Symptomatology

Pathognomonic symptoms of HF are pain, bulging knots and bleeding, which usually develops after or during defecation, and rarely leads to significant blood loss and anemia. Considered a significant cause of rectal bleeding NG should only be when other diseases, most often leading to this state. In most cases, hemorrhoidal bleeding is noticed on the trail of blood on toilet paper.

Exacerbation of HF is always more or less painful. Ulceration, or thrombosis of the nodes can cause severe pain, in some cases, disabling the patient. Very strong pain syndrome develops when a particular form of the disease an acute attack of hemorrhoids, which refers to impairment of sharply swollen or thrombosed hemorrhoids. Thrombosis NG can lead to bulging of the perianal region and the typical foreign body sensation in the anorectal region and, in some cases, complicated by gangrene of hemorrhoids.

SH decompensation in most cases is less painful than NG. SH characteristic for a sense of incomplete defecation or her inability, a feeling of fullness in the rectum syndrome "laced" rectum [3].
The main criteria for the diagnosis of decompensation of hemorrhoids

* Anorectal bleeding
* Characteristic pain syndrome
* Bulging hemorrhoidal
* Unnatural discharge from the rectum
* Swelling and abnormal sensation in the perianal area
* Dissatisfaction with the act of defecation

When SH is also possible discharge of mucus or pus in the stool. SH III and IV stages can be brand viagra complicated by thrombosis, ulceration and gangrene nevpravlyaemyh or affected by PG, which is accompanied by increased pain, signs of systemic toxicity and / or fever.

At the end of the often recurrent course in WG may be formed failure of internal sphincter and rectum and fecal incontinence.

Diagnosis

In a survey of the patient, in addition to the collection of active complaints, be sure to specify the nature of the bowel, the parameters of the chair, the mode of using laxatives.

The diagnosis of an acute attack of hemorrhoids, NY, or thrombosis of hemorrhoids is easy to put under examination the anus and rectum in the normal state, as well as straining the patient kolennoloktevom position and with good lighting. Perianal and rectal finger study rectovaginal study in complicated hemorrhoids may be accompanied by severe pain and therefore in need of a terminal surface anesthesia.

Detailed diagnosis of WG, as well as a differential diagnosis with other diseases of anorectal band performed at anoscopy or sigmoidoscopy to the level of 15-60 cm above the anus. For the formation of the diagnosis and choice of adequate treatment strategy is viagra the search for drugs important to remember anatomofiziologicheskih differences between external and internal hemorrhoids cause different pain sensitivity and risk of systemic complications in these two forms of the disease [3]. In clinical practice, not uncommon, and concomitant localization of the hemorrhoids.

Treatment

The choice of tactics and methods of hemorrhoid treatment in each case based on: assessment of severity of patient's general condition, severity of pain and degree of disability the patient, location and severity of hemorrhoids, the presence of complications, such as impairing or thrombosis of hemorrhoids; plans for a patient to treat the disease in future. Figure 1 reflects all the currently known methods of hemorrhoid treatment.

Conservative therapy

Drug therapy is widely used for a course of planned and preventive treatment of hemorrhoids, as well as in preparation for radical surgery or noninvasive surgical treatment, and as part of combination therapy in the postoperative period. Decompensation hemorrhoids conservative pharmacological treatment, in most cases local, is a means of providing emergency assistance to the patient [1].

Main part of conservative therapy - the use of topical agent for the rapid and effective analgesia anorectal zone. To this end, traditionally used surface mestnoanesteziruyuschih drugs: benzocaine, dicaine and others that may be used by applications, but more often in combined ointments, creams and suppositories. Traditionally in officinal formulations for the treatment of hemorrhoids combined with anesthetics mestnodeystvuyuschimi anti-inflammatory and astringent agents or glucocorticoids. As part of the complex before or postoperative therapy, as well as in complicated forms of hemorrhoids for analgesia and anti-inflammatory to increasingly use non-steroidal anti-inflammatory drugs.

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