1. HEMORRHOIDS 2. HEMORRHOIDS: DESCRIPTION, SYMPTOMS, DIAGNOSIS AND METHODS OF TREATMENT The hemorroids affect about 80% of the population at a certain moment. The hemorroids made Napoleon sit on a buttock, sent Jimmy Carter in the surgery room, and kept George Brett on the emergency bench during the world championship from 1980. Over 2/3 from the healthy population which went to a doctor was diagnosticated with hemorrhoids. By hemorroids we define the clinical expression of the varicose dillatations of the veins which are at the level of the anal channel and the rectum. The volume growth of those veins is produced through the disturbance of the reversion of the venous circulation. Unfortunately, this circulation, richly represented, is realized against gravitation. Sometimes, to this thing are added deficiencies in the alimentation which lead to constipation, the irritation of the rectal area through alchool consumption or excessive spices. Pregnancy and birth amplify an already existent pain through the volume growth of the uterus and the compression effect on the venous pelvic system. But the most frequent cause is considered to be the long sitting position. It is also known as the clergymen’s and drivers’ disease. The mechanism of its production is very simple. The rectum is an elastic cylinder which can be easily crippled under the pressure of the intraabdominal organs producing the compression of the blood-vessels which drive the venous blood from the periphery. The result is the rise of the venous pression in the haemorrhoidal system with accumulation in the vascular rectal cushions and their dilatation. Generaly, the process is reversible till one point. From now on the integrity of the conjunctive system appears, namely if we succeed an elastic tissue less elastic, after every new rise of volume, those vascular cushions do not return to their initial dimension. They lead to greater and greater vascular varicose dilatations. The only wise thing you can do is to go immediately to a proctologist. You will receive good advice in what concerns the way of living, the daily diet and the most efficient treatment. We perceive lately a great variety of therapeutical methods from the administration of local ointment to simple and easily supported interventions which can be done by the patient. The clasical surgery remained the emergency for the advanced forms of the disease, of the neglected forms, with an evolution which lasts from a longer period of time. The hemorrhoids are venous cushions localized within and around the rectum. When the haemorrhoids get inflammed, they can cause itch or pain and they can bleed. Unfortunately, the haemorrhoids’ condition can only get worse over the years, and never gets better. That is way we recommend a sure treatment, easily supported and efficient for the haemorrhoids, when you notice their presence. The internal hemorrhoids appear upper on the anal channel, without being seen. The bleeding is the most frequent sympton of the internal haemorrhoids and the only one in the majority of cases. The external haemorrhoids are visible outside the anal channel. The haemorrhoids are actually veins under the skin which bloat and have a blue colour. Usually those haemorrhoids appear without any symptom. But when they get inflammed, those haemorrhoids are red and sensitive. Sometimes, the internal haemorrhoids goes out through the anal channel, this phenomenon being called haemorrhoidal prolaps; it is very difficult to introduce them back in the anal channel and they are usually very painfull. When a clot of blood is formed in the interior of an external haemorrhoid, the patient usually feels an acute pain. These trombothized haemorrhoids are felt in the anal area as some peas with a tough consistency.
The
appearence and the classification of the hemorrhoids The haemorrhoids are both in the interior and above the anus (internal) or under the skin around the anus (external). The haemorrhoids appear as a result of the congestion of the internal and external plexi around the anal channel. The haemorrhoids are classified in four groups, according to their gravity, in this manner being easier to be evaluated for the treatment. Which are the symptoms for the hemorrhoids? Many anorectal problems, including cracks, fistula, abscess or irritations and itches (anal pruritus), have the same symptons and are incorrectly diagnosticated as haemorrhoids. The haemorrhoids are not usually dangerous and they do not menace life. Rarely, a patient can have such a bleeding so as the severe anaemia or even death can appear. In some cases, the haemorrhoidal symptoms dissappear in few days. But in the majority of cases, the haemorrhoidal symptoms will appear again, usually worse than before. Even if many persons have haemorrhoids, not all have symptoms. The most frequent symptom for the internal haemorrhoids, is the pure bleeding which covers the stool, the toilet paper or the toilet pot. However an internal haemorrhoid can go outside through the anus, being irritant and painfull. The symptoms for the external haemorrhoids can include painfull and tough swellings around the anus which are result of the forming of a blood clot. This stage is known as the “external thrombosis”. In addition scratching in excess or the anus cleaning can cause irritations with bleeding and itch. This can produce a vicous circle of symptoms. How common are the hemorrhoids? The haemorrhoids are very common among men and women. About half of the population has hemorroids until the age of 50. The haemorrhoids are usually met at the pregnant women. The pressure of the fatten in the belly, the same as the hormonic changes, lead to the increase of the haemorrhoidal vessels. These vessels support a great pressure during the birth. For the majority of women, the haemorrhoids caused by the birth are a temporary problem. How are the hemorrhoids diagnosed? A serious evaluation and a professional diagnostic given by a doctor is important when the bleeding at the anus appears or when you notice blood in the toilet pot. The bleeding can be a symptom for other peptic troubles, including the colon cancer. The doctor will examin the anus and the rectum, searching to see if there are swelled vases, which indicate the presence of haemorrhoids and he will make a rectal exam introducing a finger with lubrifiant in order to feel the abnormalities. A more attentive evaluation of the rectum to see the haemorrhoids needs an exam with a videorectoscope which can visualise the whole rectum. In order to exclude other causes of the bleeding, the doctor can examine the rectum and the lower part of the colon (sigmoid) through sigmoidoscopy or the whole colon through colonoscopy. Both are procedures that suppose the use of some flexible tubes introduced through the rectum, connected to a videocamera. How can we prevent the hemorrhoids? The best way of preventing the haemorrhoids is to keep the stool soft, the pressure dicreases. The physical exercice, including walking and the growth of fibres in the diet help to reduce the constipation and to a softer stool which passes easily through the guts. Which is the treatment? The medical treatment for heamorrhoids supposes the settling of the symptoms. The measures to reduce the symptoms include: Warm baths several times a day in luke warm water for 10 minutes. The application of a hemorrhoidal cream or suppository on the affected area for a limited period. The prevention of the emersion of the haemorrhoids will need the release from the pressure and the stop of the constipation. The doctors will recommend the introduction in the diet of more liquids and fibres. Eating of a corresponding quantity of fibres and drinking about 6-8 glasses with liquids (not alchool) will lead to softer and more consistent stools. A soft stool makes the draining of the guts easier and leads to the weakening of the pressure on the haemorrhoids caused by abstention. The elimination of the abstention from the stool prevents the appearence of haemorrhoids. Good sources of fibres are the fruits, the vegetables and all the cereals. In some cases, the haemorrhoids have to be treated endoscopically or by surgery. These methods are used to lower and destroy the haemorrhoidal tissue. The doctor will do the procedure in a cabinet or in a hospital. Other methods can also be used for the reduction and removal of the hemorrhoids. The surgery for the hemorrhoids can be avoided in favor of more sophisticated and painless methods. The non operatory methods can be used for all the patients, as a viable and final alternative for the treatment of the haemorrhoids, being included in: - The Bipolar Coagulation The bipolar electrotherapy applies for a direct coagulation of the mucosa near the haemorrhoid. - LAH Arterial Ligation of the Hemorrhoids is made with a modified anuscope and with a Doppler probe with ultrasounds. A needle with a suture will ligate the artery in order to stop the bleeding. - Photocoagulation A device called photocoagulant, merges a spot of light in the infrared spectrum in the top of the sounder, in this manner the haemorrhoid is fixed in its place. It is a method used for the bleeding haemorrhoids. - Rubber band ligation – the less painful method for the treatment of haemorrhoids. A special tool fixes on the hemorrhoid a small rubber collar. Being very tight on the haemorrhoid, this collar stops the flux of blood towards the swelled portion, which falls in about one week. This method is often used for the haemorrhoids from the anal channel. For the patients with a low degree of prolaps, Rubber band ligation is one of the most used methods from USA and Europe for the treatment of the internal haemorrhoids. In this procedure, the haemorrhoidal tissue is drawn in a cylindrical bell in order to allow the placement of the latex or rubber collars on the haemorrhoid. In time the tissue under the collar dies and it is eliminated during the stool. Rubber band ligation is a method which does not involve pain and can be done in a medical cabinet. Very often, one or more meetings are necessary for the resolution of the patient’s problem. Rubber band ligation has a real succes if it is accompanied by a scleroterapie for prolaps. - Injection In order to lower the hemorroid and the afferent blood vases, the doctor pumps antibiotic in the mucosa near the haemorrhoid. This method is used also for the smaller hemorrhoids. - Criogenia of the hemorrhoids A criogenic device uses liquid nitrogen to freeze the hemorrhoids. This method leads the affected tissue to death and thus a new tissue will grow on that place. This method has a real succes for the external hemorrhoids.postat: 10.11.2006 3. CONDILOMA ACUMINATA (GENITAL VERUCI)The genital veruci are the clinical manifestation of an active cutaneo-mucosal infection of the genital, the perigenital and perianal, masculine and feminine area, with some types of papiloma human viruses (HPV). The transmission can be sexual but also non sexual (infected hands, iatrogenic, antenatal or perinatal transmission for children). The infection consists in a great contagiousity and it is frequently associated with other diseases that can be transmitted sexually (syphlis, HIV, etc.), which imposes the realization of the respectively tests. In some countries it is considered the most frequent disease with sexual transmission. We also have to mention the possibility of the malignant transformation. The pathologic exam: It is indicated only for the cases when the treatment is not working or it is getting worse during the therapy (a possible displasia), in case of pigmented lesions, infiltrated or in case of an uncertain diagnosis. Condiloma acuminata are tumoural lesions with a small size, with a cauliflower aspect, whitish, with a tendence of grouping in placards. They can be localized at women at the level of the cervix or of the intravaginal mucosa (rarely to men, at the level of the penis). They can reach giant forms localized at man at the level of its perianal secernent (rarely at women). Complications: - micotic or bacterial infection - Malignant degeneration (cervical condiloma , cervical intraepidermal condiloma). Exams for establishing a diagnosis: Compulsory: - Tests for hunting out the concomitant presence of other diseases with sexual transmission (syphilis, HIV infection) Optional: - The test of smearing with a solution of acetic acid 5% which, in the case of pozitive reactions, will accentuate a witish network (it is made for the hunting out of the sulclinical forms, of the unspecific eritematoase forms and for the prominence of the extension area of the infection around a obvious clinical lesion) - The pathologic exam: the prominence of the cells with an koilocitar aspect. It is indicated only in the cases when the treatment does not work or it gets worse during the therapy (possible displasia), in case of pigmented lesions, infiltrated or in case of an uncertain diagnosis. - The viral analysis and viral typification with the PCR testing technique. Treatment: The choice for the optimal method of treatment depends on various factors: the localization of condilomas, their oldness, the concomitant infection of the partener, the immune status, the HPV subtype, other concomitant genital infectionsetc. Local therapies: The local application of the tricloracetic acid, Podophylin, Podophylinotoxin associated to methods of condiloma distruction ; criotherapy, electro-cauterization, the surgical excision or with a CO2 laser. The following topical imunomodulators and antiviral preparations with a topical application or intralesional injections can be used. General therapies: For extended lesions, relapsing on the field of a severe imunodepression, for the treatment of the latent infection with HP Isoprinosine, Levamisol, BCG. Criteria for internment and direction: The giant clinical forms, the forms that resist to all the applied therapies, forms that appear on an imunodepressed field. Prophylactical measures: Preservatives: no matter what the method of treatment is, the patients will be adviced to use them in their sexual contact 3-6 months after the clinical healing. The preservatives do not assure a total protection, the infection can be done through the cutaneous contact with the perigenital area. Nevertheless, they assure the protection against the infection of the uterine cervix with the HPV oncogene types. The vaccine therapy with prophylactic and therapeutical goal is in course (especially with HPV tipe 16, the most frequent associated with the cervical uterine cancer). postat: 13.12.2006 4. THE HEMORRHOIDAL DISEASE: MEDICAL TREATMENT, SURGICAL OR NONSURGICAL TREATMENT?The hemorrhoids (internal) are veins that line up the anal channel like some cushions, assuring the solid closing of the anus, so as, in normal conditions, neither the diarrheic stool nor the gas can be involuntary exteriorized. The hemorrhoidal disease is manifested through the progressive dillatation of those venous cushions, caused by various factors such as: heredity (varix, hernia, haemorrhoids to blood relatives, which transmit the heritage of an elastic texture less elastic to the level of the venous walls), the working factor (jobs that suppose a sitting position for a long period, such as in the case of drivers, clergymen etc.), chronical constipation, pregnancy and birth. All those mentioned factors suppose a defective drain of the venous blood which does not flow efficiently, and the little cushions are transformed in varicose dillatations situated in the anal channel, which can bleed in the case of a difficult stool or after a diarrhoeal episod, alarming the patient, who goes frightened to the doctor. The anal bleeding (rectoragia) is the most frequent manifestation of the haemorrhoidal disease, linked with itches, wet anus, difficulties in defecation or even pain. Generally 90% from the anal bleedings are caused by hemorrhoids, the rest of 10% being generated by other causes, not necessarily malignant (colon cancer), but also benign (anal canker, Crohn disease, anal adenoids) That is way a colonoscopic exam is necessary, even if we are sure that the visible haemorrhoids, are the cause for bleeding. The hemorrhoidal disease: medication only, surgery or non-surgical treatment ? Lets take them one by one: The drugs used now for the hemorrhoidal disease are very efficient and they ameliorate the symptoms in a short period of time, but TEMPORARILY. It is better to understand that the hemorrhoids, those varix existent in the anal channel, are daily, at every stool, pushed towards the exterior like a piston in a cylinder, what leads to their gradual and irreversible extension, even if there are not other symptoms, especially for the patient with a normal stool. Sequelly, the hemorrhoids do not disappear and cannot be cured through drugs; they continue to increase their size and to evolve towards more advanced stages. The drugs (ointments, creams, suppositories) have a great importance and are broadly used, AS ADJUVANT FOR A RADICAL THERAPY. The classical intervention, with all its disadvantages ( hospitalization, anaesthesia, operational risk, pains that are hard to be supported at a month after the intervention), has its benefits, namely IN THE ADVANCED STAGES OF THE HEMORRHOIDAL DISEASE, WHEN THE NON-OPERATORY METHODS ARE NO MORE POSSIBLE. That is why you have to get a diagnosis from a doctor who deals with both methods, namely a surgeon, and in the same time to have enough experience in practising the non operatory methods, in order to be able to choose the treatment with the best and sure results for you. Obviously, the surgeon who does not have to much experience and practice for the non opertatory methods will recommend you what he knows best – the classical intervention. The non-operatory methods used in our Proctomed clinic, are known in the urbane world for a long period of time; they are used for many patients, with a proved efficiency GREATER than the classical method, but, as I was saying at point 2, with few counter-indications, in the case of the neglected hemorrhoids, in an advanced stage. The treatment does not suppose internment, anaesthesia, hospitalization, but only some therapeuthical appointments in the Proctomed clinic, when the sequential link with elastic bands and the photothermacoagulation of a haemorrhaoidal mass or two on the appointment are realized. The patient will come back to the clinic for a new appointment after 2-3 weeks, so as in several stages (average 3-5), all the dilated hemorrhoidal masses to be removed. You have to notice that, in this manner, you do not have to stop your daily activity or your work, but, about once a month you come at the Proctomed clinic, to benefit from a modern treatment, known as the most efficient treatment for the hemorrhoidal disease. postat: 09.01.2007 5. PAIN IN PROCTOLOGYThis is one of the most important and frequent plaints for the anorectale pathology. With a variable intensity, which goes from a simple local discomfort to an intensive pain, is the symptom that compulsory leads the patient to doctor, especially when the pain is accompanied by other local phenomena. The most frequent causes for the anal pain are given by (in the order of their frequence): the haemorrhoidal disease, the anal crack, proctalgia fugax, the infectious pathology– the perianal abscess, ischiorectal abscess. Other causes can be the rectal cancer, the inflammational diseases of the gut (the Crohn disease), the strange intrarectal additions. The haemorrhoids generate a soft pain perceived under the form of a local discomfort. The intensive pain appears in the case of the haemorrhoidal thrombosis, it installs rapidely and remains intensive for 3 – 4 days. The pain linked to the anal crack is acute, like a blade cut, with a maximum intensity in the stool, then it changes its characteristics, being perceived as a burn or as a smarting, which remains from few seconds to hours depending on the ampleness and oldness of the affection. The pain from the other pathological affections has variated characteristics, and for a corect diagnosis (a thing which is not always easy) you much go to a doctor. postat: 01.02.2007 6. EAT MORE FRUITS AND VEGETABLESA healthy alimentation has to include at least 5 portions of fruits and vegetables, including here the fresh ones, but also the refrigerated ones, dry or juice. In this manner you will diminish the contingency of the appearence of cardiovascular affections caused by ateromatosis (aterosclerosis, peripheric arteriopathy or even stroke). The regular consumption of fruits and vegetables decreases the frequency of appearence of colon and lungs cancer. The survey taken in Great Britain shows a diminish with about a quarter of the mortality caused by cardiovascular troubles and cancer when the fruits and vegetables consumption is raised. All those things because fruits and vegetables: - contain fibres that fix the bowel movements, avoiding the appearence of constipation and of colonic diverticulosis complications. - contain many vitamins and minerals and antioxidants which protect the organism against cancer - have a lower content of fat - produce fastly the sensation of satiety but they have a low content of calories. A PORTION OF FRUITS AND VEGETABLES (FROM THE 5 RECOMMENDED) MEANS: - a big fruit such as apple, banana, orange, a big slice of water melon - two small fruits such as plums, kiwi, clementine - a cup with small fruits such as grapes, raspberry, strawberry, cherry, sour cherry - one – two big spoons with raisins - a glass (150 ml) with fresh juice - two big spoons with any kind of vegetable HOW TO INCREASE THE QUANTITY OF FRUITS AND VEGETABLES FROM YOUR DIET 1. Try the ones you do not know, variety can stimulate 2. Try to add pieces of apple, banana or other fruits to cereals 3. Propose yourself at least two different types of vegetables at the main dish. Do not boil them extremely. 4. Add frequently juice to dishes. 5. Fruits are good for desert also. Encourage your children to replace the sweets with fruits for desert. postat: 11.02.2007 7. THE IMPORTANCE OF FIBRES IN THE DIETThe vegetal fibres are that part of the plant that cannot be digested, being blot out through excrements as waste. Practically, the vegetal fibres give volume and consistency to stool, contributing decisively to the adjustement of the intestinal movements and through this avoiding the appearance of some complications and affections of the colon and the anal channel. Practically, if a person absorbs almost 30-35 grams of pure fibres, having an enough contribution of 1,5-2 litres of liquids, he/she will not have problems with constipation. The role of the vegetal fibres: - they give volume to the stool, stimulating the intestinal receivers which assign the bowel movements and assure a normal stool - they prevent the colonic diverticulosis - they prevent the appearence of the haemorrhoids and the anal crack, two affections strongly connected to constipation. - they reduce the risk of the appereance of colon cancer - being hipocaloric, they prevent obesity, giving in the same time a precocious sensation of repletion. Aliments with great content of fibres: - whole bread and the biscuits from whole cereals - wholeflour - fruits and vegetables, eat al least 5 portion of fruits and vegetables daily - whole cereals for breakfast - brown rice, spaghetti and pasta from wholeflour You can buy from the pharmacy fibres supplement, with different commercial names, that are used in the treatment against constipation. They have to be used carefully according to the indications. Remark!: Once you increase the quantity of ingered fibres you must increase the quantity of liquids (about 2 litres daily), and you do not have to get anxious if, for several days, there will appear a sensation of natural distension until the completion of the accomodation of the gut to a rich content of fibres in alimentation. postat: 20.04.2007 8. THE IMPORTANCE OF THE HUNTING OUT OF OCCULT BLEEDINGS IN THE STOOLThe occult bleedings (invisible) are those type of bleedings that are quantitatively reduced, they cannot be visually noticed by the pacient during the stool. Still, through repetition and the absence of a diagnosis can lead, in time, to a severe anaemia. There are many affections that can generate occult bleedings such as canker, colitis, adenoids and particularly the colon cancer. If those affections bleed in abundance, they usually lead to melaena, which is a stool that contains adapted blood, digested, with a black colour, with oil aspect. If the bleeding is minor, it can be unnoticed, and that is why the test for hunting out the occult bleedings is so necessary. The test shows that somewhere on the colon is a bleeding but it cannot specify the right place. In what consists the test for occult bleedings: It is very simple, namely: on a small sample of excrements is added a chemical agent and a specific colour is obtained, which can confirm the fact that there is a bleeding on the colon. In general there has to be done 2-3 tests in several days, because the bleeding can be incidental and in this way we increase the posibility to discover it. The test is used in Great Britain for screening of the population in what concerns the colon cancer, every individual being asked once in two years to do it, hoping that there is a faster way of hunting out the colon cancer. postat: 03.05.2007 9. CONSTIPATION1. What constipation is? It is an usual and common affection. The feces become more consistent, difficult or even painfull to evacuate. The period between stools increases in comparison with the characteristical feature (normal stool means for some people 2-3 times a day and for others 2-3 times a week). Normal characteristics can be also distension and even abdominal cramps. 2. Which are the causes that lead to constipation? - the diet low in vegetal fibres, which, without being digested, are useful because they add some ammount to the stool and stimulate the intestinal movements, leading to an increase of the stools’ frequency. - a defective contribution of liquids. You have to drink 1,5-2 liters daily - some reducing cures low in fibres - some drugs (lenitive based on methylmorphine), some acidproof, antidepresive medication, pharmaceuticals with iron, some medication for the heart diseases. - some concomitant affections such as those of the tyroid gland, the syndrome of the irritable gut, or others affections that make the patient lie on bad all the time - pregnancy– almost a fifth part of the pregnant women suffer of constipation, because of the hormonic modofications. - dolicocolon, namely the thick gut longer and more dilated than usual, which can have a more reduced peristaltism. SUDDEN CONSTIPATION CAN BE AN EMERGENCY SIGNAL FOR THE COLON CANCER !!! Are tests necesary? Yes, if the constipation appears suddenly, if it becomes difficult to control, if it is accompanied by lasting pains and bleeding at stool, then a colonoscopy, a test for occult bleedings or a barium enema become necessary. What can be done in order to prevent and ameliorate constipation? - Higher consumption of fruits, vegetables, cereals, fresh juice, whole bread - An adequate contribution of liquids (8-10 ewers per day), of any kind, excepting alchool in excess, which provokes an opposite effect, namely dehydrating. - Physical activities - Regular going to toilet. Avoiding to go to the toilet makes the evacuation more difficult for the future. The cure with laxatives can start only if the measures below don’t have any notable results. The laxatives can create adiction. Once the stool fixed, the cure with laxatives has to be stopped and not continued as a preventing measure. The laxatives based on vegetal fibres have a latter effect, after 12-24 hours or more; that is why we are not adviced to supplement the ingered quantity before detecting any effects, because otherwise we can obtain an opposite effect. There are some laxative which stimulate the bowel movements, that have to be used carefully because they can provoke „gut’s lounge” the same as the osmotic ones stimulate the accumulation of a great quantity of liquids in the gut favouring the cramps and the distensions. If you do not obtain any improvement you must go to the doctor. postat: 03.05.2007 10. RECTORAGIARectoragia reprezinta exteriorizarea sangelui prin orificiu anal. Ea poate fi in cantitate mai mica sau mai mare, cu sau fara modificarea parametrilor vitali (scaderea tensiunii arterale, cresterea pulsului), uneori necesitand transfuzii de sange, sau conducand la anemie. In functie de acesti parametrii rectoragia poate fi acuta sau cronica. Cauzele principale care duc la pierderea sangelui prin orificiu anal sunt: -hemoroizii interni, -FISURI ANALE, -cancerul de rect sau colon, -polipi rectali sau colonici, -diverticuloza colonica, -angiodisplazia colonica, -colita radica, -colita ischemica, -colita infectioasa, -boli inflamatorii intestinale, -rectocolita ulcero-hemoragica, -alte cauze (ulcere rectale solitare, varice colonice, ulcere colonice dupa ingestia de antiinflamatorii). Cele mai comune si frecvente cauze de rectoragie sunt hemoroizii interni si fisurile anale. In aceste situatii rectoragia este in cantitate mica si intermitenta, caracterizata prin eliminarea de sange rosu, proaspat, ce tapeteaza scaunul sau la sfarsitul scaunului si nu este amestecat cu materiile fecale. La inceput sangerarile sunt minore, apar la sfarsitul scaunului si se repeta dupa o perioada mare de timp. Ulterior sunt mai frecvente, abundente, apar dupa fiecare scaun, odata cu cresterea in dimensiuni a hemoroizilor. In cazul fisurilor anale sangerarea este mai mica, apare dupa defecatie si se asociaza cu durerea. Pierderile mici si repetate de sange prin orificiul anal caracteristice hemoroizilor pot duce la aparitia anemiei cronice. Cauza unei rectoragii nu este totdeauna usor de gasit, cu atat mai mult cu cat uneori hemoroizii se pot asocia si cu un cancer de rect sau polipi rectali. De aceea in cazul rectoragiilor este obligatorie explorarea endoscopica prin anuscopie, rectosigmoidoscopie sau daca este cazul colonoscopie, decizie care este luata de medic. Rectoragia reprezinta un semnal de alarma care trebuie sa sperie pe orice pacient, motiv pentru care trebuie sa se adreseze de urgenta unui medic dintr-un cabinet de proctologie.Va asteptam in Clinicile Proctomed pentru stabilirea diagnosticului si a tratamentului corespunzator. postat: 03.07.2007 |
