What are the common symptoms of hemorrhoids. How are internal and external hemorrhoids different. When should you see a doctor for hemorrhoid symptoms. What methods do doctors use to diagnose hemorrhoids.

Understanding Hemorrhoids: Causes and Risk Factors

Hemorrhoids are swollen, inflamed veins in the skin around the anus or lower rectum. While the exact cause remains unclear, several factors contribute to their development:

• Aging: Decreased muscle tone can weaken tissue, causing hemorrhoids to bulge
• Obesity: Excess weight increases pressure on the anal area
• Pregnancy: Hormonal changes and increased abdominal pressure can lead to hemorrhoids
• Constipation and straining: Repeated pressure during bowel movements can cause swelling

Although hemorrhoids are generally not dangerous, they can be painful and uncomfortable. Understanding the risk factors can help in prevention and early intervention.

Recognizing Common Hemorrhoid Symptoms

Identifying hemorrhoid symptoms early can lead to more effective treatment. Here are the most common signs to watch for:

• Bright red blood on toilet paper, in stool, or in the toilet bowl after a bowel movement
• Anal itching or irritation
• Pain around the anus, especially while sitting
• Discomfort during bowel movements
• One or more hard, painful lumps around the anus

Is bleeding always a sign of hemorrhoids? While rectal bleeding is a common symptom, it’s crucial to consult a healthcare provider to rule out other potential causes, such as colorectal cancer or anal fissures.

Internal Hemorrhoids: Characteristics and Grading System

Internal hemorrhoids develop inside the lower rectum and are often painless. They may, however, cause bleeding during bowel movements. In some cases, internal hemorrhoids can protrude through the anus, a condition known as prolapse.

Healthcare providers use a grading system to classify internal hemorrhoids:

1. Grade 1: No prolapse
2. Grade 2: Prolapse that retracts on its own
3. Grade 3: Prolapse that requires manual pushing back
4. Grade 4: Prolapse that cannot be pushed back

Understanding the grade of internal hemorrhoids helps determine the most appropriate treatment approach. How does the grading system impact treatment decisions? Higher-grade hemorrhoids may require more aggressive interventions, such as surgical procedures, while lower-grade hemorrhoids might respond well to conservative treatments.

External Hemorrhoids and Thrombosed Hemorrhoids

External hemorrhoids form under the skin around the anus and can be itchy, painful, and feel lumpy. A particular type of external hemorrhoid, called a thrombosed hemorrhoid, occurs when a blood clot develops within the hemorrhoid.

Thrombosed hemorrhoids are characterized by:

• Intense pain, especially within the first 48 hours
• Bluish color due to the blood clot
• Possible formation of an anal skin tag after the clot is absorbed

Can thrombosed hemorrhoids resolve on their own? In some cases, the blood clot may dissolve naturally, but the stretched skin might result in a residual skin tag. If the pain is severe or persistent, medical intervention may be necessary.

When to Seek Medical Attention for Hemorrhoids

While many cases of hemorrhoids can be managed with home remedies, certain symptoms warrant a visit to the doctor:

• Persistent bleeding from the anus or rectum
• Blood in the stool
• Severe pain or discomfort
• Hemorrhoid symptoms that don’t improve with home treatment
• Recurrent hemorrhoid problems

Why is it important to see a doctor for these symptoms? Medical evaluation can help rule out more serious conditions, such as colorectal cancer, and ensure appropriate treatment for hemorrhoids.

Diagnostic Procedures for Hemorrhoids

When you visit a healthcare provider for suspected hemorrhoids, they will typically perform several diagnostic procedures:

1. Medical history review: Your doctor will ask about your symptoms, eating habits, toilet routines, and use of laxatives or enemas.
2. Physical examination: This includes a visual inspection of the anal area to check for external hemorrhoids, skin irritation, or anal fissures.
3. Digital rectal examination: Using a gloved, lubricated finger, the doctor checks for abnormalities within the anal canal and lower rectum.
4. Anoscopy: A hollow, lighted tube is used to view the anal canal and lower rectum in more detail.

How do these diagnostic procedures help in treatment planning? By accurately identifying the type, location, and severity of hemorrhoids, healthcare providers can recommend the most effective treatment options tailored to each patient’s needs.

Differential Diagnosis: Ruling Out Other Conditions

Hemorrhoid symptoms can mimic those of other anorectal conditions. Therefore, doctors must consider alternative diagnoses during the evaluation process. Some conditions that may present similar symptoms include:

• Anal fissures: Small tears in the lining of the anus
• Anal abscesses: Infected cavities filled with pus
• Anal warts: Growths caused by the human papillomavirus (HPV)
• Rectal polyps: Abnormal tissue growths in the rectum
• Colorectal cancer: Malignant tumors in the colon or rectum

Why is differential diagnosis crucial in hemorrhoid evaluation? Accurate diagnosis ensures that patients receive appropriate treatment for their specific condition, avoiding potential complications from misdiagnosis or delayed treatment of more serious ailments.

Advanced Diagnostic Techniques for Complex Cases

In some instances, especially when symptoms are severe or recurrent, healthcare providers may employ more advanced diagnostic techniques:

• Colonoscopy: A long, flexible tube with a camera is used to examine the entire colon and rectum
• Sigmoidoscopy: Similar to a colonoscopy but focuses on the lower part of the colon and rectum
• Endoanal ultrasound: Uses sound waves to create detailed images of the anal canal and surrounding tissues

These advanced techniques can provide more comprehensive information about the state of the anorectal area and help identify any underlying conditions that may be contributing to hemorrhoid symptoms.

Treatment Options for Hemorrhoids: From Home Remedies to Surgery

Once diagnosed, hemorrhoids can be treated through various methods, depending on their severity and type. Treatment options include:

1. Home remedies: Warm baths, over-the-counter creams, and lifestyle changes
2. Minimally invasive procedures: Rubber band ligation, sclerotherapy, or infrared coagulation
3. Surgical interventions: Hemorrhoidectomy or stapled hemorrhoidopexy for severe cases

How do doctors determine the most appropriate treatment plan? Factors such as the grade of internal hemorrhoids, the presence of external hemorrhoids, the patient’s overall health, and the severity of symptoms all play a role in treatment selection.

Preventive Measures and Lifestyle Modifications

Preventing hemorrhoids or reducing their recurrence often involves lifestyle changes:

• Increasing fiber intake to soften stools and reduce straining
• Staying hydrated to promote regular bowel movements
• Exercising regularly to improve circulation and bowel function
• Avoiding prolonged sitting on the toilet
• Practicing good anal hygiene

Can lifestyle changes alone manage hemorrhoids effectively? For many individuals, especially those with mild symptoms or early-stage hemorrhoids, lifestyle modifications can significantly improve comfort and prevent progression of the condition.

Long-term Management and Follow-up Care for Hemorrhoid Patients

After initial treatment, ongoing management and follow-up care are essential for hemorrhoid patients. This may include:

• Regular check-ups to monitor healing and prevent recurrence
• Adjusting treatment plans based on symptom changes
• Addressing any complications that may arise
• Providing guidance on maintaining a hemorrhoid-friendly lifestyle

Why is long-term management crucial for hemorrhoid patients? Hemorrhoids can be a chronic condition for some individuals, and ongoing care helps prevent flare-ups, manages symptoms effectively, and improves overall quality of life.

Emerging Treatments and Research in Hemorrhoid Management

The field of hemorrhoid treatment continues to evolve, with researchers exploring new approaches to manage this common condition. Some areas of ongoing research include:

• Novel surgical techniques with reduced recovery time
• Advanced topical treatments with improved efficacy
• Targeted therapies to address underlying causes of hemorrhoids
• Personalized treatment plans based on genetic factors

How might these emerging treatments impact future hemorrhoid management? As new therapies are developed and refined, patients may benefit from more effective, less invasive treatments with fewer side effects and improved long-term outcomes.

Understanding hemorrhoids, from their causes and symptoms to diagnosis and treatment options, empowers individuals to seek timely medical attention and make informed decisions about their healthcare. By recognizing the signs of hemorrhoids and knowing when to consult a healthcare provider, patients can effectively manage this common condition and improve their overall well-being.

Hemorrhoid Symptoms and Diagnosis: Internal and External Hemorrhoids

Hemorrhoids occur when veins in the skin around the anus or in the lower rectum get swollen and inflamed. It’s not exactly clear what causes people to get hemorrhoids, but there are some common, accepted risk factors and conditions that lead to their development.

Aging can decrease muscle tone in the area, weakening the tissue and causing hemorrhoids to bulge, while obesity and pregnancy can increase the risk for hemorrhoids due to increased pressure on tissue in the area. (1)

Repeated straining to make a bowel movement, as well as constipation, are also associated with hemorrhoids.

Hemorrhoids are generally not dangerous or life-threatening, but they may be painful.

Common Hemorrhoid Symptoms to Watch For

The following signs and symptoms may indicate hemorrhoids:

• Bright red blood on toilet paper, in stool, or in the toilet bowl after a bowel movement
• Anal itching
• Pain around the anus, especially while sitting
• Pain during bowel movements
• One or more hard, painful lumps around the anus

If you have any symptoms of hemorrhoids, try to avoid excessive straining, rubbing, or cleaning around the anus.

Doing these things can make any irritation and itching worse, and can sometimes lead to bleeding.

Internal Hemorrhoids vs. External Hemorrhoids

There are two main types of hemorrhoids:

Internal Hemorrhoids These hemorrhoids develop inside the lower rectum. Internal hemorrhoids usually don’t hurt, but they often bleed painlessly, resulting in bright red blood you might notice when you go to the bathroom and wipe.

Most of the time, internal hemorrhoids are not visible to the naked eye. But in some cases, internal hemorrhoids may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own. Protruding hemorrhoids can become irritated and itchy, and patients may find it difficult to clean themselves after a bowel movement.

Internal hemorrhoids are categorized by how prolapsed they are, which helps determine how they should be treated.

Grade 1 hemorrhoids means there is no prolapse. A prolapse that goes back in by itself is categorized as grade 2. Prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse can’t be pushed back in. (2)

External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy.

External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops. (1)

Thrombosed hemorrhoids tend to be bluish in color due to the clot. Sometimes the blood clot will go away on its own, but because the clot has stretched the skin, it may result in an anal skin tag — excess skin left when the blood clot in a thrombosed hemorrhoid is absorbed by the body. Skin tags do not require removal, but if it’s particularly bothersome to a patient, excision is an option. (1)

If a thrombosed hemorrhoid has been present for longer than two days, the pain has often peaked and you might try home treatments while waiting for the clot to clear up on its own. When the clot first forms, it can be very painful; if you make it to your doctor’s office during this time, an in-office surgical procedure, involving local anesthesia and excision of the hemorrhoidal tissue, may be available. (2)

RELATED: 8 Myths You’ve Been Told About Hemorrhoids

How Hemorrhoids Are Diagnosed by Your Doctor

See your doctor if you think you might have hemorrhoids, especially if you notice bleeding from your anus or rectum, or have bloody stools. Your doctor will want to rule out more serious problems that can cause bleeding from the anus or rectum, such as cancer.

Hemorrhoid symptoms may also be similar to those of other anal and rectal problems, including anal fissures, abscesses, warts, and polyps.

Your doctor will ask about your medical history and will ask you to describe your symptoms. Questions about your eating habits, toilet habits, and enema and laxative use are likely to come up. (3)

Your doctor will also perform a physical exam to look for lumps or swelling, prolapsed internal hemorrhoids, external hemorrhoids, skin irritation, skin tags, and anal fissures, which are small tears in the anus that can result in itching and bleeding. (3) This will involve a visual examination of the area.

Your doctor may also perform a rectal exam to diagnose internal hemorrhoids, check the muscle tone of your anus, and check for blood in the stool. This is done with a gloved, lubricated finger (called a digital rectal examination) and a tool called an anoscope.

An anoscope is a type of endoscope — a hollow, lighted tube that is inserted a few inches into the anus to help the doctor see any problems inside the lining of the rectum. This procedure is performed in the doctor’s office and doesn’t require anesthesia. (3)

Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.

These tests may include:

Colonoscopy After you’re sedated with medicine, your doctor uses a thin, flexible tube called a colonoscope to look at the inner lining of your colon.

A colonoscopy can help discover ulcers, polyps, tumors, and other areas of inflammation or bleeding.

Sigmoidoscopy This procedure is similar to a colonoscopy, but it uses a shorter tube called a sigmoidoscope to examine the lining of the rectum and the sigmoid colon (the lower part of the colon).

Barium Enema X-ray This is a special type of X-ray of the colon and rectum in which your doctor inserts a liquid solution containing barium sulfate into the rectum. The solution helps highlight specific areas in the colon for your doctor to examine in the X-ray images.

RELATED: 4 Signs Your Hemorrhoids Warrant a Doctor’s Visit

Additional reporting by Deborah Shapiro.

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What Is a Gastroenterologist and What Do They Treat?

Are There Different Types of Gastroenterologists?

While some gastroenterologists treat general GI diseases, others cultivate an area of expertise within their specialty. For instance, they may have specific knowledge or experience in managing:

• Inflammatory bowel diseases
• Pancreatic disease
• Liver disease
• Liver transplantation
• GERD
• Conditions that require complicated endoscopic procedures

A gastroenterologist may choose to become a hepatologist: a doctor who specializes in diseases of the liver, gallbladder, bile ducts, and pancreas. A hepatologist must complete a three-year fellowship in gastroenterology with an additional year of concentrated training in hepatology.

Gastroenterologists often work closely with surgeons, oncologists (doctors who specialize in cancer), and radiologists (doctors who specialize in imaging).

How Do I Find the Best Doctor for Gastroenterology?

Your primary care physician is a good place to start. Your doctor likely knows some of the best specialists in your area and can provide you with a list of gastroenterologists to consider.

Word of mouth is another way to find a gastroenterologist who fits your needs. Try asking friends or family members for recommendations.

You can also do a little research yourself. A practice’s website will often feature the doctor’s bio, which includes information like their credentials, education, areas of special interest, and more. Reading online reviews can supply you with feedback from other patients.

How Can I Find Out if a Gastroenterologist Accepts My Insurance?

Your insurance company should supply you with a hard copy or online list of gastroenterologists in your area who accept your coverage. However, it’s a good idea to call your insurance provider and confirm that the specialist you’re considering is on your policy. Physician lists are often out of date.

What Other Factors Should I Consider When Selecting a Gastroenterologist?

When choosing a gastroenterologist, you might want to consider the following factors:

• The location of the office in relation to where you live
• The doctor’s experience, education, and credentials
• The doctor’s subspecialities or special interests
• The procedures the doctor performs or doesn’t perform
• The doctor’s personality
• Hospitals that the doctor is affiliated with
• Whether the practice offers telemedicine options
• How long you’ll have to wait for an appointment
• Whether the office accepts new patients

Some gastroenterologists offer in-person or telehealth consultations for prospective patients. This visit gives you a chance to ask questions and determine if you and the physician are well matched.

How Do I Find a Gastroenterologist Who Will Be Sensitive to My Racial or Ethnic Background and Sexual Orientation?

It’s important to feel comfortable with your doctor, but finding a gastroenterologist who is sensitive to your race, ethnicity, or sexual orientation may take a little bit of effort. If you are having trouble finding a doctor who shares your background, it could be helpful to research your prospective doctor’s memberships and affiliations. This information could help you determine if they make an active effort in educating themselves or advocating about inequities in the healthcare system.

Telemedicine visits also give you an opportunity to see a doctor of your choice who isn’t necessarily located in your area.

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articles of the Oxford Medical Center Kryvyi Rih

Hemorrhoids is a disease that is always heard, BUT many patients are not serious about its first signs. Wikipedia tells us that HEMORRHOIDS is a disease in proctology, a pathological expansion of hemorrhoidal veins, their inflammation, which contributes to the development of hemorrhoids.

Symptoms of hemorrhoids are very diverse and only a doctor can deal with them. The signs that are characteristic of this disease coincide with the manifestations of rectal cancer, and only an experienced proctologist can make a correct diagnosis and prescribe treatment. It is important to recognize the first symptoms in time and immediately consult a doctor, because hemorrhoids can lead to serious consequences:

With all the inconvenience that accompanies this disease, people do not rush to see a doctor for help, they all hope for “maybe it will go away on its own” – this is the whole reason for such a large percentage of chronic diseases.

Our proctologists at the appointment always try to explain to the patient in an accessible way that inflamed hemorrhoids will not disappear anywhere and it is necessary to immediately use the treatment in order not to bring it to the chronic stage. In the chronic stage, the disease can resume at any time with more serious symptoms and at the most inopportune moment due to the slightest misconduct: nutrition, heaviness, stress.

What are the conditions for visiting a proctologist?

• if you are 30 years old or older and your relatives suffered from hemorrhoids (there is a predisposition to varicose veins), then you should have an annual examination by a proctologist even if you do not have symptoms. In this case, prevention is the best treatment;

• there is discomfort in the anus – this is the first signal that can warn you about the development of hemorrhoids;

• swelling, inflammation or displacement of the anal folds at certain times;

• anal itching, mucus, burning already indicate prolapsed hemorrhoids;

• discharge of blood on toilet paper, in feces is a characteristic symptom of hemorrhoids. In this case, immediately go to the doctor, because the disease progresses.

• prolapse of hemorrhoids – already directly indicates the presence of hemorrhoids and the need for its urgent treatment.

If you understand that you have a health problem in this area, but do not know where to turn, go to a PROCTOLOGIST. You should not waste time and life on self-treatment and folk methods, you just start the disease and give it the opportunity to progress.

Hemorrhoids are a disease that can be cured, any proctologist will confirm this to you. The main thing is the timely appeal for help!

Our medical center will provide you with the most comfortable appointment with a proctologist and the most effective and fastest treatment methods.

Make an appointment with a proctologist by phone:

( 056) 409-3000, (067) 560-01-02

Published: 02/19/2020

Updated : 02/19/2020

( Rating: 4. 60, votes: 5 )

Treatment of hemorrhoids free of charge under the compulsory medical insurance policy – MSZ.RF

Head of the Department of Coloproctology, City Clinical Hospital No. 15 named after O.M. Filatov about a disease that is not customary to discuss.

Hemorrhoids is a disease of our time, with which almost everyone is familiar. And yet, many believe that the symptoms of the disease are more of a joke than a visit to the doctor. Why such a position is dangerous and why it is so important not to ignore the first signs of hemorrhoids, said the head of the department of coloproctology of the City Clinical Hospital No. O.M. Filatova, Doctor of Medical Sciences Eteri Enverovna Bolkvadze.

Sometimes you sit and sit at work, and suddenly it becomes uncomfortable to sit… Is this a reason to talk to a doctor? Yes, because it is quite possible that this is hemorrhoids, when varicose veins of the rectum leads to the appearance and pathological increase in hemorrhoids. Then these nodes, depending on the stage of the disease, can grow, become inflamed, bleed and fall out of the anus.

— How many stages will pass before a slight discomfort becomes unbearable?

• The disease has a chronic and acute form. There are 3 stages of acute hemorrhoids:
• – thrombosis without inflammation;
• – thrombosis with inflammation;
• – thrombosis with inflammation extending to the perianal skin and subcutaneous tissue.

• For chronic hemorrhoids stage 4:
• Stage 1: bleeding without prolapse of hemorrhoids.
• stage 2: hemorrhoids prolapse, which is accompanied by bleeding.
• Stage 3: hemorrhoids prolapse with or without bleeding, the nodes can be set on their own.
• stage 4: large hemorrhoids cannot be reduced by themselves, may or may not be accompanied by bleeding.

— Where does the disease “legs grow” from? What are the causes of hemorrhoids?

One of the main reasons is a sedentary lifestyle. For example, when you are at the computer all day long, congestion occurs in the pelvic organs, varicose veins swell and become inflamed – that’s hemorrhoids for you. The cause can also be malnutrition and, as a result, chronic constipation. Hemorrhoids often occur during pregnancy. There is also a hereditary predisposition to the disease.

It is believed that stress can be the cause of hemorrhoids. There is no direct influence, but experiences can cause constipation, and this, in turn, can provoke hemorrhoids.

— Why is “non-dangerous” hemorrhoids dangerous?

Complications. The inflammatory process in the surrounding tissue in acute thrombosis can lead to the development of paraproctitis, a purulent inflammatory disease.

By the way, the proctology department of the City Clinical Hospital No. 15 named after. O.M. Filatov is the only one in Moscow where anaerobic paraproctitis is seriously dealt with. This is one of the most formidable proctological diseases. Sphincter-preserving plastic surgery for complex fistulas of the rectum, treatment of extensive anaerobic phlegmon of the perineum with further skin plasty of wound defects … These are very complex and expensive operations, caring for patients who have undergone them is a huge job. In Moscow, no one else is doing this important work.

— What are some alarm bells that are important to hear in time?

The first symptoms of hemorrhoids may be itching, burning in the anus, discomfort after stool, spotting. But it is important to understand that bleeding can be a sign of another disease. If at least one of these symptoms is noticed, you need to go to the doctor without delay. Hemorrhoids can only be diagnosed by a specialist after examinations.

Unfortunately, in medical practice there are cases when a patient pulls and endures to the last, and when he comes to us, a tumor is found during examination. How many of these young patients we see, who should not be treated, but saved. ..

“… proctological department of the City Clinical Hospital No. 15 named after. O.M. Filatov is the only one in Moscow where anaerobic paraproctitis is seriously dealt with.”

— What types of diagnostics do you need to be prepared for?

Timely diagnosis is very important. It is recommended to visit a proctologist annually. Here is a list of studies that are in the arsenal of a proctologist:

• – Finger examination.
• – Anoscopy, when using a disposable anoscope (they come with illumination), a specialist evaluates the condition of the anal canal and the distal part of the rectum. This type of diagnosis is no less important than a colonoscopy.
• – Sigmoidoscopy, in which the intestine is viewed at 25 centimeters, due to which it is possible to assess the condition of the anal canal, rectum, distal part of the sigmoid colon.
• – Colonoscopy (recommended every two years) is performed if all the tests performed did not reveal the disease. If it is difficult for a patient to withstand a colonoscopy, an irrigoscopy (X-ray with contrast) is done.

Is it necessary to operate on hemorrhoids?

Of course not. It all depends on the stage of the disease. If we are talking about the initial stage, the patient feels only discomfort, itching and burning, then the specialist prescribes ointments, suppositories, therapeutic nutrition to prevent constipation.

When it comes to stage 3-4 disease, if a person has thrombosis more than twice a year, external hemorrhoids swell and fall out of the rectum, and the bleeding is so profuse that it causes anemia, surgery is needed.

— How can a proctologist help in such cases?

In the initial stages of hemorrhoids, if the internal nodule is small, but it bleeds, a procedure such as sclerotherapy is performed. As a result, the bleeding stops.

If the hemorrhoid is large and prolapsed, which is common in older patients, hemorrhoid desarterization with Doppler-guided mucopexy can be done. The essence of the method is to use the Doppler to find the vessel and the upper branches of the hemorrhoidal artery, and then flash them. The blood flow in the hemorrhoid stops and the node immediately decreases.

• Depending on the form and stage of the disease, also apply:
• – Thrombectomy.
• – Sclerotherapy.
• – Sclerotherapy in combination with ligation of the hemorrhoid.

If we are talking specifically about the operation, then this is an open or closed hemorrhoidectomy. In any case, the choice of one or another method of treatment depends on many factors, individual for each patient.

In private clinics, the operation with the HAL-RAR device will be very expensive, but we do it free of charge under compulsory medical insurance.

— What innovative methods are used to treat hemorrhoids?

Minimally invasive intervention using the HAL-RAR device, stands for Haemorrhoidal Artery Ligation (ligation of the hemorrhoidal artery), RAR stands for Recto Anal Repair (mucopexy and mucosal lifting). As a result of the intervention, ligation with latex rings stops the arterial blood supply to the nodes, after which the hemorrhoidal plexuses become sclerosed and return to normal size. Then one or more mucopexies are performed.

The operation lasts no more than half an hour and is absolutely painless, and the risk of complications after it is minimal. The patient can return to a healthy lifestyle within a few days.

In private clinics, the operation with the HAL-RAR device will be very expensive, but we do it free of charge under compulsory health insurance.

— How to reduce the risk of developing hemorrhoids?

First of all, eliminate constipation, that is, eat right: add coarse fiber (vegetables, fruits, cereals) to your daily diet, do not forget to drink water. It is also important to lead an active lifestyle – move more and sit less on the couch.

— Is the treatment of hemorrhoids available under the CHI policy for patients from other cities?

Of course! If you are a citizen of the Russian Federation with a compulsory medical insurance policy, you have the possibility of planned hospitalization in the City Clinical Hospital No.