Hemarrhoids Flashcards
Haemorrhoids, or piles, are abnormal swellings of the ___________________ around the anus.
vascular mucosal anal cushions
Internal haemorrhoids arise above the ______________ and are usually painless unless they become strangulated. External haemorrhoids originate below the ______________ and can be itchy or painful.
dentate line
dentate line
Internal haemorrhoids arise above the dentate line and are usually _______________. External haemorrhoids originate below the dentate line and can be _______________.
painless unless they become strangulated
itchy or painful
Women are predisposed to developing haemorrhoids during _____________
pregnancy
What is the non-drug treatment of hemorrhoids? (2)
Stools should be kept soft and easy to pass (to minimize straining) by increasing dietary fiber and fluid intake
Advice about perianal hygiene is helpful to aid healing and reduce irritation and itching
If constipation is reported in patient with hemorrhoids, a ____________ can be prescribed
Bulk-forming laxative
Analgesics such as ________________ can be used for pain relief in patients with hemorrhoids, whereas ____________ and _____________ should be avoided
Paracetamol
Opioid analgesics (may cause or worsen constipation)
NSAIDs (if rectal bleeding is present)
For symptomatic relief of hemorrhoids, topical preparations are available containing…. (5)
Local anesthetics, Corticosteroids, Astringents, Lubricants, and Antiseptics
Topical preparations containing local anaesthetics (lidocaine, benzocaine, cinchocaine and pramocaine) should only be used for a few days as they may cause ______________
sensitisation of the anal skin
Topical preparations containing local anaesthetics (lidocaine, benzocaine, cinchocaine and pramocaine) should only be used for ____________ as they may cause sensitisation of the anal skin
a few days
Local anaesthetics can be absorbed through the _________________ and very rarely may cause increased irritation; therefore excessive application should be avoided
rectal mucosa (with a theoretical risk of systemic side effects)
Do topical preparations containing corticosteroids with local anesthetics reduce perianal inflammation, swelling, bleeding, or protrusion of hemorrhoids?
May ameliorate local perianal inflammation but do NOT:
reduce swelling, bleeding, or protrusion
Topical corticosteroids are suitable for occasional short-term use in the symptomatic treatment of hemorrhoids (no more than __________) after exclusion of infections
7 days
Topical corticosteroids are suitable for occasional short-term use (no more than 7 days) after exclusion of ________________
infections (such as perianal streptococcal infection, herpes simplex or perianal thrush)
Long-term use of corticosteroid creams can cause ______________ or permanent damage due to _______________ and should be avoided
ulceration
thinning of the perianal skin
- Continuous or excessive use also carries a risk of adrenal suppression and systemic corticosteroid effects.
