Hemorrhoids Evaluation I Jessie Hester Candice Perkins October
Hemorrhoids Evaluation I Jessie Hester & Candice Perkins October 1, 2003
What Are Hemorrhoids? § Alternative Names § Rectal Lump § Piles § Lump in the Rectum § Definition: § Dilated or enlarged veins in the lower portion of the rectum or anus.
Cont. § Two Types: § Internal- Under the skin § External- Around the anus Grades: I- Hemorrhoids only bleed II- Prolapse and reduce spontaneously III- Require replacement !V- Permanently Prolapsed
Frequency § § § 10 million Peak ages: 45 -65 years ½ of adults experience hemorrhoids by age 50 § Common among pregnant women § Temporary
Symptoms § § § Rectal Bleeding Bright red blood in stool Pain during bowel movements Anal Itching Rectal Prolapse Thrombus
Causes § Pressure § Constipation § Diarrhea § Sitting or standing for long periods of time § Obesity § Heavy Lifting § Pregnancy
Signs and Tests § Rectal Examination § Visual § Digital § Tests § Stool Guaiac (FOBT) § Sigmoidoscopy § Anaoscopy § Proctoscopy
Referral § Gastroenterologists § Seek emergency care if : § large amounts of rectal bleeding § Lightheadedness § Weakness § Rapid HR < 100 BPM
Complications § The blood in the enlarged veins may form clots and the tissue surrounding the hemorrhoids can die (Necrosis) § This causes painful lumps in the anal area. § Severe bleeding can occur causing iron deficiency anemia.
Treatment Non-surgical § Mild cases are controlled by: § Preventing constipation § Drinking Fluids § High-fiber diet § Use of Fiber supplements § Stool softeners
Cont. § Apply and OTC cream or suppository containing hydrocortisone § Keep anal area clean § Soak in a warm bath § Apply ice packs or compresses x 10 min
Cont. § If prolapses, gently push back into anal canal § Use a sitz bath with warm water § Use moist towelettes or wet toilet paper instead of dry toilet paper.
Treatments § For painful or persistant hemorrhoids: § Tying off a hemorrhoid § Sclerotherapy § Infered Light § Laser Therapy § Freezing § Electrical Current § Surgery
Hemorrhoid Surgery § Alternative Name: Hemorrhoidectomy § Hemorrhoid surgery is the removal of enlarged veins around the anus
Cont. § Indications § Persistent itching § Anal bleeding § Pain § Blood clots § Infection
Cont. § Risks § Reactions to medications of anestesia § Bleeding § Infection § Narrowing of the anus *The outcome is usually very good in the majority of cases.
Prevention § § § § Eat high fiber diet Drink Plenty of Liquids Fiber Supplements Exercise Avoid long periods of standing or sitting Don’t Strain Go as soon as you feel the urge
Questions § What grade of hemorrhoids prolapse and reduce spontaneously? A) Grade I B) Grade II C) Grade III D)Grade IV
§ How many people are treated for hemorrhoids yearly? A) 3 million B) 8 million C) 10 million D) 20 million
§ What are two causes of hemorrhoids? A) Standing on your head B) Heavy lifting C) Jeans being too tight D) Constipation
§ What is a sigmoidoscopy? A) An internal examination of the rectum, distal colon and large bowel using a type of small camera. B) Detects the presence of hidden blood in the stool. C) A procedure that enables a physician to view the anus, anal canal, and lower rectum using a lubricated plastic scope into the rectum.
Questions? ?
- Slides: 26