Anorectal diseases
Anorectal diseases are the diseases that affect the rectum which is the last part of the anus (breech) and the intestine which is approximately 10-12 centimeters long. Hemorrhoids, proctitis fissures, pruritis are the most common anorectal diseases.
What is Hemorrhoids?
Hemorrhoids are also commonly referred to as hemorrhoids and are very common in adult individuals. Hemorrhoids are vascular tissues located in the anal canal as part of the anatomical structure. It is thought that there are approximately 2.5 million hemorrhoid patients in our country. Approximately 45% of the population is referred to a doctor for hemorrhoid disease at some point in their lives. Hemoidal disease has been reported in 50% of the population over the age of 50. According to many studies, the age of the disease becoming the most common symptomatic age is between 45-65 years. Since this group of patients is considered private, confidential and even shameful by the patients, significant delays and errors occur in their diagnosis and treatment. Patients usually tend to pass on and hide the event by asking for information from the ear and from their close circle.
How Does Hemorrhoids Occur?
The anus (breech) and surrounding (perianal region) arteries are dilated by the dilation of the veins and the anal pillows. Hemorrhoids are associated with straining and irregular bowel habits. Stiff and thick stools due to straining and constant straining due to diarrhea are closer to pushing anal cushions out of the anal canal. Compression also causes cushioners to swell during defecation, paving the way for them to lose their places. In hemorrhoid patients, connective tissue on anal cushioners is disrupted and disrupted.
What are the types of hemorrhoids?
Internal and external hemorrhoids are divided into two. Internal hemorrhoids Hemorrhoids are located inside the anus that are not noticed when the anus is viewed from the outside. Internal hemorrhoids are classified as 4 degrees according to their severity: 1st degree hemorrhoids: They cannot be seen from outside by the patient, they can only be seen with anoscope. May cause slight bleeding. Grade 2 hemorrhoids: They go out during defecation, but they spontaneously inflate. Grade 3 hemorrhoids: They come out spontaneously or during defecation and need to be pushed back by hand. Grade 4 hemorrhoids: They hang out, cannot be pushed back by hand. Internal and external hemorrhoids are mixed at this stage. External hemorrhoids are hemorrhoids that can be felt and felt by the outside.
What are the symptoms of hemorrhoids?
During defecation, painful bleeding occurs due to straining, trauma of the feces to the vessel wall (injury). Blood in the finger is red in the bleeding, usually in the fresh red blood sugar following defecation, when taking the bidet, contamination of toilet paper, bleeding after dropping or bleeding in the toilet without noticeable expression is expressed in the style. It may be beneficial to consult a doctor immediately as long-term and excessive bleeding can cause anemia. In addition to severe pain, redness, edema and swelling may occur due to spasm in the hemorrhoids that go out of the anal canal. The patient may become unable to sit. Even if one of these symptoms is present, a doctor should be consulted. Another main symptom is the hemorrhoid breasts that are present following defecation and which patients try to replace. The recognition of these breasts is directly related to the stage of hemorrhoidal disease. Especially in the 3rd and 4th stage hemorrhoids, complaints of wetness and feeling of fullness and inadequate cleaning can occur.
What Causes Hemorrhoids?
Hemorrhoids may occur in cases of chronic diarrhea or constipation, straining habits, pregnancy, hereditary factors, long-standing occupational groups, nutritional habits and impaired anal anatomy. Hemorrhoidal disease is more common in patients with prolonged strains and irregular bowel movements. It is thought that more hemorrhoidal diseases develop in those who deal with sports such as weightlifting and bodybuilding as an example of chronic distress. How to Diagnose Hemorrhoids? It should be noted that the examination is mandatory. For more detailed examination of patients with rectal bleeding and breech pain, the rectoscopy procedure is used to visualize the last part of the large intestine. Diagnosis and treatment of hemorrhoids without necessary and adequate examinations can mean skipping the early diagnosis of an underlying cancer.
What are the treatment options?
There are many treatment options for hemorrhoids such as suppositories, creams and herbs. However, none of them is capable of providing definitive treatment of the disease. Changes in daily life are beneficial in the treatment of hemorrhoids. Hemorrhoids can be treated by medication or surgery, depending on the stage of the hemorrhoid and its internal or external location. A hot water bath is also a method to accelerate healing. Once symptoms begin to be observed, it should not be too late to see a doctor because the delay may cause the hemorrhoids to recover in a short period of time and become operable.
Constipation prevention is the first condition and proper diet, pulp foods, plenty of fruits and vegetables should be consumed. Medication is used for small hemorrhoids. The healing process varies from 4 to 6 weeks if it is done with medications and treatments recommended by the doctor (hot sitting bath). Among the non-surgical treatment methods of hemorrhoids, according to the degree of hemorrhoids, attaching a rubber to the neck of the hemorrhoid nozzle and the rubber band ligation method that causes hemorrhoids to decompose, bipolar coagulation, which is the process of burning blood vessels causing hemorrhoids, infrared coagulation method which allows the reduction of the vessels by laser beam, sclerotherapy methods.
Surgical methods include cutting the hemorrhoid breast, which is the classical surgical method, cutting the intracranial muscle with the aim of lowering the breech pressure. . What is the probability of recurrence of hemorrhoids after treatment? Traditional methods (sitting baths, faecal emollients, creams) provide relief, but symptoms may recur if inflammation of the vessels is involved. Pregnancy-related hemorrhoids usually heal spontaneously a few weeks after birth.
While rubber band ligation improves 80-90%, symptoms may recur in 40% of patients within 5 years. The results obtained with coagulation methods are good but require several times of application, 12-15% of patients are therefore compatible with treatment. Between 5% and 10% of hemorrhoid cases require surgical procedures. Full recovery can be achieved between 2-4 weeks. Although less than non-surgical methods, recurrence can be seen in 5-10% in 2% to 5%. Fiber-based nutrition, regular defecation, fluid consumption and hygiene are the factors that should be considered to prevent recurrence of hemorrhoids.
ANAL FISSURE (Breech fracture) What is it?
It is the name given to a small rupture of skin-like structure covering the anus. It can be seen at any age and is more common in young and middle age (30-40 years old). The incidence of both genders is equal in infants aged 6-24 months.
How does anal fissure occur?
It is thought to occur after a trauma. Generally, a hard and dry stool is forced to pass through the rectum, causing a crack in the rectum.
What are the types of anal fissures?
Anal fissure is divided into acute (newly formed) and chronic (chronic).
Acute Anal Fissure: During intense constipation or diarrhea, a small tear occurs on the inner surface of the breech. As long as this condition continues, the tear is renewed and causes pain in every defecation. The acute period covers the first 1-2 months. With appropriate treatment, it will heal in about 4-6 weeks.
Chronic Anal Fissure: After the diagnosis of fissure, the fissures that do not change with the treatment and feeding order become chronic after 4-6 weeks. Chronic anal fissure is deep and stubborn. There may be a raised image around the fissure due to inflammation and wound. It is a painful condition that lasts longer than 6-8 weeks
What are the symptoms of anal fissure?
It is characterized by severe pain in the breech, pain during defecation, pruritus, bright bleeding and burning that is seen on toilet paper or dripping. What Causes Anal Fissure? Intense constipation or diarrhea, dietary changes, buckling during defecation, birth, inflammation caused by various diseases in the region are among the most common causes. Because pain and pain are very severe, patients often avoid defecation. Irregular stooling may result in constipation and may result in delayed healing of the fissure. As long as this cycle continues, the anal fissure is likely to become chronic. Rare causes include inflammatory bowel diseases, syphilis, tuberculosis, Crohn's disease, AIDS and cancer.
How is Anal Fissure Diagnosed?
Anal fissure is diagnosed by the doctor by examining the anus and surrounding tissue. Since the patient with anal fissure has hypersensitivity and pain, the examination can be performed after applying local anesthetic pomades or under general anesthesia.
What are Anal Fissure Treatment Options?
Acute anal fissures usually heal in one or two weeks with appropriate medical treatment. The aim is to reduce or eliminate spasm in the anal sphincter (muscles surrounding the breech). In short, rich nutrition, warm-water sitting baths, local anesthetic pomades, stomatal-containing or non-stomatal pomades provide significant improvement. In chronic anal fissure, non-surgical methods are less likely to heal. Injection of chemical solutions such as glyceryl trinitrate (GNT), botilinum toxin (botox), diltiazem (chemical sphincteromy) can be applied. Surgical methods include anal dilatation (3-4 fingers enlargement), local lateral anesthesia, "lateral sphincteromy" (cutting the subcutaneous astringent internal muscles).
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