Hemorrhoids

Question 1

What are the clinical features of haemorrhoids?

Answer 1

Painless rectal bleeding (most common), pruritis, pain (if thrombosed) and soiling

Question 2

What is the grading of internal haemorrhoids?

Answer 2

Grade 1 - Do not prolapse out of anal canal.
2 - prolapse on defecation but reduce spontaneously.
3 - Manually reduced
4 - cannot be reduced

Question 3

What is the management of haemorrhoids?

Answer 3

Soften stools,
Topical local anaesthetics and steroids.
Outpatient treatment - rubber band ligations.
Surgery
Haemorrhoidopexy

Question 4

What is the presentation of acutely thrombosed external haemorrhoids?

Answer 4

Typicaly presents with significant pain, purplish, oedematous tender subcutaneous perianal mass.
Can be surgically removed if present within 72 hours. Otherwise manage with stool softners and analgesia.