{"id":26033,"date":"2022-12-01T11:58:58","date_gmt":"2022-12-01T09:58:58","guid":{"rendered":"https:\/\/astrea-apotheke.ch\/hemorroides-eternel-tabou\/"},"modified":"2024-12-29T22:07:41","modified_gmt":"2024-12-29T20:07:41","slug":"hemorroides-eternel-tabou","status":"publish","type":"post","link":"https:\/\/astrea-apotheke.ch\/fr\/hemorroides-eternel-tabou\/","title":{"rendered":"H\u00e9morro\u00efdes: \u00c9ternel tabou"},"content":{"rendered":"

H\u00e9morro\u00efdes: \u00c9ternel tabou<\/h1>\r\n\r\n\r\n

Quand des d\u00e9mangeaisons ou des saignements apparaissent dans la r\u00e9gion anale, cela peut venir des h\u00e9morro\u00efdes. Dans cet entretien, la Dre m\u00e9d. Daniela Cabalzar-Wondberg nous explique comment la crise h\u00e9morro\u00efdaire appara\u00eet et comment la traiter.<\/em><\/p>\r\n\r\n\r\n

Text:<\/strong><\/p>

Susanna Steimer Miller<\/a><\/p>

<\/p><\/div><\/div>\r\n\r\n\r\n

<\/div><\/div>\r\n\r\n\r\n\r\n

La Dre m\u00e9d. Daniela Cabalzar-Wondberg, EBSQ Coloproctology, est proctologue et chirurgienne \u00e0 l\u2019H\u00f4pital universitaire de Zurich.<\/p>\r\n\r\n\r\n\r\n

Personne n\u2019aime parler de ses probl\u00e8mes d\u2019h\u00e9morro\u00efdes. Pourquoi?
<\/em>Dre m\u00e9d. Daniela Cabalzar-Wondberg: <\/strong>je constate chaque jour dans mon cabinet que parler ouvertement de probl\u00e8mes touchant la r\u00e9gion anale se heurte encore \u00e0 de tr\u00e8s fortes inhibitions. Et en cas d\u2019incontinence f\u00e9cale, la honte est encore plus grande.<\/p>\r\n\r\n\r\n\r\n

Que sont exactement les h\u00e9morro\u00efdes?
<\/em><\/strong>Pour commencer, il faut savoir que tout le monde \u00e0 des h\u00e9morro\u00efdes. Il s\u2019agit en fait de paquets de vaisseaux, qu\u2019on appelle le \u00abplexus h\u00e9morro\u00efdaire\u00bb, situ\u00e9s entre le rectum et le canal anal. Ils se composent d\u2019un entrelacs d\u2019art\u00e8res et de veines qui contribue \u00e0 la continence \u00e0 hauteur de 20\u2009% environ en emp\u00eachant que des gaz, du liquide ou des mucosit\u00e9s ne s\u2019\u00e9chappent involontairement de l\u2019anus. Les 80\u2009% restants sont assur\u00e9s par le sphincter anal. Normalement, ces coussinets vasculaires fonctionnent comme un corps caverneux et assurent l\u2019\u00e9tanch\u00e9it\u00e9 de l\u2019anus. Mais s\u2019ils grossissent et provoquent une g\u00eane, on parle de troubles h\u00e9morro\u00efdaires.<\/p>\r\n\r\n\r\n\r\n

\u00c0 quoi ces troubles sont-ils dus?
<\/em><\/strong>Diff\u00e9rents facteurs peuvent entrer en ligne de compte. Par exemple, la pression accrue qui s\u2019exerce sur le p\u00e9rin\u00e9e pendant la grossesse, lors de l\u2019accouchement, quand on porte des charges lourdes ou en raison d\u2019un surpoids favorise les h\u00e9morro\u00efdes. Une alimentation pauvre en fibres, la consommation excessive d\u2019alcool, la diarrh\u00e9e ou la constipation, la s\u00e9dentarit\u00e9 et le fait de rester longtemps sur les toilettes sont d\u2019autres facteurs favorisants.<\/p>\r\n\r\n\r\n\r\n

Combien de personnes cela touche-t-il?
<\/em><\/strong>Les troubles h\u00e9morro\u00efdaires sont une maladie tr\u00e8s fr\u00e9quente, on ne dispose cependant pas de chiffres exacts. On estime que 1000\u202fconsultations chez le\/la m\u00e9decin pour 100\u2009000\u202fhabitants sont motiv\u00e9es par ce probl\u00e8me. Mais beaucoup de cas ne sont pas recens\u00e9s, car beaucoup de patients traitent eux-m\u00eames leurs sympt\u00f4mes \u00e0 l\u2019aide de m\u00e9dicaments en vente libre. Le plus souvent, ces probl\u00e8mes apparaissent entre 45 et 60\u202fans.<\/p>\r\n\r\n\r\n\r\n

Quels sont les sympt\u00f4mes?
<\/em><\/strong>Les sympt\u00f4mes caract\u00e9ristiques sont des saignements rouge clair, des d\u00e9mangeaisons, des suintements ou une sensation de br\u00fblure. Certaines personnes observent aussi de petites quantit\u00e9s de selles dans leurs sous-v\u00eatements. Une sensation de pression anale peut \u00e9galement \u00eatre ressentie, de m\u00eame que l\u2019impression que le rectum n\u2019est pas compl\u00e8tement vide apr\u00e8s le passage \u00e0 la selle. Les douleurs ne sont pas un sympt\u00f4me caract\u00e9ristique mais peuvent \u00eatre pr\u00e9sentes en cas de thrombose veineuse anale ou d\u2019inflammation.<\/p>\r\n\r\n\r\n\r\n

Comment traite-t-on la maladie?
<\/em><\/strong>Il est primordial d\u2019adapter ses habitudes de vie. Sinon, les troubles peuvent revenir constamment, m\u00eame apr\u00e8s un traitement m\u00e9dicamenteux ou chirurgical. Il est important de veiller \u00e0 avoir des selles souples. On peut y parvenir gr\u00e2ce \u00e0 une alimentation riche en fibres, des apports hydriques suffisants ou \u00e0 l\u2019aide de m\u00e9dicaments. Une multitude de m\u00e9dicaments sous forme de suppositoires, de pommades et de comprim\u00e9s peuvent att\u00e9nuer les d\u00e9mangeaisons et l\u2019inflammation, avoir un effet d\u00e9congestionnant et renforcer la paroi des vaisseaux.<\/p>\r\n\r\n\r\n\r\n

Quels sympt\u00f4mes doivent alerter et amener \u00e0 consulter?
<\/em><\/strong>Au d\u00e9part, les sympt\u00f4mes sont l\u00e9gers et peu sp\u00e9cifiques. Beaucoup peuvent aussi \u00eatre li\u00e9s \u00e0 d\u2019autres maladies de la r\u00e9gion anale.
En cas de saignements, une visite chez le\/la m\u00e9decin est toujours indiqu\u00e9e pour exclure le risque de cancer des voies digestives ou de la r\u00e9gion anale. Pour poser le diagnostic, une consultation chez le\/la m\u00e9decin est incontournable. Elle est aussi conseill\u00e9e quand les sympt\u00f4mes affectent la qualit\u00e9 de vie, ne disparaissent pas apr\u00e8s un traitement par autom\u00e9dication ou reviennent sans arr\u00eat.<\/p>\r\n\r\n\r\n\r\n

Quand faut-il envisager une op\u00e9ration et que faut-il savoir \u00e0 ce sujet?
<\/em><\/strong>La pertinence d\u2019une op\u00e9ration d\u00e9pend du stade de la maladie et de la souffrance individuelle occasionn\u00e9e. C\u2019est une op\u00e9ration qui se fait normalement en ambulatoire, sauf chez les patients \u00e0 risque. Il existe diff\u00e9rentes m\u00e9thodes comme la pose de ligatures \u00e9lastiques, l\u2019ablation des h\u00e9morro\u00efdes probl\u00e9matiques ou la technique de Longo, qui consiste \u00e0 r\u00e9s\u00e9quer un anneau de muqueuse rectale juste au-dessus des h\u00e9morro\u00efdes. Apr\u00e8s l\u2019op\u00e9ration, on peut manger normalement. Il est ensuite tr\u00e8s important d\u2019avoir une alimentation riche en fibres pour conserver des selles souples. Selon la technique op\u00e9ratoire, il est possible de reprendre le travail d\u00e8s le lendemain ou apr\u00e8s une semaine d\u2019arr\u00eat.<\/p>\r\n\r\n\r\n\r\n

L\u2019op\u00e9ration est-elle risqu\u00e9e?
<\/em><\/strong>Tr\u00e8s rarement, des saignements secondaires ou des douleurs peuvent survenir suite \u00e0 l\u2019apparition d\u2019une thrombose veineuse p\u00e9rianale ou d\u2019une infection. Mais, dans l\u2019ensemble, il s\u2019agit d\u2019op\u00e9rations peu risqu\u00e9es.<\/p>\r\n\r\n\r\n\r\n

Que peut-on faire en pr\u00e9vention?
<\/em><\/strong>R\u00e9guler le transit par une alimentation riche en fibres et des apports hydriques suffisants, pratiquer une activit\u00e9 sportive et \u00e9viter de rester trop longtemps assis(e) ainsi que de pousser aux toilettes. Quand votre corps vous signale le besoin de d\u00e9f\u00e9quer, ne remettez pas la visite aux toilettes \u00e0 plus tard. Id\u00e9alement, utilisez un petit tabouret pour sur\u00e9lever vos pieds et soutenir le processus physiologique de vidange de l\u2019intestin.<\/p>\r\n\r\n\r\n\r\n

\r\n
\r\n

Les quatre stades des troubles h\u00e9morro\u00efdaires<\/h2>\r\n\r\n\r\n\r\n

On distingue quatre stades:<\/p>\r\n\r\n\r\n\r\n

    \r\n
  • Stade 1: les h\u00e9morro\u00efdes ne sont pas visibles de l\u2019ext\u00e9rieur.<\/li>\r\n\r\n\r\n\r\n
  • Stade 2: les h\u00e9morro\u00efdes sortent \u00e0 l\u2019ext\u00e9rieur lors de la d\u00e9f\u00e9cation mais rentrent de nouveau dans l\u2019anus apr\u00e8s le passage \u00e0 la selle.<\/li>\r\n\r\n\r\n\r\n
  • Stade 3: les h\u00e9morro\u00efdes ne se r\u00e9tractent plus spontan\u00e9ment et doivent \u00eatre repouss\u00e9es manuellement dans l\u2019anus.<\/li>\r\n\r\n\r\n\r\n
  • Stade 4: les h\u00e9morro\u00efdes sortent durablement de l\u2019anus.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n\r\n\r\n","protected":false},"excerpt":{"rendered":"

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