Haemorrhoids

Question 1

What are enlarged anal vascular cushions that project distally called?

Answer 1

Haemorrhoids

Haemorrhoids can be classified into internal and external types based on their location.

Question 2

List risk factors for haemorrhoids.

Answer 2

• Constipation and straining
• Pregnancy
• Obesity
• Increased age
• Increased intra-abdominal pressure (e.g. weightlifting, chronic coughing)

Increased intra-abdominal pressure can also be caused by factors such as heavy lifting or chronic coughing.

Question 3

What is the classification of haemorrhoids based on size and prolapse?

Answer 3

• 1st degree - no prolapse
• 2nd degree - prolapse with straining, spontaneous reduction
• 3rd degree - prolapse when straining, manual reduction
• 4th degree - permanent prolapse, irreducible

Each degree reflects the severity of the prolapse and the ability to reduce it manually.

Question 4

What are two clinical features of haemorrhoids?

Answer 4

• Painless, bright red bleeding
• Sore/itchy anus

These symptoms are often key indicators of the presence of haemorrhoids.

Question 5

What are some differential diagnoses for haemorrhoids?

Answer 5

• Anal fissures
• Diverticulosis
• IBD
• Colorectal cancer

These conditions can present with similar symptoms and should be considered during diagnosis.

Question 6

Name two topical treatments for haemorrhoids.

Answer 6

• Anusol (astringents)
• Germoloids cream (with lidocaine)

Topical treatments are aimed at relieving symptoms and reducing swelling.

Question 7

What are two non-surgical management options for haemorrhoids?

Answer 7

• Rubber band ligation
• Increasing fibre intake

Non-surgical options focus on symptom relief and prevention of worsening conditions.

Question 8

What are two surgical options for treating haemorrhoids?

Answer 8

• Haemorrhoidal artery ligation
• Haemorrhoidectomy

Surgical options are considered for severe cases or when other treatments fail.

Question 9

What is a complication of haemorrhoids that can occur due to strangulation?

Answer 9

Acute thrombosed haemorrhoids

This condition can lead to severe pain and requires specific management.

Question 10

True or False: Acute thrombosed haemorrhoids appear as purple, tender, swollen lumps around the anus.

Answer 10

True

These characteristics are indicative of thrombosis in the haemorrhoid.