Hemorrhoids

Hemorrhoids

Alternative Names
Rectal Lump
Piles
Lump in the Rectum
haemorrhoids-piles
Definition
Dilated or enlarged veins in the lower portion of the rectum or anus.
Two Types
Internal- Under the skin
External- Around the anus
Grades
I.Haemorrhoids only bleed
II.Prolapse and reduce spontaneously
III.Require replacement
IV.Permanently Prolapsed
Frequency
10 million
Peak ages: 45-65 years
½ of adults experience haemorrhoids by age 50
Common among pregnant women
Symptoms
Rectal Bleeding
Bright red blood in stool
Pain during bowel movements
Anal Itching
Rectal Prolapse
Thrombus
Causes
Pressure:
Constipation
Diarrhea
Sitting or standing for long periods of time
Obesity
Heavy Lifting
Pregnancy
Sign & Tests
Rectal Examination:
Visual
Digital
Tests:
stool guaiac test or guaiac faecal occult blood test (gFOBT)
Sigmoidoscopy
Anoscopy
Proctoscopy
Referral
Gastroenterologists
Seek emergency care if:
large amounts of rectal bleeding
Lightheadedness
Weakness
Rapid HR > 100 BPM
Complications
The blood in the enlarged veins may form clots and the tissue surrounding the haemorrhoids can die (Necrosis)
This causes painful lumps in the anal area.
Severe bleeding can occur causing iron deficiency anaemia.
Treatment
Mild cases are controlled by:
Preventing constipation
Drinking Fluids
High-fiber diet
Use of Fibre supplements
Stool softeners
Apply an OTC cream or suppository containing hydrocortisone
Keep anal area clean
Soak in a warm bath
Apply ice packs or compresses for 10min
If prolapses, gently  push back into anal canal
Use a sitz bath with warm water
Use moist towelettes or wet toilet paper instead of dry toilet paper.
For painful or persistent haemorrhoids:
Tying off a haemorrhoid
Sclerotherapy
Infrared Light
Laser Therapy
Freezing
Electrical Current
Surgery
Hemorrhoid Surgery
Alternative Name: Hemorrhoidectomy
Haemorrhoid surgery is the removal of enlarged veins around the anus
Indications:
Persistent itching
Anal bleeding
Pain
Blood clots
Infection
Risks:
Reactions to medications of anaesthesia
Bleeding
Infection
Narrowing of the anus
Prevention
Eat high fibre diet
Drink Plenty of Liquids
Take Fibre Supplements
Exercise
Avoid long periods of standing or sitting
Don’t Strain
Go as soon as you feel the urge

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