It is often heard that ten men and nine hemorrhoids, ten women and ten hemorrhoids. Although this statement is not evidence, the incidence rate of hemorrhoids can be seen at any age group. What is more, more than half of the 50 year old people have hemorrhoids. So what is hemorrhoids? Clinically, it refers to the soft venous mass formed by the expansion or varicosis of the venous plexus under the mucosa at the end of the rectum and under the skin of the anal canal. Patients can show symptoms such as bloody stool, prolapse of hemorrhoids, anal pruritus, dampness and so on.
According to the location of hemorrhoids, they can be divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. The most common in clinic is internal hemorrhoids, which is located above the dentate line. It is mainly characterized by bloody stool, prolapse of hemorrhoids and anal discomfort. According to the degree of prolapse, internal hemorrhoids are divided into 4 degrees:
Degree I, bleeding only during defecation, hemorrhoids do not come out of the anus;
II degree, hemorrhoids prolapse out of the anus during defecation and return to the anus after defecation;
III degree, hemorrhoids prolapse outside the anus and need hand assistance before they can be returned;
Grade IV, hemorrhoids are outside the anus for a long time, and can't be returned or will come out immediately after returning.
External hemorrhoids occur below the dentate line and are divided into varicose external hemorrhoids, thrombotic external hemorrhoids and connective tissue external hemorrhoids; The main clinical features were conscious swelling, pain and foreign body sensation.
Mixed hemorrhoids are located at the same point above and below the dentate line, and their surfaces are covered by rectal mucosa and anal skin respectively. Their clinical manifestations have dual symptoms of internal hemorrhoids and external hemorrhoids; Mixed hemorrhoids are often formed when internal hemorrhoids develop above grade III. If mixed hemorrhoids are aggravated, they can fall out of the anus in a ring, which is called circular hemorrhoids. If they are not restored to the anus in time, edema, blood stasis, even necrosis and severe pain may occur, that is, "strangulated hemorrhoids" or "Incarcerated Hemorrhoids". In addition, hemorrhoids can also lead to hemorrhagic anemia, thrombophlebitis and other complications.
Got hemorrhoids can produce anal itching, anal dampness, pain and other discomfort. Should hemorrhoids be surgically removed? In fact, there is no need to treat asymptomatic hemorrhoids. As long as you increase fibrous food, change bad stool habits, keep stool unobstructed, prevent constipation and diarrhea, etc; For symptomatic hemorrhoids, it is important to reduce or eliminate symptoms. For example, hot bath can improve local blood circulation. Sometimes thrombotic external hemorrhoids can relieve pain after local hot compress and external application of anti swelling and analgesic drugs. Simple hemorrhoidectomy can be used for grade ⅱ ~ ⅳ internal hemorrhoids and mixed hemorrhoids; Stapler hemorrhoidectomy can be used for grade III and IV internal hemorrhoids, grade II internal hemorrhoids and circular hemorrhoids that fail to be treated by non-surgical treatment, rectal mucosal prolapse, etc; For the treatment of thrombotic external hemorrhoids, thrombus can also be removed by thrombus external hemorrhoid stripping. There are other treatment methods, such as injection therapy, rubber band ligation therapy, Doppler ultrasound-guided hemorrhoid artery ligation and so on. Most patients can be cured by conservative treatment, and patients with severe symptoms can also be cured by surgery, but there is the possibility of recurrence.More recommended