Normally, there are vascular networks in the last part of the large intestine that opens to the outside. These vascular networks, called hemorrhoidal veins, located in the anus (breech) and rectum, have very important functions in our body.
- Hemorrhoidal veins are divided into two as external (external) and internal (internal) according to their location.
- External ( external) hemorrhoids develop around the anus.
- Internal (internal) hemorrhoids develop inside the anus.
WHAT IS HEMORRHOID DISEASE?
In some people, hemorrhoids occur around the anus (anus) and rectum (the last part of the large intestine). The veins become extremely dilated and protrude from the anus. For example, in individuals suffering from constipation, the stool becomes hard and defecation becomes difficult. The individual needs extreme straining and straining to evacuate this hard stool. In the meantime, the layers and veins covering the anal canal are damaged. This causes dilation and swelling in the veins. This enlargement and swelling in the veins is called hemorrhoidal disease, or simply hemorthoid. In this case, the veins cannot perform their normal functions and sometimes cause serious complaints. These signs and symptoms vary depending on which hemorrhoidal group is affected.
External (external) hemorrhoids develop around the anus and are covered with a thin skin. If a blood clot forms in these veins, it will be very painful. The patient says that a hard and painful swelling (breasts) appears on his hand right next to his anus. When they rupture, it causes bleeding complaints.
Internal hemorrhoids develop inside the anus. Painless bleeding is the most important symptom. Sometimes internal hemorrhoids come out of the anus (anus) during defecation and the patient complains of a swelling in his hand. In addition, internal hemorrhoids that come out during defecation and do not go in can cause pain.
CAUSES OF HEMORRHOIDAL DISEASE:
Another important reason is eating habits. When the fiber (fibrous) foods in the diet decrease, hemorrhoidal disease may develop. Irregular defecation habits cause hardening of the stool. Straining during defecation and waiting for a long time in the toilet increases the dilation of these veins. Damage to these vessels during the passage of solid and hard stool through the anus occurs. For this reason, pain and sometimes bleeding occur. Another important factor in regulating defecation habits is the amount of water drunk. It is necessary to drink at least 8-10 glasses of water a day. Drinking small amounts of water can cause constipation. Since constipation will cause straining, complaints about hemorrhoids may increase.
Factors that cause the aggravation of hemorrhoidal disease are:
- long-term constipation or diarrhea
- pregnancy
- genetic causes (hereditary)
br /> - frequent use of drugs (laxatives and enemas) that facilitate defecation
- difficult and prolonged straining to defecate
- sitting on the toilet for a long time (reading newspapers, books, etc.)
- heavy load removal
- consumption of nutrients that cause aggravation of the disease (alcohol, spicy foods)
What are the Symptoms of Hemorrhoids?
Bleeding during defecation (defecation)
.Defecation (defecation) Protrusion of the anus during bleeding, palpable swelling.
.Pain and itching in the anal area (anus).
A colonoscopy should be performed for differential diagnosis in a patient complaining of blood in the stool. Otherwise, other diseases that may cause bleeding may be overlooked.
What Diseases Can Hemorrhoids Be Confused With? What is the Importance of Differential Diagnosis?
It is necessary to consider all anal and colon diseases that cause bleeding from the anus in the differential diagnosis.
Many disorders may occur with bleeding during defecation as the first symptom. Large intestine cancer (colon and rectum cancer), large intestine polyps, hemorrhoidal disease (hemorrhoids), anal fissure (Anal Fissure), inflammation (abscess), fistula formation, inflammatory bowel disease (Ulcerative colitis and Crohn's Disease), Intestinal Prolapse, Incontinence, Itchy Anus Disease, Irritable Bowel Syndrome, Sexually Transmitted Diseases and many other conditions can affect this area. For this reason, differential diagnosis is very important and should be made by a specialist doctor.
Can Cancer develop from Hemorrhoids?
No. There is no relationship between hemorrhoids and cancer. But the signs and symptoms of cancer are the signs and symptoms of hemorrhoid disease. Similar to.
Since the symptoms of hemorrhoids are similar to the symptoms of colon cancers and other digestive system diseases, it should be evaluated by a doctor first when there are complaints. Medicines used by others or drugs randomly obtained from pharmacies without the supervision of a doctor may cause loss of time.
How Are Hemorrhoids Treated?
1- The area affected by the disease (internal and external hemorrhoidal disease)< br /> 2- Stage of the disease
3- The decision should be made by taking into consideration the severity of the complaints.
METHODS USED IN THE TREATMENT OF INTERNAL HEMORRHOIDS
- Regulation of defecation habit
Regular defecation habit treatment It is important for. Avoid sitting on the toilet for long periods of time (smoking, reading newspapers, etc.) and excessive straining. It reduces the tension and pressure in the hemorrhoidal veins and thus hemorrhoids can be prevented from coming out of the anus. During defecation, hemorrhoidal swellings (nozzles-packs) that come out of the anus need to be pushed back again. Otherwise, hemorrhoidal breasts that remain outside may cause pain, bleeding and inflammation.
- Regulating the diet
Increasing the proportion of fibrous (pulp) foods in meals and acquiring regular defecation habits may help. An important issue is to increase the number of fruits and vegetables in your meals and to drink enough water. You should drink at least 10-12 large glasses of water a day. Fruit juice, coffee, tea do not replace water.
- Sitz bath
Sitting in warm water for 10 minutes, several times a day, reduces symptoms (symptoms, complaints).
- Cream-Pomade applications
/> .Interventional Methods
1) Ligation with Rubber Band Method (Band Ligation)
It is used in the treatment of internal hemorrhoids. It is applied to hemorrhoids that protrude and bleed. It is a very good method to tie the hemorrhoid packets (sacs) from their roots. It is a simple application and can be performed under outpatient clinic conditions. The hemorrhoid and the band fall off on their own within a few days, and the wound heals within a week or two. Some patients may experience discomfort and bleeding after this application.
2) Injection (Sclerotherapy)
Complaints of bleeding and not coming out of the anus. It is used in the treatment of internal hemorrhoids that cause tinnitus. A liquid (phenol solution) is injected into the hemorrhoidal veins. Thus, bleeding can be prevented, as well as vascular expansion and prolapse outwards.
3) Laser Coagulation
With the help of a light source laser, the hemorrhoids that cause the complaint are treated and the treatment is achieved.
Locally acting anesthetic (pain relieving) ointments may also be useful in relieving pain after surgery. A warm sitz bath (10-15 minutes) can provide relief.
Treatment with surgery
The palpable breasts that cause bleeding and protrude from the anus are surgically removed or fixed into the anus. It is the best method in the treatment of hemorrhoids that do not respond to long-term and conservative methods. Hemorrhoidectomy surgery is the process of removing the diseased hemorrhoids that cause complaints. Hemorrhoidectomy may require anesthesia (narcosis) and hospitalization.
Hemorrhoidal packets (breasts) can be removed by an open or closed surgical method, or it can be done with a special device called a stapler.
TREATMENT OF EXTERNAL (THROMBOZED) HEMOROIDS
(EXTERNAL HEMORRHOID FILLED WITH CLOTS)
Thrombosed (with blood clot) external (external) hemorrhoids occur with the accumulation of clots in one or more of the hemorrhoidal packets located on the edge of the anus (anus). These appear as blue bumps under the skin around the anus and can be felt by hand. It can generally cause moderate pain, severe pain, itching and discomfort.
Treatment
If the patient complains of severe pain, it is necessary to drain the clot inside the hemorrhoid pack. For this reason, under regional anesthesia (local anesthesia), the skin on the hemorrhoid pack should be cut and the clot inside should be removed. The wound can be left open or closed with a stitch.
HOW CAN COMPLAINTS RELATED TO HEMORRHOIDAL DISEASE BE PREVENTED?
- Preventing constipation
- Eating plenty of pulp (fibrous) food and not using hot and spices
- Drinking plenty of water (8-10 glasses a day) - When the need to defecate is felt, defecate without delaying it. Delaying it may cause straining
- Not spending too much time in the toilet. Sitting and straining for long periods of time, complaining It increases meat.
- Regular physical activity helps digestion.
- Paying attention to cleaning the anal area (anus) after going to the toilet. Excessive cleansing will irritate the skin there. Be careful not to keep this area moist or wet.
Anal Fissure
Anal fissure is a small tear (crack) in the skin covering the anus (breech) area that causes pain, bleeding and itching.
WHAT CAUSES ANAL FISSURE?
Fissure usually occurs following a period of Constipation. Rarely, it may occur following an attack of diarrhea. A tear occurs in this area when a hard, dry (stone-like) stool is forced through the anal canal (anus). Generally, the fissure starts superficially and heals quickly. Sometimes it can deepen and reach the underlying sphincter muscle (the muscle that controls the defecation habit around the anal canal). In this case, the disease has become chronic (ongoing).
Contraction of the sphincter muscle (the muscle that surrounds and controls the anus) prevents the fissure (tear) from healing.
Rarely, the cause of the fissure may be Crohn's Disease or an infection. Treatment of the underlying disease usually results in healing of the fissure. Fissures very rarely cause an inflammatory disease.
DOES ANAL FISSURE CAUSE CANCER?
No. There is no relationship between anal fissure and cancer. However, the signs and symptoms of anal fissure disease may be similar to the symptoms of colon and rectum cancers and other digestive system diseases. Therefore, when there are complaints, it must first be evaluated by a doctor.
WHAT ARE THE SYMPTOMS OF ANAL FISSURE?
Rectal pain: Patients often describe a burning or tearing pain that occurs during defecation. Pain may last for minutes or hours after defecation. Pain is due to spasm (contraction) of the sphincter muscle (the muscle that controls the habit of defecation around the anal canal). Sometimes patients do not want to go to the toilet due to pain.
Rectal bleeding: It is usually a small amount of bright, red bleeding and can be seen on toilet paper or droplet bleeding may occur.
Swelling: Skin swelling may develop as a result of swelling on the outer edge of the fissure. It can be noticed during cleaning of the anal area.
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