haemarrhoids

Question 1

what are haemarrhoids?

Answer 1

swelling of veins in the anus

Question 2

what is the most common cause of rectal bleeding?

Answer 2

haemarrhoids

Question 3

what are they associated with?

Answer 3

constipation

pregnancy

Question 4

what are they caused by?

Answer 4

congestion of the venous plexus in the anal region

Question 5

clinical features?

Answer 5

bleeding (bright red blood)
discomfort
pruritis ani (irritation of the skin around the anus producing the urge to scratch)
mucus discharge

Question 6

types of haemarrhoids

Answer 6

Primary (internal ) – these may cause bleeding, but are not visible from the outside
Second degree (prolapsing) – these can also bleed, and may ‘pop out’, but they can retract (and prolapse again) spontaneously.
Third degree (prolapsed) – these require manual replacement after they have prolapsed.

Question 7

primary treatment

Answer 7

methods to avoid constipation and straining

Question 8

what are more invasive techniques?

Answer 8

Sclerotherapy – this is where there is an injection into a vein that causes it to dramatically shrink. It can also be used on lymphatic drainage vessels. It is a common procedure to treat haemorrhoids and varicose veins in adults.

Question 9

what other invasive techniques can be used?

Answer 9

Band ligation – a small band is tied round the vessel and this restricts the blood flow, and the vessel will be absorbed (as seen in treatment of oesophageal varices).

Question 10

treatment of an rectal abcess

Answer 10

They are surgically excised and drained, and follow up treatment is with antibiotics.