Trĩ không gì khác hơn là những mạch máu bình thường nằm ngay ở cửa hậu môn. Ngoài công dụng giống như những mạch máu khác trong cơ thể với máu luân chuyển để nuôi sống hậu môn, những mạch máu này nối dài từ hậu môn tới lỗ đít nằm chen lẫn với các sớ thịt có công dụng giúp cho cơ vòng hậu môn co thắt chặt, ngăn ngừa phân bị tuôn ra bất chợt. Khi các mạch máu hậu môn này bị sưng phồng lên vì rặn nhiều, bị sưng hay rách vì phân cứng thì được gọi là TRĨ. Trĩ rất là thông thường. Cứ một trong 2 người trên đời có triệu chứng trĩ trước tuổi 50 chứ không chỉ mỗi mình có. Mỗi khi bị trĩ hành đừng có ôm nỗi niềm riêng tư “Nắng mưa là bệnh của trời, riêng TRĨ là bệnh của trời cho ta”.

Lý do bị bệnh trĩ:

ImageLý do bị bệnh trĩ không được biết chắc chắn. Tuy nhiên có một số trường hợp có thể làm cho mạch máu hậu môn sưng to lên thành trĩ như tuổi già, táo bón kinh niên, đi cầu bón phải rặn nhiều, tập thể thao quá độ, hay vì mang bầu, hay lúc rặn đẻ con, dùng thuốc sổ quá độ, “ngồi thiền” trong nhà cầu quá lâu như đọc sách, đọc truyện chưởng khi đi đại tiện.

Triệu chứng của bệnh trĩ:

Trĩ ngoại thường làm đau, sưng, ngứa. Triệu chứng thông thường của trĩ là tiết ra chất nhờn, chảy máu tươi, ngứa ngáy, hay lồi cộm ở hậu môn. Trĩ thường không làm đau trừ khi bị nghẹn lại thành máu bầm, đọng lại làm trĩ bị sưng phồng lên. Bệnh nhân thường rất là đau đớn và khó chịu mất vài ba ngày. Nếu trĩ bầm (thrombosed hemorrhoid) được mổ và nặn máu ra trong vòng ba ngày ngay sau khi bị sưng lên thì bệnh nhân sẽ đỡ bị đau đớn.

Trĩ có gây biến chứng gì nguy hiểm không?  

Trĩ là bệnh thông thường không có gì là nguy hiểm tới tính mạng hay sức khoẻ cả. Có thể nói là chưa có ai chết về bệnh trĩ cả. Tuy nhiên, để trĩ chảy máu quá lâu làm thiếu máu, hoặc đôi khi bị nhiễm trùng hay bị sưng phù khi bị trĩ bầm làm đau đớn. Trĩ không làm ra bệnh ung thư ruột.

Trĩ có thể chia làm 3 loại: Trĩ nội: nằm bên trong hậu môn và nếu nhỏ bệnh nhân không cảm thấy gì cả. Loại này không đau tuy có thể làm chảy máu hay ngứa ở hậu môn.

Trĩ ngoại: style=’font-size:11.0pt; font-family:”Times New Roman”; nằm ở ngoài hậu môn và có thể làm cho bệnh nhân cảm thấy chậm khi đi đứng.

Trĩ hỗn hợp: style=’font-size:11.0pt;font-family:”Times New Roman”; trĩ nội nối liền chung với trĩ ngoại.

Trĩ bầm: style=’font-size:11.0pt; font-family:”Times New Roman”; thường là trĩ ngoại bị máu đóng cục bầm làm sưng to và lồi cộm ở ngoài hậu môn. Thường làm cho bị đau hậu môn cấp tính mất vài ngày tuy nhiên sẽ hết đau sau đó và máu bầm sẽ tan và trĩ xẹp xuống nhỏ lại bình thường sau vài tuần.

Tuỳ theo triệu chứng và độ to lớn của trĩ và bệnh trĩ được chia làm bốn cường độ (degree):

• Ðộ 1: trĩ sưng nhỏ bên trong hậu môn và có thể đôi khi bị chảy máu lúc đi cầu.

• Ðộ 2: trĩ lớn hơn và lòi ra trong hậu môn. Ðôi khi lòi ra ngoài khi đi cầu và tự động thụt vào trong sau khi vệ sinh xong.

• Ðộ 3: trĩ có thể lòi ra bất kỳ và thường xuyên. Bệnh nhân cần phải lấy tay nhét vô trở lại vào hậu môn. Với độ này bệnh nhân thường thấy rất khó chịu và trĩ dễ bị máu bầm đọng làm đau đớn. Cách chữa trị có thể tạm thời như độ 2 nhưng thường là cần phải đốt hoặc mổ thì mới dứt được.

• Ðộ 4: trĩ luôn luôn lòi hẳn ra ngoài không cách nào nhét lại vào hậu môn được. Ðộ này luôn làm bệnh nhân khó chịu, ngứa ngáy và đau. Bệnh nhân cần phải mổ chứ không đốt hay có thuốc nào làm cho đỡ hơn hay tan đi được.

Làm sao tránh bị trĩ?  

Các mẹo vặt giúp tránh bị trĩ rất là đơn giản nhưng thường khó theo thường xuyên:

• Tránh đừng ngồi quá lâu. Nên đi hay đứng trong lúc có break.

• Lúc rặn ráng thở ra chứ đừng nín hơi.

• Ðừng để bị ỉa chảy hay táo bón nhiều.

• Ðừng ngồi lâu trong cầu để đọc báo hay luyện chưởng. style=”mso-spacerun: yes”>

Mẹo vặt chữa bệnh trĩ:

Một là giảm bớt triệu chứng do trĩ gây ra như đau, ngứa, khó chịu, và hai là làm trĩ bớt sưng.

• Ngồi bồn nước ấm mỗi ÐẶC BIỆT – BỆNH TRĨ style=’font-size:11.0pt; font-family:”Times New Roman”; 15-20 phút 3-4 lần mỗi ngày.

• Uống thuốc giảm đau như Aleve, Motrin, Advil nếu bị đau. Nếu hậu môn bị ngứa hay nóng có thể bôi thuốc Anusol HC Cream hay thuốc nhét. Hai thuốc này có thể làm trĩ bớt sưng và đỡ khó chịu.

• Dùng thuốc làm mềm phân như Citrucel, Mylanta nước để giúp phân tốt mềm dễ đi cầu.

Cách chữa bệnh trĩ:

Với độ 1 và 2, thường bệnh nhân không bị khó chịu gì lắm. Cách chữa trị thường là dùng thức ăn có nhiều chất bã để tránh bị bón, ngồi nước ấm và nhét thuốc hậu môn. Trĩ sẽ xẹp xuống và hết chảy máu.

Với trĩ độ 2 và 3 làm cho khó chịu vì lòi ra hoài hay chảy máu, ngứa ngáy cách tốt nhất là đốt bằng Infrared hay laser hay cột đi không cần phải mổ. Với phương pháp cột trĩ bác sĩ dùng dụng cụ để tròng các sợi dây thung thật nhỏ làm cho trĩ chết và rụng đi. Phương pháp cột này đã được áp dụng rất nhiều năm. Tuy nhiên thủ thuật này ngày càng tiến bộ nhất là sử dụng với phương pháp nội soi bác sĩ có thể cột 2- 3 trĩ cùng một lúc trong vòng 5-10 phút mà bệnh nhân không cảm thấy đau đớn gì cả. Nếu trĩ bị độ 3 nặng hay độ 4 thì cách chữa duy nhất là mổ. Khi mổ bác sĩ sẽ cắt các mạch máu hay trĩ đi chứ không phải cắt hậu môn và nối ruột ra ngoài bụng như các lời đồn bậy bạ.

Những câu hỏi thông thường về bệnh trĩ:  

Hỏi: Bệnh Trĩ có phải là bệnh gia truyền không vì trong gia đình cha mẹ, anh em đều bị bệnh trĩ cả?

Ðáp: Bệnh trĩ là bệnh rất phổ thông nhất là người Việt. Thống kê cho thấy cứ một trong hai người là bị bệnh trĩ thành ra trong cùng một gia đình phân nữa có thể bị.

Hỏi: Bệnh trĩ lâu ngày nếu không chữa có thể biến chứng thành ung thư không?

Ðáp: Như đã nói trên bệnh trĩ chỉ là những mạch máu ở hậu môn bị sưng làm chảy máu, ngứa, đau. Những mạch máu này không có biến chứng thành ung thư. Theo thống kê cứ một trong hai người là bị bệnh trĩ nếu mà trĩ thành ung thư thì biết bao nhiêu người đã bị ung thư hết.

Hỏi: Tôi nghe nói thuốc gia truyền bôi cho rụng trĩ rất hay không bao giờ bị trở lại và không có đau đớn như mổ trĩ.

Ðáp: Thuốc gia truyền bôi trĩ có thể là một chất giống như axít làm cho mạch máu bị đóng nghẽn lại sưng lên và teo đi. Chất thuốc này có thể làm cho chỗ bôi bị sưng lở, bầm rất là đau đớn và có thể bị nhiễm trùng áp xe. Không có cách chữa nào là hết trĩ không bao giờ bị lại cả. Trĩ là mạch máu ở cửa hậu môn. Cơ thể cần mạch máu nếu không có thì chỗ hậu môn có thể bị hư. Tránh đừng để bị bón hay ngồi nhà cầu lâu giúp tránh các mạch máu bị sưng lên thành trĩ. Nếu sợ mổ trĩ bị đau thì cách đốt trĩ bằng laser hay cột trĩ rất là đơn giản và không bị đau.

Hỏi: Bệnh nhân phải đeo bọc ở bụng sau khi mổ trĩ vì hậu môn bị cắt đi.

Ðáp: Mổ trĩ chỉ cắt các mạch máu ở ngay cửa hậu môn đi chứ không cắt bắp thịt, cơ vòng hay cắt hậu môn gì cả. Mổ trĩ rất là đơn giản không có gì nguy hiểm mặc dầu sau khi mổ bệnh nhân thường đau mất một tuần. Bệnh nhân không có phải đeo bọc gì cả thường chỉ xảy ra khi bệnh nhân bị ung thư ngay chỗ hậu môn làm bác sĩ phải cắt hậu môn đi.

Tóm lại trĩ chỉ là những mạch máu ở hậu môn bị sưng to làm chảy máu hay lồi ra. Trĩ không có làm biến chứng như ung thư hay bướu ruột. Trĩ chỉ nên chữa nếu bị chảy máu nhiều, làm đau, ngứa ngáy thường xuyên hay lồi ra làm cuộc đời mất vui chứ trĩ không phải là một bệnh đáng sợ mà một bệnh nhân đã phải than rằng “Trời đã sinh ra ta sao còn làm ra TRĨ”.

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Bác sĩ Trịnh Ngọc Huy, MD, AGAF, FAASLD -- Bác sĩ Trịnh Ngọc Huy chuyên khoa Bệnh Tiêu Hóa và Gan. Bác sĩ Huy tốt nghiệp y khoa tại Northwestern University School of Medicine; tốt nghiệp chuyên khoa Bệnh Nội Thương tại UCLA VA Wadsworth và tốt nghiệp chuyên khoa Bệnh Tiêu Hóa và Gan tại University of California, Irvine. Bác sĩ Huy hiện đang làm việc với Trung Tâm Chuyên Khoa Tiêu Hóa và Gan San Jose Gastroenterology, MC tại San Jose, California

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