hemorrhoid

[hem'?roid]
Etymology: Gk, haima + rhoia, flow
a varicosity in the lower rectum or anus caused by congestion in the veins of th
e hemorrhoidal plexus. Also spelled haemorrhoid. -hemorrhoidal, adj.
observations Internal hemorrhoids originate above the internal sphincter of the
anus. If they become large enough to protrude from the anus, they become constri
cted and painful. Small internal hemorrhoids may bleed with defecation. External
hemorrhoids appear outside the anal sphincter. They are usually not painful, an
d bleeding does not occur unless a hemorrhoidal vein ruptures or thromboses.
interventions Treatment includes local application of a topical medication to lu
bricate, anesthetize, and shrink the hemorrhoid. Sitz baths and cold or hot comp
resses are also soothing. The hemorrhoids may require sclerosing by injection, l
igation, or surgical excision. Ligation is increasingly the preferred treatment
because it is simple and effective and does not require anesthesia. The hemorrho
id is grasped with a forceps, and a rubber band is slipped over the varicosity,
causing tissue necrosis and sloughing of the hemorrhoid, usually within 1 week.
nursing considerations Straining to defecate, constipation, and prolonged sittin
g contribute to the development of hemorrhoids. The client is counseled about wa
ys to prevent these predisposing factors. Because pregnancy is associated with a
n increased incidence of hemorrhoids, pregnant women, as well as individuals who
have cirrhosis of the liver, are advised to avoid constipation.