One of the most common complications of hemorrhoids is thrombosis of the external hemorrhoidal node. And if in the initial stages of hemorrhoids it is easy enough to be treated, then in advanced cases, with the development of thrombosis, a serious and competent approach to treatment is required. Professional assistance in such cases is provided by a proctologist.
Thrombosis or the so-called acute hemorrhoids develops in about 10% of the adult population. At the same time, a thrombus forms in the external hemorrhoidal node, the disease progresses, giving the patient a lot of inconveniences and constant pain sensations.
- 1 Stages of thrombosis
- 2 Causes and provoking factors leading to thrombosis of the hemorrhoid node
- 3 Symptoms and manifestations of thrombosis
- 4 Diagnosis of the disease
- 5 Treatment of thrombosis
- 6 Operation of thrombectomy of the hemorrhoidal external node
- 7 Sclerotherapy of nodes
- 8 TreatmentThrombosis of the external hemorrhoidal node athome
Stages of development of thrombosis
First degree .Hemorrhoidal nodes small, have a tight elastic consistency. The pains are permanent moderate, accompanied by itching, burning and discomfort. Symptoms intensify with errors in nutrition( alcohol, spicy, fatty foods) or with prolonged sitting.
Second degree .There is quite pronounced hyperemic swelling in the anal region, spasm of the sphincter and severe soreness in the rectal finger examination.
Third degree .Hyperemic and swollen entire circumference of the anus. At visual inspection, there are purple-cyanotic hemorrhoidal nodes protruding from the anus. Dense and jammed nodes can not be inserted into the lumen of the anus. If untreated, they can bleed profusely. Rectal examination in this case is impossible because of severe pain and severe spasm of the sphincter.
Causes and provoking factors leading to the development of thrombosis of the hemorrhoidal node
The primary cause of this condition is experienced proctologists who consider impaired vascular functions of the rectum. With increased intake of arterial blood to the intestine and obstruction of venous outflow, veins proliferate. Overcrowded and dilated veins eventually form nodes. These nodes in the exacerbation of the disease can fall out of the anus and be thrombosed.
In addition, the development of complications of hemorrhoids is facilitated by the following provoking factors:
- Long work in a sitting position and a way of life in which a person moves little. In this case, blood circulation in the pelvic region is disturbed, the blood stagnates, which causes the development of venous insufficiency.
- Prolonged physical activity. Heavy, prolonged physical labor or constant work in the standing position leads to stagnant phenomena, the walls of the vessels lose elasticity, which contributes to the appearance of hemorrhoids.
- Disorders in the work of the digestive tract. With constipation, the feces harden, this prevents the normal flow of blood through the veins. In addition, patients with chronic constipation are forced to strongly push, which in its effect is equivalent to lifting weights. With diarrhea, the anus and rectum experience an adverse effect, they are strongly irritated and inflamed.
- Errors in nutrition and tobacco and alcohol abuse. Under the influence of alcohol, the vessels expand, they accumulate and stagnate blood. Acute, salty, fatty food irritates the intestinal mucosa.
- Tumors and inflammation in the pelvic area. Tumor formation contributes to the influx of blood, with the outflow of which the veins do not cope, there are stagnant phenomena. Inflammatory processes lead to a spasm of the sphincter, as a result of which the veins are squeezed and injured.
- Pregnancy and childbirth. During pregnancy the uterus grows and squeezes the vessels going to the rectum, and attempts at birth contribute to stretching the walls of the intestine and the development of the disease.
Symptoms and manifestations of thrombosis
External thrombosis of hemorrhoids is accompanied by constant severe pain in the anus. It can occur suddenly and, in contrast to the pain that appears in the anal fissure, is not associated with the act of defecation. After evacuation of the intestine with constipation, pain can be intensified.
Any stress that causes a rush of blood into the pelvic area can cause vascular rupture and thrombosis. In this case, the formed thrombus from the inside presses on the walls of the vessel, acting on the nerve endings and causing unbearable painful sensations when walking and sitting. In this regard, doctors note the appearance of the patient a kind of "duck gait."
Simultaneously with pain syndrome, painful edema in the anus is observed. Burning and itching in the anal area, sensation of a foreign body, bleeding can occur. The power of painful sensations is not related to the size of the hemorrhoidal node and even with a small thrombosis it can be pronounced.
The diagnosis of external thrombosis is simple enough and is carried out on the basis of a simple visual inspection of the perianal area. From the anamnesis the doctor can find out details about the development of hemorrhoids and its exacerbations. When examined, there is a strong swelling, capable of masking thrombosis. At the same time, it is different from the drop-down nodes. Sometimes, in the case of postpartum thrombosis, there may be extensive swelling around the anal passage. Finger research and proctoscopy in such cases are not applied due to severe soreness. Usually the outcome of thrombosis of external hemorrhoids is quite favorable. The thrombosed node may necrotic or the thrombus itself breaks out. At the same time, bleeding starts, but the patient's condition is characterized by quick relief. The pain stops, the swelling gradually goes away and falls down.
Prolonged external thrombosis can leave traces on the skin in the form of hemorrhoidal fringes, which are formed due to stretching of the skin in the region of the anal opening. In the future, they can cause itching and interfere with hygiene procedures, so they are best removed under local anesthesia.
Treatment of thrombosis
In case of external thrombosis of the hemorrhoidal node, treatment should be started as soon as possible. This can be conservative therapy or surgery.
In case of acute thrombosis, hospitalization in a specialized proctology department is necessary. Independent attempts to fix a thrombosed node are unacceptable. This can lead to injury to the mucous membrane, cause bleeding and life-threatening complications.
Patient is prescribed a bed rest, warm sessile baths in which potassium permanganate is dissolved, cold lotions with lead acetate every half hour. Assign reception of anticoagulants and a milk-growing diet, inside accept vaseline oil( on a table spoon three times a day).
Safe and effective phlebotrophic drugs, such as Detralex, may be prescribed. They strengthen the vessels and relieve inflammation. In addition, a good local action is provided by multi-component ointments ( heparin, troxevasin, hepatrombin G).Candles for thrombosis of the external node do not help.
Conservative treatment is used mainly with not too painful small thrombosis. After relief of the acute phase of the inflammatory process, surgical intervention is possible. The fastest and most effective way of surgical intervention in thrombosis of external nodes is thrombectomy.
Operation of thrombectomy of the hemorrhoidal external node
The procedure is performed under local anesthesia. During the operation, the hemorrhoidal node is opened and the thrombus removed. A surgical incision is made up to 0.5 cm in length and thrombosed clots are removed. The knot immediately falls, and the pains are stopped, the operation is short, takes only a few minutes.
After this procedure, the patient receives the necessary recommendations and on the same day goes home. On the site of the thrombus remains a small wound, which heals within a few days. Often surgeons offer to completely remove the thrombosed node. This option is preferable, as it excludes further relapse of the disease and the formation of hemorrhoidal fimbria.
In some cases, when an exacerbation occurs against the background of the launched hemorrhoids, under urgent indications a radical operation is performed. After such a surgical intervention, the patient is completely cured of manifestations of thrombosis of the nodes.
At present, modern and minimally invasive methods such as laser treatment, node ligation, infrared coagulation and sclerotherapy have been used to treat thrombosis of external nodes. Let's consider these methods in more detail.
Laser thrombectomy is indicated for the removal of large external nodes. The operation is performed under local anesthesia and lasts about an hour. The laser acts bloodlessly and effectively, immediately after the intervention pain disappears, the anal opening does not deform and maintains its natural appearance. Immediately after removal of thrombi, the patient can return to normal life.
Ligation of external hemorrhoids .The essence of the method is the clamping of hemorrhoids with latex rings and is performed in patients with stage 2-3 hemorrhoids. During the operation, the surgeon uses a special device - an anoscope, with which he finds access to the nodes. Latex rings are then applied by the ligator, which compresses the node, depriving it of food. Over time, it dies and disappears during a bowel movement.
Infrared coagulation .A special device is used - a coagulator acting with a powerful beam of infrared rays. Thermal energy burns mucous near the node, forming a small scar. This scar will prevent the flow of blood into the hemorrhoidal junction, and it will soon be depleted and disappear.
The sessions of sclerotherapy are reduced to the fact that a patient injects a syringe drug into the area where hemorrhoids are actively supplied with blood. Thus, the blood supply of the node is cut off, in time it decreases considerably in size and is sclerized, inflammation and edema disappear, bleeding stops.
Treatment of thrombosis of the external hemorrhoidal node at home
There are quite a lot of folk remedies used in the treatment of acute hemorrhoids. But it is worth remembering that all of them are not effective enough for complications and can be used only at the initial stage of the disease. When developing thrombosis, you can not rely only on herbs and lotions, here you need more cardinal methods of treatment. Therefore, with exacerbations of hemorrhoids, it is best to seek medical help urgently.
In uncomplicated cases, the following folk remedies can be used:
Birch decoction of .For preparation of broth 100 gr. Birch leaves pour 2 liters of boiling water and insist. The ready-made broth is used for taking sedentary baths.
Treatment with leeches .To buy medicinal leeches. One leech is put on each hemorrhoids. It sucks the blood, then it falls off, and the inflamed knot decreases and withers.
Birch tar, .It is considered a very effective remedy for relieving inflammation. Birch tar is lubricated with external cones or injected with a tampon into the anus.
Pochechuyaya grass .The grass is brewed like tea, and is drunk three times a day. This tea helps reduce the symptoms of inflammation and relieve itching.
To soften the stool and eliminate constipation, folk medicine recommends using beets, carrots, melons, grapes, pickled cabbage brine, raw pumpkin. As a laxative and analgesic, it is advised to take a decoction of berries of gooseberry or an infusion of dill seeds. As anti-inflammatory and astringents, decoctions of quince, pomegranate flowers, strawberry leaves or blackberries are good.
All these drugs can be used in conjunction with medications, after consultation with your doctor. At manifestations of acute hemorrhoids, it is better not to engage in self-medication, but as soon as possible to turn to the proctologist's help. The specialist will choose the appropriate method of treatment and help to cope with the disease.