Clinical course

Bleeding is one of the main symptoms of hemorrhoids, but at the same time, the continued allocation of blood from the anal canal should be regarded as a complication of the disease, leading to severe anemia with decreased hemoglobin to 40-50 g / liter.

Equally, the inflammatory process, developed in the surrounding tissue as a result of thrombosis, hemorrhoids, and often leads to acute paraproctitis is also a complication of hemorrhoids. Prolonged loss of hemorrhoids, especially in the elderly leads to a lack of anal sphincter and flatus, and sometimes liquid intestinal contents.

Recognition of hemorrhoids is not difficult. The diagnosis is usually brand viagra set at the poll and the first examination the patient. On examination should assess the state of the skin of the anal area, the degree of loss of hemorrhoids, the possibility of self-reposition the anal canal and the severity of bleeding. Hemorrhoids are defined as vybuhayuschih intestine in the formation of dark-cherry-colored soft elastic consistency, covered with a mucous membrane. With finger-study should determine the functional state of the obturator apparatus of the rectum. It is possible to establish the presence of compacted hemorrhoids, anal polyps or papillae. Dropping out internal nodes clearly prolapses from the anus during straining.

The differential diagnosis must first conduct a rectal prolapse, in which the drop-down education is cylindrical in shape with clear boundaries. Also, hemorrhoids must be distinguished from the dropdown hypertrophied anal papillae, genital perianal warts, villous tumor and colon cancer.

Acute hemorrhoids on the clinical course is divided into three stages. The first stage is characterized by thrombosis of the external and internal hemorrhoids with no inflammatory process. For the second characteristic feature is the addition of an inflammation of hemorrhoids. In the third stage in the background of thrombosis and inflammation of hemorrhoids develop inflammation of the subcutaneous tissue and perianal skin.

Chronic disease should be divided into four stages. For the first stage is characteristic of only a selection of red blood from the anus during bowel movements without the loss of hemorrhoids. The second stage is characterized by the deposition of hemorrhoids, but independent of their reduction in the anal canal (with or without bleeding). Sign of the third stage is the periodic loss of nodes of the anal canal with the need to reposition their hand (with or without bleeding). The fourth stage is a permanent loss of hemorrhoids from the anal canal with the mucosa of the rectum, the inability to reposition them in the anal canal with the manual benefit (with or without bleeding).

Drug treatment of hemorrhoids

The indication for drug treatment are the initial stages of chronic hemorrhoids and acute course of the disease. This therapy consists of general and local treatment. Certainly, in acute hemorrhoids shown conservative treatment. However, it should be noted that its prevention first and foremost is the normalization of the digestive tract, the treatment of constipation, which occurs more than 75% of patients suffering from hemorrhoids. We assign enzyme preparations, affecting flora, and peristalsis of not just a byproduct small intestine and large intestine, hydrophilic colloids (dietary fiber) during the regular and adequate fluid intake. To this end, our country has traditionally used wheat bran, sea kale and flax seed in their natural form or in the form of pharmaceutical preparations. Abroad often use the seeds and husk psyllium and flaxseed in the form of drugs such as regulaks, fayberlaks and others that have a high water-holding capacity. Our task does not include the analysis of drug therapy of irritable bowel syndrome. However, the consistency of the regulation of intestinal contents and the time of its transit through the colon is a prerequisite not only prevention but also the successful treatment of hemorrhoids.

Local treatment

Local treatment is aimed at eliminating pain, thrombosis, or inflammation of hemorrhoids and bleeding. When selecting the topical treatment of acute hemorrhoids one must take into account the prevalence of symptoms of pain, thrombosis, the prevalence of inflammation and the presence of a destructive component. When bleeding should clearly estimate the blood loss, and its activity and severity of post-hemorrhagic anemia.

Pain syndrome is usually caused by hemorrhoids thrombosed haemorrhoid infringement or the appearance of acute anal fissure. Most often in the mechanism of its formation is a spasm of the anal sphincter, associated with inflammation in hemorrhoidal node. Therefore, to eliminate pain demonstrates the use of non-narcotic analgesics and local anesthetics combined. For the local treatment of hemorrhoids, we use drugs such as aurobin, ulraprokt, proktoglivenol and others from this group stands out for its efficiency neflyuan new drug containing a high concentration of lidocaine and neomycin.

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