Hemorrhoids are soft vein clusters formed by the enlargement and varicose veins of the rectal veins beneath the mucosa and anal canal skin at the end of the rectum. Hemorrhoids is the most common anorectal disease, with a incidence rate of 51.53%. It can occur at any age, and the incidence rate increases with age. According to the different locations of onset, it can be divided into internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids.
The etiology of hemorrhoids is not fully understood and may be related to multiple factors, such as increased intra-abdominal pressure caused by factors such as constipation, prolonged sitting, pregnancy, etc., which weaken the elastic fibers and smooth muscle elasticity of the anal cushion, causing the anal cushion to move downward during defecation and unable to retract to its original position after defecation; It may also be related to various reasons causing increased intra-abdominal pressure, leading to rectal vein dilation, blood stasis, and reflux disorders. There are many high-risk factors for hemorrhoids, such as prolonged sitting, standing, and squatting; Long term alcohol consumption and consumption of large amounts of stimulating foods; Bad bowel habits, such as playing with mobile phones or reading books in the bathroom; Long term diarrhea or constipation, perianal infection; Pregnancy and childbirth; Prostate enlargement and giant pelvic tumors; Frequently lifting heavy objects, etc.
Common symptoms of hemorrhoids include rectal bleeding, hemorrhoid prolapse, constipation, perianal wetness, itching, etc.
1. Hematochezia: Hematochezia is the most common clinical symptom of this disease. Bleeding during defecation can be caused by toilet paper staining with blood. In severe cases, it can appear as drops or sprays of blood. The blood does not mix with the stool, and the stool is red in color. In severe cases, there may be symptoms of anemia such as fatigue, palpitations, dizziness, and pale complexion.
2. Hemorrhoid prolapse: During defecation, hemorrhoids can be seen protruding out of the anus, which can appear bright red or grayish white. Prolapsed hemorrhoids can be self treated at the initial stage, but gradually increase in size and are difficult to self reduce. They must be pushed back by hand.
3. Constipation: Fear of defecation due to bloody stools, pain, and other reasons can cause changes in bowel habits and lead to habitual constipation.
4. Dampness and itching around the anus: The main symptoms are discomfort and dampness in the anus, often accompanied by mucous discharge and sometimes itching.
Regarding the treatment of hemorrhoids: Asymptomatic hemorrhoids do not require treatment and require lifestyle adjustments to avoid worsening; Symptomatic hemorrhoids focus on reducing or eliminating symptoms, with non-surgical treatment being the main approach. If the hemorrhoids are incarcerated, recurrent, and non-surgical treatment is inadequate, surgical treatment is necessary.
1. General treatment: Drink plenty of water and consume foods rich in fiber, such as fresh vegetables, fruits, and whole grains; To develop good bowel habits, maintain smooth bowel movements, and keep the perianal area clean and hygienic; Local hot compress and warm water sitz bath can help relieve pain.
2. Medication therapy: Topical application of hemorrhoid cream and hemorrhoid suppositories can help alleviate pain, swelling, and bleeding symptoms; Intravenous active drugs can improve venous tone and stabilize capillary permeability. Commonly used drugs include citrus flavonoids tablets and Mai Zhi Ling; Symptomatic painkillers such as ibuprofen can be taken.
3. Sclerotherapy or ligation therapy: Local injection of sclerotherapy causes hemorrhoids to shrink. The rubber ring ligation therapy involves inserting a specially designed rubber ring into the root of an internal hemorrhoid, blocking its blood flow and allowing the hemorrhoid to heal due to ischemia, necrosis, and shedding.
4. Surgical treatment: including hemorrhoidectomy, transanal hemorrhoid artery ligation, thrombotic external hemorrhoidectomy, etc.
Prevention of hemorrhoids is also important. Patients with perianal infections, malnutrition, prostate enlargement and other diseases should be actively treated; Pay attention to perianal hygiene, change underwear frequently, and take a shower; Regularly defecate and maintain smooth bowel movements; Avoid prolonged sitting, standing for long periods of time, long-distance travel with heavy loads, and fatigue; Doing more anal exercises is effective in preventing hemorrhoids.