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The main stages of hemorrhoids

Hemorrhoids - a common proctological disease, which is accompanied by expansion of the veins and the formation of nodes in the pelvic area. The cause of the occurrence lies in a passive lifestyle, malnutrition, increased stress, or in a person's genetic predisposition. The problem affects 15% of the world's population, 77% of them are men. The risk group includes pregnant women.

Ignoring hemorrhoids leads to an aggravation of the disease and the subsequent appeal to surgical methods of treatment. In addition to physical discomfort and loss of emotional and psychological well-being of the patient, hemorrhoids sometimes lead to breakthrough of pus in the abdominal cavity and rectal cancer - more than 200,000 such cases are registered annually in the world.

Each stage of the development of the disease is characterized by a set of specific clinical symptoms. This article will talk about the features of each stage of the disease, the characteristic physiological manifestations and the necessary treatment at one stage or another. The information will help to detect the "alarm bells" that the body sends, and timely contact the coloproctologist with the problem.


Many people usually say that hemorrhoids are varicose veins. Such an explanation is generally understandable, but in reality everything is more complicated.

The human anus is the entrance to the rectum, the intestinal section is 14-18 cm long. Here, as well as under the skin around the anus, hemorrhoids are located. With them, a person is born, and the very presence of nodes does not mean an illness. Each hemorrhoidal nodule is a complex formation: a cavity (cavity), mucous membranes, as well as veins and arteries. The disease occurs when the nodes pathologically expand.

Disease qualification

What is hemorrhoids? Doctors classify the disease in several ways.

In the field of development (localization), pathology happens:

  1. Inner. Pathologically enlarged hemorrhoidal nodes are located in the rectum.
  2. Outdoor. The disease concerns the nodes located under the skin around the anus.
  3. Combined. Violation of the outflow of blood occurs in both internal and external hemorrhoidal nodes.

Qualification of the disease distinguishes 3 types of disease

The disease can occur acutely or have a chronic form without special manifestations (remission).


If at the initial stage you can not pay attention to minor discharge of blood, itching in the anorectal region, then the symptoms of the third stage cannot be overlooked.

  • Those hedgehogs remain unpleasant manifestations, but in a more pronounced form - discomfort in the anus, itching, burning.
  • Defecation is almost always accompanied by bleeding, pain. Sometimes the painful sensations are so strong that only anesthetic can relieve them.
  • The most striking symptom of the third stage of hemorrhoids is prolapse of the nodes. Gradually, they increase in size, appear outward in the process of bowel movement, lifting weights, long idle time, sitting on a soft chair, sneezing, coughing. Unlike the 4 stages of hemorrhoids, the nodes can be adjusted independently, they are kept inside. Loss does not occur at rest.
  • The presence of hemorrhoids of stage 3 can be determined by the appearance of the sphincter. It becomes inflamed, increases in size, is deformed. The presence of mucus is present.

At this stage of the disease, the likelihood of complications increases - the attachment of a secondary infection through cracks, pinching of nodes, tissue necrosis, thrombosis. In such situations, emergency medical assistance is required, which often ends with surgical intervention.

Initial Stage 1

At this stage, the disease rarely manifests itself with noticeable symptoms. Subtle discomfort, itching, slight burning sensation can be felt in the anal area. Blood smears may appear on the surface of feces. Separate spots can be found on toilet paper.

Stage 1 hemorrhoids are dangerous because people rarely go to doctors. Some are ashamed to talk about such a delicate problem, while others are worried about diagnostic methods. This is a big mistake, because it is at the first stage that the disease is cured relatively easily. But neglected forms are difficult to treat.

Many people in the period of exacerbation are interested in: what does the initial stage of hemorrhoidal illness look like.

Photo of the initial stage of hemorrhoids

Therapy for early hemorrhoids is the use of rectal suppositories. Their action is different: they stop pain, inflammation, establish normal blood flow. Traditional medicine advises making potato candles and using them between bowel movements.

Stage 2 pathology

At this stage, bowel movements or any other pressure on the press can lead to prolapse of hemorrhoidal nodules. The nodes are pulled back effortlessly from the side. Scarlet blood discharge can be found on underwear. Slight strokes appear even when a person does not visit the toilet and does not strain at all. In addition, even immediately after a “trip to the big one”, there may be a feeling of an empty bowel.

Stage 2 hemorrhoids require immediate treatment. Lost time may be the result of surgery.

Medical methods of treatment at this stage - as at the previous stage of the disease plus hemostatic drugs. Such methods are joined: sclerotherapy (special injections into the bases of blood clots), infrared coagulation (laser cauterization of nodes), latex ligation. The last method is to squeeze the ring from the latex of the blood vessel that feeds the pathological hemorrhoid. Without blood flow, the node dies and is removed from the intestine.

Among the folk remedies for the treatment of hemorrhoids, microclysters can be distinguished. They are made with sea buckthorn or rosehip oils. Also useful are baths with the addition of decoctions of chamomile, potassium permanganate, oak bark, and a special anti-hemorrhoid collection.

Complicated Stage 3 Disease

Stage 3 hemorrhoids used to be considered an absolute indication for surgical excision of nodes. Now they are trying to reduce hemorrhoids, bypassing the surgeon's scalpel. Surgery is required only if conservative methods have not given a positive effect from the treatment.

Expanded hemorrhoidal nodes still fall out, but are no longer pulled inward. They can be adjusted independently. This must be done, at least after each bowel movement. But such a procedure may be necessary in other circumstances related to the tension of the abdominal muscles.

It is important to remember that knot reduction is not a treatment for hemorrhoids! This is only a temporary measure, and unpleasant and often painful. At this stage of the disease, false shame and fears no longer exist. The help of an experienced doctor is required.

Local drugs in the third stage of the pathology are aimed more at alleviating the human condition than at effective treatment. To cope with overgrown hemorrhoidal nodes is possible only by invasive (penetrating) methods. The main ones are already listed above.

If the disease has already gone so far, folk remedies are simply useless. Attempts to do without medical assistance with advanced pathology can give unpredictable results and even provoke rectal cancer.

Heavy Stage 4

The last 4 stage of hemorrhoids requires the immediate removal of hemorrhoids. Here, doctors are already talking about a neglected and really serious disease. Knots drop out already without any straining efforts: when walking, and even at rest. It is already impossible to fix them.

Bleeding is so intense that anemia develops. At the same time, thrombi can form in the cavernous veins, which exacerbate blood circulation problems.

As in the previous stage, treatment can only be operative. In addition, it must be urgent. The disease itself is not fatal. But complications can be very dangerous.

For example, hemorrhoids can become inflamed. As a result, suppuration, necrosis (dead tissue) appear. Pathogenic microbes multiply at tremendous speed and further worsen the condition of a person.

Table: Recommended treatment for hemorrhoids at each stage

Creams, gels, rectal suppositories, preparations, sclerotherapy, photocoagulation, diathermocoagulation Bicap

Sclerosis of nodes, medications, photocoagulation, latex ring ligation, heat probe, Ultroid current

Drug therapy, latex ring ligation, Ultroid current, hemorrhoidectomy

Hemorrhoidectomy, phlebotropic drugs

Reasons for development

Why does hemorrhoids occur? What are the reasons for its development? Most often, the innate predisposition is to blame. The functions of hemorrhoids can be impaired in any person: the influx of arterial blood exceeds the outflow of venous. The result is stagnation of blood, expansion of cavities and other consequences. However, dysfunction is not always manifested and not immediately, but only in adverse conditions.

The main causes of the disease:

  • inactive life, constant sitting position,
  • work associated with frequent physical exertion (for example, weight lifting),
  • excessive love of spicy foods, alcohol,
  • various diseases in which bowel movement occurs more often than usual,
  • tumors, inflammation of the pelvic organs,
  • persistent severe constipation.

Other risk factors. In addition to the main, there are several additional factors. For example, quite often hemorrhoids are diagnosed in pregnant women. When carrying a child, the intestines of the expectant mother are overloaded for many reasons. This is the altered position of the internal organs, the pressure of the uterus on them, as well as the increased blood volume and digestive load.

Such a diagnosis is not excluded in young children. One of the rarest causes is the congenital expansion of cavernous formations. Frequent and prolonged crying increases blood flow to cavernous formations and provokes stagnation. The next unfavorable factor is a long sitting on the pot. A specific cause of hemorrhoidal illness in adolescents (except for the “adults” listed above) is masturbation, as a result of which the circulation of the pelvic organs is disturbed.

Finally, the so-called hemorrhoids of the elderly is known. In old age, physical activity, often involuntarily, is limited. Various diseases, many of which develop with age, require a large number of medications. Side effects of drugs can sometimes provoke circulatory disorders and the development of the disease.

Disease prevention

Candles, baths, microclysters, moxibustion and other procedures simply will not be needed if the hypothetical hemorrhoids are properly prevented. All measures are very simple, do not require either financial costs or great efforts.

  • Diet. Vegetables, dairy products and a sufficient amount of liquid are essential components of the diet. Coffee liters, alcohol, hot sauces and seasonings are the enemies of good digestion in general and intestinal peristalsis in particular.
  • When sedentary work, mandatory breaks during which it is advisable to walk. You can do several squats, or at least a couple of times to strain and relax the muscles of the abs and buttocks. It all depends on the environment.
  • The lifting of everything heavy should be limited as much as possible. If this is not 100% possible, then at least minimize the sharp muscle tension.
  • Washing the anus with cool water is another way to activate blood circulation in the problem area and avoid hemorrhoids. A good alternative is wet toilet paper.

Treatment of the disease can be very expensive. Caring for health will help to avoid a lot of delicate problems, the disease itself and possible complications. It is important to understand that it is necessary to treat hemorrhoids, given the stage of its development. It is better to consult a proctologist at the first symptoms.


Types of disease

Hemorrhoids are a fairly common disease that affects the intestines. In the event that a person suffers from this ailment, hemorrhoidal nodes begin to fall out. Prolapse of the nodes usually begins with the second stage of the disease. Ailment comes in three different forms.

Interior: Hemorrhoid cones are located inside the large intestine. This form cannot be seen visually.

External: Hemorrhoid cones are located outside, around the anus. This form is visually noticeable.

Combined: In this case, the hemorrhoidal nodes are located both inside the rectum and on the outside of the anus.

The causes of the disease are as follows:

  1. Bowel injury
  2. Digestive upset, constipation,
  3. Frequent nervous breakdowns
  4. Age changes
  5. Blood stasis in the pelvic area,
  6. Heredity,
  7. Alcoholism,
  8. Malnutrition
  9. The presence of tumors in the gastrointestinal tract,
  10. Overstrain of the peritoneum,
  11. Weak vein walls,
  12. Overweight
  13. Hepatitis C.

In the initial stages of the manifestations of the disease is very small. Often the manifestations that are still present, men do not attach any importance.

Manifestations of the initial stage of the disease can be as follows:

  • After a bowel movement, a small amount of blood may be released,
  • A person experiences itching and burning in the anus,
  • A sick person may feel like a foreign body is in the rectum,
  • Possible slight pain during the act of defecation.

Over time, they progress and we can observe hemorrhoids of the third degree.

Features of the internal

In the second stage, the cones fall out only when trying. At the third stage, the patient's condition worsens, cones fall out more often. Cones can fall out when coughing and sneezing, as well as after any physical exertion. In the third stage, the nodes do not retract independently. Therefore, a sick person is forced to set them with his fingers. Itching and burning at this stage are quite strong.

Why hemorrhoids have stages

Hemorrhoidal disease passes through several stages in its development, since it has a steadily progressing course. The formation of hemorrhoidal nodes is accompanied by an outflow of blood in the venules located on the folds of the skin and mucous membrane of the anorectal region.

Venous cavities overflow with blood, as a result subcutaneous protrusions appear (external nodes of hemorrhoids) or formations arise inside the rectum under the mucosa (internal nodules). Following there are anal fissures, bleeding, pinching of the cones.

Hemorrhoidal nodes increase in size, are displaced to the anal canal, which causes trauma during defecation or simple careless movement. There is inflammation, swelling, pain.

Since the clinical signs of internal and external hemorrhoids are very similar (excluding the localization of nodes), only the proctologist can determine the stages of hemorrhoidal disease using a digital rectum examination or with a rectoscope according to the following signs:

  • for the first degree, slight hemorrhoidal nodes are characterized by trauma, discomfort in the anus,
  • the second stage of hemorrhoids is diagnosed by the beginning of prolapse of hemorrhoids with tension during bowel movements, which bleed, but independently fall into place after the disappearance of additional effort,
  • a feature of the third stage is the need for manual reposition of precipitated cavernous formations,
  • at the fourth stage of hemorrhoids, the nodes fall out together with the rectal mucosa, do not set back.

The need to divide the disease into stages is associated with the selection of adequate therapy for a specific period of hemorrhoids progression.

Stages of hemorrhoidal disease

For the external form of hemorrhoids of all stages, common symptoms are characteristic:

  • protrusion of a node in the anus,
  • tension of hemorrhoids at the time of defecation,
  • the appearance of blood clots,
  • discomfort, itching, burning of the anorectal region,
  • pain in the anus during movement, coughing.

Internal hemorrhoidal nodes are not visible, they are localized intrarectally. The main common symptoms:

  • bleeding during bowel movements,
  • pain during bowel movements,
  • feeling of incomplete emptying of the rectum,
  • discomfort in the anal area.

Often there are combined forms of hemorrhoids.

Hemorrhoids - a progressive disease

Hemorrhoids can occur in external or internal form. With the external form of the disease, hemorrhoids are located outside the anus, which causes discomfort and pain. If the patient does not struggle with the first symptoms, leads a sedentary lifestyle, does not devote time to active exertion, the disease becomes a progressive chronic form.

For this form of the disease, symptoms are characteristic:

  • protrusion of the cone in the anus,
  • the presence of hemorrhoids, which increase with tension during bowel movements,
  • the appearance of blood clots,
  • burning and itching
  • painful cramping when walking, sudden movements, coughing.

In the case of the development of internal hemorrhoids, hemorrhoids are located inside the anus and are invisible visually. In the absence of appropriate treatment, the disease can develop and become chronic.

More detailed information about internal hemorrhoids, its characteristic manifestations and features of the course, can be found in the article of our expert.

About what are the common symptoms of hemorrhoids and the mechanism of development of the pathological process, you can find out by reading the articles of our specialist.

We also recommend that you carefully read the article devoted to a detailed description of the symptoms of hemorrhoids in the initial and late stages.

The main signs of the presence of the disease are:

  • spotting during bowel movements,
  • pain during bowel movements, with tension,
  • a feeling of fullness of the intestine even after emptying,
  • the occurrence of volumetric neoplasms in the rectum,
  • discomfort and discomfort in the anus.

Stages of hemorrhoids: symptoms and features

Specialists, in order to determine treatment regimens, distinguish the main stages depending on the manifestations and symptoms of the disease. If you are interested in the question, how many stages of the disease exist, then most often they talk about the four stages of the disease.

So, consider the signs of how to determine the stage of hemorrhoids:

  • at the first stage, the patient observes only minor spotting without loss of venous nodes (for more information about grade 1 hemorrhoids, see our author’s article),
  • at the second stage, nodes with or without blood flow out, which are self-adjusting to the anal canal (you can learn about symptoms and treatment of hemorrhoids of the 2nd degree from an article by a qualified specialist)
  • the third stage is characterized by prolapse of nodes with the need for manual reduction (learn more about grade 3 hemorrhoids from the materials of our experts),
  • at the fourth neglected stage, hemorrhoids are present outside the anus and fall out along with the rectal mucosa, while it is not possible to set them back into the anus (for how degree 4 hemorrhoids manifest, read in an informative medical article).

The classified stages of hemorrhoids allow you to determine and prescribe effective therapy for a specific stage of the disease. Today, minimally invasive treatment methods (photocoagulation, sclerotherapy, ligation with latex rings) are often used, which can be used in a hospital and in outpatient treatment. Thanks to these techniques, as a rule, it is possible to achieve an effective cure for most patients.

Features of the treatment of hemorrhoids at each stage

For each stage of hemorrhoids, the attending proctologist selects the most suitable technique:

  • at the first stage, conservative therapy, infrared photocoagulation, sclerotherapy are recommended,
  • in the second stage, in combination with the above methods, suture ligation can be used,
  • at the third stage, some minimally invasive procedures and radical operations are performed with the removal of venous nodes and cones. In the postoperative period, the appointment of restorative medicines has proven itself well, which helps the patient almost completely get rid of the disease,
  • at the 4th, neglected stage, the medications themselves will not have the proper effect on the foci of the disease; radical surgery is necessary.

First stage

At the first stage, the symptoms are not pronounced, the patient is prescribed medication in parallel with regular examinations by a proctologist to identify the process of the disease. At this stage, with effectively selected therapy, the transition of the disease into chronic and advanced stages can be avoided.

How to treat the initial stage of hemorrhoids with medications and folk remedies, you can find out by reading a detailed review of our expert.

We also recommend that you read another article on treatment at the initial stage of hemorrhoids with the help of modern therapeutic practices.

Drug treatment

At the initial stage, drug therapy can significantly slow down the development of the disease. You can use rectal suppositories and ointments Anuzol, Hepatrombin G, Relief and others. These drugs not only eliminate the signs and symptoms of the disease, but also successfully relieve pain.

They are appointed by a proctologist to solve such problems:

  • relief of pain and stopping the development of the inflammatory process,
  • relaxation of the walls of the rectum,
  • normalization of blood flow in the anus.

Sea buckthorn suppositories, rectal suppositories with calendula and propolis (also used in combination with the above drugs) are also effective agents.

Second stage

Hemorrhoids of the second stage can be easily recognized by regularly falling hemorrhoidal nodes, this symptom is provoked by straining during bowel movement. The reason for the difficulties in sending needs is malnutrition and persistent constipation. As a result of advancement in the intestines of dry feces, anal fissures occur that bleed.

Folk remedies

In addition to standard medicines, often folk remedies and treatment methods help patients. For example, proven and effective means are honey and potato suppositories, enemas with decoctions of herbs, mountain ash juice.

Second stage

Hemorrhoids of the second stage can be easily recognized by regularly falling hemorrhoidal nodes, this symptom is provoked by straining during bowel movement. The reason for the difficulties in sending needs is malnutrition and persistent constipation. As a result of advancement in the intestines of dry feces, anal fissures occur that bleed.

Drug treatment

As a medical treatment to slow the progression of the disease are prescribed:

  • venotonic tablets (Detralex, Venarus, Troxevasin, Phlebodia 600). These drugs help strengthen the walls of the veins and prevent the further development of the disease,
  • rectal suppositories and ointments with anti-inflammatory, angioprotective and wound healing effects (for example, Ultraprokt, Relief Advance, Proctosan, Posterisan Forte).

Folk remedies

A small effect in the treatment can be achieved using folk remedies made from natural ingredients. So, for the treatment of the second stage, gauze dressings soaked with propolis, baths with medicinal herbs (oak bark, chamomile flowers, a special collection of herbs for hemorrhoids), ice rectal suppositories (to stop bleeding) are used.

Also, an effective alternative method for treating hemorrhoids is small enemas made of warm water with sea buckthorn oil, fish oil or rosehip oil.

Third stage

The disease is already turning into a pronounced form, the symptoms are aggravated and hemorrhoidal nodes fall out. At this stage, the ailment cones come out constantly, and not just in the process of straining and defecating. Especially noticeable is the loss of nodes during physical or sports loads, even insignificant. This degree of the disease differs from the neglected fourth in the fact that the drop-down nodes can still be adjusted independently.

Minimally invasive methods

The following minimally invasive surgery methods are used as an additional treatment for hemorrhoids in the second stage: infrared coagulation, therapeutic injections for sclerotherapy, and ligation using latex rings.

Third stage

The disease is already turning into a pronounced form, the symptoms are aggravated and hemorrhoidal nodes fall out. At this stage, the ailment cones come out constantly, and not just in the process of straining and defecating. Especially noticeable is the loss of nodes during physical or sports loads, even insignificant. This degree of the disease differs from the neglected fourth in the fact that the drop-down nodes can still be adjusted independently.

Drug treatment

Conservative and standard methods of treatment with pharmacy medicines at this stage are ineffective. They only relieve sensations of itching and burning, but do not give a pronounced therapeutic effect. Therapy with drugs is prescribed in most cases as a "distracting" moment, since at this stage the effectiveness of their action on the foci of inflammation lasts a short time.

Among such antihemorrhoidal drugs can be called Proctosedil, Hepatrombin G, Prednisolone, Troxevasin, Mafinid. You can and should use venotonic tablets to strengthen the walls of the veins. However, they should all be prescribed by a proctologist after a thorough examination.

Minimally invasive methods

Methods similar to the second stage are used: infrared coagulation, sclerotherapy sessions, latex ligation. Deserterization can be used as an effective technique to prevent the development of serious complications.

Radical operations

For a successful struggle not only with the symptoms of the disease, but also with its causes, a radical surgical intervention in the form of hemorrhoidectomy is used. With this operation, hemorrhoids are removed along with foci of inflammation, after which restorative drug therapy is prescribed.

Fourth stage

Hemorrhoids in the fourth stage is a neglected acute degree of the disease, when the hemorrhoids constantly fall out and are not subject to reduction. Such cones can reach large sizes in diameter, they are visible even when the patient does not strain and does not lift weights.

It should be noted that in many cases the last stage is complicated by additional pathologies that are provoked by hemorrhoids: thrombosis, necrosis of the rectal tissues, prolonged bleeding, which are weakly amenable to stop and control.

The importance of timely access to a doctor

At all stages of the disease, one of the key ways to a successful cure is to contact a doctor who, after examination and selection of tests, will prescribe an adequate and competent treatment. Determining the degree of ailment in this case is crucial.

It is undesirable to bring the disease to an advanced stage, it is recommended to take measures when the first symptoms appear. You should not independently determine the degree of development of the disease and take medicine without a doctor’s prescription, as this can lead to extremely undesirable consequences.


Dividing the hemorrhoids into stages, doctors can choose the most effective treatment technique that will allow the patient to get rid of pain, discomfort and itching in the anus. It is not recommended to treat varices of anorectal veins on their own, since there is a risk of starting the disease and "getting" various complications.

Types of hemorrhoids

According to the position relative to the sphincter, internal, combined and external species are distinguished, which flow from one to another if treatment measures are not taken, and hemorrhoids move from the internal cavity of the body to the outside.

By the nature of the course, the disease is acute (recurring) and chronic. With the latter, there is a prolapse of the nodes, circulatory disorders, swelling and sharp pains occur, which differ in severity. In the acute form, the changes increase intensively, there are pronounced pain symptoms. Blood stagnates in the strangled cone, tissues begin to die.

Stages of hemorrhoids

In the clinical course of chronic hemorrhoids, 4 stages of development are distinguished. Each of them is able to stretch for 2-3 years, the deterioration grows slowly and implicitly for the patient.

The acute form includes 3 stages. At the same time, it is possible to achieve the last neglected degree in 5-7 days.

Do not forget that only a doctor can correctly determine the stage of hemorrhoids, after carrying out diagnostic procedures through a rectoscope or other modern medical devices.

Stage I

It is difficult to identify the problem at first. Signal of the development of the disease swelling of the nodes in the area of ​​the anal passage, blood drops on toilet paper or underwear that appear after defecation. Pain symptoms are more often absent, but a person is concerned about mild discomfort, itching and burning. The situation is aggravated by systematic constipation. Symptoms appear irregularly, exacerbations occur 2-3 times a year.

With the assistance of a proctologist, patients get rid of hemorrhoids of the first degree quickly and painlessly, so it is better not to postpone the treatment. In the absence of the opportunity to visit a doctor, it is recommended:

  • Use soft toilet paper so as not to irritate the skin of the anus, or discard it and wash the area with warm water after defecation,
  • Go to cotton underwear, exclude synthetics and friction in the anal area,
  • Start a healthy diet, avoid stomach irritating foods,
  • Anesthetize and soothe the anus. Processing with ice, potassium permanganate, infusion of chamomile, oak bark or special anesthetics - gels or ointments will help
  • For a greater effect, it is worth using rectal suppositories - “Relief”, “Anestezol”, “Hepatrombin” or analogues,
  • If severe discomfort is present, it is worth taking painkillers or sedatives.

What does hemorrhoids of degree 3 look like?

The disease has several forms, the external symptoms are somewhat different in each of them.

  • Internal hemorrhoids is characterized by the development of pathology on the inner wall of the sphincter. Nodes gradually increase in size, but are not visible from the outside. They can be seen by a specialist during an instrumental examination, or by a person himself, when the nodes already begin to fall out. Internal hemorrhoids are accompanied by severe pain during bowel movements, bleeding, a sensation of a foreign body inside. Externally manifested by inflammation of the sphincter, deformation, discoloration, the presence of mucus.
  • External hemorrhoids of stage 3 can be seen with the naked eye. The anorectal region becomes inflamed, mucus appears, the sphincter increases in size, is deformed, and a cyanotic color appears. Inflamed hemorrhoidal nodes resembling bumps are visible.
  • Combined hemorrhoids are characterized by an increase in hemorrhoids outside, inside. The most severe form of the disease, requiring different approaches to the treatment of pathology.

The presence of hemorrhoids of stage 3 can be determined by a specialist during a visual examination. But to assess the severity of the disease, an instrumental examination is required.

Is treatment possible without surgery?

The treatment methods for the late stages of hemorrhoids are somewhat different from the first two. External means in the form of a cream, ointment, lotion, suppository are ineffective. They are used only as concomitant drugs on the path to recovery. They relieve the external manifestations of the disease - itching, burning, pain, stop bleeding, but enlarged nodes do not disappear.

However, the operation does not guarantee complete recovery, the absence of relapse. Treatment should be comprehensive. Enlarged nodes are removed by minimally invasive methods, continue treatment with medicines, folk remedies. In parallel with this, adjustments are made to the lifestyle, nutrition, and normalize the intestines. Only if there is maximum effort on the part of man can a positive result be achieved.

At home, you can reduce the size of hemorrhoidal nodes in the first stages of the disease. Therapy of more severe forms involves the use of minimally invasive methods, which, in general, can hardly be called an operation. The procedure is carried out for several minutes under local anesthesia. A person goes home to continue treatment, having received specialist advice. Therefore, if there is a question about classical surgery with a scalpel, general anesthesia, you can do without it at the 3 stages of hemorrhoids.

Home treatment

It is strictly forbidden to carry out therapy for hemorrhoids at home if the disease has already reached 3 degrees. Hemorrhoids have no particularities to disappear on their own, the lack of qualified treatment leads to a transition to a more severe form of the disease, serious complications.

You can temporarily use medications to stop pain, stop bleeding, and relieve other painful symptoms. However, a temporary improvement in well-being does not guarantee recovery, it is impossible to postpone with the operation. Due to some circumstances, minimally invasive methods are not carried out in all cities, a certain amount needs to be collected, it is possible to treat grade 3 hemorrhoids temporarily at home.

The most convenient and effective means for treating internal, external, combined hemorrhoids are candles. In this case, it is necessary to select drugs with anesthetic, hemostatic effect, anti-inflammatory. Preparations on a natural basis in the form of candles from sea buckthorn, calendula will not give the desired result.

We need strong medicines with painkillers, anti-inflammatory, regenerative, astringent effects. These are:

  1. Anuzol
  2. Relief Ultra, Advance,
  3. Proctosed,
  4. Hepatrombin,
  5. Procto-glivenol,
  6. Aurobin.

Suppositories are administered twice a day after bowel movement. The maximum course of therapy is 14 days.

Additionally, you can use funds for external use - cream, gel, ointment. Especially if the increase in hemorrhoids is external. Most manufacturers produce products for the treatment of hemorrhoids in two forms. Must be combined to obtain a greater effect. The ointment is applied up to 3 times a day with increased painful symptoms, or after bowel movement with preliminary washing.


The most common treatments for any form of hemorrhoids are sedentary baths. Cold is preferably done in the morning. Cold stops bleeding, eliminates pain, increases the elasticity of the sphincter muscles. Warm baths are done before bedtime or, if it is impossible, goes to the toilet. Warm water relaxes muscles, normalizes blood circulation. The procedure must be carried out 20 minutes daily for 14 days.


In second place lotions. Put cheesecloth in several layers, moisten in a decoction of medicinal herbs, or apply oils and grated vegetables. Apply to a sore spot, on top of the cling film, fix with underwear or a plaster. It is preferable to leave overnight. You can apply pharmacy ointment on gauze, then its effect will last as long as possible.

Effective Recipes

In the people there are many remedies for the treatment of hemorrhoids. You can use any.

  • Dissolve potassium permanganate in water, so that the solution turns out a light pink color. Water is used for washing, compresses, sitting baths.
  • Cut a candle from raw potatoes, grease with medical vaseline, insert into the rectum. Grate potatoes on a fine grater, put on cheesecloth, attach to a sore spot in the form of a compress. You can use fresh juice. Also, carrots, beets, viburnum have a healing property.
  • Freeze ice cubes in the form of candles, use to stop pain, stop bleeding.
  • Mix in equal proportions chamomile, calendula, St. John's wort, nettle, thyme, oak bark. Pour boiling water, insist in a closed container for half an hour. The broth is used for sedentary baths, lotions, frozen in molds.
  • Several times a day, lubricate the anus with oil from calendula, sea buckthorn.
  • Mix honey with cinnamon, lubricate the problem area several times a day. Ointment relieves painful symptoms, improves blood circulation.

Alternative drugs as an independent therapeutic agent give a good result only in the first stages of the disease, in this case they are used additionally.

What will happen if you do not consult a doctor on time?

The third stage of hemorrhoids is a serious disease that requires immediate help from specialists. The lack of qualified treatment leads to complications, the transition to the most complex, life-threatening form - the fourth. The last stage of hemorrhoids is treated exclusively by surgery.

  1. The presence of cracks in the anus opens the way for pathogens to enter the intestines. Inflammation progresses, mucus, pus secretion begins, accompanied by an unpleasant odor.
  2. Loss of elasticity of the sphincter leads to uncontrolled excretion of feces. There is irritation of the rectal mucosa, ulcers, erosion, and wounds appear. The passage of feces during bowel movements provokes bleeding of different intensities.
  3. Loss of nodes is dangerous by pinching, thrombosis, tissue necrosis. This situation requires emergency surgical intervention.

Proper nutrition and diet

Bowel disease is becoming one of the most important provocateurs of hemorrhoids. Recurrence of stool disorders, in particular, constipation. To ease the course of the disease, prevent relapse, you must constantly adhere to a diet, eat right.

Products can enhance pain, weaken. You just need to choose the right diet:

  • Exclude fried, spicy, salty, greasy dishes.
  • Eat small meals 6 times a day. Dinner should be no later than 2 hours before bedtime.
  • Refuse alcoholic drinks, carbonated, coffee.
  • Do not eat legumes, cabbage, beer, sweets. These products cause fermentation, bloating.
  • Eat more porridge, vegetables, fruits, drink still mineral water, green tea, dried fruit compote.
  • Sour-milk products improve intestinal function, normalize microflora, and eliminate constipation.

Nutrition plays a very important role in the treatment of hemorrhoids, preventing relapse, and recovering from surgery.

Main symptoms

The main manifestations of hemorrhoids of the third or fourth degree include:

Painful symptoms

  • The prolapse of the cavernous nodes from the rectum occurs not only with severe constipation, but also with a slight tension of the abdominal wall (cough, weight lifting).
  • Dropped hemorrhoidal formations do not resolve on their own. If you do not set them by hand, then their infringement is possible.
  • The subcutaneous tissue and skin around the anus are painful, bulging bluish or crimson.
  • Pain and blood appear with every act of defecation.

A patient at this stage of the disease may have a fever, irritability, and a breakdown.


In the third stage of chronic hemorrhoids, the following complications may develop:

Hemorrhoid Complications

  • Infringement of the hemorrhoid by sphincter muscles.
  • The development of paraproctitis.
  • Bleeding from dilated venous cavities.
  • Secondary infection of the skin or inflamed cones.
  • Thrombosis of varicose veins of the anus.

If the patient has any of the above manifestations, he needs immediate hospitalization. The elimination of some complications at this stage is possible only surgically.

The initial stage of hemorrhoids

Hemorrhoids of stage 1 is only the beginning of the development of the disease, which may, in general, not manifest itself with any symptoms. Often such a course of the disease is not a reason for a person to seek qualified help, which is why patients themselves cause a complicated course of the disease. This is due to the fact that hemorrhoids are not clinically manifested and do not cause particular inconvenience. Hemorrhoidal nodes have not yet reached large volumes and do not fall out of the anus.

Despite the fact that the initial stage of hemorrhoids does not cause a manifestation of the characteristic symptoms of the disease, patients may complain of:

  • discomfort and sensation of a foreign object in the anus,
  • slight itching around the anus,
  • the appearance of blood and mucus impurities during bowel movements. A characteristic feature is that the inclusions do not mix with feces, but are on the surface of the feces.

One of these symptoms indicates the onset of pathology. While people do not pay attention to such manifestations, the disease gradually progresses and develops to the second stage.

Another feature of hemorrhoids at an early stage is that its treatment can be carried out without surgical intervention. In such cases, conservative therapy will consist of:

  • taking medications
  • respecting a sparing diet,
  • the use of traditional medicine recipes - only in combination with other therapeutic methods,
  • physiotherapeutic procedures.

Drug treatment of the initial stage of hemorrhoids includes:

  • the use of rectal suppositories to relieve symptoms,
  • taking medications that are aimed at preventing the formation of blood clots, eliminating hemorrhages and strengthening the walls of blood vessels,
  • the use of antiviral, wound healing and antipruritic substances,
  • the use of local anesthetics, which are in the form of suppositories or ointments,
  • intake of the vitamin complex.

Therapeutic nutrition in the treatment of the initial stage of hemorrhoids is aimed at fulfilling the following rules:

  • refusal of fatty, overly spicy and salted dishes, as well as carbonated and coffee drinks,
  • reduction in fluid intake and sodium chloride,
  • enriching the diet with high fiber ingredients.

Alternative medicine prescriptions can also help in the treatment of the initial stage of hemorrhoids. Such therapy involves the use of:

  • sea ​​buckthorn and olive oil,
  • berries and flowers of viburnum,
  • nettle and yarrow,
  • bones and raspberries,
  • chestnut seeds and hazel leaves,
  • daisies and calendula,
  • oak and buckthorn bark,
  • dogwood and rose hips,
  • honey and propolis.

In some cases, treatment of the initial stage of hemorrhoids can be carried out using such a painless procedure as sclerotherapy, which consists in the injection of special medications aimed at obliterating hemorrhoidal sacs.

Is the operation dangerous

With the advanced stage of hemorrhoids, the general condition of a person worsens. The expressed pain syndrome is growing, the patient experiences noticeable discomfort when standing, sitting, various movements. It may cause weakness, dizziness, anemia with severe bleeding from varicose veins.

Treatment of hemorrhoids of stage 3 without surgery is possible only in those cases when the surgical intervention itself can do more harm than the existing pathology.

The operation to remove nodes in the later stages can be dangerous in the following situations:

  • Existing renal, cardiovascular, or liver failure.
  • Exacerbation of respiratory diseases (bronchial asthma, tuberculosis, sarcoidosis).
  • Malignant neoplasms of any etiology.
  • Malignant arterial hypertension.
  • Decompensated diabetes with uncontrolled glucose levels.
  • Diseases of the blood coagulation or anticoagulation systems.
  • Exacerbation of chronic bowel disease.

In all other cases, the third stage is treated with minimally invasive surgery. But nevertheless, they try to abstain from carrying them out in women during pregnancy or in persons older than 70 years. In the first case, the operation is postponed until delivery, and in the second case, hemorrhoids of the 3rd degree are treated without surgery. To do this, use drugs, antihemorrhoidal suppositories, baths, special exercises that strengthen the sphincter muscles.

Postoperative period

The rehabilitation recovery period after hemorrhoidectomy or other manipulations includes:

Conversation with a Doctor

  • Compliance with diet. Such patients should not overload the stomach with food. You need to eat in small portions, but often throughout the day. Dairy and plant foods, meat, and fish should predominate in the diet. Fresh and salted cabbage, whole milk, buns, green peas should be limited, because these products cause increased flatulence. In order for soft fecal masses to form, you need to drink at least 2 liters of water per day.
  • Daily dressings for 3-5 days.
  • Adequate physical activity. The patient is allowed to get up and walk the very next day. After a few days, they can let him go home for outpatient treatment. In order not to cause congestion in the pelvic area, to prevent possible complications, it is recommended to walk at least 3-4 hours a day.
  • Seated baths. They must be done with various antiseptics (potassium permanganate, calendula, sage) in order to avoid infection of soft tissues and hemorrhoids.
  • In the first postoperative days, it is recommended to drink a laxative (lactusan, duphalac, bisacodyl) to facilitate bowel movements. This will help avoid possible trauma to the anus with solid feces.
  • In case of unpleasant sensations in the area of ​​the anus, ice or lotion with absorbable ointment is allowed to be applied.It is recommended to use a special antihemorrhoidal pillow.

With severe pain (which is possible within a short time after surgery), it is recommended to take a non-steroidal anti-inflammatory drug (ketoprofen, nimesulide, nurofen).

Fourth degree of the disease

Hemorrhoids of the 4th stage is a neglected and severe pathological process, the hallmark of which is the constant loss of hemorrhoids and the absence of their reduction.

An intense manifestation of symptoms is noted not only during bowel movements, during physical exertion or prolonged sitting position of the patient, but also during walking and performing normal daily activities.

The severe course of the disease does not lend itself to the methods of treating hemorrhoids in the early stages. The only way to eliminate the ailment is surgery. Operations can be performed in one of the following ways:

  • Longo technique
  • closed hemorrhoidectomy, which involves crosslinking of the mucosa,
  • laser coagulation,
  • open hemorrhoidectomy with leaving the wound surface until subsequent self-healing.

The main consequences of untimely treatment of hemorrhoids of the 4th degree are:

  • anemia - due to heavy bleeding,
  • thrombus formation,
  • failure of the anal sphincter.


In order for the clinician to be able to determine what hemorrhoids looks like, its location and volume, patients will need to undergo a series of instrumental examinations. However, before performing them, the proctologist must independently perform several manipulations, namely:

  • conduct a detailed survey of the patient for the presence and degree of manifestation of the symptoms of the disease. This will make it possible to determine the stage of hemorrhoids,
  • to study the medical history and medical history of not only the patient, but also his immediate family - to identify the causes of the disease,
  • perform a physical examination, which involves a digital examination of the anus.

Laboratory tests of urine, blood and feces carry a minimum of diagnostic information, but may indicate the development of complications of the disease.

The basis for establishing the correct diagnosis is the following instrumental examinations:

  • Ultrasound of the abdominal cavity,
  • colonoscopy
  • sigmoidoscopy,
  • irrigoscopy
  • gastroscopy.

It is such procedures that can help distinguish hemorrhoids in the initial stage from a fourth-degree ailment. In addition, it is on the basis of the results of such diagnostic measures that the clinician prescribes the most effective tactics for treating hemorrhoids individually for each patient.

What are the diagnostic methods?

At this stage, the disease is diagnosed much more often than in the first two. The patient is already experiencing enough discomfort to abandon the idea of ​​self-medication and visit a doctor.

They diagnose it with a personal examination. A doctor may have a colonoscopy. This is an examination of the large intestine with a coloscope, a special tool.

Also, the doctor can give a referral for an ultrasound examination of the large intestine.

Overview of Treatment Options

Drug treatment

Grade 3 hemorrhoids can be tried without surgical intervention. But such a treatment may not have the desired effect.

Even if the hemorrhoidal nodes decrease, relapses are possible. Basically, drug treatment at this stage is used to reduce pain and relieve inflammation.

The following suppositories and ointments can be used in the treatment of hemorrhoids 3 stages:

The ointment has a warming and analgesic effect. It is used to treat external hemorrhoids. It has a healing effect. It is prescribed in the case of anal fissures and after surgical removal of hemorrhoidal cones. Internal hemorrhoids are not treated.Hepatrombin-g

The active ingredients of the ointment are heparin and allantoin. It has an analgesic effect, improves blood flow in the vessels. Relief

These candles relieve itching and burning, have a healing effect. They help soften feces. If the stool is softened, then bowel movement for the patient becomes less painful. Papaverine candles

These candles help restore tone to the intestines in places where hemorrhoids are localized.

You can try to relieve the symptoms of hemorrhoids at this stage:

Such candles help relieve pain in stage 3 hemorrhoids. Making them is quite simple. A candle is cut from raw potatoes and inserted into the anus at night. Do not try to remove it. It will come out independently during bowel movements. Sea buckthorn oil

Sea buckthorn oil helps relieve pain and reduces bleeding. Sea buckthorn oil is applied to the hemorrhoidal nodes. Great for treating external hemorrhoids.

In fact, this is a surgical intervention. Nevertheless, this is a rather gentle and effective treatment option. After all, with such an intervention, injuries to surrounding tissues will be minimal. Consider the various methods.


Hemorrhoid cones are frozen with liquid nitrogen. As a result of this procedure, rejection of hemorrhoid cones occurs. The patient does not have any serious pain. Latex Ligation

The doctor imposes a latex ring on the node leg. It survives the vessels that feed the node. After this, the node, devoid of blood supply, dies.

All these manipulations are performed on an outpatient basis. Hospitalization in this case is not required. The sick leave is not issued.

In the near future, the patient will be able to start work. Sometimes there are painful sensations. They are removed with painkillers.

Surgical removal

Surgical removal of hemorrhoids in the third stage is rarely used. Usually it is used in the most advanced cases.

Such removal is carried out in a hospital. For the operation, local or spinal anesthesia is used. The patient is required to be in the hospital from 2 to 7 days.

How fast does the disease progress?

If the disease is not treated, then the deterioration of hemorrhoids of degree 3 to stage 4 occurs quite quickly, after 3-4 weeks.

Therefore, it is necessary to consult a doctor as soon as possible.

Grade 3 hemorrhoids cause quite severe suffering to a sick person. Do not bring the disease to such a state.

It’s much easier to cure the disease in the earlier stages. You should not be afraid to visit a doctor. The doctor will not do anything unnecessary, his task is to help the patient. Do not pull with a doctor!

You can find out about harmful and useful products for the male organ here.

Fourth stage

A feature of the 4th stage of hemorrhoids is the development of serious complications: thrombosis with necrosis of the tissues surrounding the anus, prolonged, uncontrolled bleeding, suppuration.

Pathological changes in the fourth stage of hemorrhoids are characterized by clusters of hemorrhoidal formations surrounding the anus, painful, bleeding, thrombosed, prone to infringement. This degree of development of the disease is characterized by large sizes of caverns, which cannot be corrected by any means. They are painful and bleed for no apparent reason, even at rest.

The fourth stage is treated only with radical hemorrhoidectomy or hemorrhoidopexy, drugs are used in preparation for surgery and during rehabilitation. For example, for the relief of anemia - iron preparations: Totem, Ferro-Folgamma, Fenyuls, Maltofer (drops), Ferrum-Lek (syrup).

In addition, a set of measures at all stages of the treatment of hemorrhoids implies:

  • identification and elimination of the causes of pathology (complete clinical and laboratory examination),
  • normalization of the digestive system, the prevention of constipation, enzymes are used: Nutriclins, Agiolax, which improve motility and soften the movement of feces in the colon.

Thanks to this treatment regimen, the effectiveness at different stages of hemorrhoids reaches more than 95%.

The importance of timely medical attention

The key to successful treatment of hemorrhoids of any stage is the timely diagnosis, that is, urgent medical attention when the very first signs of the disease appear. Determining the degree of pathology is crucial. It is unreasonable to allow the progression of hemorrhoids to such an extent that radical surgery remains the only way of treatment, especially since this can lead to undesirable complications, both in the first and fourth stages:

  • thrombophlebitis,
  • infringement of a cavity by a sphincter with necrosis,
  • uncontrolled blood loss with the development of anemia,
  • secondary infection with the development of abscesses, fistulas,
  • anal fissures,
  • proctitis, paraproctitis,
  • dermatitis, eczema of the anorectal zone.

Therefore, you should not independently diagnose and prescribe treatment for yourself even at the initial stage of the disease. Health and life are more expensive than excessive independence.

The course of acute hemorrhoids

Acute hemorrhoids are characterized by a rapid course. The causes of exacerbation are many, ranging from hypothermia to hygiene. The victims of the disease are both people suffering from chronic hemorrhoids and those who have not encountered the problem before.

Due to the pronounced symptoms, exacerbation always attracts the attention of the sick. It can be “muffled” with drugs and translated into a chronicle, but this does not exclude a subsequent exacerbation, with a combination of unfavorable factors.

Grade III

In addition to anorectal thrombosis and inflammation, the patient develops edema, tissue necrosis of hemorrhoids begins.

Regardless of the stage, with exacerbation of hemorrhoids, it is recommended to urgently consult a coloproctologist, to self-medicate in this situation - it is dangerous for life and health.

Treatment of the acute stage includes anti-inflammatory, phlebotropic therapy, local anesthesia. After suppressing the inflammatory process, surgery and removal of the thrombosed portion of the node occur.

So, the article examined the features of the course of chronic and acute forms of hemorrhoids 1-4 stages. This information will help diagnose the disease and take the necessary measures, however, it is only the doctor who can make the correct diagnosis and prescribe the appropriate treatment method for a particular case after a set of diagnostic examinations.

In some cases, hemorrhoids are an indicator of another serious problem. It can be detected with a comprehensive examination and decoding of the analyzes by a proctologist.

You can put a lot of effort, time and money into ineffective self-medication, change a dozen ointments and suppositories, avoiding going to the proctology office. But, even then, it is difficult to find means that correspond to the parameters of the pathological process.

On the contrary, the proctologist selects a proven therapeutic treatment technique that quickly yields results and allows the patient to soon return to a full life.

For the prevention of hemorrhoids, it is recommended to lead in an active way of life, not to make unnecessary loads when playing sports, to avoid stress, reasonably approach the preparation of the diet and consume enough water.

Watch the video: Hemorrhoid Removal Hemorrhoidectomy (February 2020).

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