Hemorrhoid Flashcards
What is a hemorrhoid?
A hemorrhoid is a soft mass formed by dilatation of part of the venous plexus of the rectum.
How are hemorrhoids classified?
Hemorrhoids are classified as internal, external, or a combination of both, depending on their location relative to the line separating mucous membranes and skin.
What are internal hemorrhoids mainly associated with?
Internal hemorrhoids are mainly associated with an abnormal dilation of the hemorrhoid vein and a descending of the anal cushion.
What are the etiologies and pathogenesis of Hemorrhoids?
Improper diet –> damp-heat flowing –> downwards to LI
Long-time standing or sitting, weight-bearing travel, long-term diarrhea (damages LI QI), or constipation, straining during constipation, pregnancy –> Qi sinking –>
prolapse of hemorrhoid
Emotions, external wind, dampness, dryness, heat –> attacking SP + ST –> Qi and Blood stagnation obstructing –> channel and collaterals at the anal area
In biomedicine, internal hemorrhoids are mainly associated with ___________ and ___________.
- An abnormal dilation of the hemorrhoid vein and
- A descending of the anal cushion
What is an internal hemorrhoid?
An internal hemorrhoid involves a vein beneath the mucous membrane.
The following classifies Internal hemorrhoid with __________ __________.
Bleeding during a BM with a small amount of fresh red blood, no pain
Painless Bleeding Internal Hemorrhoid
The following classifies Internal hemorrhoid with ________.
Internal hemorrhoids pushed outside the anus, constipation, discharge of secretion, bearing down sensation of the anus, soft, smooth, non-tender mucosal swelling, could have little pain and blood
Prolapsed Internal Hemorrhoid
What are the 4 different types of External Hemorrhoids?
Inflammatory
Thrombosed
Connective Tissue
Varicose Vein
What is an external hemorrhoid?
An external hemorrhoid involves a vein beneath the skin and below the dentate line.
What are the clinical characteristics of an External Hemorrhoid?
A bearing down distending sensation and pain in the anus
What are the characteristics of inflammatory external hemorrhoids?
Red, warm, and painful lumps, following inflammatory irritation of the anal skin due to toxic heat, Qi & Blood stagnation, damp-heat
What does ‘thrombosed’ refer to?
Round lumps resulting from subcutaneous blood stagnation following rupture or bleeding of hemorrhoid venous plexus due to internal heat with blood dryness, straining during bowel movements. (Heat is more internal, LI heat and dryness)
What is the connective tissue type of Hemorrhoids?
Hyperplasia or hypertrophy of anal skin due to recurrent or chronic inflammatory irritation.
Due to the downward flow of damp heat, Qi and blood stagnation, with no abnormal swelling, enlargement, or dilation of the veins
What are varicose veins hemorrhoids?
Soft round or oval lumps due to enlargement & varicosity of the hemorrhoidal venous plexus. Due to recurrent prolapse or childbirth.
What is a combined hemorrhoid?
A combined hemorrhoid involves veins beneath both skin and mucous membrane and may manifest symptoms of both internal and external hemorrhoids
The following are patterns of __________.
Damp-heat
SP Xu causing SP Qi Sinking
Yin Xu w/ Heat or Fire
Hemorrhoids
The following are S/sx of an External Hemorrhoid due to __________.
Hemorrhoids may be swollen, hanging, fresh red in color, may have local moistness and itching, bleeding, and hematochezia (blood in stool) all S/sx worsen with damp-heat-forming foods
T: Red w/ yellow, greasy coating
P: Rapid + Slippery
Damp-heat
The following are S/sx of an Internal Hemorrhoid due to __________.
Prolapsed hemorrhoid that requires manual movements from outside to inside of anus after BM, sallow complexion, SOB, fatigue, may have palpitation
T: Pale w/ thin, white coating
P: Weak + Thready
SP Xu causing SP Qi Sinking
The following are S/sx of an Internal Hemorrhoid due to __________.
Late-stage and if no treatment happens, heavy bleeding from hemorrhoid, fresh red in color, thirst, constipation, scanty and dark urine
T: Red w/ scanty coating
P: Rapid + Thready or Surging
Yin xu with Heat or Fire
(Internal hemorrhoids or external hemorrhoids w/ thrombosis)
What are the main points in treating Hemorrhoids?
BL-35: Clears Damp-Heat + treats hemorrhoids (level with the tip of the coccyx)
BL-54: Local + Regulates urination + treats hemorrhoids
BL-57: Empiric pt to treat hemorrhoids
BL-58: Luo-connecting + Treats hemorrhoids
BL-60: Clears heat
DU-2: Local
Baliao: Local
Er Bai: Empiric pt to treat hemorrhoids
For hematochezia-
DU-1: Local pt + Benefits 2 lower orifices
Strengthen SP + ST:
Moxa on REN-6 + REN-12 + ST-36
What are the points for treating each pattern of hemorrhoids?
Damp-Heat:
SP-9 + SP-6
BL-65: Clears heat + dissipates swelling
SP Qi Xu:
DU-20 + BL-20 + SP-3 + ST-36
REN-4 + REN-6 + REN-8 (moxa)
KI Yin Xu:
KI-3 + KI-6 + SP-6
LI-11
SP-10 + BL-17
