Hemorrhoids in children: symptoms and treatment

Hemorrhoids in children: symptoms and treatment

I. Understanding of hemorrhoids: what is it and why does it occur in children?

Hemorrhoids, often perceived as a problem that affects exclusively adults, can, although rarely, also meet in children. Hemorrhoids are varicose veins in the rectum and anus. These veins, known as hemorrhoidal veins, support the normal functioning of the rectum and help control the defecation process. However, when these veins become excessively expanded, swollen and inflamed, hemorrhoids develop.

A. Types of hemorrhoids:

Hemorrhoids are classified into two main types, depending on their location:

1. Inner hemorrhoids: This type of hemorrhoids develops inside the rectum, above the anorectal line. Since this area has fewer nerve endings, internal hemorrhoids are often painless, especially in the early stages. The internal hemorrhoids are classified according to degrees depending on the degree of prolapse (loss) from the anus:

   • And degree: The veins are enlarged, but do not fall out of the anus.
   • II degree: Hemorrhoids fall out during defecation, but spontaneously settled.
   • III degree: Hemorrhoids fall out during defecation and require manual reduction.
   • IV degree: Hemorrhoids are constantly falling out and cannot be set.

2. External hemorrhoids: This type of hemorrhoids develops under the skin around the anus, below the anorectal line. External hemorrhoids contains more nerve endings and therefore is often painful, especially if a blood clot is formed (thrombicated hemorrhoids).

B. The causes of hemorrhoids in children:

Unlike adults, where the main cause of hemorrhoids is the age -related weakening of tissues and chronic constipation, in children the causes are slightly different, although they can be associated with similar factors:

1. Chronic constipation: This is perhaps the most common cause of hemorrhoids in children. The tension during defecation exerts pressure on hemorrhoids, leading to their expansion and inflammation. Construction can be caused by insufficient fiber consumption, insufficient fluid consumption, diet changes, the habit of holding the stool (due to fear of the toilet or insufficient time) or some drugs.

2. Diarrhea: Although more often constipation leads to hemorrhoids, chronic or severe diarrhea can also cause irritation and inflammation in the rectum, which can contribute to the development of hemorrhoids.

3. Long -term sitting on the toilet: Conducting a long time on the toilet, especially while playing the phone or reading, can exert pressure on hemorrhoids and lead to their expansion.

4. Family predisposition: In some cases, a genetic predisposition can play a role in the development of hemorrhoids. If parents or other close relatives had hemorrhoids, the child may have an increased risk of its development.

5. Obesity: Excess weight can exert additional pressure on the pelvic veins, including hemorrhoidal veins, which increases the risk of hemorrhoids.

6. Inflammatory diseases of the intestine (BCC): In children with BCC, such as Crohn’s disease or ulcerative colitis, the risk of hemorrhoids is increased due to chronic inflammation in the intestines.

7. Other medical conditions: In rare cases, hemorrhoids can be associated with other medical conditions such as portal hypertension (increased pressure in portal vein caring from the intestines to the liver) or tumor in the pelvis.

II. Symptoms of hemorrhoids in children: what to look for?

Symptoms of hemorrhoids in children can vary depending on the type and severity of hemorrhoids. Some children may not experience any symptoms, especially in the early stages of internal hemorrhoids. Others may experience one or more of the following symptoms:

A. General symptoms:

1. Bleeding from the rectum: This is one of the most common symptoms of hemorrhoids. Blood is usually bright red and can appear on toilet paper, in the toilet or on a chair. Bleeding can be insignificant, in the form of a few drops, or more abundant. It is important to note that bleeding from the rectum can also be a sign of other diseases, so it is important to consult a doctor for diagnosis.

2. Itching and irritation in the anus: Inflammation and swelling around the anus can cause itching, irritation and discomfort. The child can constantly scratch the area of ​​the anus, which can aggravate irritation.

3. Anus pain: The pain is usually associated with external hemorrhoids, especially if a blood clot is formed (thrombed hemorrhoids). The pain can be acute, pulsating or dumb.

4. Swelling and swelling around the anus: External hemorrhoids can appear in the form of edema and swelling around the anus. Edema can be painful to the touch.

5. Littleing (prolapse) of hemorrhoids: Inner hemorrhoids can fall out of the anus during defecation. The fallen nodes can be visible and tangible. In mild cases, the nodes are adjusted independently, and in more severe cases manual reduction is required.

6. Mucus from the rectum: In some cases, hemorrhoids can cause mucus release from the rectum.

7. Discomfort for defecation: A child may experience discomfort or pain during defecation.

B. Symptoms depending on the type of hemorrhoids:

1. Inner hemorrhoids:

   • Most often manifested by bleeding from the rectum.
   • It can be painless, especially in the early stages.
   • It can fall out of the anus during defecation (prolapse).

2. External hemorrhoids:

   • It is most often manifested by pain, itching and swelling around the anus.
   • It may be painful to the touch.
   • It can form blood clots (thrombled hemorrhoids), causing severe pain.

C. Important warnings:

• Any bleeding from the rectum in a child requires a mandatory consultation of a doctor. Although hemorrhoids are one of the possible causes, bleeding can be a sign of other, more serious diseases, such as anal cracks, polyps, inflammatory intestinal diseases or even cancer (although this is extremely rare in children).
• If the child experiences severe pain in the anus, especially if it is accompanied by fever, chills or purulent discharge, you must immediately consult a doctor. This can be a sign of infection.
• Do not try to treat hemorrhoids in your child without consulting a doctor. Self -medication can be dangerous and can lead to complications.

III. Diagnosis of hemorrhoids in children: when to consult a doctor and what examinations can be prescribed?

When the symptoms appear that indicate hemorrhoids, it is important to consult a doctor to make an accurate diagnosis and exclude other possible causes of symptoms. The doctor will conduct a physical examination and may prescribe additional examinations.

A. When to see a doctor:

• In the presence of bleeding from the rectum.
• In the presence of pain, itching or edema in the anus.
• In the presence of loss (prolapse) of hemorrhoids.
• If hemorrhoids are suspected in a child.
• In the absence of improvement of symptoms after home measures.
• If new symptoms appear or existing.

B. examinations that can be prescribed by a doctor:

1. Physical examination: The doctor will conduct a visual examination of the anus and rectum. It can also conduct a finger rectal examination (for), in which the doctor introduces a finger in a glove and lubrication into the rectum to evaluate the condition of the rectum walls and identify the presence of hemorrhoidal nodes or other anomalies.

2. Anoscopy: This is a procedure in which the doctor introduces a small pipe with backlight (anoscope) into the anus to inspect the inner surface of the rectum and anus. Anoscopy allows you to evaluate the state of hemorrhoidal nodes in more detail and identify other possible causes of symptoms.

3. Rectosigmoidoscopy: This is a procedure similar to anoscopy, but the tube (rectosigmoidoscope) is longer and allows you to examine the large part of the colon (sigmoid colon). Rexigmoidoscopy can be prescribed to exclude other diseases, such as inflammatory intestinal diseases or polyps.

4. Colonoscopy: This is the most invasive procedure in which the doctor introduces a long, flexible pipe with backlight (colonoscope) into the anus for examining the entire colon. Colonoscopy is usually prescribed only in cases where there is a suspicion of a more serious disease, such as inflammatory diseases of the intestines, polyps or cancer.

5. Blood tests: Blood tests can be prescribed to exclude other diseases that can cause bleeding from the rectum, such as anemia or impaired blood coagulation.

6. The analysis: The analysis of feces can be prescribed to identify the presence of blood in feces or to exclude infections.

C. Differential diagnosis:

It is important to differentiate hemorrhoids from other diseases that can cause similar symptoms. Such diseases include:

• Anal cracks: These are small tears in the anus mucosa, which can cause pain and bleeding.
• Polyps: These are benign formations that can develop in the rectum or colon.
• Inflammatory diseases of the intestine (BCC): These are chronic diseases that cause inflammation in the intestines.
• Infections: Some infections, such as perianal streptococcus, can cause itching and irritation in the anus.
• River’s loss: This is a condition in which part of the rectum falls out of the anus.
• Cancer: Although this is extremely rare in children, cancer of the rectum or colon can cause bleeding from the rectum.

IV. Treatment of hemorrhoids in children: conservative methods and when surgical intervention is required.

Treatment of hemorrhoids in children usually begins with conservative measures aimed at eliminating constipation and relief of symptoms. Surgical intervention is rarely required and is usually considered only in cases where conservative methods are ineffective or in the presence of complications.

A. Conservative methods of treatment:

1. Elimination of constipation: This is the most important aspect of hemorrhoid treatment in children. It is necessary to provide regular stools without tension.

   • Diet rich in fiber: Increase fiber consumption in the child’s diet. Good sources of fiber include fruits, vegetables, whole grain products and legumes. The recommended daily fiber consumption for children is calculated by the formula: child’s age + 5 grams. For example, a 5 -year -old child requires 10 grams of fiber per day.
   • Increased fluid consumption: Make sure that the child drinks fluid enough to soften the chair. The recommended daily fluid intake depends on the age and activity of the child. Water is the best choice.
   • Regular physical exercises: Physical activity helps stimulate the intestines and prevents constipation.
   • Using laxatives: In some cases, the use of laxatives to soften the stool may be required. However, laxatives should be used only as prescribed by a doctor and for a limited time to avoid addiction. The doctor can recommend softeners of stools (for example, sodium document) or osmotic laxatives (for example, macrogol). Stimulating laxatives, such as senna, are usually not recommended for long -term use in children.
   • Tooling to the toilet: Accustom the child to regularly visit the toilet at the same time every day. Make sure the child does not hold the chair.

2. Local funds: Local remedies can help alleviate the symptoms of hemorrhoids, such as itching, pain and inflammation.

   • Sitting baths: Regular sessile baths (immersion of the anus area in warm water for 10-15 minutes several times a day) can help relieve pain, itching and inflammation.
   • Creams and ointments: There are various creams and ointments containing hydrocortisone or other anti -inflammatory components that can help alleviate the symptoms of hemorrhoids. However, the use of these funds in children should be coordinated with a doctor.
   • Wet napkins: Use wet wipes instead of dry toilet paper to avoid irritation of the anus area. Choose napkins without fragrances and alcohol.

3. Anesthesia: To relieve pain, you can use painkillers, such as paracetamol or ibuprofen. The dosage should be observed in accordance with the instructions and age of the child.

4. Change in behavior:

   • Limit the time of sitting on the toilet: Make sure the child does not spend a long time on the toilet.
   • Avoid tension during defecation: Teach the child not to strain during defecation.
   • Follow the hygiene of the anus area: Regularly wash the anus area with warm water and soft soap.

B. Surgical treatment:

Surgical treatment of hemorrhoids in children is rarely required and is usually considered only in cases where conservative methods are ineffective or in the presence of complications, such as:

• Strong bleeding.
• Constant prolapse of hemorrhoids.
• Thrombered hemorrhoids with severe pain.

There are various surgical methods of treating hemorrhoids, including:

1. Ligating with latex rings: This is a procedure in which the latex ring is put on the base of the hemorrhoidal node, which leads to the cessation of the blood supply to the node and its death. This procedure is usually used to treat internal hemorrhoids of the I-III degree.

2. Sclerotherapy: This is a procedure in which a special solution is introduced into the hemorrhoid node, which causes its gluing and reducing. This procedure is usually used to treat internal hemorrhoids of the I-II degree.

3. Infrared coagulation: This is a procedure in which the hemorrhoidal node is cauterized by infrared radiation, which leads to its decrease. This procedure is usually used to treat internal hemorrhoids of the I-II degree.

4. Hemorrhoidctomy: This is surgical removal of hemorrhoids. This procedure is usually used to treat severe hemorrhoids of the III-IV degree or thrombed hemorrhoids. Hemorrhoidctomy can be performed in various ways, including traditional surgery, stapler hemorrhoidctomy and laser hemorrhoidctomy.

5. Hemorrhoidopexy: This is a procedure in which the fallen hemorrhoids are pulled back into the rectum and fixed there. This procedure is usually used to treat internal hemorrhoids of the III-IV degree.

The choice of surgical method depends on the type and severity of hemorrhoids, as well as on the general state of health of the child.

C. Possible complications:

Although hemorrhoids in children are usually not a serious disease, in rare cases, complications can occur, such as:

• Anemia due to chronic bleeding.
• Infection.
• Thrombosis of hemorrhoids.
• Anus stricture (narrowing of the anus).

V. Prevention of hemorrhoids in children: how to prevent the occurrence of a problem?

Prevention of hemorrhoids in children is to maintain a healthy lifestyle and prevent constipation.

A. Prevention measures:

1. Diet rich in fiber: Provide the child with a diet rich in fiber.
2. Increased fluid consumption: Make sure the child drinks enough fluid.
3. Regular physical exercises: Encourage regular physical activity.
4. Tooling to the toilet: Teach your child to regularly visit the toilet.
5. Limiting the time of sitting on the toilet: Make sure the child does not spend a long time on the toilet.
6. Avoid tension during defecation: Teach the child not to strain during defecation.
7. Follow the hygiene of the anus area: Regularly wash the anus area with warm water and soft soap.
8. Control weight: Support the healthy weight of the child.
9. Timely treat intestinal diseases: If the child has any intestinal diseases, such as inflammatory intestinal diseases, treatment must be carried out in a timely manner.

B. Tips for parents:

• Carefully follow the child’s chair.
• If constipation appears, take measures immediately to eliminate them.
• Create comfortable conditions for the child to visit the toilet.
• Feel free to consult a doctor in case of any problems.

VI. Alternative methods for treating hemorrhoids in children (attention: consultations with a doctor are required).

Despite the fact that conservative methods and, in rare cases, surgical intervention are the main methods of treating hemorrhoids in children, some parents consider alternative treatment methods. It is important to emphasize that the effectiveness of most alternative methods for treating hemorrhoids in children has not been scientifically proven, and before their use it is necessary to consult a doctor. Improper use of alternative methods can be dangerous to the health of the child.

A. Some of the most commonly mentioned alternative methods:

1. Fitotherapy (herbs treatment): Some herbs, such as Hamamelis, chamomile, calendula and aloe vera, have anti -inflammatory and soothing properties and can help alleviate the symptoms of hemorrhoids. These herbs can be used in the form of ointments, creams, sitting baths or compresses. However, before using any herbal products in children, you need to make sure that there is no allergy and consult a doctor.

2. Homeopathy: Homeopathy is a system of alternative medicine, which is based on the principle of “like this.” Homeopaths use very diluted substances to treat various diseases, including hemorrhoids. However, the effectiveness of homeopathy has not been scientifically proven, and its use in children is a controversial issue.

3. Acupuncture (Iglowerie): Acupuncture is a method of traditional Chinese medicine, which consists in introducing thin needles into certain points on the body to restore the energy balance. Some studies show that acupuncture can help relieve pain and other symptoms of hemorrhoids, but additional studies are needed to confirm its effectiveness.

4. Probiotics: Probiotics are living microorganisms that bring health benefits, especially for the digestive system. Some studies show that probiotics can help prevent constipation and other digestive problems that can contribute to the development of hemorrhoids. Probiotics can be found in yogurt, kefir and other fermented products, as well as in the form of food additives.

5. Dietary additives: Some dietary supplements, such as routine and hesperidine, have antioxidant and anti -inflammatory properties and can help strengthen the walls of blood vessels. However, before using any dietary additives in children, it is necessary to consult a doctor.

B. Important warnings:

• Alternative methods for treating hemorrhoids in children should not be used as a replacement for traditional medicine.
• Before using any alternative treatment methods, it is necessary to consult a doctor.
• Make sure that the alternative treatment methods used are safe for children.
• Carefully monitor the condition of the child and when any side effects appear immediately consult a doctor.

VII. Psychological aspects of hemorrhoids in children: how to help the child cope with discomfort and fear.

Hemorrhoids can be not only physically unpleasant for the child, but also cause psychological discomfort, especially if it is accompanied by pain, itching or bleeding. A child can experience shame, constraint, fear and anxiety. It is important that parents understand the psychological aspects of hemorrhoids and help the child cope with these feelings.

A. How to help the child cope with discomfort and fear:

1. Explain to your child what hemorrhoids are: Use a simple and understandable language to explain to your child what hemorrhoids are, why it arises and how it is treated.
2. Assure the child that hemorrhoids are not his fault: Emphasize that hemorrhoids are a common problem that can occur in any person, and that he is not to blame for what he has hemorrhoids.
3. Support the child and show sympathy: Show the child that you understand his feelings and that you are ready to support him.
4. Provide the child with comfortable conditions for visiting the toilet: Make sure the child feels comfortable and safe in the toilet. Give him soft toilet paper, wet wipes and other necessary products.
5. Teach the child relaxation techniques: Teach the child to relax the techniques, such as deep breathing, meditation or yoga, to help him cope with stress and anxiety.
6. Talk to the doctor if the child has strong fear or anxiety: If a child experiences a strong fear or anxiety, consult a doctor or psychologist.

B. Tips for parents:

• Be patient and understandable.
• Do not make fun of the child and do not belittle his feelings.
• Create an atmosphere of trust and support for the child.
• Seek professional help, if necessary.

VIII. Hemorrhoids in infants: Features and methods of treatment.

Hemorrhoids in infants are extremely rare, but still possible. The causes and methods of treating hemorrhoids in infants differ from those in older children.

A. The causes of hemorrhoids in infants:

• Voltage during defecation: Babies can strain during defecation, especially if they have constipation.
• Diarrhea: Chronic diarrhea can cause irritation and inflammation in the anus.
• Anal cracks: Anal cracks can cause pain and bleeding, which can be mistakenly mistaken for hemorrhoids.
• Congenital anomalies: In rare cases, hemorrhoids may be associated with congenital anomalies of the rectum or anus.

B. The symptoms of hemorrhoids in infants:

• Bleeding from the rectum: Blood is usually bright red and can appear on a diaper or on a chair.
• Irritability and crying during defecation: The baby can cry or be irritable during defecation due to pain and discomfort.
• Protrusion in the anus: In rare cases, the hemorrhoidal node can fall out of the anus.

C. Treatment of hemorrhoids in infants:

Treatment of hemorrhoids in infants should be prescribed by a doctor. Self -medication can be dangerous to the health of the child.

• Elimination of constipation or diarrhea: If hemorrhoids are caused by constipation or diarrhea, it is necessary to eliminate the cause. The doctor may recommend changing the mother’s diet (if the baby is on breastfeeding) or prescribe special mixtures for feeding.
• Sittle of the stool: The doctor can recommend softeners of stool, such as lactulose or macrogol.
• Sitting baths: Sutting baths with warm water can help relieve pain and inflammation.
• Local funds: The doctor may recommend local products, such as creams or ointments with petroleum jelly or zinc oxide.
• Surgical treatment: Surgical treatment of hemorrhoids in infants is extremely rare.

D. Important warnings:

• When the baby appears in the baby indicating hemorrhoids, you must immediately consult a doctor.
• Do not try to treat hemorrhoids yourself in the baby without consulting a doctor.
• Follow all the doctor’s recommendations.

IX. The long -term consequences of hemorrhoids in children: what to expect and how to prevent relapse.

In most cases, hemorrhoids in children take place without any long-term consequences with timely and proper treatment. However, if hemorrhoids are not treated or if it occurs often, the following long -term consequences may occur:

A. possible long -term consequences:

1. Chronic pain and discomfort: Chronic hemorrhoids can cause constant pain and discomfort in the anus.
2. Bleeding from the rectum: Chronic bleeding can lead to anemia.
3. River’s loss: In severe cases, hemorrhoids can lead to the loss of the rectum.
4. Anus stricture (narrowing of the anus): Chronic inflammation and scarring can lead to narrowing of the anus.
5. Psychological problems: Chronic hemorrhoids can cause psychological problems, such as fear, constraint and depression.

B. How to prevent the relapse of hemorrhoids:

1. Observe a diet rich in fiber: Provide the child with constant consumption of a sufficient amount of fiber.
2. Increase fluid intake: Make sure the child drinks enough fluid.
3. Regularly engage in physical exercises: Encourage regular physical activity.
4. Accustom the child to regularly visit the toilet: Create a regular visit to the toilet.
5. Limit the time of sitting on the toilet: Make sure that the child does not sit on the toilet.
6. Avoid tension during defecation: Teach a child to avoid tension during defecation.
7. Follow the hygiene of the anus area: Teach the child the correct hygiene of the anus area.
8. Timely treat intestinal diseases: Timely treat any intestinal diseases.
9. Visit the doctor regularly: Regularly visit a doctor for preventive examinations.

X. Заключение (NOTE: Do not include a conclusion here, as requested)

(Intentionally left blank).