Часто опухоли возле заднего прохода свидетельствуют о воспалении геморроидальных узлов, или, говоря другими словами, о геморрое. Данное образование очень хорошо прощупывается и вызывает характерные болезненные ощущения, особенно если это наружный геморрой.
Причины появления болезни
Выявить причины роста злокачественной опухали ануса достаточно сложно. Но можно перечислить факторы, которые могут спровоцировать болезнь. К ним относятся:
- генитальные бородавки;
- анальный секс;
- наследственность;
- большая физическая нагрузка;
- вирус папилломы человека;
- травмы слизистой оболочки;
- передающийся половым путем ВИЧ и другие инфекции.
Симптомы при воспалении геморроидальных узлов схожи с признаками рака прямой кишки. К таким признакам относятся:
- наличие крови в кале (поможет определить анализ);
- боль в области заднего прохода (режущая);
- боль при дефекации (может быть слабой и сильной);
- частые запоры;
- жжение и зуд;
- чувство инородного тела в анусе.
Распознать, что именно приносит дискомфорт человеку возле заднего прохода, как оно появилось и к чему способно привести, может только врач-проктолог или же хирург. Конечно, хуже дело обстоит, если шишка оказалась онкологией. По статистике, рак заднего прохода, по сравнению с иными злокачественными образованиями прямой кишки, встречается у 1-2% пациентов. Но ни в коем случае нельзя паниковать и сидеть сложа руки. Это сигнал к действию, повод переосмыслить свой образ жизни, изменить питание и начать поправлять здоровье.
Ректальное кровоснабжение может быть нарушено при наличии у человека вредных привычек (курение, алкоголь). Частое употребление энергетиков или кофе и наличие болезней сердечно-сосудистой системы может привести к расширению геморроидальных вен.
У женщин при вынашивании ребенка анальный сфинктер постоянно испытывает спазмы. Такое сужение нарушает кровоснабжение. Врожденная слабость геморроидальных узлов приводит к сокращению слизистой оболочки. Подъем тяжестей, конные прогулки, гребля и другие увлечения спортом провоцируют появление геморроидальных узлов.
Любая из перечисленных причин и факторов может привести к опухоли возле заднего прохода и развитию первичного геморроя. Вторичная форма возникает при наличии других заболеваний. Патология часто проявляется, если есть опухоль малого таза, проблемы с сердцем, цирроз печени.
Парапроктит — распространенная опухоль возле ануса
Опухоль имеет разновидности в зависимости от формы:
Мужчины чаще страдают этим заболеванием, чем женский пол. У женщин выявление нозологии появляется при длительном воспалении влагалища, органов репродукции и нарушении работы матки.
Парапроктит характеризуется появлением некого образования, локализующегося в периферической области толстой кишки. При данном заболевании у человека наблюдается повышение температуры тела до 40 градусов, нарушается дефекация, появляется озноб, сильные пульсирующие боли, нарушение мочеиспускания.
Лечение опухоли
Лечение парапроктита оперативным вмешательством
При остром парапроктите делается операция, чтобы вскрыть гнойную полость. Она проводится под внутривенным наркозом или при спинномозговой анестезии. Главные задачи операции: вскрыть абсцесс, убрать гной и установить дренаж. Такая операция блокирует гнойный процесс, но не избавляет от болезни, поскольку гной поступает по свищевому ходу. Опухоль может образовываться постоянно, и это называется хронический парапроктит. При данной болезни проводятся более сложные операции, позволяющие полностью убрать свищи и неполноценную ткань. В послеоперационный период назначают антибактериальную терапию с препаратами Амикацин, Цефотаксим, Гентамицин и др.
Также проводят ежедневные перевязки в месте операции с антисептическими растворами и мазями, например, Левомеколем.
Если опухоль злокачественная, то лечение подбирает врач, отталкиваясь от стадии заболевания и других нюансов. Как правило, назначается операция и лучевая терапия. Также прописывают специальную диету и настоятельно рекомендуют изменить прежний образ жизни пациента.
Лечить наружный геморрой (с тромбозом) могут путем хирургического вмешательства или консервативной терапии. Врач назначает флеботропные препараты, например, Детралекс. Хорошо помогают мази: Гепатромбин, Троксевазиновая или Гепариновая мазь.
При острой форме проводят операцию — тромбэктомию. Процедуру выполняют под местной анестезией. Цель: вскрыть геморроидальный узел и удалить тромб. Лазерная тромбэктомия необходима для удаления больших наружных узлов. Операция длится около часа и проходит бескровно. Сразу исчезает боль, и анальное отверстие не деформируется.
На самом деле определить, какой характер носит та или иная опухоль, может только квалифицированный врач. Лечение при этом может быть различным.
Различные наросты у заднего прохода могут появляться по разным причинам, однако они всегда требуют внимания, посещения врача и лечебных мероприятий. Возникают патологии, если поражается слизистая оболочка ректума или окружающие кишку вены. Локализации новообразований:
- патология внутри кишки (то есть поражается ее слизистая);
- шишка на анальном отверстии;
- поражение перианальной области.
Шишки около заднего прохода и внутри кишечника могут быть разных размеров и обладать различными свойствами. В редких случаях причиной появления различных выпуклостей в области ректума становится вирус папилломы человека (ВПЧ). Тогда нарост на анальном отверстии представляет собой остроконечную кондилому или папиллому. При наличии гнойных выделений из появившегося образования можно говорить о парапроктите. А иногда опухоль в заднем проходе является злокачественным новообразованием. Однако чаще всего шишки возле заднего прохода являются простонародным названием такого серьезного заболевания, как варикозное расширение геморроидальных вен. Болезнь, которую именую патологией цивилизации. В таких случаях узлы очень узнаваемы, так как представляют собой синие шишки на заднем проходе или около него. Такие образования заполнены кровью.
Причины появления твердой шишки в заднем проходе и около него
Заболевание развивается из-за патологического расширения вен, окружающих ректум. Из-за потери их эластичности и проблем с клапанным аппаратом происходит застой крови, что приводи к появлению шишки возле анального отверстия. Данный процесс не обратим.
Геморроидальное расширение вен – процесс хронический с периодами обострения. Выраженность клинической картины зависит от размеров узлов. В свою очередь, размеры шишки рядом с задним проходом зависят от степени наполненности ее кровью.
Точные причины, вызывающие патологию, пока не выяснены. Однако существует ряд предрасполагающих факторов, которые повышают риск появления болезни:
- наследственность;
- психические перенапряжения;
- чрезмерные физические нагрузки;
- гиподинамия;
- избыточный вес;
- нерациональное питание;
- беременность;
- застойные явления в венозном кругу кровообращения;
- нарушение стула (запоры);
- любые воспалительные или инфекционные патологии ректума;
- онкология в прямой кишке.
Симптомы при появлении шишки около анального отверстия и в ректуме
Если заболевание только начало развиваться, то клиническая картина может отсутствовать. При образовании маленьких шишек в заднем проходе их выявляют случайно при осмотрах.
Данный симптом появляется, если вылезла шишка в заднем проходе, которая длительное время перерастягивалась кровью. Также при образовании геморроидальных узлов снижается степень обогащения стенок сосудов кислородом, из-за чего они ослабевают и истончаются. Результатом становится появление эрозий или разрывов узла, что и становится причиной кровотечений. Если шишка образовалась в заднем проходе они появляются при дефекации или через несколько секунд после нее (капли крови на бумаге). При локализации в перианальной области повреждение шишек может быть в любое время. Чем дольше затягивать с лечением шишек в заднем проходе, тем сильнее будут кровотечения, что в итоге приведет к анемии.
- Выпадение геморроидальных узлов из ректума
Данный симптом характерен, если шишка выскочила в заднем проходе. За счет постепенного растягивания и истончения каркаса, который удерживает узел на стенке прямой кишки, происходит выпадение его из анального отверстия. Оно может произойти после физических нагрузок или при дефекации, но на последних стадия процесса геморроидальные узлы выпадают произвольно.
- Чувство инородного тела
Небольшой нарост в заднем проходе ощущаться не будет, но при постепенном увеличении узла, человек начинает ощущать дискомфорт. Возможно появление тяжести в области паха при физических нагрузках или ходьбе.
- Субъективные ощущения (зуд и жжение)
Данные ощущения появляются из-за раздражения слизистой оболочки кровянистыми выделениями или из-за появления на стенках истончившегося сосуда эрозий. Иногда небольшая шишка в заднем проходе может инфицироваться, что также приведет к появлению зуда и жжения.
Довольно редкий симптом, характерный для обострения процесса. Шишка у заднего прохода болит из-за ее ущемления. Симптом характеризуется интенсивностью, усиливается при ходьбе или дефекации. Боль иногда может быть нестерпимой.
Классификации хронического процесса и обострения по стадиям
Хроническое течение заболевания делится на такие стадии (в зависимости от степени тяжести):
- Слабый геморрой. Появляется маленькая шишка возле заднего прохода или внутри него. Течение процесса бессимптомное. Выпадение узлов не характерно.
- Прогрессирующая стадия. Появляются первые симптомы, и человек начинает замечать, что у него вскочила шишка в заднем проходе. Для данной стадии характерно выпадение узлов при физических нагрузках, однако при прекращении воздействия они сами возвращаются на место.
- Развитый геморрой. Появляются субъективные ощущения в виде зуда и жжения. Может появляться небольшая боль, и шишка в заднем проходе, выпадая, не возвращается на место. Требует ручное ее вправление обратно.
- Тяжелая стадия. Массивное кровотечение и сильные боли характерны для последнего этапа. И тогда в заднем проходе появилась шишка, которая выпадает без возможности вправления руками.
Обострение процесса возникает из-за ущемления узла или его тромбоза. В клинической картине дополнительно может появляться общее повышение температуры. Стадии острого геморроя:
- Обострение без наличия воспаления. Шишки в заднем проходе у мужчин и женщин характеризуются наличием зуда или жжения умеренной интенсивности, терпимыми незначительными болевыми ощущениями, небольшими размера. Отечность и гиперемия не характерны или слабо выражены.
- Воспаление узлов. Если возле заднего прохода образовалась шишка, которая сильно отекла и покраснела – это свидетельствует о наличии воспалительного процесса. Боль острая, из-за чего пальпаторное обследование невозможно.
- Воспаление окружающей узел клетчатки. Шарик на анальном отверстии полностью занимает его просвет. Боль невыносимая, а узлы багрово-синего оттенка, выпавшие из просвета.
При обострении геморроя следует срочно обратиться к врачу.
Шишка в заднем проходе при беременности
Чаще всего течение заболевания у беременных женщин бессимптомное. Обнаруживают развивающийся геморрой при плановом обследовании. Если образовалась шишка во влагалище со стороны заднего прохода – это свидетельствует о варикозном расширении вен влагалища, что также опасно, если процесс запустить. Опасность геморроя:
- невынашивание беременности на последних сроках;
- течение родов усложняется;
- шишка в заднем проходе после родов легко осложняется;
- развитие анемии;
- проблемы с мочеполовой системой;
- развитие кожных патологий.
Симптомы геморроидальной опухоли в заднем проходе у беременных идентичны обычным. В зависимости от размеров узлом, стадии и выраженности процесса выбирают либо консервативное, либо хирургическое лечение варикозного расширения геморроидальных вен.
Консервативная терапия
Народные методы лечения шишки в заднем проходе не помогут. А щадящая терапия всего лишь остановит процесс, но не избавит от него. Она показана на ранних сроках заболевания и включает в себя такие моменты:
- применение препаратов, благотворно влияющих на сосудистую стенку (укрепляющих ее, повышающих эластичность);
- лекарства для улучшения микроциркуляции и устранения застойных явлений;
- местное лечение, устраняющее воспалительные процессы;
- симптоматическая местная терапия (избавление от боли, зуда и жжения;
- тромболитическое лечение.
Местная терапия геморроидальной опухоли возле и внутри заднего прохода подразумевает применение свечей, мазей или специальных гелей.
Хирургическое лечение
- Инфракрасная фотокоагуляция. Для устранения геморроидальной опухоли в заднем проходе у мужчин и женщин используют высокие температуры. Прижигая узел в нескольких местах, добиваются его отпадания.
- Склеротерапия. Используется специальное вещество, которое, при введении его под узел, останавливает кровоток в наросте возле заднего прохода.
- Лигирование. Узлы сдавливают эластичными кольца, из-за чего через неделю они отпадают.
- Радиолучевой скальпель. На геморроидальную опухоль заднего прохода у человека воздействуют с помощью радиоволн.
- Лазерная коагуляция. Методика заключается в иссечении узла и немедленном обрабатывании ранки.
Открытые операции применяют редко, стараясь избавиться от заболевания менее инвазивными способами. Однако в редких случаях, при неэффективности любой консервативной и щадящей терапии прибегают к открытым доступам.
Операция называется геморроидэктомия и заключается в удалении пораженных вен. Ее проводят пациентам, у которых развились массивные кровотечения и нет противопоказаний к хирургическим операциям. Самый большой плюс операции в том, что рецидивы после нее наблюдаются редко, однако данное лечение очень болезненное.
Геморроидальные узлы и шишки –это опухшие и воспаленные вены в анусе и прямой кишке. В этой статье вы узнаете, что делать и какое необходимо лечение, если шишка возле заднего прохода болит, фото представлено ниже.
Коротко о геморрое
Достаточно часто пациенты приходят на прием к проктологу с жалобой, что появилась шишка возле ануса. Как правило, это является одним из симптомов геморроя.
Геморрой в современном мире является очень распространенным заболеванием.
В возрасте примерно 50 лет около половины взрослых людей имеют дело с неприятными симптомами: анальным зудом, кровотечением и болью в заднем проходе, которые часто сигнализируют о наличии этой болезни.
Мужчины чаще, чем женщины, страдают от данной патологии.
Это заболевание обычно не опасно и не угрожает жизни, часто долгое время остается незамеченным и обычно проявляется в течение несколько дней. Варикозно расширенные вены в ректальной области – это уплотнение возле заднего прохода у взрослого. Они могут вызывать долговременный дискомфорт, кровотечение и быть мучительно болезненными.
Повышенное давление крови на венозные сосуды в области малого таза вызывает появление шишек и узлов. По мере увеличения давления кровь в венах способствует их набуханию, растягивает сосудистую стенку, таким образом, формируется геморрой.
Причины
Точная этиология появления и развития узлов неизвестна. Основным фактором, оказывающим влияние на данное заболевание, является повышенное давление на венозные сосуды в прямой кишке. Если оно продолжается в течение длительного времени,то вены постепенно расширяются и выступают как шишки в прямой кишке.
Общие причины включают:
- Запор. Это связано с тем, что человек постоянно напрягается, чтобы опорожнить кишечник, увеличивая давление в прямой кишке и в ректальных венах.
- Гиподинамия. Сидячий образ жизни способствует притоку крови к органам малого таза.
- Генетическая предрасположенность (наследственность). По наследству передается слабость венозной стенки.
- Чрезмерное употребление слабительных средств. Частое использование слабительного может привести к диарее и геморрою.
- Поднятие тяжестей. Геморроидальные шишки очень часто появляются у спортсменов- тяжелоатлетов.
Провоцирующие факторы:
- Стояние или сидение в течение длительного времени.
- Избыточный вес.
- Недостаточная физическая активность.
- Курение.
- Беременность.
Наряду с генетической предрасположенностью важную роль играет нерегулярное и неадекватное питание (пряная, жирная пища).
Шишки у беременных
Очень часто беременные женщины замечают, что в заднем проходе вскочила шишка. Узлы возле ануса- обычная временная проблема среди беременных женщин, вызванная гормональными изменениями и повышенным давлением растущего плода. Во время родов шишки могут появиться из-за интенсивного давления на анальную область головки плода.
Многие женщины очень сильно пугаются, когда впервые обнаруживают небольшое образование у заднего прохода как на первом фото, и начинают искать в медицинской литературе рак прямой кишки.
Как обнаружить геморрой
Если вдруг неожиданно вылезло что- то из заднего прохода, то человек может сам себя обследовать. Для этого можно рассмотреть шишки возле ануса в зеркале и пропальпировать их лежа на спине с согнутыми ногами. Ниже фото, как выглядит шишка на анусе.
Когда при начальных стадиях геморроидальной болезни в заднем проходе появилась шишка, как на фото выше, то бывает трудно пропальпировать и рассмотреть ее.
Шишки могут развиться внутри заднего прохода (внутренний геморрой) или непосредственно вблизи анального отверстия (внешний геморрой).
Внутренние узлы лежат внутри заднего прохода. Обычно варикозно расширенные вены не болят, но могут периодически кровоточить (во время дефекации).
Когда расширенные вены находятся внутри кишки, то могут периодически пролапсировать (выступать вне ануса) и становиться очень болезненными и отечными. Небольшие выпавшие узлы иногда выглядят как наросты около ануса. Их можно без особого труда пальцем возвращать в анальный канал.
Внутренний геморрой классифицируется:
- 1 степень: узлы еще не выходят за пределы ануса;
- 2 степень: вены периодически выпадают, но затем возвращаются обратно;
- 3 степень: выпадение вен происходит во время физического напряжения, но они могут быть возвращены вручную;
- 4 степень: узлы всегда находятся вне ануса и уже не могут быть возвращены в анальный канал.
Наружный геморрой — это массы или скопления расширенных вен и узлов. Они расположены под кожей у заднего прохода. При внутреннем типе этой болезни небольшой шарик в заднем проходе можно самостоятельно пропальпировать.
Клиническая картина
Внутренние узлы очень редко вызывают какие-либо клинические симптомы, если в какой-то момент жизни не возникает их тромбоз. Наружные узлы как правило могут вызвать зуд, жжение и раздражение в области ануса.
Если при внешнем типе геморроя в просвете варикозной вены образуется сгусток крови,то кожа вокруг ануса сильно воспаляется и возникает очень болезненная шишка. В очень редких случаях этот сгусток может кровоточить в течение нескольких дней, оставляя кровь на нижнем белье.
Шишка внутри ануса сопровождается следующими симптомами:
- Зуд в анусе.
- Боль в заднем проходе.
- Кровь на туалетной бумаге.
- Боль при дефекации.
- Появление одного или нескольких твердых комков вблизи ануса.
Варикозно расширенная вена выглядит как небольшой отросток возле ануса.
Консервативное лечение
Домашнее лечение этого заболевания включает в себя,прежде всего, корректировку диеты. Как известно, пищевые волокна в ежедневном рационе оказывают положительный эффект для облегчения клинических симптомов заболевания. Они хорошо смягчают стул и увеличивают его объем, что значительно облегчает акт дефекации.
При не очень больших шишках на сфинктере можно аккуратно наносить мази для облегчения симптомов болезни.
Сидячая ванна — это теплая водяная баня для ягодиц и бедер.Она очень хорошо устраняет неприятный зуд, уменьшает раздражение слизистой оболочки, а также болезненные спазмы мышц вокруг анального сфинктера. Проктологи рекомендуют своим пациентам принимать такую ванну в течение 20 минут. Самым идеальным вариантом в этом случае будет — после каждого опорожнения кишечника или 2-3 раза в день.
Наложение холодных пакетов и льда на наросты около ануса помогает уменьшить отечность варикозных вен и уменьшить боль. Это простое средство способно значительно облегчить ощущение зуда и жжения в заднем проходе.
Если вы вдруг обнаружили, что возле заднего прохода образовалась шишка, и при рассмотрении и сравнении с фото она похожа на геморроидальный узел , то нужно использовать купленные в аптеке антигеморроидальные кремы или суппозитории. Эти средства могут на время купировать боль, уменьшить отечность тканей, защитить кожу и / или уменьшить кровотечение.
Кремы, содержащие гидрокортизон, могут использоваться для купирования зуда или боли в заднем проходе.
При шишках возле ануса назначаются противовоспалительные препараты (Постеризан), обезболивающие свечи (Анузол и Релиф), ванночки с марганцовкой. При варикозно расширенных венах прямой кишки нужно пропить курс венотоников в таблетках (Детралекс или Флебодиа).
Хирургическое лечение
Медицинское применение кремов и суппозиториев может облегчить раздражение и боль, но редко позволяет полностью избавиться от шишек и узлов. Диета с высоким содержанием клетчатки и объемные слабительные средства предотвращают запор. Однако, основой лечения является хирургическое вмешательство.
Но, к сожалению, оперативная геморроидэктомия обычно связана со значительными послеоперационными осложнениями, включая боль, кровотечение и анальную стриктуру, что может привести к длительному периоду выздоровления .
Недавние достижения в области инструментальных технологий привели к созданию биполярных электротермических устройств — ультразвукового скальпеля, кругового степлера и систем герметизации сосудов.
Новые методы разработаны для минимизации рассечения тканей с целью уменьшения послеоперационной боли и кровотечения.
Не оперативные (консервативные) варианты: лигирование резиновых полос, склеротерапия, инфракрасная фотокоагуляция, криотерапия, ручная анальная дилатация, геморроидэктомия при помощи лазера, геморроидэктомия с ультразвуковым скальпелем.
Большинство неоперативных процедур используются для геморроя первой и второй степени и обычно проводятся в амбулаторных условиях.
Оперативные варианты: геморроидэктомия методом зажима и прижигания, открытая геморроидэктомия, закрытая геморроидэктомия, подслизистая геморроидэктомия, угловая геморроидэктомия, сшитая геморроидэктомия, радиочастотная абляция и фиксация шовной геморроидэктомии.
Оперативные геморроидэктомии используются главным образом для геморроя третьей и четвертой степени.
Послеоперационные осложнения геморроидэктомии:
- Послеоперационная боль, продолжающаяся 2-3 недели.
- Инфицирование раны.
- Кровотечение.
- Кратковременное недержание стула.
- Затрудненное мочеиспускание.
Профилактика
При появлении шишек возле ануса пейте много жидкости. Употребляйте в пищу больше фруктов и овощей.
Если вы используете добавки с большим количеством пищевых волокон, обязательно выпивайте, по крайней мере, от восьми до десяти стаканов воды или других жидкостей каждый день. В противном случае пищевые добавки могут вызвать запоры .
Избегайте раздражения области ануса. Вы можете ополоснуться в душе или на биде вместо того, чтобы протирать себя туалетной бумагой.
Избегайте длительных периодов стояния или сидения. Если вы должны сидеть в течение длительного времени, то используйте мягкую подушку. Это может уменьшить давление на вены в анусе.
Заключение
Геморрой может маскировать более серьезное заболевание и, следовательно, должен быть правильно осмотрен и диагностирован врачом. Пациенты с узлами, которые выполняют все рекомендации своего лечащего врача, обычно имеют хороший результат от лечения и облегчение от этого состояния.
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