MEDICAL

If you meet an appointment with a proctologist, you need to prepare the rectum, respectively, that is, to put a cleansing enema.

Just specify that, if you have severe pain (pain of setting themselves an enema), or bleeding, before the primary medical examination clysterize not need. Do not traumatize the patients once again plots. The doctor will check (anoscope) and without this training. Cleansing enema should be set if the doctor will hold you to any special studies (rectoromanoscopy, irrigoskopiyu, colonoscopy).

In the general case before the initial examination, the patient puts in approximately 2 hours before taking two a cleansing enema. And it should not consume food before provoking you flatulence. If you make an appointment in the evening, the day is not possible to prepare, then a cleansing enema can be placed after morning stool.

Remember that a visit to a proctologist does not impose on you any limitations in eating, so help yourself to health.

Now let’s talk about how to properly put an enema?

As for constipation, as well as in preparation for diagnostic studies in the rectal area often used enemas, tell about the correctness of their implementation.

There are three types of enemas:

Cleansing enema

For the production, cleaning enema use mug Esmarch. You can buy virtually any pharmacy

Mug Esmarch – a reservoir (glass, enameled or rubber) 1,5-2 liter capacity. At the bottom of the mug has a nipple, which put on thick-rubber tube. In rubber reservoir tube is its direct extension. The length of the tube about 1,5 m, diameter – 1 cm tube ends with a removable tip (glass, plastics), 8-10 cm long tip must be an integer, with smooth edges. Preferably use plastic tips, as well as a glass tip with cleaved edge can seriously injure the intestine. After use the tip of a well washed with soap under running hot water and boil. Near the tip of the tube has a valve that regulates flow of fluid in the intestine. If the crane is not, it can replace the laundry clothespin, clip, etc.

For enema, use only water from trusted sources (such that you can drink). For children better to use only boiled water. Water temperature – about 37-38 degrees. More cold water significantly increases the motor activity of the intestine, causing the unpleasant sensation of pain. Use an enema to the water with a temperature over 40 degrees is dangerous to health.

Drug enema

When the drug enema medications are absorbed into the bloodstream, thus they do not fall, and liver and much less destroyed, acting more actively. Drug can be called any enema with herbal infusions.

30-40 minutes before the drug pose a cleansing enema and only after bowel movement injected medication. Medicinal enema – this is mainly microclysters, the volume of their contents should not exceed 50-100 ml. The temperature of the drug should be at least 38-40 degrees, as at lower temperatures there are desires on defecation, and the medicine does not have time to be absorbed.

Lie on your left side, legs and bend your knees and pull to the belly. Pushing the left hand buttocks, right rotational movement type liquid paraffin-lubricated catheter at 10 cm and the rectum. Then, connect the catheter with a syringe in which the medicinal substance, and slowly squeeze this solution in small portions of the catheter under slight pressure. To this end, you can use a small syringe. Hold and squeeze the outer end of the catheter to prevent stepping back from the liquid. Carefully remove the syringe from the catheter, type it in the air, re-insert a catheter and sell it to push the remainder into the liquid.

Oil enema

Oil enemas are used for persistent constipation. To do this, use vegetable oils: sunflower, olive, hemp, vaseline. For one enema take 50-100 ml warmed to 37-40 degrees oil. Enter oil is usually a rubber balloon through a syringe with a catheter that is pushed into the rectum at 10 cm oil flows onto the intestinal wall, envelops the calories, the muscle relaxes muscles and promotes the excretion of feces. The patient must lie still for 10-15 minutes, so that oil does not.

Consider also the means of posing enema.

1-st way

Lie on the bed close to the edge on the left side with flexed and tightened down to the stomach. Under the buttocks carrier oil cloth (plastic sheeting), free edge is lower in a bucket in case you can not hold water. Pour into a mug Esmarch 1-1,5 liters of water at room temperature, lift it up to a height of 1-1,5 m and the lower tip down to release a small amount of water, and with it air from the tube. Fill the tube (Bring a little liquid from the tube), and then, without lowering the cup, close the valve on the rubber tube. Check to see whether the tip is broken, lubricate it with petroleum jelly (vegetable oil) and, apart buttocks, enter a tip into the rectum light rotational motion. The first 3-4 cm to enter the tip toward the navel, and then another 5-8 cm – parallel to the coccyx. If there are obstacles and the tube rests against the intestinal wall or hard stool, pull it to 1-2 cm and open the faucet. Water pressure will do in the colon.Almost immediately a sense of "filling" the intestine, desires on a chair. At these moments, you should reduce the rate of delivery of liquid from the pot, turn off the tube or perezhav it. To reduce the unpleasant sensations help soft circular strokes abdomen.

When clogging the tip stool should be drawn, cleaned and put back. If the rectum is filled with feces, try to dilute it a jet of water. Cap Esmarch need not completely emptied. Leaving at the bottom of a little water to the intestine did not hit the air, close the valve regulating the flow of liquid, and remove the tip.

At the perineum, place the prepared pad (tissue, repeatedly folded the tape and toilet paper, etc.) that you want to squeeze between the legs.

2-nd way (by Hegar)

Stand on all fours in the bathroom (Bozeman) position, leaning on one elbow, the second hand to enter a tip into the rectum.

The tip should be introduced slowly and cautiously, especially with hemorrhoids. Introducing the tip, head and shoulders, and begin to fall below the depth, but not often breathing belly, sucking in his breath mouth or nose. " If the water came not all, but you already feel the pain in the gut, Turn off the tap on the hose, deep breathe.

When the water in the circle is complete, remove the cap, put on the anus to the prepared pad.

It is desirable to keep the water within 10 minutes. To do this, lie on your back and breathe deeply. The pain, the feeling of bursting open in his stomach calms stroking. If you can, walk to the introduced water or lie down on his stomach. When setting sweeping enema to make sure that at one time was introduced no more than 1,5-2 liters. If you need to put two enemas in a row, you should be an interval between 45 minutes-1 hour, making sure that washings from the first enema gone completely.

Popularity: 50% [?]

This "shameful" to the general terms of disease – one of the most common.

40% of visits to doctors about the bowel associated with hemorrhoids. Proctologists believe that 70% of people will sooner or later face the gemorroynymi symptoms. And if you’re a day sitting in front of a computer, the probability to get hemorrhoids becomes even higher.

Hemorrhoids is in the body of each person. It folds of mucous membrane of the anal canal. In addition to the action of muscles, they provide the withholding stool. At rest, haemorrhoids are involved in overlapping anal canal intestine. When defecation bumps should be smoothed so as not to interfere with the passage of stool. Stagnation of venous blood, and excessive straining violate the provisions of nodes, they slide down together with the mucous membrane.Then there is a reorganization and circulatory disorders, this leads to an increase in the size of hemorrhoids and their protrusion outwards.

Risk everything!

Each of us can make hemorrhoids. Particularly at risk are those who:

·  leading a sedentary lifestyle, including works at the computer;

·  suffered from constipation, obesity;

·  loves to lay the collar (get drunk);

·  table pitch in smoked, spicy, salty, spicy;

·  baluetsya anal sex;

·  has inflammatory diseases in the pelvic area;

·  engaged in a major sport such as lifting weights, pushing the nucleus or jumping, mowing, chopping, dragging gravity – in short, as the plow horse.

Major factors contributing to the development of hemorrhoids

1. Lifting, prolonged work in a standing position

When the physical congestion venous pressure rises due to the delay of blood in the veins, it leads to a loss of elasticity of vein walls. Therefore, hemorrhoids often develops in the stevedores, dancers, athletes, barbers, teachers – those who are engaged in heavy physical work or spend the day standing .

2. Sedentary work, including a computer, a sedentary lifestyle

Do not spare hemorrhoids and those who have a lot of sitting. Between the chair seat and the body sitting in the heat compress is formed, which leads to stagnation of blood in the pelvic organs. Therefore, in the "at risk" fall programmers, computer operators, drivers, accountants, representatives of other sedentary occupations. In addition, a sedentary lifestyle is a risk factor for venous insufficiency, whereas moderate physical activity, swimming and gymnastics, on the contrary, reinforce and stimulate blood circulation, prevent stagnation of blood in the veins.

3. Chronic constipation

Constipation is caused by a violation of the formation of feces and its promotion of the intestines. Hard stool, staying in the lower regions of the intestines, put pressure on the surrounding veins and impedes the normal flow of blood. The habit of long heave during defecation, the inherent suffering from chronic constipation, also contributes significantly to hemorrhoids: straining during a bowel movement operates on the veins of the rectum is similar to weight lifting.

4. Inflammatory, neoplastic processes in the pelvic area

Inflammatory diseases and cancer in women (fibroids, uterine fibroids), diseases of the prostate gland in men, liver cirrhosis with portal hypertension, malignant tumors of the rectum – all contribute to the flow of blood to the organs of the pelvis, therefore, the development of hemorrhoids. Cracks, ulcers, fistulas of the anus are also risk factors for hemorrhoids: a spasm occurs during stimulation of the sphincter (circular muscle that closes the exit of the rectum), resulting in efferent veins are compressed and injured.

5. Abuse of acute food, alcohol

Alcohol widens blood vessels of the digestive tract, including vessels of the rectum. Vasodilation leads to stagnation of blood in the hemorrhoidal nodes, inflammation. Spicy dishes, richly flavored with spices, stimulate digestion, but also cause rapid blood flow to the rectum and irritation of the mucous membranes.

6. Severe diarrhea (diarrhea), anal sex

Irritation and inflammation of the rectum and anus with severe diarrhea, mechanical stretching of the sphincter and rectum during anal sex contribute to the appearance of hemorrhoids, increase over the existing disease.

7. Pregnancy, childbirth

The uterus, increasing with the development of the fetus occupies an increasing part of the peritoneum. In this moving bodies are displaced upwards, and the rectum, in contrast, pressed to the bowl – as a result of venous vessels suboccluding, overflowing with the blood of the cavernous bodies. Strained attempts at childbirth also stimulate the formation of hemorrhoids.

For hemorrhoids characterized by the following main symptoms:

·  Bleeding during defecation, the admixture of blood in the stool (finding this symptom as quickly as possible, consult a doctor!)

·  itching, burning sensation in the anus;

·  foreign body sensation, a feeling of gravity;

·  dropping nodes from the rectum;

·  pain during defecation, walking, in sitting position;

·  painful hemorrhoids to the touch.

The most basic characteristic of hemorrhoid symptoms – pain and loss of units from the anal canal. Let us examine these and other manifestations of the disease.

1. Bleeding during defecation, the admixture of blood in the stool

Stagnation of blood in the hemorrhoidal nodes worsens food venous wall oxygen, long congested stretches them. The walls of the units thin, erosion and the formation of small gaps, which leads to bleeding. A distinctive feature of bleeding hemorrhoids: it only appears during, before or immediately after defecation. Most patients first notice blood stains on her underwear or toilet paper, sometimes it follows trickle in late defecation. Hemorrhoidal bleeding can be quite intense, which could lead to the development of iron deficiency anemia.Separation of blood from the anus can be a sign of malignant tumors in the large intestine. When this symptom as soon as possible refer to the proctologist for further diagnosis!

2. The loss of units from the rectum

The development of degenerative processes causing the displacement of nodes in the side of the anus, ultimately, loss. This is facilitated by prolonged straining during defecation, the habit of smoking, read in the toilet.

3. Foreign body sensation, a sense of gravity

Patients complain of a foreign body sensation in the anus, the severity of the groin when walking. These symptoms are caused by swelling of congested hemorrhoidal.

4. Itching and burning in the anus

Itching, burning – a manifestation of the erosion of the walls hemorrhoids. Discharge of blood and lead to irritation of the mucous membranes and skin anus.

5. Pain during bowel movements, walking and in sitting position

This characteristic symptoms of incipient acute attack of hemorrhoids infringement haemorrhoid. Around the anus are many receptors, pain can be very strong. Arching pain in the anus increases in walking and during defecation, sometimes becomes intolerable, the patient can neither sit nor walk.

6. Morbidity touch hemorrhoids

In the case of thrombosis or inflammation of the hemorrhoids swell and become tight, painful to the touch. The external examination of the nodes visible blue-purple color, resembling the plum, can reach a diameter of 2 cm Touching the nodes causes a sharp pain.

Again: typical symptoms of hemorrhoids, especially bleeding from the anus, may be signs of other, more serious diseases. When it does happen as soon as possible, consult a doctor!

Popularity: unranked [?]

Epithelial coccyx move in a different way this disease is called the coccyx cyst, dermoid cyst, fistula tailbone, etc. Americans usually speak of pilonidal sinus. The essence of this disease lies in the fact that it is always in the epithelial coccygeal course strictly on the gluteus line at a distance of typically 4-7 cm from the edge of the anus is at least one hole. It may be a point, barely noticeable, and sometimes wide, in the form of the funnel. This is like "home" of the coccygeal. The patient or the patient, usually young people, can live for years, unaware of the existence of the disease.

For various reasons, such as the tailbone injury, cooling, cold in the chest, and sometimes without apparent cause infection through this so-called primary penetrates deep into the hole in the fabric and start the inflammatory process in the coccyx and sacrum. Have pain, swelling and sometimes redness at the projection of the primary holes, or in any side of it (above, below, right, left), who are forced to ask the patient to the doctor. In such cases we speak about the acute stage of illness, and sick at the same time, as a rule, first learned of his illness.Abscess in the area of the coccyx reveal the doctors, or he opened independently, while the pain passes, brings relief, but in the subsequent revelations on the spot holes formed secondary fistulous opening, from which occasionally can be allocated pussy content. The presence of a fistula – Recurrent pain in krestsovo an oil-field pachkanie linen, problems with hygiene.

In some cases, after opening the abscess sacrococcygeal area of the wound is closed without fistula formation and occurs imaginary period of prosperity. Remaining pockets dormant chronic infection in epithelial coccygeal ducts, which usually gives the re-aggravation of the formation of an abscess, and sometimes phlegmon. This exacerbation may occur in the months, sometimes – a few years. In the intervals between relapses patients may disturb the periodic dull pain or discomfort in the coccyx, especially when sitting, sometimes the allocation of the primary hole course. In any case remains a chronic inflammation of the hearth.

With long-term failure patient from radical treatment, inflammatory changes in the course of epithelial and surrounding tissue may lead to the formation of multiple secondary fistula opening far enough: in krestsovo an oil-field, on the perineum, the scrotum, the inguinal folds. In these cases, often align pyoderma, and sometimes aktinomikoznye (fungi) defeat, which greatly complicate the course of the disease. During surgery, these patients have to excise the affected tissues in a large area, and sometimes it is necessary to divide the operation into several stages. There is another serious complication of long-term untreated epithelial coccygeal turn. Last prolonged illness of more than 10 years may ozlokachestvitsya. Sometimes it is extremely rare, but such is the case.

Treatment of epithelial coccygeal progress to date, only surgery, and only radical surgery can completely cure the patient. The operation is to remove the core of the epithelial coccygeal progress along with all the primary openings and with all its branches. To date, there are a number of surgical interventions, aimed on the one hand hewn all the pathological focus, on the other hand – to take in the wound partially or podshivaya wound edges to the bottom in order to minimize the overall healing time. Transactions made after the survey and preparation of the patient with the use of full anesthesia (epidural-sacral anesthesia).

Postoperatively, the patient for several hours in the day care until the complete normalization of the total state with mandatory dropper, anesthesia. Usually after 1-1,5 hours after the operation the patient begins to walk, drink enough water, wets itself. After 6-7 hours re-examine the patient, changing dressings and fixation, and then accompanied by a car sent home.Subsequently, until the full and complete wound healing, the patient is under medical supervision.

Complex, multi-forms of epithelial coccygeal course with a lot of fistulous passages and flowing, infiltrates operate in inpatient hospital.

In normal cases, the operation of the coccygeal easily tolerated by patients. Complete wound healing usually occurs within one month after the operation, but recovered the ability to work much earlier – from 1 to 3 weeks depending on the nature of work.

Few people today can boast that he had never faced proctological disease.

What are hemorrhoids?

Hemorrhoids – expansion and overflow with the blood of the cavernous (sponge) cells of the rectum and anal canal are normal anatomic entity. Accordingly, about hemorrhoids speak only when the cavernous calf grow and begin to be felt.

What is the external and internal hemorrhoids and hemorrhoids is it always manifests the presence formations on the skin around the anus?

Hemorrhoids can be located either outside (external hemorrhoids) or inside the rectum (internal hemorrhoids), which are not visible from the outside.

As shown hemorrhoids?

The main manifestations of hemorrhoids are bleeding and loss of hemorrhoids. Pain for chronic hemorrhoids are not typical – in this case it is either the acute hemorrhoids, or other diseases of the rectum. By the way, is not always the selection of blood from the rectum and the loss of any entity indicates hemorrhoids. This diagnosis can reliably deliver only proctologist doctor after the test. Hemorrhoids can mask the other and often more serious diseases of the rectum.

Why am I getting hemorrhoids and how to prevent the development of hemorrhoids?

One of the main factors in the development of hemorrhoids is heredity. Therefore, if your parents suffered from hemorrhoids, then with a certain degree of probability we can say that hemorrhoids can occur and you. Often hemorrhoids combined with varicose veins of the lower extremities, and flat-footed, which is a consequence of congenital weakness of connective tissue is the skeleton of veins. In addition, the risk factors are dietary habits (abuse of an acute food), excessive alcohol consumption, sedentary lifestyle, long stay in the same situation (the work of the seller, a hairdresser, manager, etc.) and intense exercise, a person suffering from constipation. Often the first manifestation of hemorrhoids are pregnancy. Accordingly, the exclusion of risk factors for piles from your life may prevent the development of hemorrhoids.

What are the complications of hemorrhoids?

Typical complications of hemorrhoids haemorrhoid thrombosis is a pain syndrome and hemorrhoidal bleeding. Contrary to popular belief hemorrhoids never turns into cancer (but can mask its presence).

Can hemorrhoids go yourself?

Hemorrhoids do not have a tendency to decrease, and vice versa with the passage of time increases. Drug treatment slows its progression, and in case of acute hemorrhoids only reduces or eliminates its symptoms.

When and how to treat hemorrhoids?

Proper and adequate treatment of hemorrhoids appoint a doctor. Symptoms of hemorrhoids are very diverse and different treatment, respectively. Besides having the person you have symptoms may be caused by other proctological diseases. Treatment depends on the stage and nature of the disease. In addition to medical and surgical treatments currently used minimally invasive outpatient procedures, such as hemorrhoids photocoagulation, sclerotherapy, ligation (the application of latex rings), hemorrhoids, showing a good effect. Abroad surgical treatment being only 25% of patients with hemorrhoids, and 75% is minimally invasive treatment of hemorrhoids.

What creams are most effective for the treatment of hemorrhoids?

Symptoms of hemorrhoids is very diverse, and applied ointment have targeted actions on certain symptoms of hemorrhoids. So choose an effective treatment for hemorrhoids can only proctologist doctor. In addition, it is proved that the topical form of drugs (suppositories) do not have therapeutic effects on the hemorrhoids, reducing only their manifestations. Therefore, in the complex treatment of hemorrhoids necessarily be included tablet form venotonic drugs.

Can hemorrhoids go to cancer?

Hemorrhoids never ozlokachestvlyaetsya. However, this does not preclude the simultaneous existence of cancer of the rectum.

Can I get rid of hemorrhoids without surgery?

Can. Currently, there is a wide arsenal of so-called maloinazivnyh non-surgical outpatient treatment of hemorrhoids. Their advantage is simplicity, painless and not burdensome procedures for the patient. The patient remains in the usual rhythm of life. However, their use is most effective in the early stages of hemorrhoids. In advanced cases without surgery is necessary.

Who is the doctor coloproctologist?

In accordance with the present nomenclature of medical specialties proctologic renamed coloproctologist as its competence in addition to diseases of the rectum (in Greek – proktos), began to enter and diseases of the colon (in Greek – a colony).

How often should visit a doctor proctologist?

Naturally, the sooner touched the patient, the easier and more effective treatment. Addition, there are terrible diseases of the rectum, does not outwardly apparent. Therefore, the optimum for preventive visits to the doctor, proctologist, it once a year, or at least once every five years. For patients older than 50 years, patients whose parents suffered proctological diseases necessarily visit proctologist once a year.

What training is required before attending physician proctologist?

Preparation before the visit to the proctologist is not required only if you suffer from intense pain in the rectum or anus. In other cases, a statement of the two cleansing enema the evening before and morning of the visit. There is an alternative – microclyster with ready-to-use drug Mikrolaks the morning of the visit. Preparation needed for a full examination and holding of any rectoscopy – examination of the rectum apparatus to a depth of 30 cm

It is necessary and painful rectoscopy?

The method is absolutely necessary for most proctological patients for diagnosis of possible latent diseases of the rectum, the sole method of diagnosis which is rectoscopy, which allows the eye to view the intestine and to detail the pathologic process. Method of unpleasant, but absolutely painless. Moreover, the appearance of pain during the study is an indication for termination procedures.

Popularity: unranked [?]

The term "rectocele" literally translated as "bag of the rectum. This term implies diverticulum anterior rectal wall toward the vagina. There is a disease in women, usually after severe, traumatic childbirth. Contributing factors – hard physical labor, obesity, weakness of the apparatus that supports the pelvic organs. Rectocele – very common pathology, which is found in almost every other women who come to the proctologist.

Most important complaint in this disease – it is constipation. Defecation is difficult, there is a feeling of incomplete emptying of the rectum, feeling disappears with compression straining. As the disease becomes necessary to use manual benefits during stool, prolonged straining, frequent, inefficient urge to defecate. Rectocele may be basic, and sometimes – the only cause of persistent constipation. Many in this notice, which the bowel "triggered" if the support or to press your fingers on the rear wall of the vagina or on the sides of the anus.

The basis of the disease is the divergence of the anterior portion of the muscles, raising the anus, as well as the weakening of muscle and skeleton perineal recto-vaginal septum. In fact, there is a variant of vaginal hernia, when the weakened wall between the gut and vagina, instead of straining at "work" to evacuate the contents of intestine bulges into the vagina, "suppressing" defecation. The failure of the pelvic floor muscles leads not only to the above complaints, but also to the leaking of urine during stress (cough, sneeze), to problems in the sexual sphere. That is why many specialists (gynecologists, proctologists) indicate: rectocele and prolapse of female genital organs – is a common process with a common etiology and clinical picture.

In the initial stages of the disease shows the conservative methods of treatment: a special diet, therapeutic exercise, including anal gymnastics, physiotherapy, etc. In some cases, this has the effect, but often the disease progresses. The actual recovery gives transaction. During surgery stapled dispersed portions of the pelvic muscles (the so-called levatorov), which allows to restore the normal anatomic relationship musculo-fascial structures of the pelvic floor. Approach to treatment of diseases of the perineum must be comprehensive. In the presence of comorbidity (cystocele, hemorrhoids, anal fissure, polyps, etc.) is made simultaneously to the operational correction. Typically, even during the first chair at 2-3 days after surgery patients note a change in a chair, his ease and efficiency. Patients tolerate this operation is relatively easy, with the second day walk, the hospital shall, as a rule, no more than 2-3 days.

Of course, like any surgery, these interventions require significant medical training. Performed on the testimony and in sufficient amounts, they give good results. It should be pointed at the need for compliance with the gentle treatment for 2-3 months after surgery.

Popularity: unranked [?]

Polyps of the colon - a benign Education, at which there is proliferation of glandular epithelium above the level of the mucosa. These growths may be in the form of a mushroom, a ball, hemisphere, may be on the stalk or without it. Polyps are classified by their histological structure, as well as by the factor of their multiplicity. From the size of the polyp depends on the probability of its malignancy – the more the size of the polyp, the greater the likelihood that the polyp can turn into cancer. Multiplicity factor is also important in the prognosis of the disease – the single polyps ozlokachestvlyayutsya less than multiple and have a more favorable prognosis.

The most common so-called gland polyps, reaching up to 2-3 cm in diameter and having a generally foot. The latter sometimes may reach large sizes, allowing greater mobility of polyps, and they may even fall out of the anal canal.

Often there are unique among the polyps, soft to the touch, melkodolchatogo buildings, painted in a reddish color, so-called villiferous polyps (tumors). The latter, because of their mild trauma may podkravlivat, allocate mucus, which, incidentally, is absolutely not a sign of their malignancy. However, these forms of polyps most dangerous in terms of transition cancerous. Majority of patients of colon polyps, asymptomatic and usually identify them by endoscopic study (anuskopiya, sigmoidoscopy, colonoscopy).

Treatment of polyps of the colon prompt. Proposed in 60 years AM Amineva method of treatment of polyps celandine not found wide application in connection with questionable effectiveness. To date, only surgical removal of polyps or endoscopic means (through rectoscope or colonoscopy) guarantees the success of treatment, surgery is usually not severe, easily carried. After removal of polyps, the patient should be under the supervision of Proctology and inspected them for at least 2 years.

Popularity: unranked [?]

Condyloma - a papillary formation, almost compact, gray-pink color, localized on the skin of the perianal region, and also often on the genitals of men and women. In some cases, warts are merged together, forming a separate conglomerates in the form of cauliflower, often arranged so densely that closes the anus. More frequently, there are simple genital warts among which is visible to non-infected skin.

Currently, there is sufficient evidence that this disease is caused by a virus.

Patients with perianal genital warts complain growths around the anus, itching, burning, feeling steeped in this area, sometimes pain during defecation and allocation of blood smears.On examination, the skin around the anus are determined by the above education and research, the finger of the rectum revealed (if available) almost compact nodules, warts in the anal canal. Compulsory study is sigmoidoscopy, which allows to inspect the anal canal and colon from the inside, as well as tests for HIV, syphilis, hepatitis.

Perianal condylomata acuminata are subject to mandatory removal followed by histological examination. Of course, to remove warts is better and easier for both patients and physicians early in their development. This should be done yet, because, firstly, they tend to be fairly rapid growth, and secondly, they may appear inside the anal canal, which exacerbates the treatment.

Currently, there are many ways to treat warts. More effective is surgical excision of warts, which can be made with a scalpel, electrotome, laser, radio wave with a knife, etc. In the presence of associated warts on the genitals should be simultaneous to excision. In advanced cases being antiviral and immunostimulatory therapy.

In any case, it is essential to observe the patient after surgery for a few (usually up to 3 months) in order to prevent relapse and eventual cure of the patient.

Popularity: unranked [?]

Acute and chronic paraproctitis paraproctitis (rectal fistula) is, in fact, one disease in its different stages. Usually the disease begins with acute paraproctitis, in which there is an acute purulent inflammation paraproctium. In these cases, the patient appeared progressively worsening pain, swelling and sometimes redness of the anus, the temperature of the body.The cause of this disease lies in the fact that for various reasons, such as constipation, diarrhea, weight lifting, errors in diet, alcohol, cooling, etc., and sometimes for no apparent reason in the anal canal at a height of 2-3 cm in locations, called anal crypts, formed by micro holes through which the infection penetrates paraproctium and there is her acute purulent inflammation. Later in the progression of the disease itself or the abscess is opened out, or reveal his doctors. Then the state of patients improved, the pain passes, the temperature returned to normal, but most are usually formed fistula rectal or chronic paraproctitis. And the "fault" it is the innermost micro (hole) in the anal canal, which is essentially a gateway for infection. 



Typically, patients with fistula complain of discomfort, sometimes pain in the anus, pussy or purulent discharge from the fistula, which may be in a particular place on the skin near the anus (called external opening of fistula). There is another variant of the disease, which is rarer. After opening the acute paraproctitis independent or operational (doctor), acute inflammation in paraproctium gradually pass and the wound completely closed. According to the statistics in these cases, only about 5-10% of patients reached the final recovery. The majority of the same in different periods (weeks, months, years) comes recurrence (repetition) of the disease, most often in the form again and again paraproctitis acute pain, fever. 



In such cases, as indeed in the primary acute paraproctitis optimal is the so-called radical surgery paraproctitis when opening the abscess in addition to liquidated inner hole (micro) in the zone of the anal crypts, which was the actual source of the disease. Such operations are usually carried out by specialists – Coloproctology. 



Fistulas of the rectum are varying degrees of complexity depending on the passage of the fistulous anal sphincter muscle fibers. The more muscle fibers "captured" fistula, the fistula is complex in nature and the more complex the surgery. But in any case only to date method of treatment of fistulas of the rectum is operational, which allows the radical removal of fistulous course and heal the sick. In addition, during the operation may fistula and prompt removal of concomitant hemorrhoids, anal fissures and other diseases that can at once rid the patient of all or at least most of proctological diseases.

Popularity: 25% [?]

Incontinence of stool and gas (anal incontinence) is observed in congenital or acquired anatomical lesions of the sphincter apparatus of the rectum or violation of its central reflex regulation, including psychological, or peripheral nature.

Most experts distinguish three clinically defined by the degree of insufficiency of the sphincter of the anus:

Older people scatacratia often combined with urinary incontinence. On the other hand, a random episode of fecal incontinence caused by a trivial reason (stress impulse in a chair with food poisoning, which in life circumstances can not be immediately satisfied, etc.) may lead to persistent dismorfofobii to be treated by psychiatrists .

Daily, at the same time of day, full-length (with a feeling of complete evacuation) the act of defecation is one of the most important indicators of a healthy organism. Need patience and a good relationship with the patient the doctor to accurately determine the frequency of incontinence episodes and the nature of what in normal circumstances, patients do not like to complain because it is difficult to reliably determine the true incidence of this syndrome. This is especially important for patients of neurological clinics, which care for such patients would have been much easier if the staff (mainly nurses) has been informed patients or their relatives on the individual characteristics of bowel function in their patients.

Separate complex problem - incontinence of feces and gases in children. Basically, this is a sign of congenital or acquired anatomical and functional integrity of the sphincter apparatus of violations of the rectum, such as fistulous forms of anorectal anomalies, malformations of the anus (imperforirovanny anus and others). Как правило, эти тяжелые поражения сочетаются у детей с хроническими запорами, ибо узкое (свищевое) отверстие препятствует опорожнению толстой кишки. If the anus is located correctly and if the sphincteric apparatus is not changed, then it comes to functional incontinence, caused by disorder of the central or peripheral nervous regulation. It is important to bear in mind the possibility of psychological disorders, often associated with the wrong upbringing of the child that a child is not accustomed to timely rhythmic defecation is not brought him the necessary hygiene practices.

Evident incontinence - is the weakening of control over the allocation of solid stool. The cases of incontinence in the normal function of the sphincter of the anus may occur in patients with chronic diarrhea, with prolapse of internal hemorrhoids, as well as by persons who do not follow accepted for civilized human hygiene after defecation. Minimal or partial incontinence occurs when lowering the tone of internal anal sphincter, usually after proctologic operations or complete prolapse of the rectum, as well as the repeated attempts of older people to retain feces.

Treatment

In all cases, there is one and the same problem: where to begin treatment with some form and degree of incontinence?

If incontinence occurs only when diarrhea, should begin by explaining the causes of diarrhea. When it comes to individual episodes of diarrhea, is clearly related to violations of the diet or with sudden changes of the usual food and water quality (travelers diarrhea), the treatment is obvious.

When signs of violation of the innervation of the structures of the pelvic floor can help direct the appointment (external) or vnutrianalnoy electrostimulation. Very important lessons therapy, physical therapy, and especially the method of biofeedback. This development of new physiological inverse relationship, ie development of specific forms of conduct that by training to develop the ability to control physical functions. Since then, both in medical practice includes monitors, dynamically register information about the state coached function, it is possible "learning tool". This is radically different from Pavlov’s classical conditioned reflexes elaborated on the basis of unconditional innate reflexes, for example, food, and the specific responses to stimulation (eg, salivation). In contrast, special exercises are a kind of reward for training in the form of weak recovery function. This is not the development of a new reflex, and the strengthening or restoration of the former function. In this particular case the patient, watching on the monitor of a graphic (the curve) of the normal volitional attempts to reduce the anal sphincter through the long, precise dose of training to achieve improved sphincter function, being able to constantly see the results of their efforts.

Biofeedback technique is the introduction into the anus of the elastic balloon to create a certain vnutrianalnogo pressure. The patient tries to compress its muscles this container, which is recorded on the monitor. In other cases, the sphincter muscle stimulation uses electric current to the "training" and re sphincter control defecation. Currently, there are portable devices and special training anorectal probes for the rectum (the instrument Swan Attika and others). Anal incontinence associated with organic neuro-muscular disorders, can be satisfactorily skorrigirovana using biofeedback. A. GIiaetal. (1998) reported that 26 patients with severe insufficiency of the anal biofeedback method has led to rapid improvement, and this improvement persisted throughout the observation (on average, within 21 months), although the immediate effect was much more pronounced.

Special method autotrenirovki sphincter rectum – biofeedback – is necessary for the initial treatment of patients with anal incontinence. The reaction of the sphincter muscles to such training largely determines the success of further conservative treatment and objectifies the indications for surgical treatment.

In the absence of opportunities to use this method or at least express the degree of violation of the anal Waxes (neuderzhivanie only gases or, occasionally, liquid stool) should begin treatment with the tonic treatment (light exercises, water therapy) and therapeutic exercises muscle sphincter. Methods such a special gym a lot and every proctologist preferred method, which, in his experience, gives the optimum result. In principle, this volitional squeezing and relaxation of the sphincter with a different tempo and duration, but not more than 10 minutes and not more than twice a day (morning and before bed). Repeat, often sick after one or two random episodes of incontinence are beginning to exacerbate their suffering. Biofeedback in recent years has become very popular, although other opinions it is not effective in neurogenic violations anal holding.

Surgical treatment of anal insufficiency should be conducted only in proctological hospitals. Indications for some form of surgical correction are processed on the basis of determining the size and nature of the defect structures of the anal sphincter muscle. If this defect is not more than a quarter of the circumference of the pulp perform sfinkteroplastiku – reveal the sphincter defect, economically excised scars and stitch the muscle two or three ketgutovymi sutures. With large amounts of sphincter defect that often occurs in postpartum perineal deformation is performed anterior sfinkterolevatoroplastika: cut through the skin cross-section, with the help of a hydraulic dissection novocaine defoliate the rectovaginal septum, pleated front wall of the rectum, thus forming anal canal and sphincter muscles take in and levatory. Front sfinkterolevatoroplastika executed even in specialized clinics, leads to the complete success is not always the case.

When the posterior wall defects of the anus is almost similar to techniques back sfinkterolevatoroplastika. In more complex post-traumatic cicatricial deformations, accompanied by severe anal insufficiency, performed various complex reconstructive surgery. The choice of plastic surgery for anal incontinence was subjective in nature, and to select the estimated minimum of three factors: the state chosen for cutting out the muscle graft, the current state of the patient’s closing apparatus and the state of the central and peripheral nervous system.

Popularity: unranked [?]

Crypt - acute or chronic inflammation morganievoy crypt. Anatomically morganievy crypts are deeper in the final part of the rectum and are a continuation of morganievyh sinuses. In the upper part, they freely communicate with the lumen of the rectum and the bottom cover them semilunar valves (flaps, pockets). At the bottom of the crypt open anal gland ducts. Blockage of the lumen of glands, poor drainage of the crypt or trauma, give rise to an inflammatory process.

The main manifestations kriptita are:

Treatment

Uncomplicated crypto treated conservatively. With the failure of conservative treatment of complications usually occur in the form of acute paraproctitis or formed part of rectal fistula. And in both cases, surgical treatment.

Popularity: unranked [?]

Dolihosigma - Elongated sigmoid colon, can be congenital or acquired.

Megacolon - the expansion of individual sections or the entire colon.

Dolihosigma, clinic, treatment

Dolihosigma often asymptomatic. Can cause constipation, there are bloating, rumbling. Diagnosis is made with irrigoskopii, when revealed varying degrees elongation Sigma. Treatment is usually conservative. It boils down to the regulation of the chair. Surgical treatment consists of resection of an extra loop of sigmoid, however, the indications for it should be defined very strictly.

Megacolon – clinical variants

The clinical picture of megacolon has something in common, and at the same time, differs on a number of parameters depending on the type megacolon. For megacolon is characterized by persistent constipation, bloating and abdominal pain. Severity of these disorders varies. Constipation can be from 2-3 days to complete absence of an independent chair for several weeks and months. Flatulence may appear a little temporary abdominal distention or bulging of permanent hyperextension and anterior abdominal wall. Objectively, there is an increase stomach, his form with irregular, asymmetric due to preferential expansion of one of the divisions of the colon or feces of stones. Sometimes visible krupnovolnovaya peristalsis.Decisive method of diagnosis is irrigoskopiya in which detected a significant expansion of individual sections or the entire colon.

Excrete 7 types of megacolon:

1. Hirschsprung disease (megacolon aganglionarny) – congenital hypoplasia in some areas of the nervous apparatus of the colon.

2. Obstructive megacolon due to mechanical obstructions in the gut.

3. Psychogenic megacolon, growing as a result of mental illness or wrong habits.

4. Endocrine megacolon in some diseases of the endocrine system.

5. Toxic megacolon, which is formed as a result of taking certain drugs, the impact of infectious agents.

6. Neurogenic megacolon – with organic diseases of the central nervous system.

7. Idiopathic megacolon, a diagnosis which is placed in the absence of a specific etiologic and pathogenetic factors.

Popularity: unranked [?]