วิธีแก้โรคริดสีดวง

โรคริดสีดวงมีกี่ชนิด

          1. โรคริดสีดวงทวารแบบภายนอก (External hemorrhoids) เป็นชนิดที่มีติ่งเนื้อนุ่ม ๆ ยื่นออกมาจากทวารหนัก สามารถสัมผัสได้ มักมีอาการเจ็บปวด และอาจมีเลือดออกได้เมื่อมีการเบ่งอุจจาระ
 
          2. โรคริดสีดวงทวารแบบภายใน (Internal hemorrhoids) จะเป็นติ่งเนื้อบวมอยู่ภายในทวารหนัก ไม่สามารถสัมผัสได้ โดยมากมักไม่มีอาการเจ็บปวด แต่สังเกตได้จากอาการเลือดสด ๆ ไหลออกพร้อม ๆ กับอุจจาระ เป็นชนิดที่พบบ่อยกว่าโรคริดสีดวงทวารแบบภายนอก


โรคริดสีดวงเกิดจากอะไร

          แพทย์หญิงนรสรา วิทยาพิพัฒน์ โรงพยาบาลพญาไท 3 ให้ข้อมูลว่า สาเหตุของโรคริดสีดวงเกิดได้จากหลายสาเหตุ โดยเฉพาะพฤติกรรมการขับถ่ายของแต่ละบุคคล ซึ่งจำแนกได้ดังนี้

          – ภาวะท้องผูกเรื้อรัง
          
          – ท้องเสียบ่อย
          
          – พฤติกรรมชอบเบ่งอุจจาระอย่างแรง 
          
          – ชอบนั่งถ่ายอุจจาระเป็นเวลานาน เช่น นั่งอ่านหนังสือหรือเล่นมือถือระหว่างการขับถ่าย
          
          – ใช้ยาสวนอุจจาระหรือยาระบายบ่อยเกินความจำเป็น
          
          – มีภาวะโรคตับแข็งซึ่งทำให้เลือดดำอุดตันจนเส้นเลือดดำบริเวณทวารหนักโป่งพอง
          
          – อายุมากขึ้น กล้ามเนื้อหย่อนยานจนทำให้เบาะรองเลื่อนลงมาจนยื่นออกมาจากทวารหนัก
          
          – บุคคลที่ในครอบครัวมีประวัติ อาจมีแนวโน้มเป็นโรคริดสีดวงมากกว่าปกติ
          
          – ริดสีดวงช่วงตั้งครรภ์ โดยริดสีดวงเกิดจากปัญหาท้องผูก ที่อาจเกิดก่อนตั้งครรภ์หรือขณะตั้งครรภ์ก็ได้ ยิ่งช่วงที่คุณแม่ตั้งครรภ์ฮอร์โมนเปลี่ยนแปลง ก็ส่งผลให้เกิดการยืดขยายตัวของกล้ามเนื้อทางเดินอาหารและการกดทับของลำไส้ เนื่องจากมดลูกที่เพิ่มขนาดมากขึ้น เมื่ออาการท้องผูกถูกปล่อยไว้นานก็กลายเป็นต้นเหตุของภาวะริดสีดวงได้

ริดสีดวงทวาร อาการไหนบ่งบอก

- มีเลือดสด ๆ ปนออกมากับอุจจาระ

- สังเกตได้ว่ามีติ่งเนื้อยื่นออกมาจากทวารหนักขณะอุจจาระ

- ทวารหนักเปียกแฉะ และมีอาการคันรอบ ๆ ปากทวารหนักร่วมด้วย

- มีอาการเจ็บที่ทวารหนัก โดยเฉพาะตอนขับถ่าย

- คลำเจอก้อนเนื้อบริเวณทวารหนัก

ความรุนแรงของโรค

ความรุนแรงของโรคริดสีดวงทวารหนักแบ่งได้เป็น 4 ระยะคือ

ระยะที่ 1 ยังไม่มีติ่งเนื้อหรือก้อนยื่นออกมานอกทวารหนัก

ระยะที่ 2 เริ่มมีติ่งเนื้อหรือก้อนยื่นออกมาขณะเบ่ง ถ่ายอุจจาระ และจะหดกลับเข้าไปได้เอง โดยไม่ต้องใช้มือช่วยดันเข้าไป ยังไม่รู้สึกเจ็บ แต่มีเลือดออก

ระยะที่ 3 มีติ่งเนื้อหรือก้อนยื่นออกมาขณะเบ่งอุจจาระ แต่ไม่หดกลับเข้าไปได้เอง จะต้องใช้มือช่วยดันเข้าไป จึงจะกลับเข้าไปในทวารหนัก

ระยะที่ 4 มีติ่งเนื้อหรือก้อนยื่นออกมาแล้ว ไม่สามารถใช้มือดันติ่งเนื้อนี้เข้าไปในทวารหนักได้เลย

ริดสีดวง รักษาด้วยตัวเอง ต้องทำยังไง

หากเป็นริดสีดวงระยะแรกที่หัวยังอยู่ภายใน ไม่เจ็บ แต่จะมีเลือดออก หรือริดสีดวงระยะที่ 2 ที่มีหัวริดสีดวงยื่นออกมาจากปากทวารเมื่อถ่ายอุจจาระ แต่จะหดกลับเข้าไปเองได้ ริดสีดวงทั้ง 2 ระยะนี้สามารถรักษาได้ด้วยตนเองในเบื้องต้น ด้วยวิธีการดังนี้ค่ะ

- นั่งแช่ในน้ำอุ่น

ผสมน้ำให้อุ่นพอเอามือลงไปจุ่มได้สบาย ๆ ในกะละมังใบใหญ่พอจะลงไปนั่งได้ เทด่างทับทิมลงผสมในน้ำจนน้ำกลายเป็นสีชมพูจาง ๆ จากนั้นให้นั่งเอาก้นลงไปแช่น้ำในกะละมังนาน 15-30 นาที ทั้งนี้ควรทำทั้งก่อนและหลังถ่ายอุจจาระ โดยก่อนถ่ายให้แช่น้ำอุ่น ส่วนหลังถ่ายให้แช่น้ำเย็นขึ้นมาอีกหน่อย วิธีนี้จะช่วยลดอาการอักเสบ

- เหน็บยา รักษาริดสีดวง

ยาเหน็บมีขายหลายชนิด หลายยี่ห้อ แต่ส่วนมาจะมีตัวยาคล้าย ๆ กันคือ มีน้ำมันสำหรับหล่อลื่น มียาชาเฉพาะที่สำหรับระงับอาการเจ็บปวด และบางชนิดผสมสเตียรอยด์เพื่อลดอาการอักเสบด้วย ทว่าแนะนำให้เลือกยาเหน็บที่มีส่วนผสมของตัวยาเบนโซเคน (Benzocaine) 1 กรัม ครีมลาโนลิน (Lanolin Ointment base) 15 กรัม ซึ่งเป็นตัวยาสำคัญในการรักษาโรคริดสีดวง

ริดสีดวง

โดยวิธีเหน็บยาริดสีดวง ภก. กรชัย ฉันทจิรธรรม เภสัชกรวิชาชีพ แนะนำวิธีเหน็บยาริดสีดวงตามนี้

- ควรถ่ายอุจจาระและปัสสาวะให้เรียบร้อย เพื่อให้ยาที่เหน็บอยู่ในทวารหนักได้นานขึ้น ไม่หลุดปนมากับของเสียจากการขับถ่าย

- อ่านวิธีใช้จากฉลากยาให้เข้าใจ หากยาเหลวไม่เป็นแท่ง ให้นำยาไปแช่เย็นในตู้เย็นช่องทำความเย็นปกติ คอยเช็กดูว่ายาแข็งตัวพอสอดได้หรือยัง และพยายามอย่าปล่อยให้ยาเหน็บเป็นน้ำแข็งเด็ดขาด เนื่องจากยาอาจเสื่อมสภาพได้

- ทำความสะอาดบริเวณทวารหนักด้วยสบู่อ่อน จากนั้นซับให้แห้ง

- ล้างมือให้สะอาด หรือจะสวมถุงมือยางก็ได้

- ฉีกกระดาษหรือพลาสติกที่ห่อหุ้มยาเหน็บออก

- นอนตะแคงข้างที่ถนัด ขาล่างเหยียดตรง ส่วนขาบนยกขึ้นเพื่อเปิดรูทวารหนัก

- หันด้านหัวยาซึ่งมีลักษณะปลายแหลม ค่อย ๆ สอดยาเหน็บเข้าไปช้า ๆ ขั้นตอนนี้สามารถใช้ยาหล่อลื่นทาหัวยาเหน็บเพื่อช่วยให้เม็ดยาสอดเข้ารูทวารได้ง่ายขึ้น

- ใช้นิ้วชี้ดันยาเหน็บให้ผ่านรูหูรูดทวารเบา ๆ พยายามดันแท่งยาให้เข้าไปลึกประมาณ 1 นิ้ว เป็นอย่างต่ำ ที่สำคัญอย่าใช้แรงดันมากในการสอดยาเหน็บ เพราะความรุนแรงอาจทำให้เนื้อเยื่อทวารฉีกขาดได้

- หนีบแก้มก้นไว้ในท่านอนตะแคงต่อประมาณ 15 นาที อย่ารีบลุกเดินทันทีเพราะตัวยาเหน็บอาจหลุดออกมาได้

- ล้างมือให้สะอาด

ยารักษาริดสีดวง

การรักษาโรคริดสีดวงขึ้นอยู่กับชนิดและระยะของโรคดังที่กล่าวไปในเบื้องต้น อย่างหากเป็นริดสีดวงในระยะเริ่มแรกหรือระยะที่ 2 ยังพอรักษาริดสีดวงด้วยตัวเองได้อยู่ โดยอาจจะใช้ยาเหน็บหรือบรรเทาอาการอักเสบด้วยด่างทับทิมก็ได้ นอกจากนี้ อาจมียาหดตัวของหลอดเลือด ยาฝาดสมาน ยาช่วยเพิ่มความแข็งแรงของหลอดเลือดดำ ยาระบาย มาใช้ในการบรรเทาอาการของริดสีดวงทวาร ทว่าสำหรับริดสีดวงระยะที่ 3 และ 4 อาจต้องรักษาอาการริดสีดวงด้วยฝีมือของแพทย์ผู้เชี่ยวชาญ ซึ่งการรักษาริดสีดวงสามารถทำได้ดังนี้

ริดสีดวง

การรักษาโรคริดสีดวง

- การรักษาโดยการฉีดยา

โดยฉีดยาเข้าไปในตำแหน่งริดสีดวงทวารที่เลือดออก เพื่อให้เลือดจับลิ่มในหัวริดสีดวง จากนั้นจะเกิดเนื้อพังผืดมาแทนที่หัวริดสีดวง ต่อมาเนื้อพังผืดก็จะหดตัวตามธรรมชาติของมัน แล้วหัวริดสีดวงก็ฝ่อไป

- การรักษาโดยการใช้ยางรัด

ยิงยางรัดโคนหรือหัวของริดสีดวงที่โผล่ออกมา เพื่อให้ริดสีดวงขาดเลือด ซึ่งจะทำให้หัวริดสีดวงนั้นฝ่อและหลุดออกไปได้เอง

- การผ่าตัด

อาการริดสีดวงระยะที่ 3 และ 4 ริดสีดวงทวารมีขนาดใหญ่มากเกินกว่าจะกลับเข้าไปได้เอง ต้องรักษาด้วยการผ่าตัดเท่านั้น ทั้งนี้การผ่าตัดจะขึ้นกับจำนวนและชนิดของริดสีดวงทวาร รวมทั้งความชำนาญของศัลยแพทย์ เช่น ริดสีดวง 1-2 ตำแหน่ง อาจใช้อุปกรณ์พิเศษช่วยในการตัดริดสีดวงทวาร โดยไม่ต้องใช้ไหมเย็บแผล แต่ถ้าริดสีดวงทวาร 3 ตำแหน่งขึ้นไป อาจใช้เครื่องมือตัดต่อเยื่อบุลำไส้ชนิดกลม โดยการตัดและเย็บนี้จะเกิดตามแนวเส้นรอบวงของช่องทวารหนัก ทำให้สามารถตัดหัวริดสีดวงออกได้ทุกหัว และไม่ทำให้รูทวารหนักแคบลง อีกทั้งแนวการเย็บแผลอยู่สูงกว่าปากทวารหนัก ผู้ป่วยจะไม่แผลภายนอกเลย รวมถึงอาการเจ็บปวดก้นหลังผ่าตัดก็จะลดน้อยลง

สมุนไพรรักษาริดสีดวง

นอกจากตัวยาและการฉีดรักษาริดสีดวงแล้ว ยังมีวิธีแก้ริดสีดวงให้หายขาดด้วยสมุนไพรไทยด้วยนะคะ ซึ่งสมุนไพรรักษาริดสีดวงที่ว่าก็มีหลายชนิด ไปดูกันเลย

- เพชรสังฆาต

วิธีการใช้สมุนไพรรักษาริดสีดวงจะใช้เพชรสังฆาตสด 1 ปล้อง หั่นเป็นข้อเล็ก ๆ แล้วหุ้มด้วยกล้วยสุกหรือมะขามเปียกแล้วกลืนวันละ 2 ครั้ง หลังอาหารเช้าและเย็น แนะนำให้รับประทานติดต่อกันเป็นเวลา 10-15 วัน อาการริดสีดวงจะค่อย ๆ บรรเทาและหายไปเอง

- ขลู่

ใบของต้นขลู่มีกลิ่นหอม สามารถนำมาต้มเป็นชาขลู่ดื่มแก้ริดสีดวงทวารหนัก หรือจะใช้เปลือกต้นขลู่ต้มน้ำ ให้ไอของต้นขลู่รมทวารหนักรักษาอาการอักเสบก็ได้ นอกจากนี้ขลู่ยังเป็นยาขับปัสสาวะ แก้โรคนิ่วในไต ช่วยย่อยอาหาร และรักษาริดสีดวงจมูกได้อีกด้วย

- ครอบสีฟันหรือหญ้าขัดหลวง

ให้นำส่วนราก 150 กรัม ต้มพอเดือด คั้นเอาแต่น้ำข้น ๆ มาดื่มประมาณ 1 ถ้วยชา ที่เหลือนำไปอุ่นเพื่อให้มีไอไว้รมที่ก้นพออุ่น ๆ ทนได้ ใช้รมวันละ 5-6 ครั้ง จากนั้นล้างแผลด้วยน้ำอุ่น

- ว่านหางจระเข้

ทำความสะอาดทวารหนักให้สะอาดและแห้ง ควรปฏิบัติหลังจากอุจจาระ หลังอาบน้ำ หรือก่อนนอน ปอกส่วนนอกของใบว่านหางจระเข้ แล้วเหลาให้ปลายแหลมเล็กน้อยเพื่อใช้เหน็บในช่องทวารหนัก ถ้าจะให้เหน็บง่ายควรนำไปแช่ตู้เย็นให้วุ้นว่านหางแข็งตัวพอที่จะสอดเข้าไปได้ง่ายขึ้น และควรหมั่นเหน็บวันละ 1-2 ครั้ง จนกว่าจะหาย

- อัคคีทวาร

นำรากหรือต้นยาว 1-2 นิ้ว ฝนกับน้ำปูนใสให้ข้น ๆ แล้วนำมาทาที่ริดสีดวงทวาร หรือจะนำใบ 10-20 ใบ มาตากแห้ง บดให้เป็นผง แล้วคลุกกับน้ำผึ้งรวง ปั้นเป็นเม็ดขนาดพอเหมาะ รับประทานครั้งละ 2-4 เม็ด ทุก ๆ วันติดต่อกัน 7-10 วันก็ได้ แต่ถ้าใครสะดวกใช้ใบแห้งป่นเป็นผง โรยในถ่านไฟ เผาเอาควันรมหัวริดสีดวงที่งอกออกมาก็ตามแต่วิธีที่อยากแก้ริดสีดวงเลย

ริดสีดวงแตก อย่าเพิ่งตกใจ

ริดสีดวงแตกสังเกตได้ง่าย ๆ จากการขับถ่ายของคุณเองเลยค่ะ หากมีเลือดปนออกมากับอุจจาระ หรือมีเลือดไหลออกมาจารูทวารไม่หยุด รวมทั้งมีอาการปวดมากให้บรรเทาอาการด้วยยาแก้ปวดอย่างพาราเซตามอลหรือไอบูโทรเฟน ในเบื้องต้น จากนั้นใช้สำลีหรือผ้าอนามัยซับเลือดที่ออกมา แล้วรีบไปพบแพทย์เพื่อทำการรักษาริดสีดวงแตกโดยเร็วที่สุด

ริดสีดวง

วิธีป้องกันริดสีดวงทวาร

- รับประทานอาหารที่มีเส้นใยสูง เช่น ธัญพืช ผัก ผลไม้ต่าง ๆ ข้าวกล้อง ถั่ว น้ำลูกพรุน หรือเม็ดลูกพรุน เพื่อให้การขับถ่ายคล่องตัวและไม่เสี่ยงกับอาการท้องผูก

- ดื่มน้ำสะอาดให้ได้อย่างน้อย วันละ 8-10 แก้ว เพราะน้ำมีส่วนช่วยให้กากอาหารมีความอ่อนตัว ช่วยให้อาหารเคลื่อนผ่านลำไส้ได้สะดวกขึ้น

- ออกกำลังกายแบบสม่ำเสมอ เพราะไม่เพียงช่วยให้ระบบขับถ่ายทำงานได้ดีขึ้น การออกกำลังกายยังช่วยกระตุ้นการทำงานของลำไส้ให้มีการเคลื่อนที่ ทำให้สุขภาพแข็งแรงด้วยนะ

- ควรหลีกเลี่ยงเครื่องดื่มแอลกอฮอล์และคาเฟอีน เช่น สุรา เบียร์ ไวน์ กาแฟ ชา น้ำอัดลม เพราะจะทำให้ร่างกายขาดน้ำ อุจจาระแข็ง และถ่ายลำบากขึ้น

- ไม่ควรกลั้นอุจจาระเป็นเวลานาน

- หลีกเลี่ยงการนั่งอุจจาระเป็นเวลานาน ๆ อบ่างนั่งอ่านหนังสือหรือเล่นมือถือไปด้วย

- ควรหลีกเลี่ยงการขัดถูบริเวณทวารหนักอย่างรุนแรง

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