Hemorrhoids are fibromuscular pillows on the anal canal orifice
What are hemorrhoids?
Hemorrhoids are fibromuscular pillows on the anal canal orifice. Their swelling during tenesmus is a component of the normal mechanism of retention of feces and gases in the colon. In the medical literature, the term “hemorrhoids” is related to a morbid process, called hemorrhoidal lesion. In short, in this text we shall call the hemorroidal lesion as “hemorrhoids”
Hemorrhoids are classified as internal and external. Internal hemorrhoids are located at the inlet anus orifice – inside, and the external on the outlet – outside.
What are the complaints in hemorrhoids?
1. Interior hemorrhoids
Painless bleeding – it is bright red by colour, adhering to feces. Prolapse of tissue from anus
Pain – it is a rare symptom for hemorrhoids, usually pain or unpleasant sense appears in sticking of big hemorrhoids.
Itching – rare symptom for hemorrhoids, it appears more when hemorrhoids are in advanced stage and excrete mucus, which irritates the adjacent skin
Staining of clothes – with bright blood or mucus
Internal hemorrhoids are classified in 4 stages, depending on complaints:
1 stage – bleeding without prolapse (extrusion of tissue from anus)
2 stage - prolapse, which spontaneously retraction
3 stage - prolapse, necessitating manual retraction
4 stage - prolapse, which cant not be retracted
2. External hemorrhoids
Usually they do not cause complaints except if they are not thrombotic. Thrombosis results at tenesmus for defecation or extreme physical loading but may become accidentally too.
Complaints in thrombosis are strong permanent pain in anus and false sense for sitting on hard surface.
At exam, thrombotic external hemorrhoids seem like blue-violet mass at anus outlet.
How to place diagnosis in hemorrhoids?
It is diagnosed by clinical interview and exam by which there is no pain.
What is the treatment for hemorrhoids?
Only the specialist surgeon may define the mode and type of hemorrhoids treatment.
1. Internal hemorrhoids:
Change of mode of life and diet, avoiding constipation – these simple and easy methods yield very good results in the initial stages of lesion.
If these methods appear to be ineffective, then non-operative mode of treatment may be undertaken like sclerotherapy, coagulation with infrared light, binding of hemorrhoids by rubber ligature (special rubber).
Operative modes – they are applied in big hemorrhoids which can not be returacted back into anus.
2. External hemorrhoidsIn the initial 24 to 72 hours from the beginning of complaints i.e. if there is strong pain, operative elimination of thrombotic hemorrhoids is recommended under local anesthesia. After the 72nd hour, usually the pain decreases and waiting conduct is recommended