Hemorrhoids

Question 1

symptoms of hemorrhoids?

Answer 1

rectal bleeding
pain due to thrombosis
pruritus
prolapse

Question 2

RF for hemorrhoids?

Answer 2

pregnancy/episiotomy
anal sex
colon ca
obesity
liver disease
spinal cord injury
rectal surgery
chronic diarrhea
increased anal pressure

Question 3

venous plexuses hemorrhoids arise from?

Answer 3

superior and inferior hemorrhoidal veins

Question 4

anatomic distinction between int and ext. hemorrhoids?

Answer 4

above and below dentate line

Question 5

ano-rectal disorders that present like hemorrhoids?

Answer 5

IBD (CD)
fissures
Polyps
condylomata late
anal cancer
rectal prolapse

Question 6

Rx for 1st and 2nd degree int. and non-thrombosed ext. hemorrhoids

Answer 6

Sitz bath
high fiber
increase fluids
stool softeners
topical/systemic analgesia
short course of topical steroids
good hygein

Question 7

Rx of refractory int and thrombosed ext. hemorrhoids

Answer 7

1.band ligation
2.sclerotherapy (less effective than band)
3.laser coagulation (can be as effective as band)
4.radio-wave ablation followed by suture
5. Hemorrhoidectomy