[SBS백세건강시대]쌀쌀해지면 찾아오는 말 못 할 고민
 '변비&치질'                                        -외과 손승국

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‘쌀쌀해지면 찾아오는 말 못 할 고민 - 변비&치질’
앉아있는 시간이 많은 현대인들이 자주 걸리는 변비와 치질! 다양한 원인으로 생기는 변비는 변비약에 의존하다가 더 큰 병을 유발할 수 있다는데요, 흔히 치질로 불리는 치핵은 치료만 빨리 시작한다면 수술 없이도 완치가 가능하다고 합니다. 날씨가 쌀쌀해지면 더 고통스러워진다는 변비와 치질! 부끄럽다고 숨기고 있지는 않으십니까?

변비는 배변 시 무리한 힘이 필요하거나 대변이 과도하게 딱딱하게 굳은 경우, 불완전 배변감(후중감) 또는 항문직장의 폐쇄감이 있는 경우, 일주일에 배변 횟수가 3번 미만인 경우 등을 말하며, 기질적(이차성) 원인이 없는 원인 미상(특발성)의 혹은 기능성 변비가 대부분을 차지합니다.

만성변비는 치핵과 같은 다른 항문질환을 유발 할 수 있는데요, 그 이유는 딱딱한 대변, 지속적으로 변을 보기 위해 항문에 힘을 주는 경우, 복압이 증가된 경우, 골반 바닥이 약해진 경우에 모두 비정상적으로 치핵 조직이 커질 수 있기 때문입니다.

치질은 ‘겨울 치질’이라는 별명이 붙을 정도로 겨울에 많이 발생합니다. 전문의들은 겨울 치질이 증가하는 이유로 몇 가지를 꼽는데, 그 중의 대표적인 것이 급격히 낮아진 기온과 활동량의 감소, 근육의 위축입니다. 최근 들어 항문질환에 대한 많은 사람들의 인식이 개선되고 있는 것은 사실이지만 여전히 쉬쉬하는 것은 마찬가지입니다. 부끄럽다는 이유로, 참을 만하다는 이유로 병원에 가는 것을 미루는데요, 그런 관행이 병을 더 키울 수 있습니다.

2013년 기준으로 대한민국 치질 환자 수는 85만 명에 달한다고 합니다. 그러나 주변에서 치질 환자를 찾아 보기는 어려운데요, 그 이유는 치질이 바로 ‘항문’ 질환이기 때문입니다. 우리가 흔히 더럽다고 생각하는 항문에 생기므로 사람들은 병을 숨기고 또 의사에게 보이는 것을 부끄러워해 버티다가 심각한 상태가 되어서야 병원에 가게 되는 것입니다.

보통 치질이라고 부르는 명칭은 정확히는 항문의 모든 질환을 지칭하는 용어이며 치질 중 가장 많이 발생하는 질환으로는 치핵, 치열, 치루 등을 들 수 있습니다. ‘치핵’은 항문 안쪽 혈관들이 늘어나거나 항문 바깥쪽 불필요한 조직 등이 늘어나서 생기며 항문질환의 50%~60%를 차지하는 질병입니다. 이 외에 항문이 찢어지는 ‘치열’이 약 20%를 차지하고, 항문이 곪아서 고름이 터지는 ‘치루’가 15%~20%를 차지하고 있습니다.

치핵은 증상에 따라 1~4기로 구분되는데요, 변을 볼 때 출혈이 있고 항문에 돌출되는 것이 없다면 1기, 배변 시 치핵이 약간 돌출됐다가 자연스럽게 들어가는 상태는 2기, 돌출된 치핵을 손으로 밀어 넣어야 들어가는 시기는 3기, 손으로 밀어도 들어가지 않거나 다시 나오는 상태가 4기입니다.

만약 변을 볼 때 항문 부위에 껄끄러운 느낌이 들고 항문 안의 피부가 조금 나온 듯하며 선홍색의 피가 대변이나 휴지에 묻어 난다면 치질 초기 증상으로 볼 수 있으므로, 이런 초기 증상이 더 악화되면 치핵을 손으로 밀어 넣어야 들어가는 상황이 되고, 변을 볼 때 항문 안쪽으로 찢어지면서 통증이 동반되기도 합니다.

치핵은 초기에 치료하면 수술 없이 생활습관 개선으로 쉽게 나을 수 있지만, 2~3기부터는 수술적 치료가 필요한 경우가 대부분입니다. 하지만 귀찮고 창피하다고 병을 숨기다가는 정말 큰 수술을 받게 될지 모르기 때문에 조기 치료가 무엇보다 중요합니다.

치핵을 예방할 수 있는 방법은 생활습관 개선과 좌욕을 생활화하는 것입니다. 또한 치핵을 유발할 수 있는 심한 변비가 생기지 않도록 일상적으로 섬유질이 많은 음식을 섭취하는 것이 좋고, 화장실에서 신문 등을 보며 오랜 시간 변기에 앉는 등의 배변 습관을 개선하는 것이 좋습니다.


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2014/01/23 11:42 2014/01/23 11:42

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