Hemorrhoids is the most common disease in the Coloproctology. According to different authors its prevalence ranges from 11 to 24% among adults, mostly working-age population.
Hemorrhoids are a pathological increase of hemorrhoids, the main manifestations of which are the periodic bleeding from the sites, their disappearance from the anal canal, and the frequent inflammation. Internal hemorrhoids are located in the submucosal layer of the rectum to the anorectal line. External hemorrhoids are located under the skin of the perineum in the projection of the external sphincter.
Hemorrhoids are manifested in two major syndromes - acute attacks and chronic disease course.
Works of national and foreign scientists determined that the basis for pay attention hemorrhoids is pathology of the cavernous vascular structures embedded in the course of normal brand viagra embryogenesis in the submucosal layer of distal colon. One of the causes of hemorrhoids is vascular dysfunction, leading to an increased inflow of arterial blood in the cavernous bodies and reduce the outflow of cavernous veins, which leads to an increase in their size and the development of hemorrhoids. The second leading factor is the degenerative processes occurring in the longitudinal muscle, submucosal layer of the rectum, and bunch of Parkes, retaining hemorrhoids in the lumen of the rectum. Under the influence of unfavorable factors is an increase of hemorrhoids, their displacement in the distal direction, and ultimately - loss of the anal canal. Most of these violations occur in high-risk groups, which include people suffering from constipation, engaged in heavy physical work or sedentary occupations.
Hemorrhoids are manifested in two major syndromes of acute attacks and chronic disease course. In essence, these syndromes are the phases of the same process.
The basis for the development of acute hemorrhoids is often thrombosis of hemorrhoids. At the same time, the inflammatory process, developed as a result proktosigmoidita, mucosal lesions haemorrhoid dense feces can also be a cause of acute hemorrhoids. Thrombosis of hemorrhoids is characterized by increases and the seal and accompanied by pain in the anus. Often appearing tissue edema and inflammatory infiltration gives the impression of infringement of hemorrhoids. In some cases, acute inflammation accompanied by edema and necrosis of the perianal sites. Thrombosis usually begins at the internal nodes and extends further to the outside. This process is usually accompanied by severe pain in the anus. Less often isolated thrombosis of the external nodes, which is manifested in the form of a dense rounded education.
A typical symptom of chronic disease course is made up of repetitive bleeding associated most often with defecation and prolapse of hemorrhoids from anus. Bleeding as a leading symptom of hemorrhoids, there is more than half of patients. Second in frequency is a symptom of hemorrhoids prolapse hemorrhoids. Between increasing duration of disease, its stage and the frequency of loss of hemorrhoids there is a direct relationship. Prolapse of hemorrhoids, as the first symptom noted when referring to a doctor in a small number of patients. With increasing duration of disease (more than ten years) the number of patients with prolapse of hemorrhoids almost twice the number of patients with bleeding from the anus.
The most common cause of primary treatment to the doctor is the separation of blood from the anus. In 80% of patients have a selection of red blood at stool or shortly afterward. In 19% there is an evolution of blood from the anus, regardless of defecation. In some patients a permanent allocation of blood leads to anemia. Most often stands without red blood clots, and much less dark blood with clots.
Anorectal bleeding not only the main symptom of hemorrhoids, but also a characteristic symptom of other diseases of the colon. Manifestation of this symptom is possible with diverticulosis, ulcerative and granulomatous colitis, and most importantly for malignant tumors of the colon. Under the guise of hemorrhoids, especially in the allocation of blood from the rectum, often occur, diseases such as polyps and colorectal cancers. Therefore, for any manifestations of gastrointestinal discomfort, especially in the allocation of blood from the rectum to perform her finger study rectoscopy, columns or irrigoskopiyu.
Dull, constant pain, typical of a long disease course with frequent relapses are fairly common reason for seeking medical attention. The main cause of pain in chronic hemorrhoids is often a chronic anal fissure. Discomfort and anal pruritus, especially pronounced in patients with irritable bowel syndrome or other functional disorders of the gastrointestinal tract, are more typical of late-stage disease. Virtually all patients with mucus from the anal canal marked comorbidity rectum and colon. Consequently, these symptoms can not be called pathognomonic for hemorrhoids.
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