Description of symptoms and methods of treatment of internal hemorrhoids 2 degrees
The disease itself has 4 stages, the first proceeds almost imperceptibly, but the patient already begins to pay attention to the second. Hemorrhoids of the second degree are varicose vessels with the formation of nodes filled with blood in the rectum and around the anus. At this stage, they acquire a significant size and entail serious consequences.
Hemorrhoids has 4 stages
Symptoms of the disease
The main manifestations of the disease:
- At the 2 stage of hemorrhoids, a constant foreign body in the rectum is firmly felt in patients. This is because the nodes have reached a fairly large size in order to cause discomfort throughout the entire time, unlike the first stage.
- The feeling is not completely empty of the intestines. It is also caused by cones and incomplete feces.
- Constipation (constipation). Due to obstacles, fecal matter is more difficult to get out, as a result of which stool begins to stagnate and solidify.
- Frequent blood in the stool, on toilet paper, and even on underwear. This is caused by the fact that during bowel movement, the cones are damaged, and due to the large amount of blood accumulated in them, moderate bleeding begins.
- Itching burning. With damage and inflammation of the surface of the nodes, mucus begins to stand out, which irritates the anal canal and anus.
- The most noticeable symptom is the periodic loss of bumps during bowel movements. At the 2nd stage of hemorrhoids, the nodes independently return to the rectum. However, with each exacerbation, the process will become more difficult and eventually lose the possibility of self-regulation.
Manifestations and signs of the disease
It is at the second stage of hemorrhoids that doctors detect a patient’s varicose veins, which provokes his appearance. If at the first stage it is impossible to precisely state that a person has hemorrhoids, then in the second stage, you can already see visual manifestations and feel it when walking.
It is very difficult to independently diagnose internal hemorrhoids of the 2nd degree, since the seals of the nodes are located inside.
What are the main signs of internal hemorrhoids of the second stage? Signs include:
- increased bleeding when going to the toilet "in a big way",
- increased itching and discomfort in the anus,
- foreign body sensation inside the intestine,
- bowel movement causes pain,
- sometimes hemorrhoids can fall out of the anus when straining,
- when walking and active physical activity, constant discomfort is felt.
Hemorrhoids of the second stage. Causes
Doctors say that the disease is caused by a combination of many reasons. Untimely access to a doctor and ignoring the symptoms at the initial stage of the development of the disease also leads to its aggravation.
Factors affecting the development of the disease:
- sedentary or standing work, and a sedentary lifestyle. With these aspects, your body becomes more sluggish, your metabolism slows down and your blood circulation worsens,
- eating large amounts of fried and fatty foods, spicy dishes and street food. All this violates the metabolism and the gastrointestinal tract,
- heredity. Often the cause of the development of the disease is a genetic predisposition, especially if you are prone to thrombosis,
- background chronic diseases
- the consequence of birth injuries and severe straining actions,
- alcohol abuse and smoking. This affects the whole body and, in particular, the blood, worsening its condition,
- constant weight lifting
- ignoring the initial symptoms.
The combination of all the above reasons is growing like a snowball, and leads to the development of the disease.
Improper nutrition can lead to hemorrhoids.
Which doctor should I go to?
If you suspect hemorrhoids, you should discard unnecessary embarrassment and consult a proctologist at the clinic. Exactly coloproctologists treat this disease at all stages.
And what to do when there is no proctologist in one's own clinic? In this case, you can consult a surgeon or a general practitioner. You can search for specialists in private clinics, but for this you will have to calculate your budget.
Never self-medicate, improper use of drugs or ineffective treatment will only aggravate the situation, and hemorrhoids will develop further, when there will no longer be no surgical intervention.
The disease has not only stages, but also forms of its manifestation. External and internal hemorrhoids of 2 degrees are distinguished. With an external manifestation, the nodes are located around the anus, having a rather large size and a dark blue color, due to the accumulation of blood in them. This causes discomfort when walking and sitting on a chair.
At this stage, patients usually use special rubber rings with a hole in the middle. When sitting on them, there is no pressure on the anus.
Detection of internal hemorrhoids of stage 2 is a little more complicated. The bumps are located in the rectum and require a finger examination or the use of tools. There are cases when patients are diagnosed with not internal hemorrhoids of the 2nd degree, but polyps of the rectum. This is an increase in the mucous tissue of a spherical or mushroom shape. To establish an accurate diagnosis, anoscopy is performed, allowing you to view up to 10 cm of the rectum, as well as sigmoidoscopy. The second procedure has more features and examines up to a quarter meter of the intestine. When the doctor determines the exact stage, then appropriate treatment 2 or another established stage is prescribed.
Treatment of internal hemorrhoids 2 degrees
A true professional in his field, when detecting internal hemorrhoids of stage 2, will insist on conservative treatment, that is, without the help of surgical intervention. To do this, he will offer to take special medications in the form of tablets, ointments, suppositories. The use of traditional medicine methods is not excluded.
How to treat hemorrhoids 2 tbsp.
Before correcting the investigation, the cause must be eliminated. Review your diet for hemorrhoids and establish a balanced diet. Start taking small breaks during work to be a bit like. Treatment of the second stage of hemorrhoids involves a full range of medicines: tablets, ointments and suppositories.
It is recommended to pay attention to the veins and vessels of the rectum. For this, very common drugs are prescribed for thrombosis or varicose veins - Troxivazin, Detralex.
They are taken for several months. For direct exposure, especially for external manifestation, an ointment from hemorrhoids helps well. To eliminate pain, use candles:
Treatment of the second stage of hemorrhoids almost always requires surgery. Only medicines can no longer cope. However, in the case of a not very advanced disease, minimally invasive procedures are performed. There are quite a few such treatment methods; the doctor selects the method of operation for each patient individually.
Treatment of hemorrhoids of the 2nd degree is the most common procedure "Desarterization". It is carried out using a special device that is inserted into the rectum. It has ultrasonic sensors to detect arteries that feed nodes. They are squeezed through a small hole in the apparatus using a special, self-absorbable thread. After the cessation of blood flow, and additional medication, the nodes begin to absorb and be rejected.
Desterterization of hemorrhoids
Sclerosing drugs. Sometimes doctors inject directly into the bumps themselves. They introduce a special tool that stops the power of the node. Soon, the node simply dies. The disadvantage of this procedure is the fact that it has to be repeated about once a year.
Ligation with latex rings. In this case, a special anoscope is inserted into the rectum, with the help of which, the base of the knot is ligated with a latex ring. After one and a half to two weeks, he dies and leaves with the ring. The procedure can be compared with how a ponytail is made.
Sometimes patients, knowing that the nodes are damaged during bowel movements, try to make this process more rare by fasting. Such actions are completely wrong and lead to negative consequences. Without proper nutrition, the gastrointestinal tract is disrupted and its muscle tone decreases, which leads to constipation. He, in turn, can exacerbate the disease.
The treatment of internal hemorrhoids of the second stage begins with the stabilization of the intestines, for this the treatment the doctor prescribes enzyme-containing drugs that support the intestinal microflora and affect its motility. These drugs include Vestal and Regulax.
Also optional high fiber diet, you need to eat more vegetables and fruits, and still drink at least two liters of water so that the stool does not condense and cause pain during bowel movements. You should abandon bad habits during treatment.
Particular attention is given to drugs that tone the walls of the veins. With their help, not only the disease itself is treated, but also the causes that caused its appearance.
For example, Eskusan drops from horse chestnut are such a medicine, Troxevasin and Detralex ointment can also be prescribed, which affect the elasticity of the vessel walls.
All further treatment will depend on the symptoms of the disease. If the patient feels pain syndromes very acutely, then pain medications are prescribed in the form of ointments or suppositories (Nefluan, Ultraproct, Proctoglivenol), tablets in this case are poorly suited, since local drugs are effective for hemorrhoids. Relif and Anestezol candles help very well.
For those who have bleeding during bowel movements, suppositories containing fibrinogen and thrombin are prescribed, which form a special film on the site and do not allow severe bleeding to open.
|Anti-hemorrhoid suppositories and ointments of general action||Proctosedylus, Relief|
|Venotonics and angioprotectors||Detralex, Venosmin, Troxevasin|
For the treatment of hemorrhoids folk methods herbs are actively used: calendula, sage, chamomile inflorescences.
Usually, tinctures are made from them, for this they take grass and water in equal proportions and insist the resulting mixture for some time. Then compresses are made from the tincture and applied to the sore spot.
Good sedentary baths with herbs help. To do this, a herbal decoction is poured into the bowl and propolis is added. In such a bath you need to sit until the water cools down.
As in traditional methods of treating this disease, primarily therapy is aimed at restoring the proper functioning of the intestine. For this tinctures from buckthorn bark, nettle leaves, mint leaves and licorice root are accepted.
The raw material is mixed and every 3 grams of the mixture is diluted with 200 ml of boiling water. The composition is infused for an hour, then filtered and consumed 100 ml 2 times a day for 2 months.
AND the most effective remedy for hemorrhoids is a candle made of potatoes. To do this, a small piece in the form of a sleeve is cut out of fresh tuber, carefully grinded so as not to damage the intestinal wall, and inserted into the anus before bedtime.
The use of pumpkin juice and pulp is good for hemorrhoids. It is enough to drink 100 ml. juice a day and eat about a pound of pulp.
Minimally invasive methods
Is it possible to recover without surgery? It is real to cure internal hemorrhoids of the second stage without surgery.
However, if suppositories, ointments and tablets do little to help, then minimally invasive and radical measures to combat the disease are used. Each of the methods has its own characteristics, the only thing that unites them is a high level of efficiency, in almost 90% of cases a complete recovery is noted.
The disadvantage is the higher cost, as well as possible relapses after 3-5 years. The advantages of minimally invasive methods are their speed; no more than half an hour is allotted to all procedures.
Mini-operations are almost painless, there is no risk of bleeding, in addition, before their implementation does not need special preparation, enemas, etc.
What can be attributed to minimally invasive methods? Laser removal of hemorrhoidal cones, the use of infrared radiation, latex rings and vascular ligation using ultrasound, as well as the Long resection.
Treatment of hemorrhoids 2 stages at home
Patients often turn to alternative methods. Using all kinds of decoctions, poultices and baths. There is nothing wrong. But do not forget that the treatment of hemorrhoids of the 2nd degree is necessary as prescribed by a qualified proctologist. And traditional medicine can only be concomitant in nature.
Folk recipes for hemorrhoids of the 2nd degree:
- drink one glass of sauerkraut juice four times a day before meals.
- take 2 teaspoons of dandelion roots purchased in a pharmacy, boil water and cool. Pour dandelions in a glass of cold water and leave for eight hours. Drink the resulting infusion four times during the day before meals.
- suppositories from hemorrhoids 2 degrees from candied honey (for 2-3 years). Take some honey and add flour or potato starch to it, mix until you get a firm consistency to form a candle. Put it at night, it will help with arising, at this stage, pain.
- boil for 10 minutes 1 tablespoon of dioecious nettle diluted with 1 glass of water. Let it brew while cooling, then strain it properly and drink one spoon 5 times a day.
- Mumiyo-based hemorrhoid ointment. Take a portion of a pill the size of a match head, mix with honey. Lubricate the problem area with the resulting mass.
Do not start the disease. Hemorrhoids 2 stages - this is not a sentence. The nodes in the rectum in the second stage can be easily removed. The main thing is not to let the disease drift.
Causes of pathology
The main reason for the development of hemorrhoids of the 2nd degree is the chronicity of the first stage of the disease due to the lack of access to a doctor, timely therapy. The resulting inflammation of the venous caverns can have internal or external localization. The combined form of hemorrhoidal disease is the most severe. It provokes hemorrhoids of stage 2 progressive varicose veins, which is associated with vasodilation, impaired blood flow in the anorectal region, and stagnation.
Hemorrhoidal nodes increase in size, are injured with each act of defecation, bleed, a secondary infection joins, adjacent to the rectum tissue are involved in the pathological process. The formation of hemorrhoids cones, characteristic for stage 2 pathology, accelerate, provoking factors:
- lack of exercise
- weight lifting
- bad habits,
- "passive lifestyle,
- hereditary predisposition
- exacerbation of somatic diseases associated with vascular pathologies,
- pregnancy, childbirth.
In itself, the second degree of hemorrhoids never occurs, only - as an untreated continuation of the first.
Signs of hemorrhoidal disease stage 2
At the second stage of the development of the pathological process, the disease is chronic. Exacerbations of hemorrhoids happen, but this is due to the attachment of a secondary infection or infringement, thrombosis of the nodes, which rarely happens.
The main symptom of chronic hemorrhoids stage 2 - prolapse of hemorrhoids during bowel movement, with excessive straining. This applies to the internal localization of nodes and, as a rule, forces the patient to consult a doctor. A feature of this prolapse of hemorrhoidal caverns is their independent return to their place after normalization of intra-abdominal pressure.
In addition, internal and external hemorrhoids of the second degree have their own symptoms.
The clinical picture of the pathology is bright:
- pain during defecation is constant (nodes are large, injured by feces),
- anal fissures join, rectal bleeding occurs with every effort,
- rectal caverns become inflamed, at the stage of exudation, fluid begins to ooze from the rectum, which provokes itching, burning, and wetting of the skin of the anorectal region,
- secondary infection occurs, inflammation spreads to the pelvic organs,
- in the second stage, prolonged exacerbations constantly occur, causing discomfort to a person, reducing the quality of life,
- in rectum there is a sensation of a foreign body.
Pain during bowel movements make a person artificially avoid bowel movements, he begins to be afraid to push. As a result, there is a compaction of feces, constipation, which only exacerbates the situation with hemorrhoids of the 2nd degree.
Internal nodes can be considered only with anoscopy: they are large, cyanotic, edematous, inflamed, often overlap the lumen of the rectum.
Symptoms of external hemorrhoids are obvious:
- subcutaneous hemorrhoid cones swell, increase in size,
- they begin to tweak under excessive stress,
- emptying the bowel may cause pain,
- due to inflammation, perianal cracks appear, itching, eczema of the anus,
- secondary infection joins, which provokes the development of paraproctitis.
Traces of blood on toilet paper after defecation should force the patient to consult a proctologist. Any of the symptoms of hemorrhoids of the second stage is a reason for immediate medical attention, since at this stage treatment is possible without surgery.
In the second stage, hemorrhoids can be detected using several diagnostic methods.
Visual examination of the anorectal region reveals external nodes. Additionally, the collected history helps with establishing the root cause of hemorrhoidal disease. Be sure to finger research, so as not to miss the combined form of the pathological process.
Internal hemorrhoids require instrumental examination. Diagnostic algorithm in this case:
- palpation of the rectum is the easiest way to reliably diagnose hemorrhoids,
- obligatory anoscopy - examination of rectum with a rectal mirror in order to visualize the state of nodes, their localization,
- if necessary, a sigmoidoscopy is prescribed - examination of the rectal mucosa with a rectoscope at a depth of up to 30 cm (the presence of cones, cracks, scars),
- if the proctologist has found a formation resembling polyps or a tumor, a biopsy is performed with a mandatory histological examination,
- in complex cases, they resort to colonoscopy - a total examination of the large intestine mucosa using anesthesia or irrigoscopy - examination of the lesion using contrast and x-rays,
- it is necessary to perform a coprogram to determine the state of the intestinal microflora,
- occult blood feces analysis,
- OAC and OAM - as a screening of the general condition of the patient.
The sooner the patient turns to a proctologist for help, the easier the diagnosis.
Treatment of hemorrhoids of the 2nd degree without surgery
The basis of therapy in the second stage of hemorrhoidal disease is complex treatment, including a combination of medicines of different pharmacological groups, minimally invasive techniques. Only in extreme cases, complicated hemorrhoids of 2 stages are treated promptly. Folk remedies are present as a background, are not able to replace drugs, require mandatory coordination with a doctor.
Conservative therapy of hemorrhoids of the 2nd degree can be carried out at home, includes the use of tablets, capsules, suppositories, ointments, taking into account the indications and contraindications for their use, which are individual for each patient.
It must be emphasized that the combined composition of agents for the treatment of hemorrhoids makes their division into groups rather arbitrary, since the spectrum of action of each drug is multifaceted.
The main drugs are presented in the table.
Venotonics - the basis of conservative therapy of hemorrhoids of the second stage, its basis. The essence of the action of drugs is to increase venous tone, strengthen the vein wall, normalize blood flow at the level of the anorectal zone. Effective in any localization of hemorrhoids.
|Drug name||Cost in rubles|
|Detralex||Pills - 640|
|Diosmin||Pills - 565|
|Vazoket||Pills - 600|
|Ascorutin||Pills - 40|
|Troxerutin||Pills - 330|
|Phlebodia 600||Pills - 850|
|Venus||Pills - 490|
|Aescusan||Tablets - 200|
Solution for oral administration - 149
Drops inside - 231
|Venoruton||Pills - 300|
|Doppelherz Venotonic||Drops for oral administration - 370|
|Angionorm||Pills - 461|
|Troxevasin||Pills - 300|
|Ginkor Fort||Pills - 550|
|Hamamelis DN||Suppositories - 100|
Granules for oral administration - 72
NSAIDs - anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs - used to simultaneously relieve pain, inflammation with external and internal arrangement of cones.
|Drug name||Cost in rubles|
|Diclofenac||Pills - 12|
|Naklofen||Pills - 69|
Ampoules for injection - 68
|Nise||Pills - 182|
|Voltaren||Pills - 99|
|Nimesulide||Pills - 29 rubles|
|Indomethacin||Pills - 15|
What happens after the first stage of hemorrhoids?
Inflammation of the hemorrhoidal nodes is divided into several types. The transition to the second degree is associated with a chronic course of pathology. The disease occurs both with the presence of cones on the inner side of the rectum, and near the anus.
However, combined chronic hemorrhoids of the 2nd degree are isolated when the patient has inflammation both inside and out. The development of a disease with internal and external lesions is classified as a severe manifestation. This type is able to accompany hemorrhoids at 2 degrees of course.
In this case, the infection of the nodes increases due to the high probability of tissue damage during bowel movements.
Internal or external hemorrhoids in stage 2 is characterized by varicose veins. This is due to the expansion of blood vessels and stagnation of blood in them. With the course of the second degree of the inflammatory process, an increase in nodes occurs, which leads to unpleasant consequences.
What leads to stage 2 pathology?
The main reason for the development of hemorrhoids is the transition from 1 degree. This is due to provoking factors. If the disease is not found at the 1st stage of development, then the patient continues to lead a normal lifestyle. Therefore, an aggravation of the inflammatory process occurs.
Factors for the development of hemorrhoids 2 stages are:
- reduced or increased physical activity,
- improper diet with fats and carbohydrates,
- body predisposition
- diseases of other systems in a chronic form.
If hemorrhoids passed from the first degree to the second, then the patient has a chronic form. The disease worsens, which is associated with provoking symptoms.
Especially if the patient's work involves heavy physical labor. For the development of the inflammatory process is a combination of factors.
Therefore, people with a genetic predisposition are prone to hemorrhoids at 2 stages of development.
Hemorrhoids 2 degrees: the clinical picture
When internal hemorrhoids of the 2nd degree in a chronic form proceed, then a prolapse of nodes is considered a pronounced sign. This is due to the increase in the size of the cones.
The first time after defecation, inflammation is eliminated independently. If you ignore the symptom, then the patient will need to help introduce the hemorrhoidal node back. The disease is accompanied by frequent constipation.
Therefore, repeated prolapse of the cone does not occur by itself.
With external and internal hemorrhoids of the second stage, frequent bleeding occurs. The process manifests itself due to an increase in the size of the cone and after bowel movement.
In the second stage of node inflammation, the patient has the following symptoms:
- incomplete rectal emptying,
- severe pain during bowel movements,
- itching and burning
- blood inclusions in feces,
- persistent constipation or loose stools,
- loss of cones.
When hemorrhoids occur, pain occurs. In order not to endure discomfort, the patient tries to postpone going to the toilet.
This worsens the state of health and leads to constipation of a psychogenic nature. Frequent prolapse of the cones causes the progression of hemorrhoids of stage 2 and the transition to a chronic form.
For treatment, surgical intervention methods may be required.
Sometimes the loss of hemorrhoidal nodes is mistaken for the appearance of neoplasms near the anus. To make sure the course of hemorrhoids, it is recommended to pay attention to soreness. If the nodes are damaged, the cones become inflamed and bring additional discomfort.
Methods for diagnosing a disease
It is enough to determine the external type of the disease by palpation. However, with internal hemorrhoids of the 2nd degree in a chronic form, the determination of inflammation is more complicated. In this case, the formations are located on the walls of the rectum. To begin with, the proctologist conducts a finger examination.
Sometimes, instead of inflammation of the hemorrhoidal nodes, the formation of rectal polyps is diagnosed. In this case, in appearance, cones are mushroom or spherical in shape.
For additional diagnostics, use the following methods:
To verify the accuracy of the diagnosis, the patient undergoes anoscopy, where they look up to several centimeters of the rectal mucosa. In addition, sigmoidoscopy is used, which allows you to thoroughly examine the inflamed area. After determining the diagnosis, the doctor analyzes the data and identifies the stage.
What methods are used to treat inflammation of the hemorrhoids?
After establishing a diagnosis, the doctor prescribes complex therapy. In extreme cases, surgical intervention is used to treat grade 2 hemorrhoids. General therapy begins with traditional and conservative methods.
In order for the patient to have a positive effect, he needs to follow the recommendations and instructions of the doctor. You can not stop drug therapy if the symptoms are resolved.
Conservative treatment of hemorrhoids without surgery at 2 stages of development is delayed for a long time.
For the treatment of internal and external hemorrhoids of the 2nd degree in a chronic form, it is recommended to use instrumental methods. For this, minimally invasive techniques are used. The use of such methods of surgical intervention is characterized by a low level of injury. Doctors prescribe instrumental methods due to the negative result of drug therapy and diet.
To choose a method of minimally invasive technique, a diagnosis and an in-depth examination of the patient are required.
The following treatment methods are considered minor tissue damage:
There are features of the treatment of internal hemorrhoids with bleeding, where the method of deserterization is used. The technique is carried out using ligation of arteries that exit into the hemorrhoid. The doctor will need to find all the vessels in the affected area using an anoscope.
There is a special sensor in the device. When an artery is detected, the branches are ligated with material. After a while, the connection resolves on its own. Then the vessel located in the nodule dies.
After some time, venous congestion is replaced by connective tissue.
To prevent hemorrhoids with bleeding, sclerotherapy is used. The procedure is carried out using special drugs. They are injected into the venous congestion, and the process of gluing vessels occurs.
After some time, the hemorrhoid resolves. Sclerotherapy is carried out under local anesthesia. Such an operation does not represent unpleasant consequences for the patient.
After removing the recovery nodes is a short period.
Cryodestruction is performed using liquid nitrogen. The destruction of venous congestions occurs under the influence of low temperature. After this, the inflamed areas freeze and die. The technique is painless, and after the procedure the patient does not have bleeding.
Infrared radiation is used to remove nodes. The procedure is carried out using a device that sends a beam to the affected area. In this area, the process of coagulation of protein substances occurs. Blood stops flowing into the bump and dries.
If the patient's hemorrhoidal nodes began to form in 2 stages, then ligation is used. The technique is carried out using latex rings, contracted on the basis of inflammation. In this case, the blood ceases to flow into the affected area. After a while, the cone dries and leaves the rectum on its own.
The use of any minimally invasive technique for removing nodes does not fight the source of the disease. Therefore, after some time, signs of manifestation of hemorrhoids of the 2nd degree or transition to late stages appear.
Prescription of medicines
For the treatment of hemorrhoids of the second stage, doctors prescribe enzyme preparations. Medications help normalize the intestinal microflora and its motility. These medicines include:
Drug therapy includes drugs to increase vascular tone. Of these drugs, Detralex and Troxevasin are used. Drugs are used in the form of ointments or cream. If the patient complains of discomfort in the anus, then prescribe medications with a combined effect. To eliminate discomfort, painkillers Aurobin, Proctoglivenol and Ultraproct are used.
Treatment of inflammation of the 2nd degree is carried out with the appointment of rectal suppositories. When thrombosis of inflamed nodes occurs, local anticoagulants are used. Otherwise, medications with a combined effect are prescribed, which include Hepatrombin G and Proctosedil.
To prevent bleeding from hemorrhoids, the patient is prescribed suppositories with adrenaline. In addition, it is necessary to take topical drugs containing thrombin and fibrinogen. When medicines are injected into the lumen of the anal canal, the substances dissolve.
Therapy in folk remedies
For the effectiveness of the treatment of hemorrhoids 2 stages at home, use folk remedies. In this case, it is necessary to consult with your doctor. Alternative recipes are considered an additional therapy to the general treatment.
At home, the patient is recommended to make baths from plants. The procedure helps relieve inflammation and anal itching. In this case, the doctor selects the correct type of sedentary baths.
To do this, often use infusion of chamomile, birch leaves and hypericum.
In addition, in folk medicine, there are homemade suppositories. The use of candles from potatoes, honey or propolis helps relieve inflammation and pain. For bleeding, ice suppositories are used. Means are prepared from frozen infusions and decoctions of plants. Ice candles help prevent bleeding and eliminate pain.
To eliminate inflammation, it is recommended to use compresses and lotions. A napkin or gauze is moistened in a decoction of herbs or other medicinal product and applied to the anus. If necessary, the tissue is fixed with a medical plaster.
In addition to the basic approaches to the treatment of hemorrhoids, the use of folk remedies requires consultation with a doctor. Some medicines and herbs can cause an allergic reaction. Therefore, pregnant women should adhere to traditional methods of therapy.
Prevention and recommendations for the disease
After surgery to remove hemorrhoids, relapses may occur after some time. Therefore, the patient is recommended to adhere to the doctor's prescriptions.
It’s impossible to completely get rid of hemorrhoids, for this you will need to change your lifestyle. First of all, you should consider your diet. For this, harmful dishes are excluded from nutrition.
To improve digestion, it is useful to include dairy products with medium fat content.
Physical activity is becoming a fundamental factor in the development of hemorrhoids. The patient is required to maintain an average load on the body. For this, walks, swimming and exercises help. So that inflammation does not become infected or does not begin to develop further, it is necessary to maintain your own hygiene.
The course of hemorrhoids at 2 stages of development is associated with the transition of the disease from the first degree. In this case, the cones often fall out and are self-correcting.
After a while, the node has to be injected back to the patient. At the same time, hemorrhoids can be treated at stage 2 using several methods where minimally invasive procedures and drug therapy are used.
Traditional medicine is used after consultation with your doctor.
The information on our website is provided by qualified doctors and is for informational purposes only. Do not self-medicate! Be sure to contact a specialist!
Rumyantsev V.G. 34 years of experience.
Gastroenterologist, Professor, Doctor of Medical Sciences. Prescribes diagnostics and conducts treatment. Expert of the group for the study of inflammatory diseases. The author of more than 300 scientific papers.
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Hemorrhoids 2 degrees: treatment, symptoms and causes
Hemorrhoids are a chronic disease of the venous cavities of the lower rectum. He is called the "reckoning for civilization."
Among the adult population, distribution increases with age from 10% at 35 years to half by 50 years. Men get sick a little more often than women.
Grade 2 hemorrhoids according to the severity of the course corresponds to prolapse of internal nodes into the anal canal during bowel movements with independent return to the place after straining is completed.
The interpretation is the same in the existing classification according to Banov L.Jr. and Goligher.
The explanation adds that the condition is accompanied by bleeding or occurs without it. The Russian version of the second stage involves a link between the manifestations and the beginning of the decompensation mechanism: an increase and extension of hemorrhoids, impaired fixation due to loss of tone of the Parks support ligament.
A rare case of the coincidence of the concepts of "degree" and "stage" in the international community of doctors. Therefore, we will not focus on this attention of readers.
Why does hemorrhoids worsen to stage 2?
The lack of timely treatment at an early stage of the disease leads pathology to regular progression.
Therapy should be started when an attentive person notices symptoms of unclear discomfort in the anus, sometimes blood on toilet paper after bowel movement, a feeling of a foreign body, itchy skin.
Self-healing is impossible. The duration of an organism's resistance depends on many factors; it is determined by:
- work in a long "sitting" or "standing" position - contributes to stagnation of blood in the lower parts of the body, stretching and growth of hemorrhoids,
- low mobility, lack of walking - reduces the rate of metabolic processes, slows down blood flow, causes constipation, this makes any tissue repair difficult, makes a person strain during bowel movements,
- unbalanced nutrition, the prevalence of spicy foods in the diet, which contributes to an increased blood flow to the intestines, a lack of vegetables and fruits (fiber), a craving for fatty, fried meat dishes, and drinking alcohol - it disturbs the blood circulation in the rectal zone in favor of the tide, complicates digestion, and is accompanied by constipation ,
- in women, pregnancy and childbirth, especially bearing twins, polyhydramnios,
- chronic bowel disease leading to diarrhea or constipation,
- circulatory pathology that violates the venous outflow to the right ventricle,
- weightlifting, cycling and horse riding, bodybuilding,
- the presence of a large tumor in the pelvis, compressing the vessels and intestines,
- decreased immunity,
- ignoring the doctor’s advice on treating early symptoms.
Under the influence of these reasons, cavernous bodies are destroyed, bag-shaped external nodes are formed under the skin and inside the rectum (less often the process becomes mixed, capturing both types of formations). In response to stretching, epithelial cells produce kinins, which provoke inflammation and contribute to blood clots.
Gradually, the walls of the nodes undergo dystrophic changes and become thinner. This increases the vulnerability of solid feces, violates the integrity, is manifested by cracks, bleeding. Adherence to the aseptic inflammation of the conditionally pathogenic flora of intestinal bacteria is manifested by a pronounced inflammatory reaction.
Dystrophic changes affect the fixing apparatus of the internal nodes. Parks's ligament is stretched, allowing hemorrhoids to exit into the anus. Sphincter irritation causes reflex contraction of muscle fibers. Therefore, with internal hemorrhoids in stage 2, paroxysmal pain occurs due to pinching of the nodes.
General symptoms for the second degree of the disease
For hemorrhoids of the second degree, the classic symptoms of the disease are characteristic.
- patients constantly feel a foreign body in the anal canal, incomplete emptying during bowel movements, a temporary improvement occurs after an outpouring of blood, then the problem resumes, which is caused by an increase in hemorrhoidal nodes, increased mobility of the internal appearance of formations,
- blood on the feces in some patients becomes frequent, in others it is completely absent, clots may appear,
- the pain is aching in nature, localized inside the anus, indicates local inflammation of the nodes or rectal fissure, at this stage does not go to the surrounding tissues, a change to “twitching” is a sign of suppuration, there may be attacks of acute pain caused by pinching of the nodes,
- the outflow of liquid mucus from the anus causes irritation of the intestinal mucosa, the liquid part of the blood is added to the composition, which is squeezed out of the nodes, the presence of a significant number of leukocytes in the discharge indicates active inflammation,
- weeping of the skin contributes to the support of itching, turns into a burning sensation, patients comb the perineum, small pustules join
- the duration of constipation increases due to a mechanical obstruction in the way of feces, the contents harden and dry out.
For the diagnosis, an important role is played by objective signs obtained as a result of examination and palpation of the anal canal.
The patient needs to prepare for the procedure, cleanse the intestines with an enema. In specialized offices, chairs are used for a comfortable position of the patient.
If not, the examination is carried out on the couch in a knee-elbow position or on the back with knees pressed to the chest.
The doctor checks the condition of the skin around the anus: redness, traces of scratching, weeping, enlarged external bumps are visible on it, reddened internal nodes come out when straining. An important difference from stage III is free independent reduction, returning to a place without outside help.
With a digital rectal examination, it is possible to assess the sphincter tone, density of nodules, size, and soreness.
Anoscopy helps to identify the number of inflamed internal nodes, the condition of surrounding tissues, cracks.
Other examination methods are used to exclude oncological diseases of the lower intestine and genitals. Therefore, women are recommended to consult a gynecologist, men - a urologist.
A gastroenterologist examines the connection of hemorrhoids with another pathology of the digestive organs of patients. It is important to check the condition of the liver, to detect hepatitis and cirrhosis. To do this, conduct biochemical blood tests.
Lifestyle Correction: diet, exercise therapy
To force yourself to move more, it is convenient to start with hiking, ignoring vehicles on the way to work and back. Skeletal muscle movements are transmitted to the vessels and intestines in the form of massage.
Therefore, there is a restoration of venous tone, increased peristalsis. The complex of exercise therapy includes exercises for the pelvic floor (Kegel), abdominal muscles.
It is recommended to perform them daily twice for 15 minutes.
Blood circulation improves swimming, gymnastics, static stress callanetics, Pilates.
Not everyone can change a profession. The hardest things are for drivers of transport, cashiers, office workers, hairdressers, teachers. They need to take five-minute breaks, walk a little for warm-up, do sedentary exercises on a hard chair (to reduce the muscles of the buttocks, the sphincter of the rectum).
The nutritional rules for hemorrhoids require:
- To eliminate constipation - stop eating heavy meat fatty foods fried and smoked, confectionery, sweets. You can eat boiled meat, ground meat dishes, low-fat soups, vegetable hodgepodge, casseroles, salads with vegetable oil, cereals, dairy products.
- Exclude substances that irritate the intestinal mucosa, dilate arterial vessels obtained with food. These include all types of alcohol, spicy sauces, seasonings.
- Add fiber and dietary fiber to the diet due to bran bread, beetroot dishes, carrots, prunes, zucchini, and eggplant.
- We must not forget about drinking water. To stool does not harden, you need to drink up to 1.5 liters of water daily.
With concomitant diseases of the digestive tract, enzymatic preparations (Mezim forte, Creon, Pancreatin), probiotics (Bifidumbacterin, Bactisubtil, Bifiform) are prescribed to activate digestion with the help of useful intestinal flora.
Conservative therapy is used to eliminate symptoms, prepare for the surgical phase of treatment, in postoperative recovery. For elderly and debilitated patients, this is the only possible way to alleviate the condition.
In order to relieve local inflammation and spasm of the external sphincter, warm sessile baths with the addition of a weak solution of potassium permanganate, decoctions of medicinal herbs are recommended. They are carried out 2 times a day. Suppositories with belladonna extract act quickly, are indicated for severe pain, suspected pinching.
To reduce pain, local anesthetic ointments and rectal suppositories are used.
They include anestezin, novocaine, lidocaine. Recommended:
To relieve inflammation of the nodes, rectal suppositories are indicated:
- with propolis, sea buckthorn oil,
- with diclofenac,
- Vishnevsky ointment,
Important! In difficult cases, hormonal drugs are prescribed, but it must be remembered that their long-term use is impossible, since it enhances the destructive processes in the mucous membrane.
Phlebotonics contain plant extracts, flavonoids and synthetic substances (calcium dobesylate). The course application for 2-3 months of Detralex, Venarus, Flebodia 600 is shown. Elderly patients with good tolerance are prescribed rectal suppositories with Nitroglycerin and Nifedipine.
- With a tendency to thrombosis (blood clots are released with feces), candles and an ointment containing heparin (Hepatrombin, Lyoton gel, Nigepan) are added to the treatment.
- If the nodes bleed, then the drug in the suppositories Natalsid is effective.
- Candles and ointment applications are used after hygienic procedures, baths.
As home remedies, traditional healers advertise:
- ingestion of sauerkraut juice, rowan berries, melon, decoction of dandelion roots, nettle leaves,
- making rectal suppositories from old candied honey (mixed with starch or flour), sea buckthorn oil, fresh potatoes, mummies.
It takes a critical approach to the promises of "forever getting rid of hemorrhoids." The disease gives relapses, treatment can extend the period of remission for years.
People with diseases of the digestive system should be especially careful when treating alternative medicine.
You can not take decoctions inside without taking into account the acidity of the gastric juice, the enzymatic activity of the pancreas, and the state of the biliary tract.
It is advisable to use decoctions of chamomile, calendula, sage, added to the water baths used for hygienic processing of the anus.
Stage II pathology is most suitable for minimally invasive methods of eliminating nodes. They do not require hospitalization, are carried out on an outpatient basis. The action is designed for scarring formations and arbitrary rejection after 7-10 days:
- Sclerotherapy - a special drug that causes sclerotherapy is injected into the external node with a syringe. Not shown when internal nodes fall out. The method is supplemented by laser irradiation. In 38% of patients gives relapses.
- The effect of coagulation (cauterization) is obtained by focusing a light beam (infrared photocoagulation) or a laser beam. Relapses occur in every fifth case.
- Cryodestruction with liquid nitrogen.
- The application of latex rings is used for dropped nodes. The cessation of nutrition of the wall is accompanied by wrinkling and drying of the tissue. Effectively in 90% of patients.
- The method of choice is ligation of the leg of the node and flashing of the arterial branch. They are used to eliminate symptoms in debilitated and elderly patients.
The disadvantage of the first three methods is the need for re-conducting.
The indication for classical hemorrhoidectomy is repeated bleeding, concomitant diseases of the rectum and perineum.
What will happen if not treated?
It must be borne in mind that the second stage of the pathology developed due to the lack of treatment at the initial signs. If you do not continue to engage in therapy, hemorrhoids pass into the following complicated forms:
- nodes become inflamed more often, both external and internal,
- bleeding contributes to the development of anemia (anemia) with additional symptoms in the form of headaches, weakness, dizziness, to compensate for blood loss and restore blood counts is not easy,
- infringement and stagnation provoke venous thrombosis, give the clinic an acute emergency, necrotizing the tissues of the node,
- mucosal trauma causes rectal cracks, lack of prevention of exacerbations, untreated inflammation from the nodules passes to the surrounding tissue, the patient is taken to surgery with acute paraproctitis, sepsis.
These conditions can not only affect health, but also threaten the life of the patient.
The second stage of hemorrhoids makes it possible to choose an effective method of treatment and prevent further progression of the pathology. Reluctance to show the doctor an intimate area is severely affecting the outcome of the disease. In this case, excessive shyness threatens the ability to work and is dangerous to health.
In women, hemorrhoids often occur amid stress. Therefore, the doctor may additionally prescribe sedatives. The main methods of therapy are the same.
If a woman simultaneously treats varicose veins on her legs, then it is more advisable to use one ointment for external use, and for suppositories, choose a suppository to avoid overdose.
Treatment of pregnant women is carried out with caution, especially in the first and third trimesters. Many drugs are absorbed into the bloodstream and can harm the fetus.
Frequent use of enemas can cause a miscarriage. Therefore, for pregnant women, the main methods will be diet and lifestyle adjustments, the use of light anti-inflammatory drugs.
How to treat?
To make it as effective as possible, doctor's advice must be strictly observed, and do not stop taking the drugs when the symptoms fade away.
Treatment of hemorrhoids of stage 2 without surgery is long and may take several months.
Usually not without pills, are prescribed:
- Troxevasin, Detralex, which improve vascular tone, eliminate their fragility, and prevent the formation of new nodes.
- To reduce inflammation and relieve pain, the doctor can prescribe painkillers and anti-inflammatory drugs - Diclofenac, Ibuprofen.
Topical treatment is used to relieve symptoms, but almost always in combination with pills.
Effective ointments for hemorrhoids 2 stages:
Hemorrhoids ointment helps relieve inflammation, improve blood circulation and the state of blood vessels, softens, facilitates bowel movements and prevents damage to nodes.
Treatment of hemorrhoids of stage 2 with candles is a more convenient option, especially if the nodes are located inside at a considerable depth.
Which candles are better - the specialist determines, based on the patient's complaints, examination and assessment of the condition.
- Proctosedin reduces pain and relieves swelling,
- Prednisolone relieves pain and burning,
- Hepatrombin G reduces thrombosis.
- To stop bleeding, candles with adrenaline are used.
Novocainic blockade with hemorrhoids stage 2 is rarely carried out, only if other drugs do not relieve pain. This procedure must be performed by an experienced professional.
To improve the general condition and speed up recovery, a proctologist can prescribe lung laxatives and drugs to improve intestinal microflora. They improve the condition of the mucosa, facilitate bowel movement, making it less painful.
For the treatment of hemorrhoids of stage 2 at home, alternative methods are used:
- Sedentary baths with decoctions and infusions of anti-inflammatory herbs (not hot, the water temperature should not exceed body temperature. Too cold is also not an option, since it is possible to cause inflammation of the cones).
- Microclysters using decoctions and infusions of chamomile, nettle. Oil enemas (olive, liquid paraffin) are also used. The volume of the enema should not exceed 100 ml. It is put after cleansing or natural bowel movement. In some cases, an oil enema is used for constipation to ease bowel movements. Do not do with severe bleeding and inflammation.
- Treatment of hemorrhoids at home stage 2 involves a diet (maximum fiber, fresh vegetables and juices, a minimum of light carbohydrates and pastries), and the use of herbal decoctions - anti-inflammatory and hemostatic. The same chamomile and nettle will come in handy.
The operative path is attractive in that there is no risk of relapse. But in no case should one rush to immediately resort to radical methods of cure.
Usually surgery is performed only on special indications and in very advanced caseswhen invasive and medical measures no longer help.
For internal hemorrhoids of stage 2, radical excision is rarely used. And recovery after surgery is quite lengthy.
Hemorrhoids are a fairly common rectal disease among men. If untreated, it progresses and from the initial stages to the most neglected.
To prevent deterioration of the clinical picture, you should consult a doctor as soon as possible. Do not forget that the best remedy for hemorrhoids is prevention.
Proper nutrition, the absence of bad habits - this is the key to a healthy intestine.
Laxatives - indicated for external and internal hemorrhoidal formations, normalize stool, peristalsis, and prevent constipation.
|Drug name||Cost in rubles|
|Phytomucil||Powder - 278|
|Bisacodyl||Pills - 12|
|Normase||Syrup - 256|
|Mucofalk||Granules for suspension - 1374|
|Dufalac||Syrup - 234|
Immunomodulators - drugs that activate immunity in the second stage of hemorrhoids, contributing to the overall strengthening of the body.
|Drug name||Cost in rubles|
|Polyoxidonium||Pills - 350|
|Esculus||Homeopathic Drops - 605|
|Traumeel C||Pills - 310|
Drops homeopathic - 477
Candles and ointments
Influencing the cause of hemorrhoids is necessary in a complex. External agents for the treatment of hemorrhoids of the 2nd degree are part of the general therapy, they have their advantages: ease of use at home, universality of exposure to nodes of any localization, absence of irritation of the gastrointestinal mucosa.
The table shows the main representatives of the groups.
Phlebotonics (angiotonics, venotonics)
Phlebotonics - external drugs that tone the vessels of the anorectal region at the local level - the basis of any therapy for hemorrhoids of any stage.
|Drug name||Cost in rubles|
|Troxerutin||Ointment - 60|
|Aescusan||Ointment - 250|
|Troxevasin||Ointment - 322|
|RectActive||Candles - 250|
|Ginkor Procto||Suppositories - 250|
Ginkor Gel - 485
|Proctis M||Candles - 450|
|Hamamelis DN||Suppositories - 100|
Hamamelis Ointment - 33
Impregnated wipes - 66
|Procto-glivenol||Candles - 334|
Liniment - 360
|Indovazin||Ointment - 243|
|Essaven Gel||Liniment - 1600|
Painkillers (anesthetics) - drugs are indicated for the relief of pain, which becomes one of the leading symptoms in hemorrhoids of the second stage, rectal or external.
|Drug name||Cost in rubles|
|Anestezol||Candles - 80|
|Neo-Anuzol||Suppositories - 79|
|Relief||Candles - 380|
Liniment - 375
|Ultraproct||Suppositories - 620 rubles|
Ointment - 180
|Bezornil||Liniment - 370 rubles|
Anticoagulants - used to resolve the already formed hemorrhoid blood clots and prevent the appearance of new ones. The active substance is heparin.
|Drug name||Cost in rubles|
|Hepazolone||Suppositories - 25|
|Hepatrombin G||Candles - 170|
Ointment - 165
|Nigepan||Suppositories - 190|
|Sinkumar||Pills - 460|
|Heparin||Ointment - 35|
|Heparoid Zentiva||Liniment - 175|
|Lyoton 1000||Ointment - 322|
Hemostatics - drugs that stop bleeding with complicated hemorrhoids of stage 2, preventing secondary infection, anemia.
|Drug name||Cost in rubles|
|Relief, Relief Advance||Suppositories - 435|
Ointment - 170
|Prostopin||Candles - 526|
|Adrenalin||Suppositories - 40|
|Natalside||Candles - 330|
|Hemo Pro||Suppositories - 370|
|Troxerutin vramed||Liniment - 38|
Antiseptics are drugs that prevent secondary infection of the skin and mucous membranes with internal or external hemorrhoids of the second degree, disinfecting the dermis of the anorectal zone.
|Drug name||Cost in rubles|
|Betiol||Suppositories - 65|
|Ichthyol||Candles - 70|
Ointment - 110
|Sea buckthorn oil||Suppositories - 70|
|Marigold candles||Candles - 95|
|Tea Tree Candles - Allergenic||Suppositories - 200|
Healing - shown at any stage 2 hemorrhoids localization, stimulate the regeneration of rectal tissues in case of damage to the nodes by fecal masses.
|Drug name||Cost in rubles|
|Glycerin candles||Candles - 160|
|Salofalk||Suppositories - 529|
|Propolis Nam||Candles - 270|
|Solcoseryl||Ointment - 369|
Gel - 450
|Methyluracil||Suppositories - 40|
Ointment - 49
Treatment options for stage 2 hemorrhoids with minimally invasive techniques
If conservative therapy does not bring the desired results or hemorrhoids are complicated by thrombosis, infringement of nodes, proctologists recommend the use of minimally invasive techniques:
- cutting off the site with a laser beam and then sealing the wound is used for single large external and internal cones,
- latex ligation is indicated only with internal hemorrhoids - a special ring is put on the node leg followed by tightening, with the exception of the varicose cavity from normal blood flow,
- sclerotherapy - the introduction directly into the site of a special drug that sticks together the walls of a varicose formation, depriving it of nutrition, followed by sclerotherapy and dying, is used for any localization of hemorrhoids,
- for small, multiple hemorrhoidal nodules, infrared photocoagulation is used - treatment of the affected area, which causes coagulation of proteins in the walls of the vessels supplying the cavity, followed by drying and the varicose formation disappears.
Two other methods of gentle operations are rarely used:
- deserterization - bandaging of the arteries supplying blood to varicose cones, with their subsequent death - due to the lack of expensive equipment,
- cryotherapy - freezing of the hemorrhoid with liquid nitrogen - due to the risk of necrotizing nearby tissues.
Minimally invasive techniques are performed on an outpatient basis, without the use of anesthesia (maximum local anesthesia). The whole procedure takes no more than half an hour, rehabilitation is not required. Less - the possibility of a relapse of the disease.
In the second stage of hemorrhoids, classical surgery is practically not used. In rare cases, according to indications, the proctologist may propose a radical excision of the nodes using hemorrhoidectomy or hemorrhoidopexy. This ensures complete cure without relapse:
- hemorrhoidectomy or Milligan-Morgan surgery is a radical excision of nodes with the mucosa without suturing the wound,
- there are varieties of this operation, when the wound is sutured, and the nodes are excised without removing the mucosa,
- hemorrhoidopexy or Longo surgery - removal of a part of the rectal mucosa located just above the dentate line, followed by sipping hemorrhoidal nodes into the wound, which disrupts their nutrition, leads to the replacement of the node tissue with connective tissue.
There are many disadvantages, the main ones are trauma, great blood loss, frequent complications, and long recovery.
Lifestyle Correction, Diet
At the second stage of hemorrhoids - this is a daily menu and daily routine. It is necessary to forget about bad habits, lead a mobile lifestyle, walk more, play sports (not power sports), and dance.
You need to learn how to control stress. Be friendly. Remember psychogenic constipation and its consequences.
Finally, the food should be balanced, fractional, in small portions, steamed, in the oven or cooked on the stove. Nothing sharp, sour, salty, smoked, greasy - exclude everything that irritates the intestines and causes constipation.
Prevention of hemorrhoids progression stage 1, 2
Under the prevention of hemorrhoids 1 and 2 degrees understand:
- reducing the burden on the digestive tract by balancing the daily diet,
- in the absence of a regular stool - the use of laxatives,
- weight lifting prohibition
- walking, swimming, dancing, skiing,
- weight control
- proper drinking regimen (40 ml per 1 kg of weight),
- annual medical examination.
The correct regime of the day, the absence of bad habits, a balanced diet reduces the risk of developing hemorrhoids of the 1st degree, its transition to the second. Prophylactic venotonics reduce the frequency of relapses.