Haemorrhoids

Question 1

Symptoms of Haemorrhoids

Answer 1

• swollen veins
• dual pain on defecation or sitting
• slight rectal bleeding
• perianal itching and burning
• swelling and soreness in perineum

Question 2

What are the two types of Haemorrhoids

Answer 2

Internal swollen veins

External swollen veins

Question 3

Referral for Haemorrhoids

Answer 3

• blood in stools
  (dark blood stools= upper GI bleeding)
  (bright red blood on surface= anal fissure/Haemorrhoids)

Mild bleeding, blood on toilet paper, can be treated by pharmacist

• abdominal pain, nausea, vomiting, fever, loss of apetite
• altered bowel habits (colorectal cancer)

Question 4

Referral for Haemorrhoids part 2

Answer 4

• Tenesmus (wanting to poo with no poo)(can be caused by rectal tumour)
• Severe sharp pain on pooing (anal fissure)
• symptoms continue after 3 weeks
• unresponsive OTC over 1 week
• taking any constipation medication

Question 5

OTC treatment for Haemorrhoids: Soothing agents

Answer 5

Anusol

• zinc oxide
• benzyl benzoate
• allantoin

Question 6

OTC treatment for Haemorrhoids: Mild Astringents

Answer 6

Preparation H

• bismuth
• zinc oxide

Question 7

OTC treatment for Haemorrhoids: Local Anaesthetics

Answer 7

Germaloids (12+)

• Lidocaine

Question 8

OTC treatment for Haemorrhoids: Products with hydrocortisone

Answer 8

Anusol plus HC (18+)

• max 7 day use
• avoid in pregnancy / breastfeeding

Question 9

Advice for Haemorrhoids

Answer 9

• increase dietary fibre
• treat constipation if present
• clean with attention to minor faecal soiling
• pregnancy increases risk of haemorrhoids