Mixed or combined hemorrhoids arise due to the location of hemorrhoids both from the inside and outside. At the initial stage, it is difficult to determine the problem of discomfort and take appropriate measures. This is due to the fact that hemorrhoids flow slowly and for a long time passes from one stage to another.
With combined hemorrhoids, the patient can feel more discomfort than with the flow of the internal or external type of the disease. This is due to the fact that the remorsement of internal hemorrhoids can exacerbate the external. And vice versa. When combined hemorrhoids can significantly worsen the patient's condition increased thrombotic education.
Combined hemorrhoids of the 2nd degree is the initial stage of the disease. There are three degrees of development.
With almost as many people as hemorrhoids. This is the most common ailment in proctology. More than 40 percent of all patients of the proctologist are treated with a hemorrhoid problem. This disease is the main dise
Hemorrhoids - a violation of the size of the hemorrhoids, in which the patient feels discomfort in the anal area, such as itching, hypersensitivity, burning, bleeding, pain during defecation and prolapse of hemorrhoids. The removal of hemorrhoids surgically occurs with thrombosis, bleeding and other symptoms.
There are four stages of hemorrhoids:
- Internal hemorrhoids belong to the first stage. With this development of the disease, the patient feels an itch in the anus and a slight discomfort during defecation.
- By the second stage is already hemorrhoids with the deposition of hemorrhoids in defecation. At this stage, the patient feels the itching of the anus, pain during defecation, burning inside the rectum and bleeding.
- The third stage involves the loss of hemorrhoids at physical exertion. This degree of hemorrhoids can be determined visually and to the touch.
- Fourth stage or acute hemorrhoids. Loss of hemorrhoids and the impossibility of their correction. Treatment is performed only surgically.
Contents of the page:
- 1 Occurrence of hemorrhoids
- 2 Internal and external hemorrhoids
- 3 Reasons for the emergence of combined hemorrhoids
- 4 Combined hemorrhoids of 2nd degree: course of the disease and symptomatology
- 5 Treatment of combined hemorrhoids
- 6 Combined hemorrhoids of 3rd degree - symptoms of illness,
- treatment 7 Methodstreatment of the last stage of hemorrhoids
The emergence of hemorrhoids
The appearance of hemorrhoids is due to stagnation of blood in the small pelvis and disruption of its circulation in the hemorrhoidal nodes. In this process, the vessels that are in the rectum are stretched, inflamed, enlarged in size and deformable.
The hemorrhoids themselves, acute or chronic, are divided into three types:
Internal and external hemorrhoids
Inflammation of hemorrhoids can occur from inside and outside the rectum. In what their differences, let's understand.
Internal hemorrhoids are not noticeable externally, it is located inside the anal passage. It can be a harbinger of external hemorrhoids, hemorrhoids can become injured during defecation and begin to bleed. It is accompanied by pain inside the rectum. Treatment takes place with the help of suppositories, ointments, lotions, which stop blood, remove swelling and inflammation.
External hemorrhoids have a non-aesthetic appearance and are determined visually. Can be under the skin or outside the anal opening. With exacerbation, severe pain and bleeding occur. It is treated conservatively and surgically.
Reasons for the emergence of combined hemorrhoids
The causes of the formation of combined hemorrhoids are the same as those of other forms of this ailment. Exacerbations are provoked by identical factors. Formation of external and internal nodes on both sides of the border of the rectum and perineum pass in parallel, that is almost simultaneously.
The reasons for the emergence of combined hemorrhoids include:
- poor blood circulation in the small pelvis;
- childbirth and pregnancy;
- hepatitis C;
- is obese and overweight;
- excessive force;
- inflammation of the intestinal mucosa;
- vascular disease;
- low mobility;
- varicose veins;
- inflammation of cavernous bodies;
- frequent anal sex and stretching anal sphincter.
Manifestations of mixed hemorrhoids
Combined hemorrhoids manifest in a patient imperceptibly. Therefore, patients seek help with a chronic form. This ailment in its chronic form also has two phases - it is:
Phases alternate, replacing each other.
Manifestations of combined hemorrhoids fall on the acute phase. When exacerbation, both internal and external hemorrhoids can become inflamed. The patient feels symptoms that indicate internal and external hemorrhoids. However, there is also such that when some nodes are exacerbated, other nodes go into a phase of remission. About this course of the disease can speak a decrease in discomfort, or the complete disappearance of hemorrhoid symptoms.
Diagnosis of the disease
For the diagnosis of combined hemorrhoids, a patient survey and an external examination of the anus are used. These are the same tools that doctors use to diagnose any kind of hemorrhoids. It is worth noting that a good specialist conducts differential diagnosis, given that many of the symptoms can be similar to the symptoms of diseases associated with oncology. Also, an experienced proctologist can refer for an additional examination to accurately diagnose the patient.
It should be remembered that you need to contact the proctologist for help in time. This will help you overcome the disease with less effort and in a more short time. Also know that chronic hemorrhoids can go from an ordinary disease to cancer( cancer of the rectum).
Combined hemorrhoids of the 2nd degree: the course of the disease and the symptomatology
The higher the risk, the higher the risk of hemorrhoids. The peculiarity of intestinal varicose is that at first it practically does not cause discomfort, and a person can not pay attention to the disease for a long time.
Hemorrhoids are divided into two forms - external and internal. However, there are cases of mixed hemorrhoids. In this case, the patient may experience the following symptoms:
- Pain during defecation.
- Blood or anthrax secretion from the anus.
- Severe itching in the perineal region, possibly burning sensation.
- A person may experience discomfort when walking or other physical activity.
The peculiarity of internal hemorrhoids is that it is more dangerous than external hemorrhoids. A person for a long time may not notice the problem, and thus, internal hemorrhoids can first develop into a chronic, and then into a combined hemorrhoids. If the course of the disease is not interrupted in time, then the patient is waiting for the next stage - combined hemorrhoids of the third degree.
Treatment of combined hemorrhoids
As a rule, with the first signs of hemorrhoids, the most optimal option is the consultation of an experienced coloproctology doctor. The doctor will assess the severity of the disease and prescribe the appropriate treatment. At both the first and second stages of mixed hemorrhoids, surgery is not necessary.
Quite enough coagulation methods in combination with drug therapy. Of course, a person will have to change his usual way of life, carefully monitor his health. The main prevention of hemorrhoids is proper nutrition and timely evacuation of the intestine from stool.
Combined hemorrhoids of the 3rd degree - symptoms of the disease, treatment of
If in the second stage of hemorrhoids the patient still does not feel severe pain and discomfort, then the third stage already makes itself felt in all its glory. Constant itching in the perineum, a painful act of emptying the bowels, streaks of blood in the feces - all this indicates that the disease is progressing.
Hemorrhoidal nodes significantly increase in size, become inflamed and bleed. Often under their pressure, they fall outside, and they have to be set independently. In connection with the constant hemorrhages of the patient hemorrhoids can accompany a serious complication - anemia. Therefore, it is not necessary to delay - it is better to see a doctor right away.
Diagnosis of mixed hemorrhoids
If you contact an experienced proctologist, he can easily diagnose even with a finger examination. But in order to make sure that the hemorrhoids are really mixed, and also to find out the stage of the disease, the patient is prescribed the following examinations:
- Anoscopy. The doctor introduces a special tool into the anal opening, with which he assesses the condition of the rectal mucosa, the presence of cracks and neoplasms.
- Recto-manoscopy. In fact, the same examination as anoscopy. But here is used a little other device - with his help a doctor can assess the condition of the rectum, even if the hemorrhoidal nodes are very high.
The patient will also be given a general blood and stool test.
Many hope that the problem will be solved by itself. But here one should understand one thing. Hemorrhoids are not a disease that can be healed without outside interference. If the patient does not seek qualified help at the first stages, the disease progresses, and otherwise conservative methods can not be avoided - surgical intervention will be required.
Chronic combined hemorrhoids - causes and remission period of
In the absence of treatment, hemorrhoids develop into a chronic form. Usually it is characterized by two stages, which alternate between themselves:
1. Period of exacerbation. The patient feels pain and discomfort in the anus, the hemorrhoidal nodes become inflamed and may fall out.
2. The period of remission. Our body is able to self-repair, small cracks gradually heal, therefore, pain passes. However, the problem itself does not disappear anywhere. In the absence of treatment, with an incorrect lifestyle and heavy physical exertions, the period of exacerbation again begins.
Important! The course of chronic hemorrhoids never ends in one stage. The disease progresses, therefore, each time the patient will feel worse. Chronic combined hemorrhoids in the last stages can be cured only by one method - surgical intervention.
Unfortunately, at this stage the disease carries with it a lot of "pitfalls".The person not only experiences constant inconvenience, a feeling of pain, but becomes exposed to other dangers, for example:
- Anemia. Occurs because of frequent haemorrhage from the hemorrhoids. It is accompanied by strong weakness and dizziness;
- Thrombosis of hemorrhoids. The veins become inflamed and swell, delivering unbearable pain. In advanced cases, the hemorrhoidal nodes acquire a cyanotic color, tissue necrosis may begin.
- Paraproctitis. The disease is contagious. With hemorrhoids, numerous cracks appear in the region of the anal opening. If you do not comply with the rules of hygiene, then these cancers are various infections that cause inflammation.
Combined hemorrhoids 4 degrees - without the help of a doctor can not do!
Consider the last, most neglected, stage of hemorrhoids. This is a pathological condition in which the patient no longer has periods of remission. To diagnose the combined hemorrhoids of 4 degrees will not be difficult - the hemorrhoidal nodes fall out, and they can not be fixed independently.
The patient has a constant discomfort, the quality of life is significantly reduced. A person becomes apathetic and weak because he is tormented by unceasing pain and bleeding. Emptying the bowels becomes a real torture. In addition, there may be numerous erosions in the anorectal area - this is due to the prolapse of hemorrhoids. Hemorrhoids of stage 4 may be accompanied by involuntary discharge of liquid feces, a person can not control the release of gases.
Due to the fact that the dropped nodes fall out, thrombi may appear. And if at stage 3 of mixed hemorrhoids such a condition is a complication, at the final stage of the thrombus is a pathology. Unfortunately, if the disease has reached a critical point, the patient has no chance to recover using conservative methods of healing. Turning to the doctor, be prepared for the fact that you will be assigned surgical intervention. And the sooner it is carried out, the better.
Methods for treating the last stage of hemorrhoids
As a rule, in case of neglected cases, doctors consider the method of hemorrhoidectomy according to Milligan-Morgan or Longo. Both operations are rather complicated, and the rehabilitation period will take at least 2 months.
Hemorrhoidectomy is divided into two types - open and closed. In the first method, the nodes are removed, but the edges of the tissues are not sewn. They heal independently, and it is very important to use medicamentous treatment in order to avoid inflammation and infection of the wound. A significant disadvantage of open hemorrhoidectomy is soreness and frequent bleeding.
In addition, wounds can not heal for a long time. Currently, doctors prefer to use closed hemorrhoidectomy - in this case, the edges of the wound are stitched. The recovery period is significantly reduced, but, nevertheless, the patient is still prescribed concomitant medication - in order to avoid complications. After removal of hemorrhoids and complete their complete healing, the disease usually passes without a trace.
Possible complications after surgery for removal of hemorrhoids
The first days, almost immediately after the patient departs from anesthesia, he will be tormented by severe pain. In order to stop them, doctors use strong analgesics. Also certain discomfort can be caused by tampons and drainages, which the doctor enters after surgery to stop bleeding.
It is very important to follow a special diet. On the first day the patient was recommended fasting - in connection with the fact that immediately after surgery, it is extremely undesirable to empty the intestines - the edges of the wound are fresh, the sutures can disperse, which will entail complications. On the second and third day the patient is recommended to observe the drinking regimen, to eat fractional. Food should be crushed thoroughly.
If you do not follow all the doctor's instructions, the following complications may occur in the patient:
- Bleeding. As a rule, it occurs due to violation of the integrity of the joints or slippage of the ligature.
- Psychological problems - fear of bowel evacuation. In such cases, the patient is prescribed light laxatives.
- If the operation is not performed correctly, the anal canal may narrow. The problem is serious, sometimes it requires repeated surgery.
- Inflammatory processes. They often develop in case of refusal from drug therapy and non-compliance with hygiene rules.
- If a musculoskeletal apparatus has been damaged in hemorrhoidectomy, the patient may suffer from incontinence of urine and feces. This complication is extremely rare.
Very important after an operation is under the supervision of a doctor. From all of the above, we can draw only one conclusion. Hemorrhoids is a disease that requires timely treatment!