HAEMORRHOIDS

OVERVIEW OF HAEMORROIDS

HAEMORRHOID (PILES)

DEFINITION:-
It is an enlargement of normal spongy blood filled cushions in the walls of anus or dilation of anal veins and lower rectum.

TYPES:-
●External: Always visible.
●Internal: Not visible.

CAUSES/AETIOLOGY:-
■Chronic constipation
■Prolonged standing
■Pregnancy
■Tumor in colon
■Due to rectal surgery or infection
■Increase intra-abdominal pressure
■Portal hypertension
■Obesity.

Signs &Symptoms
●Pain during defecation
●Constipation
●Bright red bleeding from the anus
●Itching surrounding anal area (pruritus)
●Sensation of incomplete evacuation
●Visible palpable mass
●Anaemia
●Melaena (blood in stool)
●Rectal pain.

PATHOPHYSIOLOGY:-
Increase abdominal pressure➪Dilation of anal vein➪Chronic constipation➪Abdominal pressure till long time➪Permanent dilation of anal vein➪Bleeding from veins

DIAGNOSTIC EVALUATION:-
■According to signs and symptoms.
■Barium enema for internal ■digital palpation.
■Anoscopy.
■Sigmoidoscopy.
■Proctoscopy.

COMPLICATIONS:-
●Anaemia.
●Incontinence.

MEDICAL MANAGEMENT:-
●Stool softener, e.g., Docusate sodium, ●Magnesium sulphate.
●High fibers diet.

SURGICAL MANAGEMENT:-
●Rubber bend ligation
●Haemorrhoidectomy (surgical removal of haemorrhoid)
●Cryo surgery (by cold therapy)
●Laser therapy (by light).

NURSING MANAGEMENT:-
■To relieve constipation, provide high fibre diet and laxatives or stool softener.
■Advice to patient to apply xylocaine ointment before and after evacuation for relieve pain during evacuation.
■To relieve anxiety
To help in activity of daily living.