rectal bleeding - haemorrhoids etyc

Question 1

haemorrhoids - normal anatomy + pathophys

Answer 1

haemorrhoidal tissue contributes to continence. it’s mucosal vascular cushions that are found at 3 points in anal canal. haemorrhoids are when they become enlarged, congested + symptomatic

Question 2

haemorrhoids - features

Answer 2

painless bleeding
itching
pain - worse if thromboses
soiling

Question 3

haemorrhoids - types

Answer 3

external - prone to thrombosis, may be painful

internal - painless

Question 4

haemorrhoids - management

Answer 4

1° - soften stools - fibre + fluids
± topical local anaesthetics + steroids

2° - band ligation
3° - surgery

Question 5

rectal bleeding - investigations

Answer 5

DRE
procto-sigmoidoscopy
?IBD - colonoscopy

haemorrhoids usually impalpable

Question 6

anal fissure - management

Answer 6

1° - topical GTN or diltiazem

2° - botox