People are prone to physical inactivity, an inactive lifestyle, and eat incorrectly and irregularly. Lifestyle, coupled with sedentary work and bad habits, leads to the development of hemorrhoids. The disease brings a person a lot of troubles and knocks him out of his usual rut in life for a long time. Exacerbation of hemorrhoids makes a person unable to work. But whether they give sick leave for hemorrhoids is a concern for people of working age.
The disease requires treatment. The faster you complete the course of treatment, the greater the chances of recovery and prevention of relapse. The patient will have to remain in bed, dosage physical activity, follow the diet and the proctologist’s instructions.
Hemorrhoids - what is it?
Hemorrhoids are characterized by distension and depletion of the venous vessels of the rectum. Pathological changes lead to degeneration of muscle and connective tissue, impaired blood flow and the appearance of congestion in the pelvis. Due to the weakening of the walls, blood does not circulate through the vessels of the rectum, but fills in them. Hemorrhoidal bumps appear at the site of filling, which can cause acute complications.
Causes of the disease
Hemorrhoids appear if:
- the process of defecation is always difficult;
- Intestinal problems often occur (diarrhea, constipation);
- have extra pounds;
- professional activity is associated with too high or too low physical stress;
- a woman is pregnant or after the birth of a child, since childbirth provokes too much pressure from the venous veins on the rectum during pushing;
- there is heredity.
Now people of completely different ages suffer from hemorrhoids. Unfortunately, the disease is getting younger every year.
Stages of hemorrhoids
External and internal hemorrhoids are separated. With the external manifestation of the disease, hemorrhoidal cones are located outside the anus. Internal hemorrhoids are characterized by bleeding and prolapse of lumps from the anus.
Hemorrhoids go through four stages of development. What symptoms accompany each stage?
- The first stage - hemorrhoidal cones are inside and do not come out. Discomfort occurs after defecation and is characterized by burning and itching, especially after eating spicy, salty foods, alcoholic beverages, or sitting on hard surfaces for a long time.
- The second stage - hemorrhoidal cones come out during defecation, and after some time they come back. The process of defecation is delayed as far as possible due to fear of pain.
- The third stage - hemorrhoids are set back only manually, there is a risk of complications. The process of defecation always occurs with pain and bleeding.
- Stage four – hemorrhoids can no longer be returned to the rectum on their own. The disease is in its most severe form, there are constant problems with bowel movements, and the mucous membrane is at risk of infection. It is necessary to urgently contact a proctologist for appropriate treatment or surgical intervention.
Hygiene during rehabilitation
Hygiene rules during the rehabilitation period after surgery to remove hemorrhoids consist of observing a number of basic measures:
- wash yourself in the morning and before going to bed, as well as after each act of defecation;
- for washing, liquid soap with a minimum of aromatic additives or intimate gel is suitable;
- the skin around the anus must be wiped dry with gentle movements using soft napkins; the use of toilet paper is prohibited;
- if you need to visit the toilet outside the home, you must use wet antibacterial wipes;
- It is permissible to take sitz baths from herbal decoctions, or add them to the water for washing, you must first consult a doctor.
Important ! Good hygiene prevents infection and helps reduce pain.
Do they give sick leave for hemorrhoids?
Hemorrhoids in the acute stage prevent a person from living a full life and performing the most basic functions. Where to go to get sick leave? This is a hospital where a proctologist sees a doctor.
There are several circumstances that determine how many days the period of incapacity for work will pass with the issuance of sick leave:
- hemorrhoids in acute and chronic manifestations;
- professional activity of the patient;
- effectiveness of treatment methods (conservative and surgical).
Will the diagnosis be made public?
Patients often avoid turning to proctologists for help or opening a sick leave sheet - they are afraid of disclosing the diagnosis to colleagues at work or management. The certificate of incapacity for work does not contain information about the patient’s illness. Indicated on the sick leave - duration of treatment, mode (outpatient, inpatient), name of the attending physician.
If a patient seeks help from a commercial medical institution, a full examination is carried out and treatment is prescribed. To obtain a certificate of incapacity for work, you will have to contact a federal or municipal health care institution. Before going to a paid medical center, find out whether they will issue a sick leave certificate. For this purpose, private institutions receive an appropriate license.
For how long is sick leave issued for conservative treatment?
Conservative treatment of hemorrhoids includes medication. This includes the use of ointments, rectal suppositories, and phlebotropic drugs. Each of the drugs has its own direction of action - relieving pain symptoms, swelling, eliminating bleeding, increasing the tone of the veins. The average period for which sick leave is given with conservative therapy is seven days.
Most often, sick leave for hemorrhoids is issued at the second and third stages of the disease. For symptoms characteristic of the first stage of the disease, the doctor may give sick leave only for a day to relieve pain.
Causes of the disease
The reasons for the formation of hemorrhoids are:
Factors provoking the disease
- difficult stool;
- digestive problems;
- excess weight;
- hard physical labor;
- the period of bearing a child and the postpartum period;
- genetic predisposition to varicose veins;
- sedentary life;
- sedentary or standing work;
- unbalanced diet.
Hemorrhoids occur in both the young and middle and older generations. The disease does not spare even children and adolescents.
For how long is sick leave issued after surgery?
The period of incapacity for work with the issuance of sick leave on time and after surgery depends on how urgent the intervention was and whether complications arose. The last stages of the disease are treated surgically.
With radical surgery
There are two methods for performing hemorrhoidectomy:
- open - wounds after removal of hemorrhoids are not sutured, healing occurs naturally;
- closed - after truncation of the nodes, sutures are applied.
A less radical method of treating hemorrhoids is hemorrhoidopexy using the Longo method, when part of the rectum is cut off. As a result, hemorrhoids, due to the removal of part of the blood vessels, stop receiving nutrition, gradually become smaller and become covered with connective tissue.
After removal of hemorrhoids, the patient is discharged from the hospital on the third to fifth day (usually earlier with hemorrhoidopexy). If any complications arise in the form of bleeding or the appearance of pus in wounds and sutures, then the patient may be detained in hospital treatment for several more days.
Sick leave does not end with the patient’s discharge from the hospital and continues at the place of residence. The person presents a certificate of incapacity for work to a proctologist (surgeon or therapist, depending on which doctor is available in the clinic). The period of stay in outpatient treatment depends on the duration of the rehabilitation period.
The recovery period on an outpatient basis can last twenty-one days if a decision is made in favor of the patient. In particularly difficult cases (for example, with open hemorrhoidectomy), the treatment period can last up to five to six weeks.
Accordingly, sick leave is extended. This happens especially often if the patient’s professional activity involves heavy physical activity, unloading and loading heavy objects, and standing for a long time.
Sometimes the doctor may advise the patient to change work, since continuing in the same place can cause irreparable harm in the form of new exacerbations of the disease.
For minimally invasive surgery
The surgical method of treatment also includes a minimally invasive, or non-surgical, method. One of the popular methods is latex ligation (squeezing hemorrhoids with latex rings).
The recovery period in this case is much shorter than after a classic hemorrhoidectomy. If healing occurs normally, then the doctor can discharge the patient after a week or 10 days of being on sick leave.
How long do you need to stay in the clinic?
Differently. Most often, 2-3 hours are enough for the anesthesia to wear off and the person to feel the degree of pain. This period is usually enough for the patient to start walking and feel normal. Before leaving home, a final examination is carried out, the bandage is changed, and detailed recommendations on activity, nutrition, and wound care are given. Sometimes it takes up to 4-6 hours for the condition to completely normalize. If there is the slightest doubt, the patient is left in the clinic under the supervision of medical staff. This also applies to people living far away.
Disability payment
The sick leave certificate must be submitted to the personnel department of the enterprise where the work is carried out immediately upon returning to work. This document will prove that the official absence from work was due to illness, and will allow you to quickly resolve the issue of sick leave payment.
Payment for days of incapacity for work on sick leave does not have an exact amount, since it completely depends on the length of service and the amount of salary. According to the Labor Code, the amount of payments is calculated as follows:
- 100% payment – if the patient’s work experience at one enterprise lasts more than eight years;
- 80% of the salary – if the work experience lasts from five to eight years at one enterprise;
- 60% of the salary – if the patient has worked at the company for no more than five years.
When an employee leaves the company, the employer is obliged to pay sick leave within one month after he leaves his workplace. The payment will be approximately 60% of the average salary.
When can an employee not count on paid sick leave? If during the illness the employee was on regular leave. In this case, the employer will pay only the first 3 days of incapacity for work, the rest will be paid by the Social Insurance Fund (SIF).
If a certificate of incapacity for work is not submitted within six months after sick leave, payment will be denied.
Nutrition rules and diet
On the first day after surgery, strict fasting is required. From the second day you can start eating liquid foods. Broths and thin porridges are recommended, as well as baked vegetables; fruits are acceptable. In subsequent days, the menu should be expanded gradually as recovery progresses.
Foods eaten play a significant role in the formation of hemorrhoids, so it is very important to follow a post-operative diet for at least two months. Its basic rules boil down to the following provisions:
- meals should be fractional and portions small, 5-6 meals a day are recommended, overeating is prohibited;
- The basis of the diet should be plant products that provide the required amount of fiber;
- availability of low-fat fish and meat is required;
- fried foods should be completely excluded;
- it is necessary to ensure that the incoming amount of vitamins and microelements complies with WHO standards;
- You need to drink at least 2 liters of water per day.
It is advisable to consume fermented milk products, whole grain bread, and vegetable oil. During rehabilitation after hemorrhoid surgery, all products that cause gas formation or solidify feces are prohibited. First of all, these include:
- fresh milk;
- pickles, canned food, semi-finished products;
- spices, spicy food;
- smoked meats;
- baked goods, sweets;
- legumes;
- rice, semolina and pearl barley porridge;
- wheat and rye bread;
- nuts.
You should refrain from drinking alcohol, soda, and strong tea and coffee.
Resolving controversial issues
Sometimes a situation arises when a doctor refuses to give sick leave, despite the patient’s poor health. What to do in this case?
As soon as the patient receives such a refusal, he should write a statement addressed to the chief physician of the clinic with a request to understand the situation.
Based on the application, a specially created medical commission will have to conduct an “investigation” - check the medical history, analyze the data and make a conclusion.
The patient has the right to appeal the commission's decision to the insurance company if it is not positive.
Proctologists
Bagdasaryan Lev Karapetovich Surgeon - coloproctologist, candidate of medical sciences, doctor of the highest category, member of the Association of Coloproctologists of Russia.
Cost of admission 3500
₽
Make an appointment
Bagdasaryan Samvel Lvovich Surgeon - coloproctologist, candidate of medical sciences, member of the Association of Coloproctologists of Russia.
Cost of admission 2900
₽
Make an appointment
Should I take baths?
The day after the operation, patients begin to take warm (38 - 40 °C) lying baths, which significantly reduce pain, promote the free passage of gases and provide maximum comfort to the vast majority of patients. Our patients enjoy taking baths: pain is reduced, the wound is cleaned, and healing is accelerated. In no case did we observe any problems associated with this procedure. We do not recommend or advise with caution taking baths for people with varicose veins of the lower extremities.
