Haemorrhoids Flashcards
What are haemorrhoids?
Enlarged vascular cushions
What are haemorrhoids associated with?
Constipation and straining
What are haemorrhoids common with?
Pregnancy
Obesity
Increased age
Increased Intra-abdominal pressure
How do haemorrhoids mainly present?
Asymptomatically
What are possible symptoms of haemorrhoids?
Painless
Bight red bleeding- on tissue paper
Lump on inside of anus
What would you find on examination of someone with haemorrhoids?
External/prolapsed haemorrhoids- see
Internal haemorrhoids- Felt on PR
May appear when ask patient to bear down
What would you use for proper visualisation and inspection of haemorrhoids?
Proctoscopy
What is the non-surgical management of haemorrhoids?
Rubber band ligation
Injection sclerotherapy
What is the surgical management of haemorrhoids?
Haemorrhoidectomy
Stapled haemorrhoidectomy
What are thrombosed haemorrhoids?
Strangulation at the base of the haemorrhoids- Thrombosis
How do thrombosed haemorrhoids present?
Purplish, tender, swollen lumps around anus
What would you find on a PR exam of someone with thrombosed haemorrhoids?
Very painful
PR exam may not be painful
What is the outcome of thrombosed haemorrhoids?
Resolve in time- can take weeks
What should you test for if there is prolonged bleeding?
Anaemia
What dietary management can be as effective as injection sclerotherapy?
Fibre supplementation
What is the management of thrombosed hemorrhoids if the patient presents within 72 hours of the onset of pain?
Offer admission for surgical management (excision)
What is the management of thrombosed hemorrhoids if the patient presents afrer72 hours of the onset of pain?
Conservative- Advise analgesia and stool softeners, suggest ice packs around the area
What are the 2 classifications of hemorrhoids?
Internal and external
What are the features of internal hemorrhoids?
originate above the dentate line
do not generally cause pain
What are the features of external hemorrhoids?
originate below the dentate line
prone to thrombosis, may be painful
