Haemorrhoids Flashcards
What are haemorrhoids?
Abnormal swelling/dilatation of anal vascular cushions
What is the classification of haemorrhoids?
1st degree = remain in rectum
2nd degree = prolapse on defecation but spontaneously reduce
3rd degree = prolapse on defecation and require digital reduction
4th degree = persistently prolapsed
What are risk factors for haemorrhoids?
Excessive straining
Increasing age
Increased intra-abdominal pressure
What are clinical features of haemorrhoids?
Painless rectal bleeding
- after defecation
- on paper
- surface of stool
Pruritus
Rectal fullness
What are features of thrombosed haemorrhoids?
Painful
Purple/blue
Oedematous
Tense
How are thrombosed haemorrhoids managed?
Stool softeners
Ice packs
Analgesia
Symptoms settle within 10 days
What are the types of haemorrhoids?
Internal
External
What are external haemorrhoids?
Originate below the dentate line
Prone to thrombosis
What are internal haemorrhoids?
Originate above the dentate line
Do not usually cause pain
How are suspected haemorrhoids investigated?
Proctoscopy
How are haemorrhoids managed generally?
Increase fibre
Increase fluid intake
Topical analgesia
How are symptomatic 1st + 2nd degree haemorrhoids managed?
Rubber band ligation
How are 2nd + 3rd degree haemorrhoids managed?
Haemorrhoidal artery ligation
How are large symptomatic haemorrhoids managed?
Haemorrhoidectomy
