Haemorrhoids Flashcards
What is the role of haemorrhoidal tissue in the body?
Contributes to anal continence
Haemorrhoidal tissue is part of the normal anatomy and consists of mucosal vascular cushions.
Where are haemorrhoidal cushions located in the anal canal?
Left lateral, right posterior, right anterior portions (3 o’clock, 7 o’clock, 11 o’clock)
These locations refer to the anatomical positions where these cushions are found.
What defines the existence of haemorrhoids?
Enlarged, congested, and symptomatic haemorrhoidal tissue
Haemorrhoids occur when the normal tissue becomes problematic.
What is the most common symptom of haemorrhoids?
Painless rectal bleeding
This symptom is often the first indication of haemorrhoidal issues.
What are two other clinical features of haemorrhoids?
- Pruritus
- Pain (usually not significant unless thrombosed)
Thrombosis can lead to more severe pain.
What is the difference between external and internal haemorrhoids?
- External: originate below the dentate line, prone to thrombosis, may be painful
- Internal: originate above the dentate line, do not generally cause pain
The dentate line is an important anatomical landmark in the anal canal.
What are the four grades of internal haemorrhoids?
- Grade I: Do not prolapse out of the anal canal
- Grade II: Prolapse on defecation but reduce spontaneously
- Grade III: Can be manually reduced
- Grade IV: Cannot be reduced
Grading helps determine the severity and management of internal haemorrhoids.
What dietary changes are recommended for managing haemorrhoids?
Increase dietary fibre and fluid intake
Softer stools can reduce strain during defecation.
What types of medications may be used for haemorrhoid symptoms?
- Topical local anaesthetics
- Steroids
These can help alleviate discomfort associated with haemorrhoids.
Which outpatient treatment is superior for haemorrhoids?
Rubber band ligation
This method is more effective compared to injection sclerotherapy.
What is the management approach for large symptomatic haemorrhoids?
Surgery reserved for those not responding to outpatient treatments
Surgical options are typically considered when other treatments fail.
What newer treatments are available for haemorrhoids?
- Doppler guided haemorrhoidal artery ligation
- Stapled haemorrhoidopexy
These techniques aim to reduce complications and improve outcomes.
What characterizes acutely thrombosed external haemorrhoids?
Significant pain, purplish, oedematous, tender subcutaneous perianal mass
This condition presents with very noticeable symptoms.
What should be done if a patient presents with thrombosed external haemorrhoids within 72 hours?
Consider referral for excision
Early intervention can prevent complications.
What is the usual management for thrombosed external haemorrhoids if not referred?
- Stool softeners
- Ice packs
- Analgesia
These methods can help manage symptoms effectively.
How long do symptoms of thrombosed external haemorrhoids typically take to settle?
Within 10 days
Most patients experience resolution of symptoms in this timeframe.
What is the role of haemorrhoidal tissue in the body?
Contributes to anal continence
Haemorrhoidal tissue is part of the normal anatomy and consists of mucosal vascular cushions.
Where are haemorrhoidal cushions located in the anal canal?
Left lateral, right posterior, right anterior portions (3 o’clock, 7 o’clock, 11 o’clock)
These locations refer to the anatomical positions where these cushions are found.
What defines the existence of haemorrhoids?
Enlarged, congested, and symptomatic haemorrhoidal tissue
Haemorrhoids occur when the normal tissue becomes problematic.
What is the most common symptom of haemorrhoids?
Painless rectal bleeding
This symptom is often the first indication of haemorrhoidal issues.
What are two other clinical features of haemorrhoids?
- Pruritus
- Pain (usually not significant unless thrombosed)
Thrombosis can lead to more severe pain.
What is the difference between external and internal haemorrhoids?
- External: originate below the dentate line, prone to thrombosis, may be painful
- Internal: originate above the dentate line, do not generally cause pain
The dentate line is an important anatomical landmark in the anal canal.
What are the four grades of internal haemorrhoids?
- Grade I: Do not prolapse out of the anal canal
- Grade II: Prolapse on defecation but reduce spontaneously
- Grade III: Can be manually reduced
- Grade IV: Cannot be reduced
Grading helps determine the severity and management of internal haemorrhoids.
What dietary changes are recommended for managing haemorrhoids?
Increase dietary fibre and fluid intake
Softer stools can reduce strain during defecation.
