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
 ½ 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
 Don’t 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????