HEMOROİD NEDİR ? SAĞLIKLI BİREYLERDEKİ İŞLEVİ NEDİR ?


Normalde doğan her canlıda kalın bağırsağın dışarı açılan en son kısmında damar ağları mevcuttur. Anüs (makat) ve rektumda (kalın bağırsağın en son bölümü) bulunan ve hemoroidal damarlar denilen bu damar ağlarının vücudumuzda çok önemli görevleri vardır.

Aşağıda bu görevler sıralanmıştır;

– Normalde bu damar ağlarında biriken kan anüsün (makatın) tam kapanmasını sağlar.

Böylelikle hemoroidal damarlar, kişi istemli olarak anüsü kontrol eden kaslarını

kasmadığı halde, dışkılama kontrolünün sağlanmasına yardımcı olur.

– Anüsü çevreleyen kas kitlesinin (sfinkter) üzerinde koruyucu bir yastık tabakası işlevi sağlar. Dışkı anal kanaldan (makat)geçerken bu kasların direkt olarak dışkı ile teması hemoroidal damarlar ile korunur. Böylelikle her dışkılamada bu kasların hasar görmesi engellenmiş olur.

– Dinlenme ve uyku halinde anüsü (makat) tam kapatarak dışkının kilodu kirletmesine engel olur. Hemoroidal damarlar yerleşim yerine göre eksternal (dış) ve internal (iç) olarak ikiye ayrılmaktadır.

Anal Kanal ve Hemoroidal Damarlar

– Eksternal (dış) hemoroidler anüsün çevresinde gelişir ve ince bir deri ile kaplıdır..

– İnternal (iç) hemoroidler anüsün içinde gelişir.

HEMOROİD HASTALIĞI NEDİR ?

Bazı kişilerde anüs (makat) ve rektum (kalın bağırsağın son bölümü) çevresinde bulunan hemoroidal damarlar aşırı derecede genişler ve anüsten dışarıya taşarlar. Örneğin Kabızlık şikayeti olan bireylerde dışkı sertleşir ve dışkılama işlevi zorlaşır. Birey bu sert dışkıyı boşaltmak için aşırı ıkınma ve zorlanmaya gerek duyar. Bu sırada anal kanalı örten tabaka ve damarlar zedelenir. Bu da damarlarda genişleme ve şişmeye neden olur. Damarlardaki bu genişleme ve şişmeye hemoroidal hastalık ya da kısaca hemortoid denir. Bu durumda damarlar normal işlevlerini yapamazlar ve bazen de ciddi şikayetlere neden olurlar. Bu belirti ve bulgular hangi hemoroidal grup hastalandı ise ona göre farklılık gösterir.

• Eksternal (dış) hemoroid anüsün çevresinde gelişir ve ince bir deri ile kaplıdır. Eğer bu damarların içinde bir kan pıhtısı oluşursa oldukça ağrılı olur. Hasta, makadının hemen yanında eline sert ve ağrılı şişliğin (memelerin) geldiğini söyler. Yırtıldıkları zaman kanama şikayetine neden olur.

• İnternal (iç) hemoroid anüsün içinde gelişir. Ağrısız kanama en önemli belirtisidir. Bazen iç hemoroidler dışkılama sırasında anüsten (makattan) dışarı çıkarlar ve hasta eline bir şişlik geldiğinden şikayet eder. Buna ek olarak dışkılama sırasında dışarı çıkan ve içeri girmeyen iç hemoroidler ağrıya neden olabilir.

HEMOROİDAL HASTALIĞIN NEDENLERİ

Kesin nedeni bilinmemekle birlikte insanın, diğer canlılardan farklı olarak ayakta dik durması, makattaki toplardamarlara (anüsteki venlere) büyük bir basınç ve hacimde kan dolmasına neden olmaktadır. Bu da hastalığın gelişmesini kolaylaştıran bir etkendir.

Önemli diğer bir nedeni, beslenme alışkanlığıdır. Batı toplumunda 20. yüzyıldan itibaren endüstrinin gelişmesiyle beslenme alışkanlığı da değişmiştir. Sonuçta diyetteki lifli (posalı) yiyecekler azalmıştır. Oysa vücutta sindirilemeyen lifler, emilinceye kadar kitlesinin 30 katı kadar su çekmekte böylece bu kitlenin sindirimi zorlaşmaktadır. Böylelikle, kolay, zorlamadan ve ıkınmadan dışkılama yapılabilir. Aksi takdirde ıkınma ve zorlama bu bölgedeki basıncı daha artırır. Bunun sonucunda hemoroidal hastalık gelişebilir. Diyetsel lifli besinlerin kullanılmaması durumunda, hemoroid hastalığının görülme sıklığı da artmaktadır.

Çoğu insan, hemoroidi olmasına rağmen alışkanlıklarını değiştirmemektedir. Dışkılama alışkanlığının düzenli olmaması, dışkının sertleşmesine neden olur. Dışkılama sırasında ıkınma, tuvalette uzun zaman beklenmesi bu damarlardaki genişlemeyi arttırır. Katı ve sert olan dışkının makattan geçmesi sırasında bu damarlarda hasar oluşur. Bu nedenle de ağrı ve bazen de kanama meydana gelir.

Dışkılama alışkanlığını düzenlemede diğer önemli bir etken de içilen su miktarıdır. Günde en az 8-10 bardak su içilmesi gereklidir. Az miktarda su içmek kabızlığa neden olabilir. Kabızlık da ıkınmaya neden olacağı için hemoroide ait şikayetler artabilir.

Buna ek olarak hastalığın şiddetlenmesine neden olan faktörler şunlardır:

– yaş

– kronik (uzun süreli) Kabızlık veya ishal

– hamilelik

– genetik nedenler (kalıtsal)

– dışkılamayı kolaylaştıran ilaçların (laksatiflerin ve lavmanların) sık kullanımı

– dışkılamak için zorlu ve uzun süreli ıkınmalar

– tuvalette uzun zaman oturulması (gazete, kitap okunması, vb)

– ağır yük kaldırılması

– hastalığın şiddetlenmesine neden olan besin maddelerinin tüketilmesi (alkol, baharatlı yiyecekler)

Nedeni ne olursa olsun bu damar ağlarını (makat kanalındaki toplar damarları) destekleyen dokular gerilir ve sonuçta bu damarlar genişler, çevre destek dokusu ve duvarları incelir ve kanama meydana gelir. Eğer gerginlik artar, basınç devam ederse incelmiş olan bu damarlar makattan dışarı çıkarlar.

HASTALIĞIN BELİRTİLERİ NELERDİR ?

Dışkılama (büyük abdest yapma) esnasında kanama

en önemli belirtisidir. Sıklıkla damla damla burun kanaması gibi taze parlak kırmızı renktedir. Dışkının üzerine ve temizlik sırasında kan fark edilebileceği gibi tüm tuvalet kan ile kirlenebilir. Genelde kanama ağrısızdır.

Dışkılama (büyük abdest yapma) esnasında makatın dışarı çıkması, ele gelen şişlikler.

Hasta makattan dışarı doğru çıkan yumuşak bir şişlikten, kitleden şikayet eder. Bazı hastalar bu dışarı çıkan şişliği makat içine doğru içeriye geri itebilirler.

Anal bölgede (makatta) kaşıntı

Hemoroidal damarların normal işlevlerini yapamaması ile makat bölgesinin hijyeni de bozulur. Makatın tam kapanmaması ile dışkı ve akıntı kaçağı olur. Buna bağlı kaşıntı ihtiyacı oluşur.

Ağrı

Hastalar bu şikayetlerini tam olarak ifade edemezler. Sancı, sızlama veya yanma şeklinde bir his olarak tanımlayabilirler. Özellikle dış hemoroidlerin tromboze (damar içinde kan pıhtısı oluşması) olması şiddetli ağrıya neden olur.

Sürekli olarak anal kanalın (makatın) dışında kalan ve dokunulduğunda ağrılı olan şişlikler

İç hemoroidlerin makattan dışarı sarkması sonucu gelişebileceği gibi dış hemoroidlerin tromboze olması ile de ortaya çıkabilir.

• Kilodun akıntı , kanama veya dışkı ile kirlenmesi

HEMOROİD HASTALIĞINDA KLİNİK MUAYENE NASIL YAPILIR ?

Anamnez:(hastalık hikayes)i: Doktor hastanın şikayetlerini dikkatle dinler. Bu görüşmenin amacı hastaya ait özellikler ve hastalığın seyrini ortaya koymaktır. Hastanın diyet şekli, dışkılama ve tuvalet alışkanlığı, hastalığın şiddetlenmesine neden olabilecek etkenler ve ailesel hikayesi değerlendirilir.

Muayene: Hastanın utanmasına neden olmayacak bir ortamda yapılmalıdır. Bu muayene sırasında doktor makat bölgesini ve kalın bağırsağın son kısmı olan rektumu da parmakla muayene etmesi gerekir. Bu şekilde ayırıcı tanıda akla gelebilecek diğer hastalıkların varlığı da araştırılır.

Endoskopik muayene (Anoskopi-Rektosigmoidoskopi-Kolonoskopi): Kalın bağırsağın içini örten tabakanın direkt gözle incelenmesine endoskopi denir. Bu işlem sadece makat için yapılırsa anoskopi, rektum ve sigmoid kolon için yapılırsa rektosigmoidoskopi ve tüm kalın bağırsak için yapılırsa kolonoskopi denir.

Dışkıdan kan gelmesi şikayeti olan bir hastada ayırıcı tanı için en az rektosigmoidoskopi yapılmalıdır. Aksi takdirde kanamaya neden olabilen diğer hastalıklar gözden kaçabilir. Örneğin dışkılama sırasında kanamaya neden olan erken evredeki bir kalın bağırsak kanserinin farkına varılmazsa ve hemoroid hastalığı diye yanlış tedavi edilirse, ileride ciddi sağlık sorunlarına neden olabileceği unutulmamalıdır. Bu nedenle ayırıc tanı için mutlaka endoskopik tetkiklerden yararlanılmalıdır.

98 Yanıt

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    have looked or felt while speaking. if i can cut out a line of awkward description simply by using “sarcastically” or “sardonically,” i’ll do it. if some critic wants to call me sloppy for it, hell, i’ll gladly keep joanne company.

  74. get one very big advantage.this huge advantage

    is summed up in one word – traffic. if you pull a lot of people with the same interests together and they all start to blog, they read the other blogs on the system.but i still think self-hosted wordpress wins the

  75. are both hosted blogs, meaning your url

    will be [http://www.yournamehere.typepad.com/]the same is true for blogger. wordpress gives you the option. you can host your blog on wordpress or redirect it to another host so your url is whatever you want it to be.read everything about your blogging…

  76. the website can experience a huge traffic.

    internet searchers always look for good content and if you are the one who provides them with good articles, they will certainly visit you over and again to grab more. this can help in developing a strong bond and you will

  77. need to check the results and copy

    all questions that you think are related to your topics. last step is to write a short article as a solution for each of questions.3. you can use your customers as a source of article ideas. there will always be an

  78. time to write.set yourself daily time to

    update your blog, or if you only update 3 time per week set specific days when you’re going to write your blog posts. if for some reason you know you can’t do it on that day do it earlier and put

  79. “a day in the life of __________”encourage

    students to model desired behaviorsstudents won’t always respond to a writing prompt out of the blue, but they will feel more comfortable with their written voice, when you allow students to see the “real” you at all times. the hardest thing

  80. help you boost your writing abilities. get

    to know them very well and submit yourself to their training.write regularly to train your brain and your hands to write. the more you write the more you will exercise your brain to squeeze out more words from it for you

  81. but anyway, one has to derive his

    or her inspiration from everyday life, not from some mysterious source that predestines one to be a writer even before he or she is born.rich experiences plus creative use of language are still inadequate for the making of a good writer.

  82. things an seo blogger must do:create your

    own wordpress blog- if you have a business and would like to start building your own authoritative blog, you can go to godaddy.com. it only takes 10 minutes to set up. you must apply for a linux-hosted account because wordpress is

  83. body cleanse is good, clean water. sip

    water all day long. set a water consumption goal. increase it daily until you are drinking a healthy amount. an average sized woman needs about 70 ounces of water daily. drink more if you’re physically active.nature has provided all you need

  84. the many options available. if you really

    don’t know which method is best for your acne, it’s an easy matter to schedule a consultation with your dermatologist. the menopause symptoms that women suffer from usually die down when they reach the post menopausal stage. however, there are cases

  85. to this subject or niche, writing about

    things like kitchens, ovens and related furniture or areas. if you try to stray too much from your niche then it is possible to become slightly unrelated which can be a detrimental thing.be concise yet informative – when it comes to

  86. with your post players and find where

    they like to catch the ball. practice post passing with defenders behind the post, side fronting baseline, side fronting high side, and against a defender that tries to front the post. the passing angles will be different for each, but the

  87. add links and add videos can be

    embedded into the blog itself.6. time frame, set a time each day to work on a blog post. give yourself a time frame in which to complete articles and set aside a few hours each day to complete an article, take

  88. you’ve got that money in your paypal

    account. so, offer to do a few blog posts or an article or two just to make sure you are certain to get your money.if you do good work for a reasonable fee, chances are they’ll want you to keep doing

  89. way to be successful in any field.passionmake

    sure you’re passionate about what you do and what you write about. if you’re not the games over before you’ve even started as your hearts not in it from day one. be passionate, you need that stay in love with what

  90. more exposure for your blog and your

    business. people love blogs. they are looking for content that can help them solve a problem. be sure to help your readers or educate them in a specific subject, and that will get you more traffic. blogs are interactive. when you

  91. website or blog site. other features of

    this plug-in include featured posts with excerpt, a java script / css effect when sliding to another post, arrows for navigating through the posts, an administration setting for category and post items and a nice image next to the text which

  92. acclaimed cold mountain, which was also well-received

    by the general public. it required a few pages to get used to the style, but i think it’s fair to state that most people found the format not to be a problem. from our school days, we remember james joyce

  93. so inspiring that they will want to

    re-share it with their group.3. you want to build your expertise by presenting yourself as a specialist. that happens when you offer intelligent ideas, speak to your audience and offer good, sound valuable tips.4. comment on other people’s posts- espe…

  94. the google adsense program, you must find

    an interesting topic which will draw readers, and also a good angle for such topic. it will take a lot of hard work, but you need to also write many worthwhile blog posts in your topic field. you will have to

  95. employees can not be friendly, personal and

    sales structured. employees can not use a rulebook in this situation. all the good, friendly rules were used in the first few letters. now in this situation, the employee will probably have to write an unfriendly letter yet maintain a good

  96. – you do several things: provide a

    steady flow of fresh content related to your business. the search engines love fresh content. the more frequently and regularly you provide it, the better your web site will fare in search rankings. maintain steady communication with customers and pros…

  97. writing is to stay completely focused on

    the task at hand. patience is of utmost importance while writing.there maybe days when you’ll manage to write loads of articles and there maybe some other days when you won’t be able to write a single word due to lack of

  98. like to add in images and videos.put

    yourself in the reader’s shoesthis article will look at the secrets of writing great posts for your blog. as i always say, behind every successful blogger is good content, repeatedly written. as an introduction to great blog post writing, here’s an

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