Preparations from hemorrhoids of
It is known that hemorrhoids are one of most widespread “misfortunes“ during pregnancy. What preparations will be appointed by the doctor to future mother in this case?
What is hemorrhoids?
the Literal translation of the word “hemorrhoids“ - bleeding. Now this term designate a disease which main symptom is release of blood from back pass.
Under a mucous membrane of a rectum located a network of blood vessels. Vessels of a venous texture of a rectum have very thin, extensible walls. At accumulation of kalovy masses the rectum is exposed to considerable stretching that can lead to the fact that the veins which are a part of this texture are overflowed with blood and lose elasticity - it becomes the reason of emergence of expanded sites (gemorroidalny knots). Especially strong stagnation of blood in a rectum arises in a sitting position, and also at long motionless standing.the Beginning of a disease (asymptomatic hemorrhoids, or the first stage diseases) does not prove
in any way, and only at inspection gemorroidalny knots are visible.
the Second stage is characterized by knots, small, painful at a palpation (palpation), internal knots leave back pass to time of a chair and are set independently. This stage of an illness is shown by an itch, discomfort in the field of back pass, depletion of intestines painfully, often is followed by emergence of a small amount of blood on the kalovy masses and toilet paper. Manifestations amplify after depletion of intestines, and then gradually decrease.
the Third stage diseases is followed by loss of internal gemorroidalny knots. The gemorroidalny knots which dropped out at a defekation should be set manually in a rectum. In process of progressing of a disease the muscular layer of a rectum weakens, and the set knots do not keep, and again drop out outside. At loss of knots the woman has feeling of overflow of a rectum and desire to release intestines, walking and sitting become extremely painful, severe pains arise at a defekation.
the Fourth stage - the most dangerous. The dropped-out gemorroidalny knots cannot be set. This stage of an illness often is complicated by formation of blood clots in knots, severe pains in the field of back pass and massive bleedings. >
it is, as a rule, simple to p to Reveal hemorrhoids to the doctor at manual research of a rectum. Sometimes specification of the diagnosis requires carrying out a rektoromanoskopiya - research at which enter the special optical apparatus which allows to see what occurs in a rectum into a rectum. At pregnancy the rektoromanoskopiya is carried out only in extreme cases.
Pregnancy and hemorrhoids
Unfortunately, the risk of development of hemorrhoids increases during the second half of pregnancy and childbirth. During incubation of the child the uterus considerably increases in volume, and by the time of childbirth occupies the most part of an abdominal cavity. Intestines are squeezed by the increasing uterus, the rectum changes the situation, its venous vessels are pressed that results in stagnation of blood. Besides, during pregnancy the susceptibility of muscles of intestines to the nervous impulses and substances stimulating its work considerably decreases. It is not casual: intestines and a uterus have the general innervation (their work is regulated by one nervous texture) therefore any excessive activization of intestines can stimulate sokratitelny activity of a uterus. Such positive protective reaction directed to pregnancy preservation has also the reverse side: depletion of intestines in a varying degree is at a loss, the woman begins to suffer from the locks demanding a natuzhivaniye at a defekation.
At the time of delivery at fights and attempts intra belly pressure sharply increases, and a fruit head, densely nestling on walls of a small pelvis, squeezes vessels including rectum veins. The available knots increase, get more dense consistence. During fights, and especially attempts, they are stuck out, become blue, during the period between attempts when intra belly pressure decreases, - decrease and take quieter form. The patrimonial process is longer, the risk of development of hemorrhoids is higher.
As is shown by statistics, hemorrhoids arise at pregnant women rather often: 7,7% of not pregnant women, 25,7% of the pregnant women and 49,8% which just gave rise suffer from it, However many pregnant women do not hurry to tell about it to the doctor, believing that hemorrhoids - a normal state of the pregnant woman. But the started, not lecheny hemorrhoids can cause anemia (decrease in amount of hemoglobin), diseases oporno - the motive device (for example, arthritises - joint inflammations), urinogenital system (chronic inflammatory processes), Existence of hemorrhoids is not taken into account at the choice of a method of a rodorazresheniye (natural childbirth or Cesarean section), however it should be considered when determining tactics of conducting pregnancy and the postnatal period.
How to avoid “a delicate problem“?
- the Pregnant woman has to treat with special attention to treatment of any disease. What is not contraindicated at a usual way of life during pregnancy can have negative effect on a fruit. Therefore during this period you should not self-medicate at all. The use of any medicines has to be coordinated with the doctor strictly. Considering variety of stages of hemorrhoids, features of a course of a disease, selection of treatment has to be individual and be carried out by the doctor - the proctologist (the specialist in treatment of diseases of a rectum). In the first stage of an illness there is enough implementation of the following rules:
- Never to strain at a defekation.
- Whenever possible should refuse long work in a standing position and sitting and if there is no such opportunity, it is necessary to change to a thicket position of a body, to do breaks.
- to Keep to a diet for prevention of locks. The diet has to be rich with vegetables and fruit at moderate amount of meat and carbohydrates. The diet (frequent fractional, not less than 5 - 6 once a day), the use of enough water is important (to 1,5 - 2 l a day). Fermented milk products, bread with bran, vegetables are useful (except bean). Seasonally it is necessary to eat daily beet, prunes, sauerkraut, pumpkin, carrots, water-melons, melons. It is necessary to limit the use of black bread, bean, fruit and berries which can cause locks. At hemorrhoids any alcoholic beverages, salty, hot, spicy, marinated dishes are strictly forbidden: these products strengthen a krovenapolneniye of pelvic venous textures. You should not eat greasy food: it slows down passing of food on intestines, creating thereby prerequisites for development of a lock.
- needs to carry out an external toilet by cool water after each defekation, at the expressed hemorrhoids it is better to refuse toilet paper at all. It is possible to arrange short (15 - 60 seconds) the ascending shower (just turn a shower and direct its streams up) or to put tampons with cold infusion of a camomile or bark of an oak (to make 1 tablespoon on a glass of water and to cool).
- 2 - 3 times a day are recommended to lie for 15 minutes on a back with the raised provision of a basin, for example on a small pillow.
to Women with the second and third stage of an illness except observance of rules of prevention carries out treatment by special medicines, heat sedentary baths with weak solution of permanganate of potassium, infusions of medicinal herbs. Hard physical work and certain types of homework are strictly forbidden such women (a long hand wash, mopping by hands without the aid of a mop).the emergency hospitalization is necessary for
At the fourth stage of an illness (plentiful bleeding, infringement and a necrosis of the dropped-out gemorroidalny knots). In these cases there is a need for expeditious treatment. Such patient carries out a gemorroidektomiya (excision of knots) or low-invasive (small or bloodless) operations. Treat more sparing interventions:
- skleroziruyushchy injections (introduction to knot of the special preparations which are “sticking together“ walls of knot);
- an alloying (the knot is jammed by a latex ring that causes in 7 - 10 days rejection (dying off) of knot, with the subsequent falling off of the struck fabric);
- infrared photocoagulation and laser coagulation (influence by the laser or high temperature on the knot basis).
, then doctors try to postpone all these interventions to that period when the woman is restored after the delivery, i.e. 2 - 3 months later.
Special medicines from hemorrhoids
In treatment of hemorrhoids can apply two types of medicinal treatment: local and system. During pregnancy of women local treatment is preferred to system.
Local treatment. Today a large number of various drugs for local treatment of hemorrhoids which are issued in the form of candles (suppositories) or ointments and creams exists. Local putting medicines reduces risk of development of side effects, increases efficiency of treatment and reduces negative influence of treatment on a fruit. Action of these preparations is directed to fast anesthesia, restriction of an inflammation and hypostasis, normalization of blood circulation in a rectum, counteraction to thrombosis of vessels, relaxation of a sphincter of a rectum, reduction of motility (physical activity) of intestines and a softening of kalovy masses.Rectal candles enter
into a rectum after a defekation. The candle needs to be entered in a prone position on one side, without pushing it in a rectum ampoule, and holding 1 - 2 minutes in the anal channel: so it will be dissolved, and its introduction will be more comfortable.
Remedial gymnastics promotes improvement of function of a large intestine, increase of a tone of muscles of anal area and a belly wall, reduction of developments of stagnation in veins of a small pelvis. Two - three times a day (especially if the woman has to sit or stand on work long) it is necessary to do the following exercises within 5 - 7 minutes (if some it is difficult for you to carry out from them, it is possible to refuse it):
- walking with high lifting of the legs bent in knees;
- swing movements by alternately right and left leg forward, back, aside;
- inclinations in the parties;
- tension of buttocks with simultaneous retraction of back pass (try to hold such situation till 10 seconds);
- of squat on tiptoe with widely divorced knees.
I shine from the refrigerator, it is necessary to take it 2 - 3 minutes in heat until it soft Ointment becomes expedient to be used at external hemorrhoids, putting it with a thin layer after a hygienic shower 3 - 4 times a day.
of the Candle for treatment of hemorrhoids is done on the basis of lanolin or cocoa butter. For fast anesthesia add the local anesthetizing preparations (Benzocaine, Benzocaine, Novocaine) to structure of many candles or ointments.
With the anti-inflammatory purpose are locally applied by preparations of glucocorticoid hormones (Prednisolonum). Except anti-inflammatory, glucocorticoids have antiallergic effect, reduce an itch, a burning sensation, It is necessary to remember that local treatment by glucocorticoids contraindicated at virus, fungal and other infectious damages of a rectum.by
To treatment of hemorrhoids widely apply the local means containing heparin, At local application heparin interferes with formation of blood clots, possesses antiedematous and anti-inflammatory action, promotes regeneration of connecting fabric. The preparations containing heparin, certainly, are preferable cure for thrombosis of gemorroidalny knots, Relative contraindication to local treatment by heparin are violations of the curtailing system of blood.At a spasm of a sphincter of back pass use of candles with a Dimedrol is possible
, for the purpose of acceleration of healing preparations of vitamin A, sea-buckthorn oil, a spark liver are used.basic therapeutic means traditionally combine
For simplicity and usability in preparations to local treatment of hemorrhoids. For example, Anestezol, Ultraprokt, Prokto`s structure - Glivenola includes anesthetic and the anti-inflammatory and knitting components.
the Preparation Gepatrombin contains three most active components of treatment of hemorrhoids: anesthetic, Prednisolonum and heparin. Thus, the effect of the given combined preparation for treatment of hemorrhoids is connected with mestnoanesteziruyushchy, anti-inflammatory, protivotrombotichesky, spazmolitichesky and protivozudny effect.
Relif advans contains oil of a liver of a shark (has anti-inflammatory, krovoostanavliayushchy and wound healing effect) and benzocaine (local anesthetic).
Ginkor Prokto - the combined preparation containing extract of a plant of a ginkgo of a bilob and butoform. Ginko the biloba raises a tone of veins, resistance of their wall to damage, butoform has local anesthetic effect.in general local preparations for treatment of hemorrhoids are rather effective
though their application and is accompanied by certain inconveniences, can cause local allergic reactions, and also no more than 5 - 7 days (in the absence of effect it is necessary to conduct additional examination) have to proceed on average.the candles containing extract of a belladonna (belladonna) are contraindicated to
during incubation of the kid from local means: Anuzol, Bellataminal, as their use can provoke pregnancy interruption threat.
System treatment. Preparations of system action are usually appointed in the form of tablets and capsules for intake.
At treatment of hemorrhoids now so-called venotonik widely use the means strengthening a vein wall, raising its tone, These preparations usually apply courses for 2 - 3 weeks with breaks 2 weeks - 2 months.
the Most effective venotonik Detraleks who, except venotonichesky, has the expressed anti-inflammatory and antioxidant effect is considered, preventing emergence of free radicals - one of factors of damage of a vascular wall. Besides, as it was proved in recent years, Detraleks has direct protective effect on blood system. Derivatives of an estsin (Aestsin, Eskuzan, Misveneal) receive by processing of seeds of a horse-chestnut. They possess anti-inflammatory action, improve blood circulation on the smallest blood vessels, reduce puffiness of the inflamed knot, viscosity of blood.
Krom of venotonik, to treatment of hemorrhoids are applied by preparations and other pharmaceutical groups. For prevention of complication of chronic hemorrhoids appoint Trokserutin (Troksevazin) who reduces permeability and fragility of capillaries, has anti-inflammatory effect. Ginkor - forte contains, except a trokserutin, extract of a tree of a ginkgo of a bilob. The preparation strengthens a venous wall, has anti-inflammatory effect. The preparations normalizing coagulability of blood (Pentoksifillin, Kurantil, Aspirin), appoint for prevention and treatment of thromboses of gemorroidalny veins. All specified preparations can be used at pregnancy.
a Specific place in an arsenal of means for treatment of hemorrhoids is held by the laxative preparations applied to reduction of a natuzhivaniye and simplification of a defekation. For this purpose purpose of laxative preparations is expedient (Regulaks, Forlaks, Dyufalak, Prelaks). At application of these preparations there is a chair softening. Application of other laxative environmentsstvo (bisakodit, fenolftalein, Senna`s preparations, buckthorns) at pregnancy it is contraindicated as they excessively stimulate a vermicular movement (physical activity) of intestines that can lead to increase of a tone of a uterus.