Haemorrhoids

Question 1

Symptoms

Answer 1

• Swollen veins
• Dull pain when defecating or sitting
• Slight rectal bleed
• Itching + burning

Question 2

Referral

Answer 2

• Blood in stools
• Abdominal pain, nausea, vomiting, fever
• Alt bowel habit
• > 3 weeks
• Unresponsive OTC >1 week

Question 3

Treatment

Answer 3

• Soothing agents (anusol)
• Mild astringents (preparation H)
• Local anesthetic 12+ (lidocaine)
• Products w hydrocortisone 18+ (anusol plus HC) Max 7 day use
  Avoid in pregnancy/BF

Question 4

Advice

Answer 4

• Inc fiber
• Treat constipation if present
• Pregnancy inc risk of haemorrhoids