hemorrhoids 2

7/30/2019 Hemorrhoids 2

1/26

HemorrhoidsEvaluation I

Jessie Hester & Candice PerkinsOctober 1, 2003


2/26

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.


3/26

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


4/26


5/26


6/26

Frequency 10 million

Peak ages: 45-65 years

of adults experience hemorrhoids by

age 50

Common among pregnant women

Temporary


7/26

Symptoms Rectal Bleeding

Bright red blood in stool

Pain during bowel movements

Anal Itching

Rectal Prolapse

Thrombus


8/26

Causes Pressure

Constipation

Diarrhea Sitting or standing for long periods of

time

Obesity

Heavy Lifting

Pregnancy


9/26


10/26

Signs and Tests Rectal Examination

Visual

Digital Tests

Stool Guaiac (FOBT)

SigmoidoscopyAnaoscopy

Proctoscopy


11/26

Referral Gastroenterologists

Seek emergency care if :

large amounts of rectal bleeding

Lightheadedness

Weakness

Rapid HR < 100 BPM


12/26

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 irondeficiency anemia.


13/26


14/26

Treatment Non-surgical Mild cases are controlled by:

Preventing constipation

Drinking Fluids

High-fiber diet

Use of Fiber supplements

Stool softeners


15/26

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


16/26

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.


17/26

Treatments For painful or persistant hemorrhoids:

Tying off a hemorrhoid

Sclerotherapy

Infered Light

Laser Therapy

Freezing Electrical Current

Surgery


18/26

Hemorrhoid Surgery Alternative Name: Hemorrhoidectomy

Hemorrhoid surgery is the removal ofenlarged veins around the anus


19/26

Cont. Indications

Persistent itching

Anal bleeding

Pain

Blood clots

Infection


20/26

Cont. Risks

Reactions to medications of anestesia

Bleeding Infection

Narrowing of the anus

*The outcome is usually very good in themajority of cases.


21/26

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


22/26

Questions What grade of hemorrhoids prolapse and

reduce spontaneously?

A) Grade IB) Grade II

C) Grade III

D)Grade IV


23/26

How many people are treated for

hemorrhoids yearly?

A) 3 millionB) 8 million

C) 10 million

D) 20 million


24/26

What are two causes of hemorrhoids?

A) Standing on your head

B) Heavy liftingC) Jeans being too tight

D) Constipation


25/26

What is a sigmoidoscopy?

A) An internal examination of the rectum,

distal colon and large bowel using a type ofsmall 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.


26/26

Questions????

hemorrhoids 2

Documents