Proctology

What are hemorrhoids?

Although most people think hemorrhoids are an abnormal phenomenon, everyone has them. It is actually a collection of blood vessels and soft tissue in the anus and lower rectum. The rectum is the back part of the large intestine, while the anus is the back part of the digestive system that holds the stool before it leaves the body.

Hemorrhoids cause problems only when they become large and swollen.

Obesity, pregnancy, straining during bowel movements or even heavy physical work and prolonged sitting are examples of increased pressure in the abdomen that causes hemorrhoids (swelling in the anal or rectal veins). Certainly, a diet poor in fiber, that is, the use of fast and spicy food, does not benefit them at all.

A burning sensation when having a bowel movement, severe pain, painless bleeding or mucus, and itching in the area of ​​the anus, probably suggest that you are suffering from hemorrhoids. You are not alone - it is estimated that three out of four people have hemorrhoids at some point in their lives. Most often, these are people between 45 and 65 years old, but due to the specific way of life that involves sitting, this phenomenon is increasingly common among younger people as well.

Division and stages of hemorrhoids

The dominant division of hemorrhoids into two main categories: internal (which arise in the rectum) and external (which originate in the anus). Doctors classify them in four stages:

• Hemorrhoids of the first degree: They may bleed but do not prolapse. These are slightly enlarged hemorrhoids, but they do not extend beyond the anus.
• Second degree hemorrhoids: They prolapse and resolve on their own (with or without bleeding). They may come out of the anus during certain activities such as passing a stool and then return to the body.
• Third degree hemorrhoids: They prolapse and must be manually pushed back.
• Fourth degree hemorrhoids: They prolapse and cannot go back into the anal canal. This grade also includes hemorrhoids that are thrombosed (containing blood clots).

Diagnosis of hemorrhoids

The goal of the examination is to determine the type of hemorrhoids, but it is even more important to rule out other causes that may have similar symptoms and require different treatment (anal fissures, fistulas, infections, tumors).

Despite the inconvenience, hemorrhoids should always be professionally examined. The doctor will first ask you to describe your symptoms, carefully examine the area, and then perform a digital-rectal examination. If necessary, rectosigmoidoscopy or colonoscopy will be recommended.

How to treat hemorrhoids?

Treating hemorrhoids is extremely important because they tend to get worse over time. In addition to a high-fiber diet and creams, treatment includes various medical procedures:

Anal fissure

An anal fissure is a shallow crack in the lining of the anus, and since the symptoms are similar to hemorrhoids, it is often mistaken for them. The fissure starts just inside the anal opening and extends 0.5 to 2 cm along the anal canal.

It is extremely painful. Passing stool irritates it, so the anal sphincter muscles can react by starting to spasm. The pain is further aggravated if the stools are hard or watery.

Anal fissures usually heal in a few weeks, however those that do not heal in 4 to 6 weeks are called chronic fissures. The causes can be different: constipation, hard stool, diarrhea or childbirth.

Anal fissure treatment

Frequent and proper anal hygiene is required, as well as maintaining soft stools. But quite often anal fissures reappear. This is where one of the most modern methods of treatment helps - botox injections.

To heal fissures, botox injections are applied around the anus, which reduces muscle spasm. Consequently, the action of Botox reduces pain and increases blood flow to the fissure, which contributes to faster healing. The procedure takes a few minutes and you can immediately return to your activities.

Pilonidal sinus

A pilonidal sinus (or pilonidal cyst) is a lump in the coccyx area that can last for months, be painful and occasionally discharge. It can occur once, but more often it occurs several times in a row, causing pain and requiring surgical intervention.

The exact cause of this condition is unknown, but it is believed to be a combination of hormones, hair growth and friction from sitting for long periods of time. The body recognizes the ingrown hair as a foreign body and creates an immune response that forms a cyst.