1. Evaluation I Jessie Hester & Candice Perkins October 1, 2003
Hemorrhoids
Evaluation I
Jessie Hester & Candice Perkins
October 1, 2003

2. 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.

3. Cont. Two Types: Grades: Internal- Under the skin
External- Around the anus
Grades:
I- Hemorrhoids only bleed
II- Prolapse and reduce spontaneously
III- Require replacement
!V- Permanently Prolapsed

6. Frequency 10 million Peak ages: 45-65 years
½ of adults experience hemorrhoids by age 50
Common among pregnant women
Temporary

7. Symptoms Rectal Bleeding Bright red blood in stool
Pain during bowel movements
Anal Itching
Rectal Prolapse
Thrombus

8. Causes Pressure Constipation Diarrhea
Sitting or standing for long periods of time
Obesity
Heavy Lifting
Pregnancy

10. Signs and Tests Rectal Examination Tests Visual Digital
Stool Guaiac (FOBT)
Sigmoidoscopy
Anaoscopy
Proctoscopy

11. Referral Gastroenterologists Seek emergency care if :
large amounts of rectal bleeding
Lightheadedness
Weakness
Rapid HR < 100 BPM

12. 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.

14. Treatment Non-surgical
Mild cases are controlled by:
Preventing constipation
Drinking Fluids
High-fiber diet
Use of Fiber supplements
Stool softeners

15. 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

16. 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.

17. Treatments For painful or persistant hemorrhoids:
Tying off a hemorrhoid
Sclerotherapy
Infered Light
Laser Therapy
Freezing
Electrical Current
Surgery

18. Hemorrhoid Surgery Alternative Name: Hemorrhoidectomy
Hemorrhoid surgery is the removal of enlarged veins around the anus

19. Cont. Indications Persistent itching Anal bleeding Pain Blood clots
Infection

20. Cont. Risks Reactions to medications of anestesia Bleeding Infection
Narrowing of the anus
*The outcome is usually very good in the majority of cases.

21. 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

22. Questions What grade of hemorrhoids prolapse and reduce spontaneously?
A) Grade I
B) Grade II
C) Grade III
D)Grade IV

23. How many people are treated for hemorrhoids yearly?
A) 3 million
B) 8 million
C) 10 million
D) 20 million

24. What are two causes of hemorrhoids?
A) Standing on your head
B) Heavy lifting
C) Jeans being too tight
D) Constipation

25. What is a sigmoidoscopy?
An internal examination of the rectum, distal colon and large bowel using a type of small camera.
Detects the presence of hidden blood in the stool.
A procedure that enables a physician to view the anus, anal canal, and lower rectum using a lubricated plastic scope into the rectum.

26. Questions????