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Anal varices (hemorrhoids) are usually caused by increased pressure due to pregnancy, being overweight, or exercising during bowel movements. In middle age, hemorrhoids often become a permanent ailment. By age 50, about half of the population has experienced one or more of the classic symptoms that include anal pain, itching, bleeding, and possibly prolapse (hemorrhoids protruding from the anal canal). Although hemorrhoids are rarely dangerous, they can be a recurring and painful intrusion. Fortunately, there is a lot we can do with hemorrhoids.
Anal varicose veins – what is it?
Anal varices (hemorrhoids) are swellings that can occur in the anus (also known as the anal canal). Inside the lining of the anus and the bottom of the rectum is a network of small veins (blood vessels). These veins sometimes become wider and swollen with more blood than usual. These swollen veins and the tissue covering them can then form one or more small swellings called hemorrhoids or haemorrhoids.
The exact reason why these changes occur and lead to the formation of anal varices (haemorrhoids) is not clear.. Some hemorrhoids appear to develop for no apparent reason. However, it is believed that pressure in and around the rectum can be a major factor in many cases. It is believed that an increase in pressure in and around the anus can lead to the development of hemorrhoids.
Here are some of the reasons why anal varicose veins may develop:
- constipation, passing large stools (faeces) and straining in the toilet. They increase pressure in and around the anal veins and these conditions appear to be a common cause of anal varicose veins development.
- pregnancy – haemorrhoids are common during pregnancy. This is likely due to the effect of pressure from the baby over the rectum and anus, and the effect that changing hormone levels during pregnancy can have on the veins.
- Aging of the body – the lining of the anus may become less supportive with age,
- hereditary factors – some of us may inherit weakness in the vein wall around the anus.
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Anal varices – types
Types of haemorrhoids – internal haemorrhoids
Internal anal varices form in the posterior canal about 2-4 cm above the edge (opening) of the anus. Their severity and size are classified into grades 1 to 4.
- class 1 – are small swellings on the inner lining of the posterior anal canal. They cannot be seen or felt from outside the anus. First-class anal varices are common. In some people it further grows to a degree 2 or more,
- class 2 – are greater than the first degree. They can be partially pushed out (dropped out) from the anus when using the toilet, but they quickly “jump” back inside,
- class 3 – haemorrhoids fall out. You may feel one or more small, soft, lumps hanging from the anus. However, you can push them back into the anus with your finger,
- class 4 – rectal varices permanently fall out of the anus and cannot be pushed back inside. Sometimes they get quite big.
Symptoms may vary. Small rectal varices (hemorrhoids) are usually painless. The most common symptom is bleeding after using the toilet. Larger hemorrhoids can cause mucus discharge, minor pain, irritation, and itching. Discharge can irritate the skin around the anus. You may have a feeling of fullness in your rectum or a feeling of incomplete emptying of the anus when you go to the toilet.
A possible complication of sagging hemorrhoids (Grade 3-4) is a blood clot (thrombosis) that may form within the hemorrhoid. It is rare, but causes severe pain if it occurs.
Types of haemorrhoids – external anal varices (called perianal hematomas)
External anal varices are less common than internal hemorrhoids. An external hemorrhoid is a small lump that develops along the outer edge of the anus. Much doesn’t cause symptoms. However, if a blood clot (“external hemorrhoid clot”) forms in a haemorrhoid, this can suddenly become very painful and require urgent treatment.
Pain from external haemorrhoid thrombosis usually worsens after 48-72 hours and then gradually subsides over the course of 7-10 days. An external hemorrhoid with thrombosis may bleed a little for several days. It then gradually contracts to become a small spot on the skin. Some people develop internal and external hemorrhoids simultaneously.
See: What is the root of the pain in the anus?
Anal varicose veins – symptoms
The symptoms of haemorrhoids can vary from person to person, and also from time to time in the same person. Sometimes there are no symptoms at all and the person may not be aware that they have haemorrhoids. Rectal bleeding is the most common symptom. This often happens after going to the toilet to pass stools (faeces). The blood is usually bright red and can be seen on a toilet tissue, toilet bowl, or stool cover.
Anal varicose veins can prolapse and can be felt and seen outside the anus. You can usually pick it up after using the toilet. However, with severe haemorrhoids, they remain permanently prolapsed and cannot be pushed back inside.
Small internal haemorrhoids are usually painless. Larger rectal varices can cause mucus discharge, pain, irritation and itching. Discharge can irritate the skin around the anus. You may have a feeling of fullness in your rectum or a feeling of incomplete emptying of the back passage when you go to the toilet.
If any symptoms also begin to appear in you, order NA HEMORRHOIDS – herbal and fruit tea that will help relieve ailments, supporting the condition of blood vessels.
Anal varicose veins – diagnosis
Anal varices can usually be diagnosed with a simple medical history and a physical examination. External haemorrhoids are generally visible, especially if a blood clot has formed. Your doctor may perform a rectal exam to check for blood in your stools. He can also examine the anal canal using an anoscope, a short plastic tube that is inserted into the anus with lighting.
If there is evidence of rectal bleeding or microscopic blood in the stool, flexible sigmoidoscopy or colonoscopy may be performed to rule out other causes of bleeding, such as colon polyps or cancer, especially in people over the age of 45.
If you have a problem with haemorrhoids, regularly drink Hemorrhoids – a mixture of herbs that seal the blood vessels.
Anal varices – treatment
Treatment of varicose lesions of the anus involves the use of a diet rich in fiber, drinking plenty of water and the use of appropriate ointments in the period of exacerbation of the disease or worsening of symptoms. You should also change your lifestyle and increase your physical activity. Some haemorrhoids are surgically removed.
An example of a preparation for haemorrhoids is Anusir ointment for hemorrhoids or Hemorella ointment for hemorrhoids. Yarrow herb, available on Medonet Market in the form of organic tea, supports the treatment of hemorrhoids.
Instrumental treatment of haemorrhoids
1. Sclerotherapy: a method intended mainly for small hemorrhoids. An injection is given under the mucosa of the enlarged nodule, it contains a foam product that causes a clot at the injection site. Then the lump comes off. Within 2-3 days after the procedure, slight rectal bleeding may occur, which stops on its own. Cost: PLN 150-300;
2. Gumming, Barron’s method: used with 7nd and 10rd degree hemorrhoids. The method consists in placing a rubber ring on the base of the tumor, which cuts off the blood supply to it and causes it to die, and then fall off (after about 24-400 days). It lasts a few minutes, after the procedure, you can return to your daily activities as usual, but sometimes the pain may remain moderate. Attention! within XNUMX hours, you should avoid bowel movements and taking medications that reduce blood clotting). Cost of one session: about PLN XNUMX;
3. Laser therapy: irradiating the nodule with laser rays. High temperature causes the vessels to contract and close, and ultimately destroy the tissue of the nodule. The cost is 600-800 PLN;
4. Unipolar and low voltage diathermy: it is a minimally invasive technique that involves acting on the vessels supplying the hemorrhoidal nodules with a current of low voltage and intensity (using two electrodes). This method takes time and patience, but is very effective. Diathermy is most often used in XNUMXst to XNUMXrd degree hemorrhoids.
5. Cryotherapy: is the effect on hemorrhoids with the low temperature of liquid nitrogen or nitrous oxide. This method leads to necrosis and reduction of nodules. The big disadvantage of this procedure is a very unpleasant smell from the anus after its completion.
Hemorrhoid gels and suppositories, e.g. Anusir hyaluronic acid suppositories, are also helpful in home treatment of haemorrhoids.
Ointments for haemorrhoids
Various preparations and ointments for haemorrhoids are commonly used. However, it should be remembered that they do not “heal” haemorrhoids. However, they can relieve symptoms such as discomfort and itching.
A mild soothing cream, ointment or suppository can ease any discomfort. Several brands are available over the counter. Ask your pharmacist for advice. Follow the instructions on the package for how to use.
An ointment that contains an anesthetic may help relieve pain. Only use one of them for a short period of time (5-7 days). If used for a long time, the anesthetic may irritate or sensitize the skin around the anus. The pharmacist should help you choose the right ointment.
An ointment that contains a steroid may be recommended by a doctor if there is a lot of inflammation around the hemorrhoids. Steroids reduce inflammation and can help reduce the swelling around the hemorrhoid. This can help relieve itching and pain. Usually, you should not use a steroid cream or ointment for more than one week.
Very painful prolapse of hemorrhoids is rare. Pain can be relieved by pressing an ice pack for 15-30 minutes. Strong painkillers may be needed.
Pregnancy hemorrhoids usually resolve after the baby is born. Treatment is similar to the above.
You can buy a mixture of herbs for hemorrhoids for sit-ins at a favorable price at Medonet Market.
Surgical methods of treating haemorrhoids
Surgery is mainly required for patients with stage IV haemorrhoids accompanied by other conditions, e.g. anal fissure or perianal fistula. Surgical treatment also requires patients who have failed other methods of treatment.
- Operation Whitehad – during the procedure, the mucosa is cylindrically excised together with the hemorrhoidal tissue with an anastomosis in the anal canal. This surgery has a large number of complications and is usually not recommended.
- Milligan’s operation – Morgana – is a procedure that is used very often. During the operation, the doctor cuts out diseased nodules and punctures the vascular pedicle, leaving the sites for healing after their removal.
- Operation Longo – it is a circular removal and stitching of an element of the mucosa with a hemorrhoidal stapler. The procedure is recommended in the second and third degree of diseases, under local or general anesthesia, for one day. Cost: PLN 2000-3000.
- Operation Park, Ferguson – this is the removal of hemorrhoidal tissue and the ligature of the vascular pedicle of the nodule.
- Selective ligation of the afferent vessels. The method is effective, it does not cause a large number of complications.
For the care of the anus, use HEMOpran – a gel for washing the perianal area, which can be used prophylactically and supportively in the treatment of hemorrhoids.
Home remedies for haemorrhoids
To ease the discomfort of hemorrhoids, there are a few things you can do yourself at home:
- take a sit-down bath. It is a warm, shallow bath that is specifically targeted at this area; most drugstores sell plastic kits that fit your toilet,
- use ice packs,
- avoid straining during bowel movements,
- thoroughly clean the anus and keep it clean after each bowel movement,
- sit on soft surfaces, rather than hard ones, to reduce swelling and prevent the formation of new anal varices.
- take over-the-counter painkillers if needed
- try over-the-counter creams, ointments, or flakes containing hydrocortisone or witch hazel. They can relieve swelling, pain, and itching. (Hydrocortisone products can also make the skin thin or weak, and should not be used for more than a week.)
For hemorrhoids – a herbal mixture of the Polish brand Aromatika you can buy on Medonet Market at a promotional price and large economical packaging.
Anal varicose veins in pregnancy
Anal varices are common during pregnancy, especially in the third trimester, when the enlarged uterus puts pressure on the pelvis and the veins near the anus and rectum. Elevated levels of the hormone progesterone during pregnancy can also contribute to the development of hemorrhoids: progesterone relaxes the walls of the veins, making them more likely to be swollen.
In some women, haemorrhoids may appear for the first time during pregnancy. Fortunately, hemorrhoids are usually not harmful to your baby’s health and will usually go away on their own after birth. You can often relieve symptoms with home care, but check with your doctor first to make sure any treatment is safe during pregnancy.
Anal varices – prophylaxis
Prevention of haemorrhoids should begin with the fact that the feces are quite soft. You can do this as follows:
- eat large amounts of fiber contained in fruits, vegetables, whole grain bread,
- drink a lot of water. Adults should try to drink at least two liters (10-12 cups) a day. Most of the fluid will be excreted as urine, but some will be excreted in the intestines and soften the faeces. Most types of beverages will be sufficient, but alcoholic beverages can be dehydrating and should therefore be avoided.
- eat dietary fiber supplements. If a high-fiber diet does not help, you can use dietary supplements that contain fiber, such as methylcellulose. Methylcellulose also helps to soften the stool directly, which makes it easier to pass it.
- avoid painkillers containing codeine, as they are a common cause of constipation,
- make sure you use the toilet properly. Go to the toilet as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the toilet later. This can result in larger and harder faeces which are then more difficult to pass. Hemorrhoids can make the rectum feel “full”.
The above measures often relieve symptoms such as bleeding and discomfort. This may be sufficient to treat small and non-shedding hemorrhoids (Grade 1). Small grade 1 hemorrhoids often resolve over time.