Digestive problems :

hemorrhoids
Prepared by :
Chawan Sanan
Dental student – komar university for science
and technology
 Table of contents

01 02 03
Introduction Signs and Causes and risk
about the disease symptoms factors

04 05 06
Complication and Diagnosis and Conclusions
prevention treatment
options
01
Introduction about
the disease
 Introduction about the disease
● Hemorrhoids are cushions of
submucosal tissue containing
venules, arterioles, and smooth
muscle fibers that are located in
the anal canal .

● Hemorrhoids are a normal part

of anorectal anatomy, treatment
is only indicated if they become
symptomatic.
Types of hemorrhoids :
Types of hemorrhoids

External Internal Combined

Can be ( intero-external piles)
subcategories into
four grades :

I , II , III , IV
 1. External hemorrhoids
are located distal to the
dentate line and are
covered with anoderm
Skin tags are often
confused with
symptomatic
hemorrhoid.
thrombosis of an
external hemorrhoid
may cause significant
pain.
may cause itching and
difficulty with hygiene
if they are large
 2. Internal hemorrhoids
are located proximal to
the dentate line and
covered by insensate
anorectal mucosa may prolapse or bleed,
but they rarely become
painful unless they
develop thrombosis and
necrosis
Internal hemorrhoids are
graded according to the
extent of prolapse.
 3. Combined internal and external
hemorrhoids (intero-external piles):

● straddle the dentate line

and have characteristics
of both internal and
external hemorrhoids.

● Best thought of as being

external extension of
internal hemorrhoids
02
Signs and
symptoms
 Signs and symptoms

Rectal bleeding Swelling and Pain and Anal itching

forming lump discomfort
 03
Main causes and
risk factors
 Main cause

The main cause for

occuring this condition is
increasing the pressure on
the blood vessels in rectal
and anal area.
 Risk factors

● Chronic constipation and excessive straining

● Chronic diarrhea
● Pregnancy
● Obesity
● Aging
● Heavy lifting
● Family history
● Low fiber diet
● Anal intercourse
04
Complication and
preventions
 Complications of hemorrhoids

Anemia and Chronic pain Anal fistula or Psychological

weakness fissure impacts
 Preventions

● Eating high fiber diets

● Stay hydrated
● Maintain healthy weight
● Avoid prolonged sitting or
standing
● Don’t strain during bowl
movement
● Avoid heavy lifting
● don’t delay bowl movement
05
Diagnosis and
treatment
 Diagnostic methods :

• Medical • Physical
History Examination
 Procedure

• Anoscopy: Your doctor will carefully examine the tissues lining

your anus and lower rectum to look for signs of lower digestive
tract problems and bowel disease.

• Rigid proctosigmoidoscopy: is similar to anoscopy, except that

your doctor uses an instrument called a proctoscope to view the
lining of your rectum and lower colon.
 Treatment

Treatment options mainly depend on the type and severity of

hemorrhoids, patient’s preference and the expertise of physicians.
Low-graded internal hemorrhoids are effectively treated with dietary
and lifestyle modification, medical treatment and/or office-based
procedures such as rubber band ligation and sclerotherapy. An
operation is usually indicated in low-graded hemorrhoids refractory to
non-surgical treatment, high-graded hemorrhoids, and strangulated
hemorrhoids. Meanwhile, external hemorrhoid requires no specific
treatment unless it becomes acutely thrombosed or causes patient
discomfort.
06
In conclusion..
Conclusion :
● Hemorrhoids also called piles, are swollen veins
in your anus and lower rectum, similar to varicose
vein. Hemorrhoids can develop inside the rectum
(internal hemorrhoids) or under the skin around
the anus (external hemorrhoids).
 References :
• “Hemorrhoids, mayoclinic.org, 2023” (https://www.mayoclinic.org/diseases-
conditions/hemorrhoids/symptoms-causes/syc-20360268 )
• “Hemorrhoids, Cleveland Clinic , 2021”
(https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids )
• “what to know about hemorrhoids, Medical News Today, 2017”
(https://www.medicalnewstoday.com/articles/320407#outlook )
• “Schwartz’s principle of surgery ,by F.charles brunicardi , 11th edition”
• https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htm
• https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html
??
Thanks..