Haemorrhoids Flashcards
What are haemorrhoids
swollen and inflamed veins in rectum and anus
Common condition- affects up to 50% of adults at some points in their lives
What are symptoms of haemorrhoids
Painless bright PR bleeding most common symptom
Anal itching/irritation
Tenesmus - with prolapsing internal haemorrhoids
- pain, itching ,bleeding , lump in anal area
- mucus from anus
What may be seen on DRE with someone that has haemorrhoids
may reveal swollen, tender or prolapsed haemorrhoids
What investigations are required
Proctoscopy is investigation of choice to confirm diagnosis and exclude sinister pathology
Colonoscopy may be indicated if there is concern for underlying pathology
What is the management options for haemorrhoids
- Conservative measures include dietary fibre, taking sitz baths, topical creams/ointments
-If symptoms persist/severe - rubber band ligation, injection sclerotherapy, IR coagulation
- For large and persistent haemorrhoids surgery may be indicated– prolapsed haemorrhoids usually need surgery
What are some surgical options
Haemorrhoidectomy or stapled haemorrhoidopexy
What are thrombosed haemorrhoids
occurs when a blood clot forms inside a haemorrhoidal vein, obstructing blood flow and causing painful swelling of anal tissues
How do thrombosed haemorrhoids present
significant pain and a tender lump
What can be seen on examination of a thrombosed haemorrhoid
purplish, oedematous, tender subcutaneous perianal mass
What is the management of a thrombosed haemmorhoids
If patient presents within 72 hours referral for excision should be considered
Otherwise can be managed with stool softeners, ice packs and analgesia
What are some causes of haemorrhoids
Constipation
Constant straining
Anal canal weakens with age making it more likely if you are older
persistent cough
lifting heavy objects
pregnancy - due to higher pressure in abdomen
