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????