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Hemorrhoids

Evaluation I
Jessie Hester & Candice Perkins
October 1, 2003

What Are Hemorrhoids?


Alternative Names
Rectal Lump
Piles
Lump in the Rectum
Definition:
Dilated or enlarged veins in the lower
portion of the rectum or anus.

Cont.
Two Types:
Internal- Under the skin
External- Around the anus

Grades:
I- Hemorrhoids only bleed
II- Prolapse and reduce spontaneously
III- Require replacement
!V- Permanently Prolapsed

Frequency
10 million
Peak ages: 45-65 years
of adults experience hemorrhoids by
age 50
Common among pregnant women
Temporary

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

Signs and Tests


Rectal Examination
Visual
Digital

Tests
Stool Guaiac (FOBT)
Sigmoidoscopy
Anaoscopy
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
hemorrhoids can die (Necrosis)
This causes painful lumps in the anal
area.
Severe bleeding can occur causing iron
deficiency anemia.

Treatment Non-surgical
Mild cases are controlled by:
Preventing constipation
Drinking Fluids
High-fiber diet
Use of Fiber supplements
Stool softeners

Cont.
Apply and OTC cream or suppository
containing hydrocortisone
Keep anal area clean
Soak in a warm bath
Apply ice packs or compresses x 10min

Cont.
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.

Treatments
For painful or persistant hemorrhoids:
Tying off a hemorrhoid
Sclerotherapy
Infered Light
Laser Therapy
Freezing
Electrical Current
Surgery

Hemorrhoid Surgery
Alternative Name: Hemorrhoidectomy
Hemorrhoid surgery is the removal of
enlarged veins around the anus

Cont.
Indications
Persistent itching
Anal bleeding
Pain
Blood clots
Infection

Cont.
Risks
Reactions to medications of anestesia
Bleeding
Infection
Narrowing of the anus

*The outcome is usually very good in the


majority of cases.

Prevention

Eat high fiber diet


Drink Plenty of Liquids
Fiber Supplements
Exercise
Avoid long periods of standing or sitting
Dont Strain
Go as soon as you feel the urge

Questions
What grade of hemorrhoids prolapse and
reduce spontaneously?
A) Grade I
B) Grade II
C) Grade III
D)Grade IV

How many people are treated for


hemorrhoids yearly?
A) 3 million
B) 8 million
C) 10 million
D) 20 million

What are two causes of hemorrhoids?


A) Standing on your head
B) Heavy lifting
C) Jeans being too tight
D) Constipation

What is a sigmoidoscopy?
A) An internal examination of the rectum, distal
colon and large bowel using a type of small
camera.
B) Detects the presence of hidden blood in the
stool.
C) A procedure that enables a physician to view
the anus, anal canal, and lower rectum using
a lubricated plastic scope into the rectum.

Questions????