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Evaluation I
Jessie Hester & Candice Perkins
October 1, 2003
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
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
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 10min
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
Prevention
Questions
What grade of hemorrhoids prolapse and
reduce spontaneously?
A) Grade I
B) Grade II
C) Grade III
D)Grade IV
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????