the scope five or six feet and another 12 minutes to take it out. If there are polyps to remove, the procedure will take longer.

What happens after a colonoscopy?

• You will stay in a recovery room for observation until you are ready for discharge. The amount of time that you are in recovery depends on whether or not you were sedated and what type of pain management medication you received.
• You may feel some cramping or a sensation of having gas, but this should pass quickly.
• Your responsible family member or friend will drive you home.
• Avoid alcohol, driving and operating machinery for 24 hours following the procedure.
• Unless otherwise instructed, you may immediately return to your normal diet. It’s recommended that you wait until the day after your procedure to resume normal activities.
• The doctor performing your colonoscopy will tell you when it’s safe to resume taking your blood thinners or any other medications you might have stopped.
• If polyps were removed or a biopsy was done, you may notice light rectal bleeding for one to two days after the procedure.

NOTE: If you have a large amount of rectal bleeding, high or persistent fevers, or severe abdominal pain within the next two weeks, go to your local emergency room and call the doctor who performed your exam.

How long will it be before my next bowel movement?

It might take a few days before you have a bowel movement because your colon is empty. It also depends on how much roughage (fibrous foods) you eat.

Results and Follow-Up

When will I know the results of the colonoscopy?

Usually, your doctor will speak with you after the procedure to explain what was done. The doctor will tell you if you did have polyps and if any tissue was removed. They will also go over when you are able to start taking your medications again if you had to stop taking something before the colonoscopy.

Also, usually you will get a formal report either mailed to you or sent to you and your primary care provider in your electronic medical record. Your healthcare team will let you know if any follow-up is needed based on the results of your colonoscopy.

Additional Details

Are there alternatives to colonoscopies?

There are other ways to screen for colon cancer. These include:

• Stool tests, such as the fecal immunochemical test (FIT), fecal occult blood test (FOBT), stool DNA tests (like Cologuard®). These tests let you collect your stool samples at home and then return them to your healthcare provider or mail them to a lab. You will have to do these more often than a colonoscopy.
• CT colonoscopy (also called a virtual colonoscopy).
• Flexible sigmoidoscopy, a test similar to the colonoscopy but covering a smaller part of the colon and the anus. It does not visualize the first part of the colon.

You and your healthcare provider should discuss the type of colon cancer screening that you should have. The choice will be based on your overall risk of colon cancer, general health, any symptoms you might be having and your personal preference. You should contact your health insurer about the costs of these less conventional tests.

You should know that some of the options that are not actual colonoscopies still call for the same type of preparation (cleaning out the colon by causing diarrhea). If polyps or other abnormalities are found on the alternative testing, they cannot be removed or treated. So it is likely that you will still have to have a colonoscopy. In addition, the costs of a screening colonoscopy may be less than of a colonoscopy completed after another, positive screening test other than colonoscopy.

Can you swallow a camera in a pill to take pictures of your colon?

Currently, the pill camera test is used to view the small intestine because the small intestine is easier to clean (for visibility) (the part of your bowel between your stomach and colon). Also, the camera passes through the small intestine in two to three hours.

The pill camera is being studied for colonoscopy. There are issues, though:

• The large intestine (colon) is wide and has folds and creases.
• It can take as long as 36 hours to pass the pill camera through the colon.
• The colon is not as easy to get and keep as clean as the small intestine.

Can you have a colonoscopy while you have your period?

The answer to this question is yes. You might want to wear a tampon if you have your period.

Can you have colonoscopy when you are pregnant?

A pregnant woman should always consult her obstetrician before having any kind of procedure. If you are having a colonoscopy for screening, it is best to wait after pregnancy. However, colonoscopy is generally believed to be safe during pregnancy.

What are the recommendations for scheduling your first and later colonoscopies?

If you are a person of average risk for colorectal cancer, the recommendation is to get your first screening test at 45. This might be a colonoscopy or a stool test. If your risk is higher or you have certain symptoms, your healthcare provider might suggest a colonoscopy or other screening test earlier than age 45. The incidence of colorectal cancer in African Americans has been increasing, and survival rates in those with colon cancer are worse than those for other groups.

You should discuss when to start screening with your healthcare provider. There are other sets of guidelines. For instance, the American Cancer Society suggests that screening for average risk people and African Americans start at age 45.

Follow-up colonoscopies will depend on the results of the first one. If you have no polyps and low risk, you might be able to wait 10 years before having another one. If you do have polyps and are considered high-risk, you might have to have a yearly procedure. (A colonoscopy every 10 years is the general rule for people who are not at high risk.)

Regular screening should be done through the age of 75. After that, you and your healthcare provider can decide on further screening needs.

Can a colonoscopy find parasites?

In the case of some parasites, like whipworms, the answer is yes. However, a colonoscopy is not the usual way to diagnose parasites.

Can a colonoscopy be used to diagnose endometriosis?

If you are a woman with endometriosis, you may have symptoms that affect your bowel, such as pain or bouts of constipation mixed with diarrhea. Your gynecologist might suggest a colonoscopy to rule out bowel problems. Usually, the endometrial tissue does not protrude through the bowel so it cannot be seen on a colonoscopy. Such tissue often sticks to the outside of the bowel or to other tissue in the area.

Can a colonoscopy be used to diagnose prostate cancer?

No. A colonoscopy is not designed to find prostate cancer. However, some doctors may choose to perform a digital rectal examination and a prostate examination before inserting the colonoscope. Men may believe that that their prostates have been examined, but this might not be true. It is a good topic to bring up with your doctor before a colonoscopy.

Here is a final thought about colonoscopies. Many people avoid them because they find the idea embarrassing and the preparation to be unpleasant. However, people often ask themselves and their care providers how we can prevent something from happening. Here is one way: colonoscopies can stop colon cancer before it starts.

Resources

Cleveland Clinic’s Bowel Preparation Instructions

Midwest Hemorrhoid Treatment Center: Is My Rectal Bleeding Coming from a Cut or Something Inside?: Betsy F. Clemens, M.D.: Board Certified Physician

It’s understandably alarming to see blood smeared on your tissue or dripping into the toilet bowl after a bowel movement. But rectal bleeding is more common than most individuals realize. The cause is typically traced to an issue within the rectum or lower colon, but may also occur outside the rectum, such as with anal tears (cuts) or external hemorrhoids. 

Regardless of the cause, however, you should see a doctor when you develop rectal bleeding to rule out more serious issues and/or gain relief from your symptoms.

At Midwest Hemorrhoid Treatment Center, Dr. Betsy Clemens specializes in anorectal issues, many of which may lead to rectal bleeding. Our patients appreciate her kind and caring personality as well as her skill in accurately diagnosing and treating the various causes of rectal bleeding.

Dr. Clemens’s goal is to relieve your symptoms by treating the underlying issue and to make sure you feel comfortable discussing sometimes-embarrassing topics such as rectal bleeding.

Characterizing the blood

You can expect Dr. Clemens to ask questions about the characteristics of the blood you’ve noticed because its color and consistency can help identify where the bleeding is occurring.

For instance, most rectal bleeding starts in your rectum or lower colon and is typically bright red. Very dark red or even maroon-colored blood may indicate an issue higher in the colon or small bowel. A dark tarry substance (melena) mixed with stool can point to problems in the stomach, such as bleeding ulcers.

As part of her detailed review, Dr. Clemens is also likely to ask when the bleeding began, how frequently it occurs, and other questions that help further clarify your symptoms.

Possible causes of rectal bleeding

A variety of issues can lead to rectal bleeding. Fortunately, most are not too worrisome, and though admittedly painful at times, they are generally easily treated. These include:

• Hemorrhoids, most common
• Rectal polyps that may or may not indicate cancerous changes
• Anal fissure or tear in the moist, thin tissue lining the anus
• Abscess or area of infection in the anus

Other conditions that may cause rectal bleeding include:

• Irritable bowel syndrome (IBS)
• Ulcers
• Diverticulosis or diverticulitis

Resolving your rectal bleeding in these cases includes treatment for the chronic condition.

Although they’re relatively rare, more serious issues such as colorectal cancer or ulcerative colitis can also cause rectal bleeding. That’s one reason we recommend you see Dr. Clemens for an evaluation regarding your rectal bleeding. Keep in mind that even conditions like colorectal cancer are more easily and successfully treated when the disease is diagnosed early.

Also, there’s really no reason to suffer with rectal bleeding when a quick visit to Midwest Hemorrhoid Treatment Center may be all you need to ease your concerns and solve the problem.

Treatment for rectal bleeding

Treatment depends upon the underlying cause of your rectal bleeding. For instance, if your bleeding is due to recurring or persistent hemorrhoids, Dr. Clemens may recommend a nonsurgical treatment such as infrared coagulation (IRC), which offers fast relief from pain and bleeding.

If an anal fissure is causing your symptoms, she may recommend a change in diet that keeps your stools soft and eliminates the need to strain during a bowel movement. These measures help relieve pressure on rectal tissue structures when you’re passing stool and gives these small, but often painful, anal skin tears time to heal.  

If your symptoms are due to factors outside of Dr. Clemens’ treatment specialty, such as peptic ulcers, she’ll make a referral to the appropriate specialist.  

If you’re having problems with rectal bleeding or require any of the other services we offer, schedule an appointment today at Midwest Hemorrhoid Treatment Center. Call the office, or book your visit online. 

Top Signs of a Thrombosed Hemorrhoid: Betsy F. Clemens, M.D.: Board Certified Physician

Hemorrhoids are a common condition that affect millions of Americans on a daily basis, according to the American Society of Colon & Rectal Surgeons. If you’re like most, you may suffer with your hemorrhoids longer than necessary before seeking medical help. 

Though hemorrhoid symptoms vary and may even be mild enough for you to ignore, it’s hard to suffer through the symptoms of a thrombosed hemorrhoid, which is an external hemorrhoid that’s developed a blood clot.

At Midwest Hemorrhoid Treatment Center in St. Louis, Missouri, our board-certified family physician Dr. Betsy Clemens has extensive experience diagnosing and treating thrombosed hemorrhoids. To limit the number of days you spend suffering in pain, we want to share the top signs of a thrombosed hemorrhoid. 

Worsening of your itching and irritation

External hemorrhoids develop under the highly sensitive skin near your anus. With this type of hemorrhoid, you may experience itching, burning, and general irritation. By comparison, internal hemorrhoids, which develop inside your rectum underneath the sensitive tissue, don’t cause physical discomfort but may cause you to have blood in your stool.

If your external hemorrhoid develops a blood clot and becomes thrombosed, you may notice a worsening of your symptoms. On a scale of 1-10, your discomfort level may jump from a 3 to a 10. 

Thrombosed hemorrhoids develop quickly, and discomfort tends to worsen during the first 48 hours and then improve slightly.  

Sitting is painful

Severe anal pain is one of the tell-tale signs of a thrombosed hemorrhoid. Unfortunately, because of the thrombosed hemorrhoid’s location, you may find sitting simply too painful to endure. Walking, too, may also exacerbate your anal pain.

Bleeding after a bowel movement

Bleeding after a bowel movement is common with all types of hemorrhoids, including a thrombosed hemorrhoid. Even though hemorrhoids are a common cause of bloody stools, it’s not a symptom you should ignore. We recommend you contact us to schedule an evaluation if you’re experiencing rectal bleeding and severe anal discomfort. 

There’s no need to suffer, and it’s important to rule out other causes of your bleeding, such as colon cancer or inflammatory bowel disease. 

Hardening of your external hemorrhoid

If it feels like you’re sitting on a stone, your external hemorrhoid may have developed a small blood clot. Blood clots are semi-solid clumps of blood created by the platelets and special proteins in your blood in response to an injury. 

The constant stretching of the tissue in your rectum causes the walls of the blood vessels to weaken and thin. Over time, these blood vessels may swell and bulge from pooling blood, which leads to hemorrhoids. When blood gets trapped in the swollen vein, blood clots develop, creating the thrombosed hemorrhoid.

Treating your thrombosed hemorrhoid

Now that you know the top signs of a thrombosed hemorrhoid, you may wonder what you can do about it. We treat thrombosed hemorrhoids with a simple in-office procedure called a thrombectomy. During a thrombectomy, Dr. Clemens makes a small incision in the hemorrhoid and drains the trapped blood. 

Anesthesia isn’t needed for the procedure. However, we may not be able to perform the simple treatment to alleviate your discomfort if you wait too long to schedule an appointment. This procedure works best when conducted within 72 hours of the blood clot’s formation.

If you’re not a good candidate for a thrombectomy, we may suggest at-home treatments to ease discomfort, such as sitz baths, a high-fiber diet, and plenty of fluids, until your body dissolves the blood clot on its own.  

You don’t have to suffer from hemorrhoid pain and discomfort, If you suspect you have a thrombosed hemorrhoid, give us a call at 636-228-3136 or contact us online today.

How To Tell The Difference?

It can be incredibly traumatizing, the first time you stand up and see blood in the toilet bowl. Unless you’re very proactive about your health, you probably hope it goes away on its own. But it doesn’t. The good news is that it is much more likely that you have hemorrhoids than colon cancer, statistically speaking. The bad news is that rectal bleeding is never a sign of anything good. You must take action.

Is It Hemorrhoids Or Colon Cancer?

The symptoms to both are similar, but the diseases are wildly different, as well as the seriousness and treatment. Regardless of which you might have, see a doctor. But to help in the interim time before you get an appointment and to perhaps ease your mind, we’ll explain the differences you should be feeling and seeing from your body. But first:

What Are Hemorrhoids?

They are swollen veins in your anus or lower rectum, that can be internal or external. The bleeding comes from internal hemorrhoids. Whenever we strain these varicose veins, they can bleed. You can strain them by lifting heavy objects, but most likely it’s strain from having a bowel movement.

Hemorrhoids are actually quite common. At any given time, about 10 million Americans have them and by age 50, roughly half of all Americans have had to deal with hemorrhoids. It can be embarrassing to think about, but you are not alone.

Causes

As we age, the tissue that supports the veins in your rectum and anus can weaken and stretch, which is why hemorrhoids is thought of as an older person’s disease. The swollen veins can develop from increase pressure due to:

• Straining during bowel movements
• Chronic diarrhea or constipation
• Pregnancy
• Low-fiber diet
• Sitting too long on the toilet

You know how you like to read in the bathroom? That’s not good for you long term.

Symptoms

The following are signs you might have hemorrhoids:

• Small amounts of bright red blood in the toilet or on the toilet paper
• Itching in the anal area
• Pain or discomfort
• Swelling around the outside of your anus
• A lump near your anus, which may be sensitive or painful

Important note is that internal hemorrhoids rarely cause discomfort. So, don’t jump to a cancer conclusion if you don’t feel discomfort, pain or itching.

What is colon cancer?

Colon Cancer and rectal cancer, which are usually lumped together and called colorectal cancer, begin with a growth called a polyp in the inner lining of either or both the colon or rectum walls. Not all polyps become cancerous.

Like with hemorrhoids, the older you get, the more likely you are to develop colorectal cancer. 90% of all new cases of colon cancer are in people who are 50 years of age or up. This is not to say younger people are not at risk, but it is uncommon (unless there’s a family history) of anyone under 30 getting colorectal cancer.

Causes

In all honesty, modern medicine doesn’t know what causes cancer. There are risk factors though. Age is one of them, as well as family history, as discussed above. Also, being obese increases your risk. Smoking and heavy alcohol drinking makes colon cancer more likely. Like with hemorrhoids, sitting for long periods of time can lead to developing cancer.

Symptoms

These are the warning signs (besides blood in the toilet) to look out for:

• Excess gas
• Constipation
• Change in bowel habits (when you go & frequency)
• Abdominal pain
• Change in shape of stool (narrower than normal stool)
• Fatigue
• Dark colored stool
• Unintended weight loss

Even if you have these symptoms, in most cases, it’s not indicative of having cancer. Only through blood tests or a colonoscopy or sigmoidoscopy can that diagnosis be made. Do not panic.

To reiterate, the one thing you have to do when you see blood is seek medical attention. Even though hemorrhoids are largely not dangerous or life threatening, left unchecked, it can lead to anemia. That has its own set of complications.

If you need peace of mind between the onset of symptoms and the time you can see a healthcare professional, take advantage of the several tests offered by Walk-in Lab. We offer quick turnaround on results and complete confidentiality.

Rectal Bleeding | Advocare Broomall Pediatric Associates

Is this your symptom?

• Blood mixed in with the stool or passed separately
• Bloody or maroon-colored stools
• Tarry-black stools
• Blood just on toilet paper or a few drops into toilet water
• Streaks on surface of normal formed bowel movement (stool)

Some Basics…

• Rectal bleeding is never normal. However, it is not always serious.
• Sometimes bleeding can be mild. There may be just a few drops of blood in the stool or blood on the toilet paper. Often this is from hemorrhoids (piles) or a small scratch from a hard stool.
• Sometimes bleeding can more severe. There may be blood clots, bloody stool or black stool. There can be a number of possible causes. A visit to the doctor is needed.

Causes

Some common causes of rectal bleeding are:

• Anal fissure: This is a small crack or tear in the skin of the anus. It may result from passing hard stools or from having many diarrhea stools. Symptoms are pain during and right after passing a stool, mild rectal bleeding, and rectal itching.
• Hemorrhoids: Another name for these is piles. These are enlarged veins that are just inside (“internal”) or outside (“external”) the rectal opening (anus). Two top reasons why people get hemorrhoids are constipation and pregnancy. People with bleeding hemorrhoids often see blood in the toilet water or small amounts of blood on the stool.

Some less common causes of rectal bleeding are:

• Angiodysplasia
• Cancer of colon (intestines)
• Cancer of rectum (anus)
• Colon polyps
• Crohn’s Disease
• Diarrhea
• Proctitis
• Pseudomembranous colitis
• Radiation treatment
• Rectal foreign object
• Ulcerative colitis

Types of Rectal Bleeding

• Bright red blood just on toilet paper: This is least serious. It often means that the bleeding is coming from the rectal opening (anus). The two most common causes of this type of bleeding are hemorrhoids and anal fissures.
• Bright red blood on the surface of a stool: This often means that the bleeding is from the anus or just inside. This can be caused by hemorrhoids or anal fissures. It can also be caused by more serious problems like cancer and polyps.
• Blood mixed with a stool: This usually means that there is a disease or problem inside the rectum or higher up in the colon (intestines). Examples are colon cancer, colon polyps, diverticulosis, and ulcerative colitis.
• Blood mixed with diarrhea: This may be a sign of a more severe colon infection. Other causes of bloody diarrhea are Crohn’s disease and ulcerative colitis.
• Tarry-black stool: This may be a sign of more severe bleeding from the stomach or esophagus. When the blood passes through the gut and comes out the rectum, it can make the stool look black or tarry. Stomach acid breaks down the blood and turns it black.

Severity of Rectal Bleeding is defined as:

• Drops, Spots, Streaks: blood on toilet paper or a few drops in toilet bowl; streaks or drops of blood on surface of stool
• Mild: more than just a few drops or streaks
• Moderate: small blood clots, passing blood without stool, or toilet water turns red
• Severe: large blood clots; on and off, or constant bleeding

What can Cause Red or Black Stools… that is Not Blood?

Causes of black-colored stools (not blood) are:

• Bismuth (Pepto-Bismol)
• Black licorice
• Blueberries
• Dark green stools may sometimes look like black. Put stool on white paper and hold under bright light. Is it green or black? Spinach and other dark vegetables can make stool look dark green.

Causes of red-colored stools (not blood) are:

• Beets
• Cranberries
• Medicines (Omnicef)
• Red food coloring dyes (red gelatin/Jell-O, red Kool-Aid)
• Red licorice
• Tomato juice or soup

When to Call for Rectal Bleeding

Care Advice

Mild Rectal Bleeding

1. What You Should Know:
   • Rectal bleeding is never normal. However, it is not always serious.
   • Sometimes bleeding can be very mild. There may be just a few drops of blood in the stool or blood on the toilet paper. Often this is from hemorrhoids (piles) or a small scratch from a hard stool.
   • You can treat very mild rectal bleeding from hemorrhoids, anal fissure, or constipation at home.
   • Here is some care advice that should help.
2. Warm SITZ Baths Twice a Day:
   • Sit in warm bath water for 20 minutes 2 times each day. This helps clean and heal the rectal area.
   • If you want, you can add ¼ cup (80 grams) of table salt or baking soda to each tub of water. Stir the water until it dissolves.
   • This is also called a Sitz bath.
3. Stool Softener for Hard Bowel Movements:
   • If you have hard stools, stool softeners can help soften the stool. This can help decrease rectal pain when passing stool.
   • Docusate (Colace) is a stool softener that you can get over-the-counter.
4. Call Back If:
   • Bleeding increases
   • Bleeding lasts more than 3 days
   • Bleeding is off and on for weeks or months
   • You think you need to be seen
   • You get worse

Constipation

1. What You Should Know:
   • Trouble passing a stool, hard stools, and infrequent stools are signs of constipation.
   • Healthy living habits can help treat and prevent constipation. Healthy habits include eating a diet high in fiber and regular exercise.
   • You can treat mild constipation at home.
   • Here is some care advice that should help.
2. Eat a High Fiber Diet:
   • Slowly increase the amount of fiber in your diet. This will help soften your stools. Fiber works by holding more water in your stools.
   • Eat more fresh fruit and vegetables. They are great sources of natural fiber. This includes peas, prunes, citrus, apples, beans, and corn.
   • Eat more foods made from whole grains. Foods made from whole grains also have fiber. Examples are bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn is also a good source of fiber.
3. Liquids:
   • Drinking enough liquids is important to keep your stools soft.
   • Drink 6-8 glasses of water a day. Caution: certain medical problems require fluid restriction.
   • Prune juice is a natural laxative.
   • Avoid alcohol.
4. Exercise:
   • Staying active is always a healthy choice.
   • Regular exercise decreases constipation.
   • Even a daily walk for 15 minutes helps.
5. Call Your Doctor If:
   • Constipation lasts more than 2 weeks after using Care Advice
   • Stomach swelling, vomiting or fever occur
   • Constant or increasing stomach pain
   • You think you need to be seen
   • You get worse

Over-the-Counter (OTC) Medicines for Constipation

1. Step-By-Step: A step-by-step approach to using OTC medicines for constipation is best.

2. Step 1 – Use a Fiber Laxative Every Day:
   • You can take a fiber laxative every day instead of eating more fiber.
   • An example of a fiber laxative is psyllium (Metamucil). You can buy this at the store without a prescription.
   • Fiber can help soften your stools. Fiber works by holding more water in your stools. Be patient. Sometimes this takes 1 to 2 weeks to work.
   • Osmotic Laxatives, as needed: You can take milk of magnesia or polyethylene glycol (PEG, Miralax). This type of medicine helps pull water into your intestines. This softens the stools.
   • Read the instructions and warnings on the package insert for all medicines you take.
3. Step 2 – Add a Stool Softener:
   • For stools that are more firm or hard, try an over-the-counter stool softener. An example is docusate (Colace, Surfak).
   • These medicines soften stools and make them easier to pass. You can buy them at the store.
   • They may take 1 to 2 days to start working.
   • Read the instructions and warnings on the package insert for all medicines you take.
4. Step 3 – Use an Osmotic Laxative if Needed:
   • If needed, you can try an osmotic laxative to treat occasional constipation. Examples are polyethylene glycol (PEG and Miralax) and milk of magnesia. You can buy these at the store without a prescription. Another option is to try a glycerine rectal suppository.
   • These medicines help pull water into your intestines. This softens the stools. They often start working in 1 to 2 days. Glycerine suppositories often work within an hour or less.
   • Do not use laxatives for more than 2 weeks unless your doctor instructs you to do this.
   • Caution: do not use milk of magnesia if you have kidney disease.
   • Caution: if you are pregnant, talk to your doctor before using these laxatives.
   • Read the instructions and warnings on the package insert for all medicines you take.
5. Step 4 – Add a Stimulant Laxative:
   • If the constipation does not get better with the Care Advice in the above 3 steps, add a stimulant laxative. Use only if needed.
   • Try bisacodyl (Dulcolax) tablets. You can buy these at the store without a prescription.
   • These laxatives often work in 6 to 12 hours. Another option is Senna. This is a mild, plant-based laxative.
   • Do not use laxatives for more than 2 weeks unless your doctor instructs you to do this.
   • Caution: do not use stimulant laxatives if you are pregnant.
   • Read the instructions and warnings on the package insert for all medicines you take.
6. Call Your Doctor If:
   • Constipation lasts more than 2 weeks after using Care Advice
   • Stomach swelling, vomiting or fever occur
   • Constant or increasing stomach pain
   • You think you need to be seen
   • You get worse

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Hemorrhoids | Michigan Medicine

Topic Overview

What are hemorrhoids?

Hemorrhoids are swollen veins in the anal canal. This common problem can be painful, but it’s usually not serious.

Veins can swell inside the anal canal to form internal hemorrhoids. Or they can swell near the opening of the anus to form external hemorrhoids. You can have both types at the same time. The symptoms and treatment depend on which type you have.

Many people have hemorrhoids at some time.

What causes hemorrhoids?

Too much pressure on the veins in the pelvic and rectal area causes hemorrhoids.

Normally, tissue inside the anus fills with blood to help control bowel movements. If you strain or sit on the toilet a long time to move stool, the increased pressure causes the veins in this tissue to swell and stretch. This can cause hemorrhoids.

Diarrhea or constipation also may lead to straining and can increase pressure on veins in the anal canal.

Pregnant women can get hemorrhoids during the last 6 months of pregnancy. This is because of increased pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.

Being overweight can also lead to hemorrhoids.

What are the symptoms?

The most common symptoms of both internal and external hemorrhoids include:

• Bleeding during bowel movements. You might see streaks of bright red blood on toilet paper after you strain to have a bowel movement.
• Itching.
• Rectal pain. It may be painful to clean the anal area.

Internal hemorrhoids

With internal hemorrhoids, you may see bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after you have a normal bowel movement. You may see blood on the surface of the stool.

Internal hemorrhoids often are small, swollen veins in the wall of the anal canal. But they can be large, sagging veins that bulge out of the anus all the time. They can be painful if they bulge out and are squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off. If hemorrhoids bulge out, you also may see mucus on the toilet paper or stool.

External hemorrhoids

External hemorrhoids can get irritated and clot under the skin, causing a hard painful lump. This is called a thrombosed, or clotted, hemorrhoid.

How are hemorrhoids diagnosed?

Your doctor can tell if you have hemorrhoids by asking about your past health and doing a physical exam.

You may not need many tests at first, especially if you are younger than 50 and your doctor thinks that your rectal bleeding is caused by hemorrhoids. Your doctor may just examine your rectum with a gloved finger. Or your doctor may use a short, lighted scope to look inside the rectum.

Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, or anal cancer. So if the first exam does not show a clear cause of your problems, your doctor may use a lighted scope (sigmoidoscope) to look at the lower third of your colon. Or your doctor may use another kind of scope (colonoscope) to look at the entire colon to check for other causes of bleeding.

How are they treated?

For most external hemorrhoids, home treatment is all you need. This includes slowly adding fiber to your meals, drinking more water, and using over-the-counter ointments for a limited time to stop itching. You also may use stool softeners. The same home treatment can be used for most internal hemorrhoids.

If your internal hemorrhoids are severe, you may need other treatment. The doctor may tie off the hemorrhoids with rubber bands or scar the tissue around the hemorrhoids. These treatments reduce the blood supply to the hemorrhoids so that they shrink or go away.

Surgery to remove hemorrhoids may be done if other treatments don’t work.

Healthy habits can help you prevent hemorrhoids or keep them from getting worse. Eat foods that have lots of fiber, such as fruits, vegetables, and whole grains. Also, drink plenty of water, and get plenty of exercise.

Cause

Hemorrhoids are usually caused by increased pressure on the veins in the pelvic and rectal area. As pressure increases, blood pools in veins and causes them to swell. Eventually, the swollen veins stretch the surrounding tissue, and hemorrhoids develop.

Bowel habits that can cause increased pressure and lead to hemorrhoids include:

• Rushing to complete a bowel movement. Hurrying can lead to excessive straining and can increase pressure on rectal veins.
• Persistent diarrhea or constipation, which may cause straining and increase pressure on veins in the anal canal.

Other things that can lead to the development of hemorrhoids include:

• Being overweight. Excess weight, especially in the abdomen and pelvis, may increase pressure on pelvic veins.
• Pregnancy and labor. Hormonal changes during pregnancy increase blood flow to the pelvis and relax supportive tissues while the growing fetus causes increased pressure on blood vessels. During labor, hemorrhoids may develop because of the intense pressure on the anal area while pushing to deliver the baby.
• Medical conditions. For example, long-term heart and liver disease may cause blood to pool in the abdomen and pelvic area, enlarging the veins.

Symptoms

Bleeding during bowel movements, itching, and rectal pain are the most common hemorrhoid symptoms.

External hemorrhoids

Rectal pain occurs mainly with external hemorrhoids. Blood may pool under the skin, forming a hard, painful lump. This is called a thrombosed, or clotted, hemorrhoid. You might also notice streaks of blood on the toilet paper after straining to pass a stool.

Internal hemorrhoids

The most common symptom of internal hemorrhoids is rectal bleeding. You may find bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after having a normal bowel movement. Blood also may be visible on the surface of the stool.

Other symptoms of internal hemorrhoids may include:

• Itching. This is a frequent complaint, because internal hemorrhoids often seep mucus, which can irritate the anal skin and cause itching.
• Skin irritation. Large hemorrhoids that bulge from the anus may secrete mucus, causing mild irritation.
• Discomfort. You may still feel the urge to pass stool right after having a bowel movement. This uncomfortable feeling is caused by the bulging of the hemorrhoid in the end portion of the large intestine (anal canal). In general, the larger the hemorrhoid, the greater the discomfort.
• Pain. Most internal hemorrhoids are not painful. But large hemorrhoids that bulge from the anus may become painful if they swell and are squeezed by the muscles that control the anus. Severe pain may be a sign that the blood supply to the hemorrhoid is being cut off (strangulated hemorrhoid). Emergency treatment is needed.

Rectal bleeding and pain and recent changes in bowel habits are also symptoms of colon, rectal, or anal cancer. People who have these symptoms, especially those age 50 or older or those with a family history of colon cancer, need to talk to their doctors.

Other conditions with symptoms similar to hemorrhoids include:

What Happens

Hemorrhoids form when increased pressure on the pelvic veins causes veins in the anal canal to swell and gradually stretch out of shape. Pressure increases can be caused by rushing to complete a bowel movement, persistent diarrhea or constipation, or other factors including being overweight or pregnant.

Persistent pressure also weakens tissues that support the veins in the anal canal. If those tissues become so weak that they can no longer hold the veins in place, the swollen veins and tissues bulge into the anal canal (internal hemorrhoids) or under the skin surrounding the anal opening (external hemorrhoids).

For some people, hemorrhoids may cause a little discomfort for a limited time. Other people have recurrent bouts of discomfort when hemorrhoids flare up. Some people struggle with hemorrhoid pain, discomfort, and itching much of their lives. The degree and duration of discomfort depend on where the hemorrhoids are.

Hemorrhoids frequently develop during pregnancy because of extra pressure on veins (from the enlarged uterus).

During labor, hemorrhoids may start or get worse because of the intense straining and pressure on the anal area while pushing to deliver the baby. For more information, see the topic Pregnancy.

External hemorrhoids

Because external hemorrhoids may not cause any symptoms, you may not be aware that you have hemorrhoids.

When a vein within an external hemorrhoid gets irritated, blood may clot under the skin, forming a hard, bluish lump. This is known as a thrombosed, or clotted, hemorrhoid. Thrombosed hemorrhoids can be very painful.

Internal hemorrhoids

Small internal hemorrhoids may not grow larger if bowel habits or other factors change to lower pressure on the veins in the bowel.

Large internal hemorrhoids may bulge from the anus. After bowel movements, you may have to push them back through the anus. At worst, large internal hemorrhoids stick out all the time.

In rare cases, hemorrhoids may bulge through the anus and swell. Muscles that control the opening and closing of the anus may cut off a hemorrhoid’s blood supply (strangulated hemorrhoid). This may cause the hemorrhoid tissues to die. If this happens, you will feel severe rectal pain and may see blood and pus at the anus. You will need urgent surgery to prevent further complications, such as death of the affected tissue and infection.

What Increases Your Risk

Bowel habits, physical stresses, and other conditions can raise the risk of developing hemorrhoids or make existing hemorrhoids worse. Some of these factors can be prevented.

Things that increase your risk

• Constipation or diarrhea that does not go away. These conditions may lead to straining with bowel movements.
• Being overweight
• A family history of hemorrhoids. You may inherit the tendency to get them.
• Being age 50 or older. Half of people who are older than 50 seek treatment for hemorrhoids.
• Pregnancy and labor and delivery. As the fetus grows during the last 6 months of pregnancy, blood volume and pressure on pelvic blood vessels increase. The strain of labor also can cause hemorrhoids to start or get worse.
• Liver disease, heart disease, or both. These conditions may cause blood to back up in the pelvis and abdomen.

Things that may make hemorrhoids worse

Hemorrhoids may be made worse by:

• Prolonged sitting or standing. This may cause blood to pool in the anal area and increase pressure on the veins.
• Frequent heavy lifting or holding your breath when lifting heavy objects. This can cause a sudden increase of pressure in blood vessels.

When should you call your doctor?

Common symptoms of hemorrhoids may be a sign of other serious health problems. Colon or rectal cancer and other conditions have many of the same symptoms as hemorrhoids. Call your doctor if you have symptoms like these:

• Stools are black or tarry.
• A lump or bulge that is not tender and does not go away develops at the anal opening.

If you have hemorrhoids, call your doctor if:

• Moderate rectal pain lasts longer than 1 week after home treatment.
• Pain or swelling is severe.
• Tissue from inside the body bulges from the anus and does not return to normal after 3 to 7 days of home treatment.
• A lump inside the anus becomes bigger or more painful.

If rectal bleeding becomes heavy or changes color (such as from bright red to dark red), or if stools change size, shape, or color (from brown to maroon or black), be sure to see your doctor.

Watchful waiting

Watchful waiting is a wait-and-see approach. And in most cases, bleeding caused by hemorrhoids should stop after 2 to 3 days. Continue home treatment to prevent bleeding from starting again. Call your doctor if bleeding:

• Occurs for more than 1 week without improvement.
• Starts again.
• Occurs when there is no reason to expect it.

If you are older than age 50 or have a family history of colon cancer, it is a good idea to tell your doctor any time you have new rectal bleeding, notice blood on your stools, have changes in bowel habits, or have anal pain. These symptoms may be signs of colon cancer or other conditions. Your doctor may recommend screening tests to see if you have a more serious problem. See Exams and Tests.

Who to see

The following professionals can evaluate and treat hemorrhoids:

If medical treatment or surgery is needed, you may be referred to a:

Exams and Tests

A doctor can evaluate symptoms of hemorrhoids to rule out other, more serious problems. A number of conditions that affect the anus and colon (large intestine) can cause bleeding, mucus drainage, itching, and discomfort. Most people who have these symptoms think they have hemorrhoids, but often they do not.

If hemorrhoids are present, the doctor will evaluate their location and size and develop a treatment plan based on the hemorrhoids’ degree of severity.

The diagnosis of hemorrhoids is based on a medical history and physical exam. A digital rectal exam and an anoscopy may be the only tests needed at first. Your doctor will decide which tests to use. If hemorrhoids are the obvious cause of rectal bleeding, you are younger than age 50, and you do not have risk factors for colon cancer, you may not need more tests.

To make sure nothing else (like colon cancer) is causing your symptoms, you may need other tests, such as:

These tests are not used routinely to diagnose hemorrhoids.

Treatment Overview

Most hemorrhoids can be treated with simple changes to diet and bowel habits. Most do not require surgery or other treatment unless the hemorrhoids are very large and painful.

The goal of nonsurgical procedures used to treat hemorrhoids, called fixative procedures, is to reduce the blood supply to the hemorrhoid so it shrinks or goes away. The scar tissue left in its place helps support the anal tissue and helps prevent new hemorrhoids.

Fixative procedures include tying off the hemorrhoids with a rubber band (rubber band ligation) or using heat, lasers, or electric current to create scar tissue (coagulation therapy). Fixative procedures can only be done on internal hemorrhoids.

Surgical removal of hemorrhoids (hemorrhoidectomy) can be used for large internal hemorrhoids, when several small hemorrhoids are present, or when other treatments have not controlled bleeding. Sometimes a combination of treatments (for example, a fixative procedure and a hemorrhoidectomy) is the most effective way to treat hemorrhoids. External hemorrhoids can only be removed surgically, if needed. If a blood clot develops in the external hemorrhoid, the clot may need to be removed to relieve pain.

Hemorrhoidectomy versus fixative procedures for internal hemorrhoids

• Fixative procedures are usually tried before surgery if hemorrhoids are small and stick out of the anus during a bowel movement but return to their normal position afterward (second-degree hemorrhoid).
• Hemorrhoidectomy may provide better long-term results than fixative procedures. But surgery is more expensive, requires a longer recovery time, is usually more painful, and has a greater risk of complications.
• Fixative procedures are the preferred treatment for people older than age 70 and for people in poor health.

Prevention

You can help prevent the irritating and painful symptoms of hemorrhoids.

Avoid constipation

• Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
• Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
• Get some exercise every day. Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week.
• Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all directions on the label.

Practice healthy bowel habits

• Go to the bathroom as soon as you have the urge.
• Avoid straining to pass stools. Relax and give yourself time to let things happen naturally.
• Avoid holding your breath while passing stools.
• Avoid reading while sitting on the toilet. Get off the toilet as soon as you have finished.

Modify your daily activities

• Avoid prolonged sitting or standing. Take frequent short walks.
• If possible, avoid lifting heavy objects frequently. If you must lift heavy objects, always exhale as you lift the object. Don’t hold your breath when you lift.
• If you are pregnant, sleeping on your side will lower pressure on the blood vessels in your pelvis. This can help keep hemorrhoids from becoming bigger.

Home Treatment

Home treatment, which mainly involves establishing healthy bowel habits, may keep your hemorrhoids from getting worse.

You can use the following suggestions to keep hemorrhoids from getting worse or to relieve your symptoms.

Avoid making hemorrhoids worse

• Blot the anus gently with white toilet paper moistened with water or a cleansing agent (such as Balneol) after bowel movements. Baby wipes or other premoistened towels (such as Tucks or Preparation H) are also useful for this purpose.
• Avoid rubbing the anal area. You can rinse off in the shower or on a bidet instead of wiping yourself with toilet paper. After cleansing, gently pat the anal area dry with a soft, absorbent towel or cloth.
• Use soaps that contain no perfumes or dyes.

Relieve pain and itching

• Take nonprescription pain relievers. Acetaminophen (Tylenol) can help with pain. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) and naproxen (Aleve) can help with pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
• Apply ice several times a day for 10 minutes at a time. Follow this by placing a warm compress on the anal area for another 10 to 20 minutes.
• Take a sitz bath. Fill your bathtub with just enough warm water to cover the anal area. Do this several times a day, especially after you have had a bowel movement. Soak for about 15 minutes at a time. Be careful! If the water is too warm, it can burn you.

Use nonprescription medicines as recommended by your doctor or pharmacist. See Medications for information on nonprescription ointments, creams, and suppositories.

Other comfort measures

• You may need a day or more of bed rest to take pressure off inflamed, irritated veins. If you are pregnant, you may find it helpful to lie on your side. If you are not pregnant, sleeping on your stomach with a pillow under your hips will help reduce swelling of hemorrhoids.
• Try not to sit or stand for a long time when hemorrhoids are irritated. If you must sit for a long time, sit on a pillow. Avoid lifting heavy objects.
• Wear cotton underwear to prevent moisture buildup, which can irritate hemorrhoids. Wear loose clothing to allow freedom of movement and to reduce pressure on the anal area.

Medications

Medicines can help relieve symptoms of hemorrhoids. You might try one or more of the following nonprescription remedies.

• Ointments that protect the skin, such as zinc oxide or petroleum jelly, are the best nonprescription remedies for hemorrhoids. Ointments can prevent further injury and reduce itching by forming a barrier over hemorrhoids.
• Use suppositories, such as those made by Preparation H or Tucks (formerly Anusol), for 7 to 10 days to relieve irritation and to lubricate the anal canal during bowel movements. Some of these products contain substances that can harm anal tissues if they are used for too long.
• Apply an ointment that contains 1% hydrocortisone, a type of steroid medicine that may relieve inflammation and itching. Your doctor may prescribe 2.5% hydrocortisone. But these products should not be used for more than 2 weeks, because they can thin the skin.
• Apply products that contain medicine to numb an area (local anesthetic). These products often have the suffix “-caine” in the name or the ingredients. Although these products help some people, especially those who have painful external hemorrhoids, some people become allergic to them. Ask your doctor before using these products.
• Take nonprescription pain relievers. Acetaminophen (Tylenol) can help with pain. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) and naproxen (Aleve) can help with pain and swelling. Be safe with medicines. Read and follow all instructions on the label.

Surgery

Most hemorrhoids do not require surgery. It is usually considered only for severe hemorrhoids.

Surgery may be done if other treatments (including home treatment) have failed. Surgery is also considered when symptoms become so bothersome that your lifestyle is affected or when hemorrhoids create a medical emergency, such as uncontrolled bleeding or blood and pus at the anus along with severe rectal pain.

External hemorrhoids

External hemorrhoids usually are not removed with surgery (hemorrhoidectomy) except if they are very large and uncomfortable or if you are having surgery on the anal area for another reason, such as internal hemorrhoids or a tear (anal fissure). If a blood clot develops in the external hemorrhoid, the clot may need to be removed to relieve pain.

Internal hemorrhoids

Surgical removal of hemorrhoids (hemorrhoidectomy) is a last resort for treating small internal hemorrhoids.

Hemorrhoidectomy is considered the most successful way to treat large internal hemorrhoids, especially those that are still a problem after treatments that cut off blood flow to hemorrhoids (fixative procedures) have been tried.

What to think about

Sometimes, increased pressure on external hemorrhoids causes them to get irritated and to clot. This causes a lump (thrombosed, or clotted, hemorrhoid) to form. You may suffer from severe pain at the site of a clotted hemorrhoid.

A procedure to relieve the pain can be done in a doctor’s office or outpatient clinic. The doctor applies local anesthesia and then makes a small incision where the lump has occurred to remove the clot and reduce pressure and pain. The procedure works best if it is done soon after the clot has formed.

If the pain is tolerable, you may choose to wait to see a doctor. The pain usually goes away in a few days. After 4 or 5 days, the pain from cutting and draining the hemorrhoid is usually worse than the pain from the clot.

Other Treatment

Many people who have hemorrhoids find relief from symptoms through home treatment. If medical treatment is needed, fixative procedures are the most widely used nonsurgical treatments. Fixative procedures are only for internal hemorrhoids.

Other treatment choices

Fixative procedures include:

What to think about

Not all doctors have the experience or the equipment to do all types of fixative procedures. This may help you decide which procedure to choose. Ask your doctor which procedure he or she does the most and how satisfied people have been with the outcomes of that procedure.

References

Other Works Consulted

• Dozois EJ, Pemberton JH (2006). Hemorrhoids and other anorectal disorders. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 945–958. Philadelphia: Saunders Elsevier.
• Madoff RD (2016). Diseases of the rectum and anus. In L Goldman, A Schafer, eds., Goldman-Cecil Medicine, 25th ed., vol.1, pp. 967–973. Philadelphia: Saunders.
• Marcello PW (2010). Diseases of the anorectum. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 2257–2274. Philadelphia: Saunders.
• Rivadeneira DE, et al. (2011). Practice parameters for the management of hemorrhoids. Diseases of the Colon and Rectum, 549(9): 1059–1064. Available online: http://www.fascrs.org/physicians/practice_parameters.

Credits

Current as of:
April 15, 2020

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD – Internal Medicine
Adam Husney MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

90,000 Blood from the anus. Diagnostics and treatment in Rostov-on-Don

The detection of blood from the anus can signal the onset of proctological problems that should be solved quickly, without delaying a visit to a proctologist.

Often in humans, the discussion of problems associated with the anus and intestines is prohibited. Therefore, there are often cases when a visit to a doctor occurs when time is lost and the disease has caused significant damage to the body.

Should you be afraid of bleeding?

There is no need to panic. But it is not recommended to relax either. Blood after defecation means the presence of injury to the mucous membrane, vessels of the anus, anal canal, rectum. It is necessary to identify the cause in a short time in order to prevent the developing disease.

The leading disease with such symptoms is hemorrhoids. Men and women are at risk. Bleeding is not accompanied by pain and, depending on the stage of the disease, it can manifest itself as a drip, stream or splash.If the bleeding is not one-time, but is observed repeatedly, then we are not talking about trauma to the anus with a hard fecal lump. Oncology is characterized by latent red blood in the stool.

To identify the cause, it is important to promptly consult a proctologist, undergo an examination, and, if necessary, an examination in order to receive adequate treatment.

Reasons for the appearance of blood

In addition to hemorrhoids and direct trauma to the anus, the anus can bleed for a variety of reasons.Moreover, both a man and a woman can be a potential patient of a proctologist equally.

• The large intestine may be affected by colitis.
• The anal fissure will bleed, accompanied by a burning sensation and itching. Little blood is observed immediately after a bowel movement.
• If a person has a tendency to constipation, then when passing solid feces, the mucous membrane and even the sphincter can be injured.
• Polyps can bleed – depending on the size and location of the discharge, it can be either scanty or profuse.
• Proctitis – the mucous membrane of the rectum is covered with ulcerations that become inflamed. Bloody discharge will be present in the feces, characterized by a noticeable amount of mucus.
• In a malignant tumor of the rectum, the symptoms will be similar to bleeding with polyps.
• Diverticulosis – if protrusions and pockets – diverticula have formed on the mucous membrane, then fecal lumps can injure them when passing. The blood will mix with the feces.
• Bleeding in people with HIV – the nature of the complication will play a decisive role.With reduced immunity, problems can arise in any possible manifestation, which will affect the nature of bleeding.

Blood from the anus may be a reaction to potassium-containing medications – these may be antibiotics or other medications. If you are taking medication and find an unpleasant side effect, tell your doctor.

What can be the blood from the anus

Blood shade may indicate the localization of the problem and its specifics.It is worth paying attention to such details in order to inform the doctor when visiting.

• Scarlet blood is a sign of anal fissure and hemorrhoids.
• The tint of cherry suggests looking for a problem in the colon.
• Dark blood clots are characteristic of tumor processes and diverticulosis.
• Red – indicates a polyp or cancer.
• Black discharge – requires the intervention of a gastroenterologist. The source of bleeding is located in the small intestine and above.

A person who finds traces of blood on underwear, toilet paper, should see a doctor as soon as possible to determine the cause of the problem. It is important to carry out a complete diagnosis to make sure there are no malignant growths and to take steps for a successful treatment.

Carrying out diagnostics

Many patients are confused by the prospect of probe insertion, they are afraid of discomfort or pain. At the same time, colonoscopy is rightfully considered the “gold standard” of proctological diagnostics, which allows detecting any changes in the large intestine.

• The proctologist performs a finger examination, uses an anoscope or rectoscope, which will allow you to see the picture at a depth of 25 cm and, if necessary, take tissue samples for histology.
• Irrigoscopy – X-ray examination with the introduction of a contrast agent.

Before the diagnosis, it will be necessary to cleanse the intestines and adhere to a diet that reduces gas production for several days. In addition to enemas, special preparations are used that allow the contents to be emptied naturally.

If the patient is sensitive or is in such a condition that endoscopic techniques may cause discomfort, local anesthetics may be used, and if necessary, spinal anesthesia and even general anesthesia.

Single case

If you have a predisposition to constipation, then there are cases when the blood appears once and after the symptom does not recur. This indicates a trauma to the sphincter or a closely located area of ​​the anal canal with a hard fecal lump.In the absence of repetitions, such a symptom does not require medical intervention.

But lovers of erotic experiments should be wary and watch: it is possible that during intercourse damage was inflicted on the anus or external sphincter, mucous membrane. If soreness is felt, there are problems with defecation, then it is necessary to contact a proctologist to avoid complications.

Treatment

After establishing the cause of bleeding, conservative, surgical methods can be used.Modern proctology, even if surgical intervention is necessary, offers low-traumatic methods of treatment, with a short rehabilitation period.

The traditional scalpel was replaced by radio wave and laser methods, which allow removing neoplasms and excising damaged tissues with minimal blood loss and practically without complications.

Hardware surgery makes it possible to shorten the hospitalization period, and in some cases the patient is allowed to go home within a day or on the day of treatment.Rehabilitation takes from 14 days to a month, except in difficult cases.

With early treatment, there is a greater chance of solving the problem conservatively. Suppositories and ointments are most preferred by patients, since even a small intervention by the surgeon imposes restrictions on the usual way of life. However, drugs are not always effective, therefore they are used in an integrated approach.

Predictions for bleeding from the anus

If the cause of the bleeding was not a malignant formation in the last stages, then the proctologist will successfully help solve the rest of the problems.There are highly qualified specialists in Rostov-on-Don, whose experience guarantees the patient a speedy recovery and a high level of well-being.

Proctological problems with bleeding from the anus can be of concern to patients regardless of gender and age. Doctors note that hemorrhoidal disease has become younger and now, even in adolescence, you can face a similar nuisance.

It is necessary to contact a proctologist without waiting for an exacerbation of the disease.In case of emergency treatment, the doctor will do everything to stop bleeding and pain, and after that he will carry out all the necessary research. There is no need to be afraid and ashamed, specialists are delicate in all procedures, trying to carry out manipulations as carefully as possible in relation to the patient.

Blood from the anus is just one of the symptoms. It is important for the patient to find out the cause of the ailment as soon as possible and to enlist the support of a specialist. It is important to eliminate the problem in time in order to prevent it from becoming chronic.

You may also be interested in hemorrhoid treatment

The author of the article is a doctor proctologist

Edelgeriev Magomed Omarovich

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best remedy for bleeding hemorrhoids

best remedy for bleeding hemorrhoids

Sound and informed treatment is very well described in all coloproctology guidelines in the world. It consists in a banal change in stool quality, elimination of constipation, normalization of the diet, including increasing the amount of dietary fiber in the diet, drinking plenty of fluids, limiting alcohol, and justifying the use of drugs in acute situations.For example, if internal hemorrhoids are bleeding, then we suggest for the treatment of suppositories so that the drug gets into the anal canal. If the external node swells, then it is more correct to use only ointments or creams.

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Rating of drugs.We suggest choosing the best remedy for hemorrhoids in women and men, providing a list of effective medicines. The drugs are intended for both symptomatic and systemic treatment. It is recommended to consult a doctor beforehand. You should also follow the manufacturer’s dosage recommendations. No. 1 – Detralex (Serdix LLC, Russia). The venotonic drug is developed on the basis of a flavonoid fraction containing diosmin and hesperidin. The action of the best remedy for hemorrhoids is aimed at reducing congestion and extensibility of venous structures.Hemorrhoids start to bleed. Blood loss indicates the onset of the inflammatory process. To determine the cause of the development of the disease, various intestinal pathologies should be excluded. Bleeding with hemorrhoids is accompanied by a number of other symptoms. These include fever, intense pain in the intestines, flatulence, profuse mucous purulent discharge from the anus. The sphincter begins to swell, redden. The patient has no appetite. This tool produces a complex effect, constricts blood vessels, disinfects hemorrhoids.The patient should take a standing position or lie on his side. Of the combined drugs for bleeding hemorrhoids, phenylephrine, which is an α-adrenergic agonist and has a local vasoconstrictor effect, is effective. Due to this effect, there is a decrease in the release of blood from the hemorrhoids. Thrombosis of hemorrhoids complicated by inflammation is an indication for the appointment of NSAIDs, combined preparations containing painkillers, thrombolytic and anti-inflammatory components.The drugs in this group include many liniment designed for combined effects (aurobin, hepatrombin G, proctoglyvenol, etc.). Conservative treatment of hemorrhoids. Hemorrhoids are the most common diseases of the rectal outlet. As of 2015, the prevalence of hemorrhoids in Russia is 130 – 145 people per 1000 adult population. Authors: Rzheshniovetskiy Gennady Petrovich. Troxerutin capsules – a herbal medicine has anti-inflammatory and venotonic effect, reduces fragility and vascular permeability.With caution should be prescribed for gastric ulcer and duodenal ulcer. Not recommended for bleeding hemorrhoids. Treatment of bleeding with hemorrhoids. Bleeding is just a symptom. Therefore, treatment should be directed towards eliminating the underlying cause of the bleeding. Only on the basis of competent diagnostic data, a specialist can prescribe the correct treatment for hemorrhoids. Modern antihemorrhoidal medicines are usually available in the form of suppositories and topical creams.A point effect on the focus of pathology gives positive results. Procto-Glivenol – reasonable price, reliable action. When a hemorrhoid ruptures, profuse bleeding appears, which is difficult to stop at home. Bowel obstruction. Stomach ache. Most often, suppositories for bleeding from the anus are prescribed to patients with hemorrhoids. The active substances that make up such drugs have several actions at the same time: they relieve pain and promote the resorption of the nodes.Also, the treatment of rectal bleeding with suppositories is carried out if the only reason for the appearance of blood is chronic constipation, as a result of which the feces during defecation are so dense that it damages the mucous membrane. Bleeding with hemorrhoids. Hemorrhoids are one of the most common diseases. It occurs in about 10-15% of the adult population. Although hemorrhoids refer to diseases with a benign course, the quality of life is sharply reduced and complications may appear.The main symptom of the disease is rectal bleeding (discharge of blood from the rectum). In some cases they are small and easy to control, while in others they are frequent and abundant. The remedy can be used to eliminate the unpleasant symptoms of hemorrhoids, including discomfort and anal itching. Another option for treating hemorrhoids is surgery. Hemorrhoids are a dangerous condition. It is important to choose the best pills for hemorrhoids and deal with the issues of preventing complications. Hemorrhoids do not always enlarge or stretch, but with age, blood stasis and varicose veins become more common, causing what we call hemorrhoids.Hemorrhoids can be painful and especially unpleasant if they recur, but they are not life-threatening, and symptoms usually resolve within a few days. There are many effective treatments, including surgery. They are selected by a doctor, based on age, stage of the process, associated diseases and additional factors. Sclerotherapy of internal hemorrhoids. Indications: the method can be used at the 1st-3rd stage of bleeding hemorrhoids; the greatest efficiency of the method is observed with bleeding hemorrhoids of the 1st or 2nd stage.It is also possible to use the method to stop bleeding in patients with any stage of hemorrhoids in case of complications of the disease by the development of post-hemorrhagic ana. Preparations for the treatment of hemorrhoids. Zatsepilova Tamara Anatolyevna. Associate Professor of the Department of Pharmacology, Faculty of Pharmacy, Moscow Medical Academy named after M. Sechenov. Hemorrhoids – an increase in the volume of the cavernous veins (bodies) of the distal rectum and anus, accompanied by a foreign body sensation, itching, burning, inflammation, bleeding and other symptoms.At the heart of the disease is a violation of the inflow and outflow of blood in the cavernous veins of the rectum, leading to stagnation and the formation of hemorrhoids. Prolonged overflow of blood to the cavernous bodies leads to their expansion and thinning of the walls, as a result of which they are easily injured with the formation of small erosions and ruptures.

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A good proctologist out of 100 people who came to him with complaints of hemorrhoids takes about 5–17% of the time for the operation, i.e.That is, on average, only 10% of patients are diagnosed with hemorrhoids, and not 100%. You calmly explain to the patient that they do not die from this, that if he coughs softly, if there is never constipation and he stops performing sharp strength exercises with a barbell, then he will like this quality of life. And you clarify how the patient imagines the operation for hemorrhoids, what are the expectations for recovery, pain syndrome, methods and methods of operations. And after that you tell me that in the first week after the operation he can expect such painful discomfort that he will think that he is pooping with “hedgehogs”, that healing can take 4-6 weeks, and many patients think about whether they need this operation in fact.Yes, we began to use the laser more often, it has excellent results in terms of minor pain syndrome, healing time, but experience has shown that in the first and partially in the third stage, it is associated with a risk of recurrence, which is 5-10 times higher than that of traditional surgery. Milligan to Morgan. Sound and informed treatment is very well described in all coloproctological guidelines in the world. It consists in a banal change in stool quality, elimination of constipation, normalization of the diet, including increasing the amount of dietary fiber in the diet, drinking plenty of fluids, limiting alcohol, and justifying the use of drugs in acute situations.For example, if internal hemorrhoids are bleeding, then we suggest for the treatment of suppositories so that the drug gets into the anal canal. If the external node swells, then it is more correct to use only ointments or creams. It is a waste product produced by bees. However, the ingredient is endowed with broad antibacterial effects. The ingredient has a regenerating, immunomodulating, antipruritic, wound-healing, adaptogenic, capillary-strengthening, blood-purifying. Dissolves adhesions, seals and relieves inflammation.The active components of propolis stabilize metabolic processes and blood circulation in the prostate gland. The properties of the product are aimed at neutralizing swelling and inflammation, restoring rational urination, preventing the formation of adenoma, and protecting the prostate from the appearance of benign tumors in more complex forms. It helps to restore material metabolism, influences male potential, and has sperm motility.

90,000 which remedy helps with bleeding hemorrhoids

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A peculiar fatty base obtained from grated cocoa (grains of young fruits of the chocolate tree).It is a recognized emollient and soothing agent, whose primary properties are the regenerating capacity of cells. A high concentration of oleic acid is absorbed inside the component. It is she who takes an important part in lipid metabolism and the restoration of the barrier functions of the epidermis. The product helps to retain sufficient moisture in the skin.

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Hemorrhoids start to bleed.Blood loss indicates the onset of the inflammatory process. To determine the cause of the development of the disease, various intestinal pathologies should be excluded. This tool produces a complex effect, constricts blood vessels, disinfects hemorrhoids. The patient should take a standing position or lie on his side. Sitting position increases intra-abdominal pressure and negatively affects the state of blood vessels. If the bleeding does not stop, call an emergency ambulance immediately. Stopping bleeding in the hospital.Rating of drugs. We suggest choosing the best remedy for hemorrhoids in women and men, providing a list of effective medicines. The drugs are intended for both symptomatic and systemic treatment. It is recommended to consult a doctor beforehand. You should also follow the manufacturer’s dosage recommendations. No. 1 – Detralex (Serdix LLC, Russia). The venotonic drug is developed on the basis of a flavonoid fraction containing diosmin and hesperidin. The action of the best remedy for hemorrhoids is aimed at reducing congestion and extensibility of venous structures.Bleeding with hemorrhoids: features and causes. Treatment of bleeding for hemorrhoids with Procto-Glivenol – reasonable price, reliable action. Procto-Glivenol reduces the incidence of bleeding from hemorrhoids thanks to tribenoside, does not contain hormones and antibiotics, is available in the form of suppositories or cream, which allows each patient to choose the most comfortable treatment. More about the drug. Diagnostics. Even with a single bleeding from the anus, the patient urgently needs to consult a proctologist! We will tell you about what to do and what drugs to take to treat bleeding with hemorrhoids, as well as the methods of therapy used.The remedy can be used to eliminate the unpleasant symptoms of hemorrhoids, including discomfort and anal itching. Another option for treating hemorrhoids is surgery. It can be minimally invasive surgery, for example Hemorrhoids – an unpleasant disease resulting from inflammation and thrombosis of hemorrhoidal veins, which pathologically change and form nodes around the rectum and anus. Content: The most effective suppositories for hemorrhoids according to buyers. Rectal suppositories with severe pain syndrome.Suppositories for hemorrhoidal bleeding. For the purpose of treating the disease, various medications are used in the form of tablets, ointments and suppositories. The latter are considered the most effective remedy for topical application, therefore, we will focus on them below. The most effective suppositories for hemorrhoids according to buyers. Of the combined drugs for bleeding hemorrhoids, phenylephrine, which is an α-adrenergic agonist and has a local vasoconstrictor effect, is effective. Due to this effect, there is a decrease in the release of blood from the hemorrhoids.Thrombosis of hemorrhoids complicated by inflammation is an indication for the appointment of NSAIDs, combined preparations containing painkillers, thrombolytic and anti-inflammatory components. The drugs in this group include many liniment designed for combined effects (aurobin, hepatrombin G, proctoglyvenol, etc.). Bleeding from the large intestine will appear as a burgundy stool in which blood is mixed with stool. If the bleeding source is located in the lowest parts of the digestive tract (rectum and anus), then blood after defecation in the form of scarlet drops is found on top of the stool or on toilet paper.It should be understood that what is visible to the eye is not always accurately blood. For example, certain drinks, foods, or medications can discolour stools black or reddish, frightening uninformed people. This happens when. With thrombosis of hemorrhoids, local anticoagulants are used, such as heparin ointment, hepatrombin-g. The use of phlebotonics is also justified, helping to restore the tone of the venous wall (detralex, phlebodia). In case of thrombosis, accompanied by inflammation, combined preparations containing an anesthetic and anti-inflammatory components (aurobin, proctoglyvenol, drugs of the Relief line) are shown.Frolov A.A., Grateful L.A., Kostarev V. Sclerotherapy with detergents is the method of choice for the treatment of patients with bleeding hemorrhoids complicated by anemia. Coloproctology. – 2011. – No. 2 (36). Hemorrhoids are a dangerous condition. It is important to choose the best pills for hemorrhoids and deal with the issues of preventing complications. Internal hemorrhoids usually do not hurt, but they bleed frequently. In some cases, internal hemorrhoids can protrude through the anus, a phenomenon known as prolapsed nodules. When this happens, the nodes are usually pulled back into the rectum.Refers to venotonic drugs, helps in the normalization of microcirculation in the rectum and anus. The drug helps to dilate blood vessels and improve tissue nutrition, oxygen content in cells. The first group of hemorrhoids, the defeat of which leads to the formation of external hemorrhoids, is located at the exit from the anal canal, in the subcutaneous tissue. The second group of cavernous formations, located in the submucous layer of the rectum, above the dentate line, is the source of the development of internal hemorrhoids.There are anastomoses between the external and internal cavernous formations, the functional purpose of which is not entirely clear, if only because with an increase in intra-abdominal pressure, as a rule, external, and not internal, nodes are thrombosed.

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No one is immune from hemorrhoidal disease.An excellent prevention and treatment is HONEYEED – a cream-stick for hemorrhoids with chaga. The disease can develop absolutely imperceptibly in the body and a moment will come when unpleasant and painful sensations, accompanied by characteristic bleeding, will come. In the medical practice of influencing the signs of hemorrhoids that have arisen, various drugs are used. However, most of them are not able to drastically influence the situation. This is due to numerous contraindications and the presence of synthetic additives.However, there is a solution to the problem! It is enough to buy a cream-pencil for hemorrhoids with chaga in order not only to alleviate the situation, but also to eradicate the problem in its main focus. In fact, hemorrhoids are a social disease that primarily changes a person’s mood. It is clear that when a person constantly sees blood in the toilet or on toilet paper, he begins to worry to the point that panic thoughts about death appear. But hemorrhoids cannot be the leading cause of death, if only mentally, in the form of depression.And so, there is nothing terrible in hemorrhoids. Sound and informed treatment is very well described in all coloproctological guidelines in the world. It consists in a banal change in stool quality, elimination of constipation, normalization of the diet, including increasing the amount of dietary fiber in the diet, drinking plenty of fluids, limiting alcohol, and justifying the use of drugs in acute situations. For example, if internal hemorrhoids are bleeding, then we suggest for the treatment of suppositories so that the drug gets into the anal canal.If the external node swells, then it is more correct to use only ointments or creams.

90,000 Polyps of the colon and rectum

Dictionary of Medical Terms

Polyps of the colon and rectum

Polyp (Greek poli – many, pus – leg, that is, millipede) is customary to call any tumor on the leg hanging from the walls of a hollow organ into its lumen, regardless of the microscopic structure. The term “polyp” was first introduced by Hippocrates.

It is rather difficult to establish the exact cause of a polyp in this or that case, since they often do not appear in any way.Most often, these benign polyps are discovered by chance. Such patients usually go to the doctor with complaints of intestinal dysfunction, discomfort, pain in the anus, sometimes pathological discharge in the form of blood or pus with mucus. Such symptoms are typical for other diseases of the rectum and colon, for example, proctitis, hemorrhoids, anal fissure, colitis, cancer of the rectum or colon, etc.

Among the reasons, more precisely the factors that affect the appearance of colon polyps, one can note the state of the environment, as well as physical inactivity.An equally important factor in the formation of colon polyps is the nature of the diet.

As you know, in modern economically developed countries, people in their diet are dominated by foods rich in fat and carbohydrates, and the amount of vegetable fiber is low. This becomes the cause of poor motility of the large intestine, stagnation in it of feces, bile acids, which affect the intestinal mucosa.

This, in turn, affects the composition of the natural microflora of the large intestine, which also affects the composition of the enzymes that it secretes.

Researchers have also found a relationship between the formation of polyps and factors such as male sex, vascular atherosclerosis, malignant tumors, diverticula in the gastrointestinal tract, and inflammatory bowel disease.

The most common type of all benign colon tumors is epithelial tumors. They are found in 92% of all benign neoplasms. Moreover, it is glandular tumors that are most susceptible to malignant transformation – malignancy.

It is noted that the size of the polyp affects the risk of malignancy – the greater it is, the higher the risk of malignant degeneration of the polyp.

Most often, benign neoplasms of the rectum and colon in patients are asymptomatic or are detected accidentally during endoscopic examination (colonoscopy, sigmoidoscopy) for other diseases.

If the polyp reaches a larger size (up to 2-3 cm), then pathological discharge (bloody, mucous) appears.Patients may complain about the appearance of a feeling of discomfort in the abdomen and anus, pain. Disorders of intestinal motility, such as constipation or diarrhea, appear.

So, the main manifestations of colon polyps are:

• Bleeding from the rectum. Rectal bleeding can be a sign of a variety of proctological conditions, such as hemorrhoids, anal fissures, ulcerative colitis, rectal or colon cancer. Therefore, it is very important, when rectal bleeding occurs, do not hesitate and immediately go to the proctologist to find out the reason.
• Constipation. They are associated with partial intestinal obstruction with polyps. With a significant size, polyps interfere with normal intestinal motility, as a result of which there is a slowdown in intestinal passage.
• Abdominal pain . This symptom is less common in polyps and is mainly associated with inflammatory changes in the polyp.

DIAGNOSTICS OF RECTAL AND COLON POLYPS

Almost all types of cancer of the rectum or colon arise initially on the background of polyps.But polyps grow rather slowly, usually over several years. Therefore, research methods play a very important role in the prevention of colon cancer. Detection of malignancy of a polyp at an early stage ensures a 90% cure rate.

The very first research method in proctology is digital rectal examination. This method allows the doctor to assess the condition of the rectal area up to 10 cm from the edge of the anus. This research should always be applied. Digital rectal examination can detect other diseases of the rectum, such as hemorrhoids, rectal fistulas, anal fissures. In addition, such a study allows you to determine the condition of the prostate in men, to identify diseases of the surrounding tissue (cysts and tumors).

This is followed by another, no less important diagnostic method for diseases of the colon and rectum – sigmoidoscopy .

Before the sigmoidoscopy is performed, the patient is given a cleansing enema and laxatives are prescribed.The method of sigmoidoscopy cannot replace any other methods, such as fluoroscopy, ultrasound, etc., since it allows the doctor to see with his own eyes the presence of polyps and assess the condition of the rectal wall. It is known that more than half of all colon polyps are localized in the rectum and sigmoid colon, that is, they can be detected with a rectoscope.

Colonoscopy is an endoscopic examination of the colon. It differs from sigmoidoscopy in that it uses a longer flexible tube that is inserted into the rectum and advanced above the sigmoid colon.For a colonoscopy, careful preparation of the patient with enemas is required.

Biopsy . This method consists in the fact that upon finding a suspicious area of ​​tissue, the doctor takes a piece of it for histological examination. A biopsy can be done during a sigmoidoscopy or colonoscopy. This is the only method that allows you to reliably state whether there is cancer in this case or not.

Fecal occult blood test . This is an important method for studying the pathology of the gastrointestinal tract.It consists in examining feces for the presence of blood components. To carry it out, you need to follow the instructions of the doctor. They consist in the fact that the day before the analysis, you cannot brush your teeth, take certain medications (in particular, iron supplements). Fecal occult blood tests are not specific for polyps. Polyps may not bleed at all, and the presence of blood in the stool can be present in many other diseases of the rectum and colon, which we have already mentioned.

90,000 Modern concepts of pathogenesis and treatment of hemorrhoids

V.L. RIVKIN , MD, professor, surgeon-proctologist, Multidisciplinary clinic CELT, Moscow

In the pathogenesis of hemorrhoids, the main role is played by thrombosis of special cavernous veins (bodies) of the rectum, which are filled with arterial blood. In the area of ​​the three terminal ramifications of the rectal artery, in the areas of the anal canal projected on the dial marks corresponding to 3, 7 and 11 o’clock, three main internal hemorrhoids with their external ramifications are formed from the cavernous veins.Hemorrhoids can be divided into asymptomatic stage, acute form, bleeding hemorrhoids without prolapse of nodes, and chronic bleeding hemorrhoids with prolapse of nodes. Traditional conservative treatment of hemorrhoids is now complemented by sclerosing injections and transanal ligation of internal nodes. Radical surgical treatment consists in the excision of three internal nodes in one block with the corresponding external nodes. Hemorrhoid treatment should be carried out only after colonoscopy so as not to miss colon tumors, the cases of which have sharply increased in recent years, especially in the elderly, who often suffer from hemorrhoids.

Hemorrhoids have been known since ancient times, the name of the disease is traditionally translated as bleeding from the rectum during bowel movements (from Latin hemo – blood and rrhoe – to flow out), although the clinic of the disease is much more diverse and wider. The most various theories of the occurrence of hemorrhoids (varicose veins of the rectum, rectal hemangioma, etc.), the history of methods of its treatment have been described many times, especially after the isolation of proctology as a separate medical specialty (R. Blanchard, 1938; A.N. Ryzhikh, 1956; A.M. Aminev, 1973), but only in the twentieth century. studied and explained, finally, the real morphological bases of the disease (Milligan et al., 1937). Hemorrhoids have long been considered a consequence of ectasia of ordinary rectal veins, but it turned out that it is based on a cluster (nodes, piles, from the Latin pila – ball) of special, so-called. cavernous veins (bodies) of the rectum with multiple arteriovenous anastomoses (Stelzner, Staubezand, 1962) and filling with arterial blood. The anatomical basis for the formation of the cavernous bodies of the rectum, hemorrhoids is the terminal branching of the rectal artery on the right lateral, left antero-lateral and left posterolateral walls of the anal canal, i.e.That is, in the projection of 3, 7 and 11 o’clock on the dial (with the body on the back). In these areas of the anal canal, in the submucosal layer, groups of cavernous veins are formed, interconnected by anastomoses and collaterals, including direct arteriovenous fistulas (“cochlear arteries”, glomus anastomoses).

A person has the same cavernous formations in other organs – in the nose, in the ureters, in the genitals, and the reasons for their appearance and localization have not yet been specially studied.The cavernous bodies of the rectum are thrombosed, filled with blood constantly, outside the act of defecation, and communicate with the usual veins of the rectal mucosa. With the smallest injuries, for example, dense feces with constipation, straining during childbirth, etc., the outer shell of a thrombosed internal hemorrhoid ruptures and arterial bleeding occurs in scarlet drops or an intense scarlet stream, usually during or immediately after a bowel movement … Bleeding, as a rule, stops on its own and in most cases does not anemize patients.The study of the gas composition and coagulation activity of blood from hemorrhoids, carried out by the aforementioned Stelzner, Staubezand and other researchers, confirms that this blood is close in composition to arterial. Note that, despite the cited scientifically grounded concept of the etiology of hemorrhoids, until now in some reputable publications, for example “Colorectal Surgery” (3rd ed., Trans. 2009), hemorrhoids for some reason are referred to as “small proctology “, and its etiology, according to the authors,” is associated with a lack of dietary fiber and stretching during bowel movements. “If this is not a translation cost, then such an interpretation is both incorrect and does not explain anything. Probably, this means persistent constipation with a subsequent weakening of the function of anal holding, but this is not an etiology, but only one of the possible reasons for the loss of nodes, which are not formed due to constipation.

The second problem is the primacy of inflammation or thrombophlebitis in hemorrhoids. Studies show that acute hemorrhoidal thrombophlebitis is secondary. It is based on inflammation caused by damage (ulceration) of the mucous membrane of the anal canal with a sharp violation of blood circulation in areas with pathogenic intestinal flora.As for the danger of embolism in acute hemorrhoidal thrombosis, it is practically impossible, since the lumens of the cavernous veins are very small, smaller than the size of the smallest blood clots (L.L. Kapuller, 1984). Thus, now the pathogenesis of hemorrhoids – both an acute painful attack and its chronic course with constant bleeding, has been studied in detail and taken into account by the majority of specialists. Further research can concern only individual links of this mechanism.

During preventive proctological examinations, quite often, mainly in older men and women who have given birth to many, during digital rectal examination painless moving areas are found on the walls of the anal canal – forming internal hemorrhoids, as a rule, do not bleed and do not fall out.This asymptomatic hemorrhoid, a “pre-disease”, does not need treatment; such persons should be combated with constipation and warn them about the possibility of bleeding during bowel movements.

Clinically, hemorrhoids most often begin with an acute attack – pain, falling out and pinching of nodes, which is usually facilitated by stool retention with straining during bowel movements. On external examination, in such cases, dense, painful when touched, cyanotic nodes around the entire circumference of the anus are determined. Digital (and all the more instrumental) examination and, especially, attempts to reposition such nodes should not be undertaken at this time, it does not give anything but pain.A set of measures is needed – warm lying baths, Detralex and candles, which are produced in many. According to our personal experience, Ultraproct candles work better than others. This combined preparation, containing the anti-inflammatory component fluocortolone and the local anesthetic cinhocaine, provides a complex effect – anti-inflammatory, antipruritic, anti-allergic, antihistamine and local anesthetic. Included in the composition of cinchocaine is a local anesthetic of the amide type, tropic to the epithelium of the rectum.The glucocorticosteroid fluocortolone provides a rapid onset of action, leads to a decrease in inflammatory exudate and cytokine production, inhibition of macrophage migration, and a decrease in infiltration and granulation processes. When applied topically, fluocortolone improves microcirculation, reduces swelling and itching, and accelerates the regeneration of CO of the rectum. The instructions for the candles describe in detail the method of their use, but many years of practice allow you to give additional advice: the tip of the candle should be lubricated with any oil, the candle should be inserted shallowly into the anal canal, and kept outside for at least a minute.

An important pathogenetic factor of acute hemorrhoids is the spasm of the anal sphincter, which occurs in pain and prevents the independent repositioning of the nodes. Baths and suppositories help relieve spasm, but in severe cases it is necessary to resort to a dosed posterior sphincterotomy used for anal fissure and some forms of paraproctitis (V. An, V. Rivkin, 2003). Conservative treatment, exclusion of salty and sour foods from food, stool dilution (phytolax, prunes and other natural fruit preparations) for an average of one week lead to almost complete disappearance of symptoms, but the patient must be warned about the possibility of recurrence of inflammation and radically decide on the future treatment.If, after an acute attack, in a cold period, a digital examination does not reveal pronounced internal nodes, if the described conservative treatment turned out to be effective, then an acute episode of hemorrhoids can be considered a single, exclusive and no specific therapeutic measures should be taken. But acute hemorrhoids occurs with already formed internal nodes, and the disease is prone to relapse or to the transition to the chronic stage, which must be warned about the patient.

The second option is bleeding hemorrhoids without the loss of nodes.With a digital rectal examination, slightly painful, soft, mobile areas in typical places are determined, traces of blood are not uncommon on the glove. Rigid anoscopy or rectoscopy, which were previously widely used in such cases, are inadequate, because no new data on the localization and state of hemorrhoids is determined, and for the diagnosis of concomitant pathology of the colon, primarily tumors, total fibrocolonoscopy is required (in recent years more and more often polyps and colon cancer are determined in the right parts of the colon, which are inaccessible with rectoscopy).Treatment of bleeding hemorrhoids without loss of nodes is carried out by adjusting the chair, suppositories, etc.; such treatment is palliative, because the substrate of the disease remains and the nodes only increase with time. This led to the search for more effective methods of treating these numerous patients, and now, especially abroad, two effective outpatient methods are widely used, for some reason poorly perceived by domestic proctologists. The first method is sclerotherapy of internal nodes. After the usual digital anus divulsion, 1.5–2 ml of sclerosing solution (thrombovar, ethoxysclerol) is injected into the upper pole of each node (remember, there are usually only three of them) with a syringe with a long needle through an operating anoscope with a light in the handle.All three nodes are sclerosed in one session. The treatment is painless, because the puncture of the nodes is carried out above the dentate line of the anal canal, where the mucous membrane does not have sensitive nerve endings. The effect comes quickly, bleeding stops for a long time. Sclerotherapy is used only in the chronic stage of hemorrhoids, without exacerbation of the disease and only with captive nodes. The second technique for this variant of the disease is transanal ligation of the legs of internal hemorrhoids with special rubber (latex) rings (washers).With the help of a special miniature instrument inserted through the operating anoscope, the top of the assembly is grasped with pins, pulled into the cylinder and a tight rubber ring is thrown onto the leg of the assembly by pressing a button. The node ceases to be supplied with blood and after a day or two, together with the washer ring, it painlessly stands out in the stool. These methods have been described in detail (O’Regan, 1995), and our own experience with these two new “semi-conservative” outpatient hemorrhoid treatments demonstrates their effectiveness (V.Rivkin et al., 2012). Surprisingly, until now, our surgeons and even proctologists have been treating such patients conservatively for a long time, for years, changing different suppositories and drugs, not paying attention to the incipient anemia. For some reason, neither sclerotherapy nor transanal ligation of nodes is included in widespread practice, while abroad these techniques prevail and their effectiveness is constantly being confirmed.

The third option, the most important in practice, is hemorrhoids with prolapse of nodes. In most cases, as mentioned above, three main internal nodes are formed, and the impression of a larger number of nodes is formed from visual observation of the distal parts (tops) of these three nodes, which look like separate formations (Fig.1). In such patients, the nodes are usually easily repositioned, but with the slightest straining they fall out again. With a digital rectal examination, usually almost painless, it is possible to determine the typical localization of the bases (legs) of the three main nodes. If the study is painful and the sphincter of the anus is spasmodic, then we are talking most often about a combination of hemorrhoids with an anal fissure: a linear, dense, painful scar is determined on the back wall of the anal canal. This combination is very common, it is explained by repeated inflammatory exacerbations of hemorrhoids.Just as often and for the same reason, chronic hemorrhoids are combined with inflammation of the walls of the rectum (proctitis) or rectum and sigmoid colon (proctosigmoiditis). Against the background of chronic hemorrhoids during colonoscopy in the colon, much higher than the hemorrhoids themselves, polyps and early forms of cancer are often detected for the first time in the elderly. This is completely unrelated to hemorrhoids, hemorrhoids do not become malignant (except, perhaps, very rare cases of anal melanoma), but colonoscopy in these, mostly elderly, people is necessary in itself, this is currently a very effective way of timely diagnosis of colonic tumors. intestines.

Radical treatment of chronic bleeding hemorrhoids with prolapse of nodes, operative. The most effective is, in our opinion, the operation developed by the above-mentioned English surgeons (Milligan et al.) Back in the 1930s. After ligation of the vascular pedicle, the boundaries of the internal node are outlined with a scalpel and excised with scissors “from outside to inside” with all external nodes. At the end of the operation, three open perianal wounds remain (in the form, as the authors figuratively described, “rubber fan blades”).In our modification, during this operation, the bottom of these three wounds is usually sutured (Fig. 2), which promotes, firstly, their faster healing and, secondly, partially narrows the anus with linear scars, which contributes to its better sealing. Until now, many surgeons, who consider the treatment of hemorrhoids to be their competence, operate on patients with the old, obsolete method of simple ligation of the external nodes, which often leads to serious complications, for example, to a persistent stricture of the anus, when the necessary wide mucocutaneous strip does not remain between the removed external nodes. fabrics.We had to treat such patients, and in one case, a complete cicatricial stricture of the anus developed, and the case ended with the imposition of a temporary colostomy followed by complex anal plasty. Despite the fully justified and effective methodology of Milligan et al., More and more new methods are constantly being proposed, described in detail by L.A. Grateful (1999), and there is a feeling of artificial, only for the sake of the notorious novelty, the development and attempts to introduce “new” techniques, sometimes completely inadequate, such as the dangerous and complex Whitehead operation and superradical resection of the anal canal (Longo operation).The vast world experience of Milligan et al. unambiguously testifies to her favor and irreplaceability. Only minor minor improvements are possible, for example, narrowing of three perianal wounds (Fig. 2e).

Radical surgery for hemorrhoids should be clearly justified; it has already been said above that in elderly patients with concomitant serious cardiovascular and other organopathology, conservative treatment with diet, suppositories, stool dilution gives a long-term beneficial effect.In many elderly people, chronic bleeding hemorrhoids are combined with persistent hypertension, and small, non-anemic hemorrhoidal bleeding may be useful for them.

We emphasize once again: it is impossible to start treating, let alone operate, hemorrhoids without a preliminary colonoscopy. We draw the attention of doctors of any specialty to the fact that bleeding from the anus, especially not associated with defecation, requires urgent colonoscopy. In recent years, cases of colon tumors, polyps and cancer have sharply increased throughout the world, and cancer of the rectum and sigmoid colon is taking the first or second place in oncological pathology.Colon tumors, especially asymptomatic adenoma polyps (optional precancer), are found in more than 15% of people over 50 years of age (N. Yakutin et al., 2002). In Russia, colon cancer is diagnosed late, at inoperable stages (N.Yu. Zalit et al., 2003), and the analysis reveals that many of these patients were treated for hemorrhoids for a long time, sometimes for weeks or months, without prior examination of the colon. intestines. They had hemorrhoids, but there was also a tumor of the colon, the diagnosis of which was delayed due to long-term treatment of hemorrhoids.Nowadays, when flexible intestinal fibroendoscopy is available in every city, the treatment of rectal bleeding without a colonoscopy is not just a mistake, but a medical crime. Colon polyps and cancer are common in the elderly, including those suffering from hemorrhoids, and long-term treatment of hemorrhoids weakens the doctor’s attention and delays the necessary colonoscopy.

Literature

1. Blanchard R. Romance of Proctology. London, 1938.
2.Ryzhikh A.N. Rectum surgery. M., 1956.
3. Aminev A.M. Guidelines for proctology. T. 2. Kuibyshev, 1973.
4. Milligan E., Morgan S., Jones L., Officer R. Anatomy of the anal canal and the operative treatment of hemorrhoids // Lancet. 1937. No. 2. R. 1119-1123.
5. R. Phillips (ed.) Colorectal Surgery. Colorectal surgery / per. from English M .: GEOTAR, 2009. Ch. 14.P. 262–268.
6. Stelzner F., Staubesand J. Das Corpus Cavernosom Recti.// Archiv. Klin. Chir. 1962. No. 299. R. 302-312.
7. Capuller L.L. Hemorrhoids // Morphological bases of diseases of the stomach and intestines. M., 1998. S. 123-128.
8. An V.K., Rivkin V.L. Emergency proctology. M., 2003.
9. O’Regan P.J. Disposable device and minimally invasive technique for rubber band ligation of hemorrhoids // Dis. Colon. Rectum. 1999. No. 42. R. 623-625.
10. Rivkin V.L., Capuller L.L., Belousova E.A. Coloproctology. M., 2011.S. 77–98.
11. Grateful L.A. Clinical and pathogenetic substantiation of modern methods of treatment of hemorrhoids. Dis. … Dr. med. sciences. M., 1999.
12. Yakutin N.A. [et al.] Diagnosis of precancerous diseases and early forms of colon cancer at the prehospital stage // Problems of Coloproctology: Collection of articles. M., 2002. S. 502–507.
13. Zalit N.Yu. [and others] The problem of colon cancer at the turn of the third millennium // Act. Coloproctology issues: Sat. Samara, 2003.S. 233–235.

Hemorrhoid Treatment, Symptoms – Medical Center

Most patients go to the Na Vostochnaya medical center with complaints of hemorrhoids.

But in many cases under the type of hemorrhoids are completely different diseases . Nevertheless, hemorrhoids are the most common coloproctological disease and one of the most common diseases of mankind in general. Do not forget that hemorrhoidal disease is often a concomitant, or even predisposing (that is, leading to the occurrence), pathology for a number of other problems – anal fissure, paraproctitis, cryptitis, papillitis, etc.Turning to statistics, we will see that the prevalence of hemorrhoids is 130-145 cases per 1000 adult population.

This spread of this disease is facilitated by the way and rhythm of life of a modern person. No wonder hemorrhoids are included in the group of diseases called “diseases of civilization.” A lifestyle that provokes the onset of hemorrhoidal disease means: a sitting position, especially associated with simultaneous physical exertion (driving a car, office work, sitting at a computer for a long time), playing sports leading to stagnation of blood in the veins of the small pelvis – weightlifting, riding on a bike; any physical inactivity that accompanies the life of many modern people; a frequent provoking factor in women is pregnancy and childbirth, since these conditions are accompanied by stagnation of blood in the veins of the small pelvis; Finally, problems with the gastrointestinal tract play an important role – constipation, the use of insufficient amounts of vegetable fiber, alcohol abuse and addiction to spicy foods.Heredity plays a significant role in the development of hemorrhoidal disease. Hemorrhoids is a socially significant disease, since it mainly affects people of working age.

By definition, hemorrhoids are pathological enlargement of hemorrhoids.

Accordingly, with an increase in internal nodes, we are talking about internal hemorrhoids, with an increase in external – about external hemorrhoids, with an increase in both internal and external nodes – about combined hemorrhoids.Briefly imagine the development of the disease, then the role is played by two main factors: vascular – impaired blood circulation in the small vessels of hemorrhoids (the so-called cavernous bodies), and mechanical – dystrophic changes in the “ligaments” that normally hold the nodes in the anal canal. Roughly speaking, under the influence of the first factor, the nodes increase in size, under the influence of the second, they fall out of the anus. Moreover, the more severe the violation, the larger the nodes, and the more they fall out of the anus.Always with this disease, there are three main groups of nodes – at 3,7,11 hours, when viewed in the supine position. In addition to the main ones, there may be individual additional nodes in any number.

Based on the foregoing, it can be assumed that the more pronounced the hemorrhoidal disease, the more nodes fall out, losing the ability to adjust back into the anal canal. Indeed, in the classification of hemorrhoids, and, accordingly, the development of therapeutic tactics, the defining feature is the loss of nodes and their ability to adjust them back:

1. Degree – the nodes do not fall out (the disease manifests itself only in blood separation)
2. Degree – the nodes fall out, but set back on their own
3. Degree – the nodes fall out, but they are adjusted with a manual aid (or its analogue – some patients are forced to take a certain posture, perform any exercises or adjust the nodes under the shower)
4. Degree – the nodes in the anal canal are not reduced.

Any of these stages can be accompanied by a separation of blood, or be “bloodless”.

In addition to the indicated chronic, there is an acute form – thrombosis of hemorrhoids. Also, the prolapse of internal hemorrhoids can be aggravated by the presence of external nodes, in this case we are talking about combined hemorrhoids of the corresponding stage.

When should you see a proctologist? What allows you to suspect hemorrhoids?

There are two signs of hemorrhoids: prolapse or constant presence of hemorrhoids and separation of blood during bowel movements.I have already mentioned the loss of nodes above. As for bleeding, hemorrhoids can be accompanied by them, or be without them, which is always indicated in the diagnosis. Actually, they gave the name to the disease (Latin Haemo – blood, rhoides – to expire, that is, hemorrhoids literally – “bleeding”). The blood has a bright scarlet color (so-called “arterial blood”), the intensity can vary – from blots on toilet paper to intense bleeding with scarlet blood and blood clots that can be life-threatening.

The remaining symptoms of hemorrhoidal disease are nonspecific and can be with any pathology of the anal canal: itching, discomfort, burning in the anal region, mucus secretion. Contrary to popular belief, pain syndrome is not typical for chronic hemorrhoids, therefore, in the presence of pain, it is necessary to exclude other diseases of the anus.

In view of the large spectrum of diseases of the anus and colon, in manifestations similar to hemorrhoids, self-diagnosis, and, moreover, self-medication is unacceptable. Treatment is prescribed only after a thorough follow-up examination, which includes:

1. (how the disease developed, what are the predisposing, aggravating factors, what measures to provide for adequate treatment of the disease) at this stage, the stage of the disease is preliminarily set, and a treatment plan begins to form accordingly.
2. Physical examination, digital rectal examination . They allow to determine not only the characteristics of the nodes, but also the presence of other pathological formations – primarily rectal tumors.
3. Instrumental examination : anoscopy, sigmoidoscopy, fibrocolonoscopy. Endoscopic research methods are extremely important for the diagnosis of diseases of the colon. They allow to exclude formidable diseases, accompanied by the separation of blood – colon cancer, inflammatory diseases of the colon. In addition, thanks to colonoscopy and sigmoidoscopy, tumors of the rectum and colon are detected in the early asymptomatic stages.

Acute hemorrhoids are a separate “front” in the structure of coloproctological diseases.

In a number of cases, against the background of a chronic course of hemorrhoidal disease, thrombosis of hemorrhoids occurs – overlap of blood vessels diverting blood from the nodes. The consequence of such an overlap (venous thrombosis) is plethora, edema of the nodes, manifested by an increase in the affected node, its irreducibility into the anal canal, and severe pain. This, incidentally, is the case when hemorrhoids really hurt. Both external and internal nodes can become aggravated (thrombosed).In the presence of a swollen enlarged sharply painful node, the doctor diagnoses acute hemorrhoids of the 1st degree. If medical measures are not taken on time, inflammation develops in the area of ​​the thrombosed node, manifested by increased pain, the appearance of fibrin, edema of the skin and mucous membrane around the node. This is already acute hemorrhoids of the 2nd degree. In the absence of treatment, and further development of the disease, necrosis – “necrosis” of tissues, appear on the node and adjacent areas. At this time, the pain is intolerable, an inflammatory reaction of the whole body may appear – weakness, lack of appetite, fever.In addition to obvious suffering, acute hemorrhoids can lead to formidable complications – paraproctitis, sepsis! You cannot delay an emergency visit to a coloproctologist!

Having made the diagnosis, having determined the stage of the disease and the concomitant pathology, the proctologist proceeds to the treatment measures.

Proctologists of the medical center “Na Vostochnaya” specialize in diseases of the ano-rectal zone, primarily chronic and acute hemorrhoids.We use the latest techniques to treat this life-threatening and sometimes dangerous pathology.

Unfortunately, it is impossible to completely cure chronic hemorrhoids with conservative, therapeutic approaches, however, these methods are extremely important for the prevention and treatment of thrombosis, slowing down the further development of hemorrhoidal disease, are used after manipulations on the anus for a smooth course of the recovery period. Therefore, one cannot fail to mention them:

1. Diet, Diet, diet again. Key points: nutrition should be complete, include proteins, carbohydrates, fats, trace elements and vitamins in sufficient quantities and the necessary calorie intake. There is no need to go on hunger strikes, it is enough to exclude spicy, spicy foods and alcohol . You also need to refrain from taking foods that cause constipation, gas formation, as well as diarrhea. During treatment, it is necessary to maintain a regular regular consistency or (after surgery) slightly softened stools.Hard, obstructed, irregular stools, as well as diarrhea with loose stools, can provoke thrombosis of the nodes, complicate wound healing after surgery.
2. Medical and protective regime. It is necessary to limit physical activity, exclude hypothermia, overheating, swimming in open water bodies, insolation (i.e. prolonged exposure to the sun). Any sports activities should be excluded until the end of treatment. After surgical treatment of hemorrhoids, the ability to work may be temporarily limited.This is especially true for those engaged in heavy physical labor, sedentary work, drivers, professional athletes. The use of new methods of hemorrhoid treatment by us today allows us to significantly reduce the period of disability, quickly return to normal life with sports, outdoor activities, normal sexual rhythm, unlimited food, travel and everything that is dear to you.
3. Drug and local therapy. Contrary to popular belief, they play a small independent role.The use of analgesic and anti-inflammatory suppositories, ointments, phlebotonic drugs, baths with antiseptics, physiotherapy procedures are necessary to stop thrombosis, temporarily reduce symptoms (in fact, delay the problem), and provide conditions for wound healing after operations and minimally invasive manipulations.
4. Minimally invasive manipulations. Conducted in several stages.
   1. With infrared photocoagulation, the mucous membrane of the anal canal is gently “cauterized” in the areas where the hemorrhoidal arteries pass under it.After such coagulation, the shrinking mucosa presses the arteries and small hemorrhoids without receiving blood, decrease in size, and thus the small “additional” nodes are eliminated, thereby eliminating a possible source of recurrence of the disease.
   2. Latex ligation of the legs of hemorrhoids. With this technique, a special apparatus is used to throw a latex ring onto the leg of the knot, each of the three main ones. After clamping the artery, the node collapses, decreases in volume and does not manifest itself.

The use of these minimally invasive techniques is attractive because they are carried out in a few minutes, are painless, safe – complications such as bleeding, suppuration are extremely rare. Finally, the main thing is that there is no loss of ability to work, the way of life does not change. But it is important to take into account that the use of the methods will be effective and, accordingly, it makes sense only if the disease is detected at the initial stages – the first and second, and only when there are no complications and concomitant pathology of the anus and perineum.

Laser treatment of hemorrhoids, surgery in the medical center “On Vostochnaya”

With a pronounced form of the disease, the more neglected with complications and concomitant diseases (fistulas of the rectum, anal fissure), the only way of treatment is the elimination of hemorrhoids. We use the latest treatment methods – dearterization of hemorrhoid nodes, excision of nodes using electric wave and laser methods of affecting body tissues, which significantly reduce tissue trauma.This means:

• Possibility of using the method on an outpatient basis or in a one-day hospital. There is no need for long-term hospitalization, the course of postoperative rehabilitation is carried out at home.
• Less pain. Higher quality of life after surgery.
• The wound heals faster, a quick return to the usual way of life and the opportunity to work.
• The cosmetic effect is much better – there are no rough scars, perianal fringes, deformation of the anus.
• Less risk of complications in the early and late postoperative period.

The nuances of the execution allow you to perform the operation itself more safely, faster than the classical methods of removing hemorrhoids. The manipulation can be carried out with local anesthesia, since less trauma allows, either under anesthesia, that is, drug sleep with general anesthesia. It is extremely important that during the removal of hemorrhoids, it is possible to eliminate concomitant pathology – cracks, paraproctitis, fibrous polyps, etc.This possibility is always discussed with the attending proctologist.

In the postoperative period, we prescribe a course of simple procedures that can be easily performed at home. For working patients, it is possible to issue a certificate of incapacity for work to comply with the medical and protective regime.

When using our proposed method of curing hemorrhoids, the likelihood of recurrence is very low, compared with classical surgery.

In conclusion, I would like to emphasize that it is necessary to consult a coloproctologist as soon as possible if signs of hemorrhoids appear – blood separation, prolapse of hemorrhoids, or any other unusual / abnormal sensations in the anus. Delay leads to the development of the disease and more labor-intensive cure, and the lack of timely diagnosis leads to the development of many life-threatening diseases of the colon. Diagnostics (colonoscopy) and treatment of hemorrhoids is possible with the use of anesthesia.

A visit to a specialist does not take much time, is painless, delicate, and a normal quality of life or a timely prevention of the threat of advanced cancer are worth the effort you spent!

The medical center receives residents of the cities: Irkutsk, Shelekhov, Bratsk, Usolye-sibirskoye, Zima, Tulun, Cheremkhovo and other cities of the Irkutsk region.

90,000 Why can there be blood in the stool?

One of the most common symptoms of suspected abnormalities in the rectum, as well as in the large intestine, is the appearance of blood in the stool. It can indicate many different diseases, which can only be determined by an experienced doctor. Surgeon-proctologist Yuri Lovitsky from the Viva clinic told the DOC.UA service about the most likely causes, one of the symptoms of which may be blood in the feces.

Diseases of the rectum are a very delicate problem that is not usually talked about among the general public. Nevertheless, according to statistics, more than half of the world’s population at least once in their life experience pathological symptoms associated with the act of defecation. In most cases, this is itching, discomfort and incomplete emptying of the rectum. Very rarely, patients go to the doctor with such complaints, preferring to endure and observe the progressive development of the disease.More often, patients come to an appointment with unbearable pain or complaints of blood in the feces, which is especially frightening for them.

In fact, there are not so many reasons for the release of fresh blood from the rectum. In addition, with different diseases, the symptom has certain features, taking into account which, it is possible to determine the cause of the pathological condition.

Hemorrhoids

Venous pathology of the rectum is the most common cause of bleeding. In this case, the symptom has characteristic features:

• bleeding is combined with anal itching, a feeling of incomplete emptying of the rectum and, sometimes, prolapse of hemorrhoids from the anal canal;
• blood has a scarlet color, due to the fact that the venous plexuses of the rectum have a direct connection with the middle rectal arteries;
• As a rule, blood appears at the end of the act of defecation, located on top of normally colored feces.

It is not uncommon for patients to experience similar symptoms over the years. Frequent recurrent bleeding can cause anemia, manifested by pallor of the skin, dizziness, persistent headache, poor skin, nails and hair.

Anal fissure

Arising as a result of severe physical exertion or constant constipation, a fissure of the rectum is manifested by severe pain in the anus, spasm of the external sphincter and the release of blood with feces.Among the features of rectal bleeding in this case, the following factors can be distinguished:

• Blood appears at the beginning of a bowel movement.
• Bowel movement is accompanied by severe pain.
• Patients develop a feeling of fear of going to the toilet, which leads to functional digestive disorders in the form of severe constipation.

Over time, patients with chronic anal fissure become irritable, restless.Against the background of rectal disease, they develop psychoemotional disorders.

Colon tumor

Unfortunately, another common cause of rectal bleeding is malignant neoplasms of the colon and rectum. Bleeding in this case has the following features:

• Blood from the rectum is mixed with feces.
• The symptom is combined with persistent constipation, which may alternate with recurrent diarrhea.
• Patients often experience general weakness, malaise, abdominal pain, flatulence, and progressive weight loss.

Discharge of blood from the rectum in malignant neoplasms is an unfavorable symptom, since it indicates the disintegration of the tumor. The prognosis for this condition can only be improved by an early appeal to a proctologist when the first symptoms of the disease appear.

Much less often, the release of blood with feces can be observed in benign neoplasms of the large intestine, Crohn’s disease, ulcerative colitis, vascular malformations and all sorts of rectal fistulas.

It is possible to identify the exact rectal bleeding only on examination by a proctologist. At the same time, for the diagnosis, you may need not just an examination and digital rectal examination, but also a list of additional measures, such as sigmoidoscopy or colonoscopy. But, regardless of this, the first thing a person should do when even a small amount of blood appears in the stool is to see a doctor.

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