Internal and external haemorrhoids
In medicine, haemorrhoids are usually divided into two forms according to the location of the nodes: internal and external. Which form of the disease a person has determines the course of the disease itself, its treatment, and how severe the consequences will be if it is ignored and treatment is put off “until later”.
Internal and external haemorrhoids
Internal haemorrhoids are sometimes considered the more insidious form of the disease. Patients cannot diagnose them accurately on their own and often ignore the symptoms, since in the early stages these are not particularly severe. This can lead to the disease becoming advanced and to the need for long and complex treatment.
With internal haemorrhoids, the enlarged nodes are located in the rectum and cannot be seen from the outside. In the early stages, when the nodes do not prolapse, patients cannot detect this form of the disease themselves without seeing a doctor. However, the following symptoms may point to it:
- Pain during bowel movements: stools can compress the nodes and thereby cause pain.
- Bleeding from the anus. In the early stages this may be just a few drops of blood on the toilet paper after a bowel movement. In the later stages, bleeding may not stop for quite a long time.
- A feeling of a foreign body in the rectum.
- A feeling of incomplete emptying of the bowel after a bowel movement.
If you notice any of these symptoms, you need to see a proctologist for an accurate diagnosis. After palpation, anoscopy (visual examination of the rectum using a special instrument – an anoscope) and, if necessary, other diagnostic procedures, the doctor will determine precisely whether haemorrhoidal nodes are present and where they are located, and will be able to prescribe treatment.
External haemorrhoids: symptoms and features
Most proctologists consider, broadly speaking, that external haemorrhoids are “easier” to diagnose, because many of their symptoms can be detected without special diagnostic procedures, including by patients themselves. However, many patients do not see a doctor, because soft, elastic lumps in the anal area often cause only minor discomfort and hygiene-related inconvenience. The picture changes dramatically when a haemorrhoidal node becomes thrombosed, which is accompanied by pain and inflammation. In severe cases, the inflammation may spread to the surrounding tissues, leading to their necrosis. To avoid things reaching the point where urgent hospitalisation and major surgery are needed, you should see a doctor straight away if you notice the following symptoms:
- Pain, itching or burning in the anal area;
- Finding a haemorrhoidal node when washing;
- Discomfort in the anal area when walking and sitting;
- Bleeding from the anus;
- Painful bowel movements.
Do not ignore the symptoms, do not be embarrassed to see a doctor, and do not rely on self-treatment. With timely and appropriate treatment, you can forget about haemorrhoids for a long time, but this is definitely not a disease that goes away on its own.
Treatment: general measures and differences
External and internal haemorrhoids are two different forms of the same disease, so most treatment measures are the same in both cases.
1. Eliminating triggering factors
Blood stasis, weakness of the vessel walls and high pressure in the abdominal cavity play an important role in the development of haemorrhoids. Where does the increased pressure come from? There are many possibilities: lifting heavy objects, prolonged straining during bowel movements and, in women, pressure from the uterus during pregnancy and childbirth. Blood vessels are also affected by lifestyle, poor diet, alcohol abuse and hormonal problems.
Accordingly, measures to eliminate the causes of the disease should also be taken in several areas:
- Stop lifting heavy objects. Get enough physical activity and do not sit in one place for long periods. Adjust your diet so that you do not suffer from constipation.
- Get enough physical activity and do not sit in one place for long periods.
- Adjust your diet. It is recommended to consume adequate amounts of fluid and dietary fibre to normalise bowel function and eliminate constipation. In acute haemorrhoids, alcohol and spicy food must be completely excluded.
2. Hygiene
After each bowel movement, use a hygienic shower. In acute haemorrhoids, even the softest toilet paper can further injure an inflamed node.
3. Taking venotonics
Doctors often recommend venotonics for haemorrhoids. Venotonics are effective medicines for treating the symptoms of both external and internal haemorrhoids. Phlebodia 600 is a modern venotonic containing highly purified diosmin. It strengthens the vessel walls, reduces the distensibility of the veins, including the veins of the rectum, improves microcirculation, reduces venous congestion and has anti-oedema and anti-inflammatory effects (1).
How to take Phlebodia 600*:
For acute haemorrhoids, the patient takes a 7-day course of treatment consisting of 18 tablets: 3 tablets a day with meals for four days, then 2 tablets a day for another three days. After this 7-day course, the main symptoms of acute haemorrhoids subside, and it is then possible to continue with 1 tablet a day for 1–2 months (at the discretion of your doctor).
The dose of the active substance (diosmin) in Phlebodia 600 is optimal for the treatment of haemorrhoids.
4. Relieving pain, tension and discomfort
In addition to eliminating the cause itself, when haemorrhoids appear it is important to relieve the unpleasant symptoms that usually prevent people from living a full life: pain, itching, burning, bleeding and a feeling of “fullness” in the rectum. For this purpose, topical products are usually used: ointments or rectal suppositories. For internal haemorrhoids, suppositories are the better choice. They act on the haemorrhoidal nodes in the rectum, are absorbed slowly and take effect gradually. For external haemorrhoids, creams and ointments with analgesic and anti-inflammatory effects are more suitable.
To relieve unpleasant symptoms, you can also use folk remedies, such as cool herbal sitz baths. This method cannot fully replace drug treatment, but it can be used as an additional supportive measure on your doctor's recommendation.