Haemorrhoids

Question 1

Definition of haemorrhoids

Answer 1

• Venous vascular cushions that have become enlarged due to increased pressure (i.e. straining in constipation)
• Degrees:
  
  • 1st - no prolapse
  • 2nd - prolapse when straining, return on relaxing
  • 3rd - prolapse when straining, no return, can be pushed back
  • 4th - prolapsed permanently

Question 2

Presentation of haemorrhoids

Answer 2

• No symptoms
• Constipation
• Painless bright red rectal bleeding
• Sore/itchy anus
• Feeling a lump around or in anus

NB - Thombosed haemorrhoids can be extremely painful and appear as purple, very tender, swollen lumps around the anus.

Question 3

Management of haemorrhoids

Answer 3

• Symptomatic (anusol cream, local anaesthetic, topical steroids)
• Laxatives
• Band ligation
• Surgical haemorrhoidectomy