Hemorrhoids for a long time can flow without any visible symptoms. Even in the presence of its rare manifestations, many patients prefer to ignore pathology, experiencing a false shame for their problem. The lack of proper treatment in many cases leads to an aggravation of the disease. In such cases, thrombosis can happen suddenly, and sometimes it can lead to an even more dangerous condition - thrombophlebitis.
Features of the disease
In most cases, the complex nature of the pathology, that is, there are both internal and external nodes. According to the ICD, the disease has the code I84, that is, it belongs to the hemorrhoid group. Also, from recent time, it relates to section K64.5 and the category "perianal venous thrombosis".
Until now, it is believed that hemorrhoids and all associated complications are specific for men, but women suffer from illness too, although less often than the stronger sex. The manifestations of thrombosis in both cases are the same. In women, the list of reasons for the appearance of this pathology is only slightly larger than that of men. This includes inflammation and diseases of the pelvic organs, a low-activity lifestyle.
And how does thrombosis of the external or internal hemorrhoidal node manifest itself during pregnancy? Women with hemorrhoids are not that rare. If you look at the statistics, you can say that women giving birth are 5 times more likely to suffer from it than girls who are nulliparous. A common cause of the problem is the process of delivery, when you have to strain hard. In the risk of hemorrhoids and its complications( thrombosis) are pregnant women who refuse to move enough, as well as not watching their food. Severe food leads to constipation, and is exacerbated by all the difficult outflow of blood due to the increased uterus.
About how the thrombosis of the external hemorrhoidal node looks, you can judge from the photo below.
Thrombosis of the Rhodal Node( Scheme)
Classification and Forms of
The formation of thrombi is, in some way, a natural process, a protective mechanism of the body that is triggered at the time of damage to the vascular wall. Inflammation and hemorrhoidal thrombosis already lead to the development of acute hemorrhoids, classified according to the severity:
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- The first degree is characterized by the appearance of the first symptoms - burning, itching, pain at the time of defecation. Inflammation yet. Symptoms can become brighter at the time of physical activity, as well as after eating a number of foods( alcohol, salty, spicy).Nodes can be as external, they are well palpated and remain sensitive. If internal nodes are involved in the process, the inflammation develops faster. In the absence of therapy, pathology passes to the next level, thrombophlebitis develops.
- In the second stage of the pain become permanent, they become sharper when sitting, bleeding starts, against the background of this there is a rise in temperature. In the perianal region, edema is developed, there is soreness, hyperemia, swelling of the nodes. Against the background of inflammation, protrusions of the external nodes also occur.
- The third degree is particularly difficult. All the signs characteristic of the acute form of hemorrhoidal thrombosis manifest themselves brightly. Patients with this stage of the disease immediately need to be hospitalized.
About, because of what causes there is a thrombosis of the external and internal hemorrhoids, read on.
More details about the features of such ailment as thrombosis of the hemorrhoidal node will be told by a specialist in the following video:
Causes of the occurrence of
Acute thrombosis often occurs not under the influence of any disease, but primarily. It can be caused by sudden lifting of gravity or straining. The latter is especially characteristic of people who have difficulty in stools. Hemorrhoidal thrombosis appears in women in the last stages of pregnancy.
A prerequisite for the appearance of a problem is permanent cold or injury in the anus. Against the background of all these factors, the walls of the veins are damaged, blood begins to actively circulate through them. This leads to the development of a clot. It is he who fills the nodule, blocking the lumen, after which inflammation develops.
Predisposing factors are also the process of natural aging, heredity. About the symptoms of thrombosis of the internal or external hemorrhoidal node, see the next section.
Symptoms of
In the most acute stage of thrombosis of hemorrhoids, the following symptoms develop:
- defecation is painful,
- painful pain,
- urinary retention,
- development of inflammation,
- elevated body temperature,
- edema.
The nodes themselves have a crimson-blue hue, and some areas even acquire a black tint, which is characteristic of necrosis. Bleeding is noticeable already at the last stages of the disease, and the ulcers open immediately on several sites. Sometimes it happens that the formed thrombus emerges independently from the damaged vein. The person in such cases experiences considerable simplification, however it is deceptive. A delay in going to the hospital entails the appearance of serious blood loss.
Pain often occurs suddenly, and a particularly severe syndrome occurs with prolonged compression of the veins by the anus opening. It can subside only with normal hemorrhoids, and with thrombosis, the pain syndrome does not pass even with complete rest, if no methods of treatment are being taken.
Diagnosis
Palpation and rectal examination of the rectum in an acute period of thrombosis is impossible because of sharp and vivid pain. This method is used only after reaching remission. For external cones are characterized by heavy bleeding. Like internal, they have a density, at the time of pressure do not subside, and after the end of palpation, gloves are often stained with blood.
Complete finger examination and examination can not be performed in the last stages of the disease, when a very large number of veins protrude. This method of diagnosis is used only after anesthesia. After the inspection phase, instrumental methods of diagnosis must be assigned. At the time of examination, use a rectoscope or rectal mirror. Studies are necessary to exclude other pathologies that can occur with the same severe pain. Exclude:
- thrombophlebitis,
- malignant tumors,
- rectal polyp,
- cracked anus,
- paraproctitis.
On the treatment of acute and other types of thrombosis of the hemorrhoidal node, read on.
Treatment
Therapeutic
Treatment necessarily involves a complex effect, so it includes:
- Diet. Products should help improve peristalsis. Avoid products that can complicate defecation by causing constipation.
- Wash in cool water. The procedure for the day is repeated several times.
- Enlarged enemas or laxatives.
- Bed rest. It is canceled only with the permission of the doctor.
- Lotions and compresses with cooling, anti-inflammatory or therapeutic effect. It is permissible to use broths of chamomile, manganese water.
- Candles, hemorrhoidal creams that have an analgesic effect.
Local therapy must necessarily be comprehensive, include various lotions, applications with ointments( Levomecol, Aurobin, Ultraproject, etc.).
Medicated
Drug treatment is aimed at preventing possible complications of hemorrhoidal thrombosis and, in fact, to eliminate the symptoms that it provokes. Drugs are administered topically, intravenously, subcutaneously or intramuscularly, using a whole range of drugs: astringents, anti-inflammatory, analgesic and antiseptics.
Anticoagulants are also used because they are able to dissolve blood clots. For this purpose, usually take heparin. This remedy is present in the composition of many medicinal products prescribed for hemorrhoidal thrombosis( suppositories, ointments).Together with it quite often add other medicines with anesthetizing and disinfecting action.
If there is bleeding, then they definitely try to recognize its cause, compensate for the loss of blood. Inside take venotonics to increase the tone of the walls of the veins and reduce swelling. Alcohol-novocaine blockades play an important role in therapy. With their help, you can achieve a reduction in pain.
Treatment with the above described drugs can continue as before the disappearance of hemorrhoids, and before surgery if it is required. In the first weeks, thanks to comprehensive tactics, they achieve improvement of health, normalization of hemoglobin, eliminates. The nodes become progressively smaller, no longer making defecation painful, and then restoring. On this treatment does not end, because at the time of passing the acute phase, the next tactic of action is selected. And in many cases, therapy involves surgical intervention.
Operation
Operations for thrombosis of the hemorrhoidal node may be aimed at stopping bleeding. For example, sclerotherapy is just right for this. In the nodes introduce a special sclerosing drug, preventing further leakage of blood. After the patient's state of health, they try to restore medication. Only after achieving a stable state is selected the method of surgical intervention.
In thrombosis, small invasive methods are completely excluded, so the site has to be removed completely. Thrombectomy is less traumatic, but is suitable only for external thrombosis and with no complications. Such an intervention is not used so often, since it is likely that the blood clot will re-form in this area due to the fact that the venous walls are damaged at the time of surgery.
Hemorrhoidectomy is often performed, both under epidural and under general anesthesia. Often, the Morgan-Milligan operation is performed, in which the vascular pedicles are bandaged or stitched. As for hemorrhoidectomy, it exists in 3 types. Only from the clinical picture will depend on what kind of intervention is required - submucosal, open or closed. The most reliable is considered hemorrhoidectomy, carried out by the Longo method. At the time of the intervention, the site of the mucosal membrane in the rectum is removed, which is located above the dentate line. Thus, the hemorrhoidal node disconnects from the circulation, as a result of which its tissue is replaced by a conventional connective.
About whether it is possible to treat thrombosis of an internal or external hemorrhoidal node at home, we will tell you further.
The following video clip will describe the dezarterization of the hemorrhoidal nodes:
Folk methods
No methods of folk treatment as basic are suitable for the acute stage of hemorrhoidal thrombosis. Only in the form of additional therapy, which is performed against the background of taking medications and using daily lotions, it is allowed to take sedentary baths with medicinal herbs.
Most attention deserves pharmacy chamomile, but you can use other herbs with healing and anti-inflammatory properties. To do this, you must get permission from a doctor, otherwise the risk of harming yourself and prolonging an already complicated treatment is great.
On prevention and diet for thrombosis of hemorrhoids, read below.
Prevention and Diet
To prevent acute thrombosis is much easier than after exposing yourself to long-term treatment and even prompt intervention. One should try to prevent hemorrhoids themselves, and especially patients with pathology of chronic course must be careful. In such cases, it is necessary to pay very much attention to the diet. Only food that is not overloaded with fatty and spicy food can maintain a normal stool. A fairly large proportion in the diet should be given to foods with fiber, as it improves intestinal motility.
The restriction is superimposed on excessively salty foods and alcohol, and the load should be moderate, otherwise the exacerbation of hemorrhoids and the appearance of acute thrombosis can not be avoided. The optimal solution is to maintain a healthy diet and try to avoid all the factors that make it develop.
Complications of
The main complication of thrombosis of hemorrhoids is their necrosis. It can affect large areas: the more extensive they are, the more complex the treatment becomes. Most often, such a complication is observed at the site of pinching cones with an anus or in the case of prolapse of submucosal nodes.
Lack of proper attention will lead to purulent paraproctitis, and he already seriously threatens the patient's life.
Prognosis for thrombosis of internal or external hemorrhoids
Predicting how quickly treatment will help is difficult. It is important to know the exact clinical picture. So, some patients with external thrombosis sometimes are able to live a lifetime without resorting to a specialist. But with acute bleeding, it is dangerous to delay and the intervention should be urgent.
The most negative prognosis is the 3 degree of thrombosis. At this stage, complications in the form of purulent paraproctitis, bleeding, necrosis develop. All this in a complex leads to sepsis, which directly threatens the patient's life and can end catastrophically. In other cases, patients after treatment live a long and happy life.
Even more useful information on the treatment of thrombosis of the hemorrhoidal node contains the video below: