Hemorrhoids (Piles)

Definition:

Swollen veins (varicose veins = dilated veins due to the stretching of the vein valves) at or near the anus.

Type of the Hemorrhoids

External Hemorrhoids:

The varicose dilation of the inferior haemorrohdest pelvis and covered with modified skin.

Internal Hemorrhoids:

The varicose dilation of the superior haemorroidal plexus and covered by the mucus membrane

Degrees of the Hemorrhoids

  1. 1st Degree:

In this varicose veins are in small size and patient complains stool with blood and pain.

  1. 2nd Degree:

The varicose veins prolapsed out from anal canal at the evacuator but return in size with little pressure.

  1. 3rd Degree:

The hemorrhoids are prominently prolapsed and unable to return inside.

Etiology:

  1. Constipation
  2. Straining at stool
  3. Prolonged sitting
  4. Pregnancy
  5. Obesity
  6. Low fiber diet
  7. Clinical features:
  8. Bright red mucosal discharge
  9. Varicose veins
  10. Discomfort
  11. Severe itching, bleeding may occurs
  12. Hypotension
  13. Anxious

Complications:

  1. Thrombosis
  2. Ischemic of the vein
  3. Anemia
  4. Gangrene
  5. Ulceration
  6. Rupture of varicose veins

Investigations:

  1. Protosigmoid scopy
  2. CBC
  3. Urine DR

Medical Management:

  1. Tab: Lexobron 1-2 tab: at bed time
  2. Syp; Levolac 10-15 ml BD
  3. Syp: Cremafin 20ml in milk
  4. Advised for fiber diet and liquid intake

Surgical Management:

  1. Hemorroidectomy

Nursing Management:

  1. Position the patient in prone
  2. For to control on pain warm compress should be provided
  3. Fiber diet, fruit juices and liquids relieve the constipation and to relieve defecation
  4. Oral laxatives should be given for easy bowel elimination
  5. In case of spinal anesthesia the foot part of the bed should be elevated.

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