Anal Fissures and Haemorrhoids Flashcards
what is an anal fissure
tear or ulcer in anal cavity leading to…
pain or bleeding on pooing
What is Acute Anal Fissure treatment
- Bulk forming laxatives
- Osmotic laxatives
- topical analgesics
Which Anaesthetic can pregnant patients not use
Lidocaine
Chronic Treatment of Anal Fissures: 1st and 2nd Line
1st Line:
- Rectal GTN
2nd Line:
- Topical or Oral Diltiazem / Nifedipine
Chronic Treatment of Anal Fissures: 4th Line and 3rd Line Specialist treatment
Specialist 3rd Line:
Botulinum Toxin Type A
4th Line:
Surgery
How long do you need to have an anal fissure for it to be considered chronic
6 weeks or longer
What are Haemorrhoids
swelling of vascular mucosal anal cushions around anus
When are Haemorrhoids at high risk
Pregnancy
Internal Haemorrhoids symptoms
painless
External Haemorrhoids symptoms
- Itchy
- Painless
How to treat Haemorrhoids
- maintain easy stools
- control pain and itching
How to maintain easy stools in Haemorrhoids
- increase dietary fibre
- bulk forming laxatives
How to control pain and itching in Haemorrhoids
- paracetamol
- topical analgesics / corticosteroids
Which analgesics can you not use in Haemorrhoids
- opioids (they cause constipation)
- NSAIDs (exacerbate rectal bleeding)
How to treat Haemorrhoids in pregnancy
Bulk forming laxatives
(no topical preparations)
