The document discusses hemorrhoids, which are swollen veins in the anus and lower rectum, and covers their definition, anatomy, etiology, types, stages, clinical features, diagnosis, treatment, complications, and prevention. It explains that hemorrhoids can be internal or external, with different causes and symptoms such as bleeding and discomfort. Treatment options include conservative methods like diet changes and surgical procedures like hemorrhoidectomy.

1. HEMORRHOIDS
Presented by: S.MUTHUKUMARAN
6th year 3rd Group
Yerevan Haybusak University

2. SYNOPSIS
• Definition
• Anatomy and pathophysiology
• Etiology
• Types
• Stages
• Clinical features
• Causes
• Diagnosis
• Treatment
• Complication
• Prevention

3. NORMAL ANAL CANAL

4. DEFINITION
• Hemorrhoids also called piles.(Swollen veins in
your Anus and lower rectum similar to varicose
veins).
• It is due to dilation of rectal venous plexus
consists of internal and external components , its
very frequent disease
• The exact cause is unknown because there is a
number of cause for hemorrhoids.

5. ETIOLOGY
• Constipation
• straining at stool
• Increased pelvic pressure during pregnancy
• By hereditary (weakness of the vein walls)

6. ANATOMY & PHYSIOLOGY
HEMORRHOID CUSHION:
The hemorrhoid cushion contains venules ,
arterioles and smooth muscle fiber that are
located in the anal canal.
• These cushion are useful in diagnosing of
hemorrhoid , inspection at 3 , 7, 11’o clock in
lithotomy position.

7. There are 3 main hemorrhoid complexes or
hemorrhoid cushion of anal canal known as
1:LEFT LATERAL(3’o clock)
2:RIGHT ANTERIOR(11’o clock)
3:RIGHT POSTERIOR(7’o clock)
When the anatomic support system of the
hemorrhoidal complexes weakens due to
straining causes exposing the tissue into the
anal canal causes hemorrhoids.

9. STAGES
• STAGE 1
occasional bleeding only
• STAGE 2
Protrusion with spontaneous reduction
• STAGE 3
Protrusion requiring manual reduction
• STAGE 4
Irreducible protrusion with inflammation

11. TYPES OF HEMORRHOIDS:
Depends on Location
Internal hemorrhoids
External hemorrhoids
Thrombosed hemorrhoids

12. • Inside the rectum ( internal Hemorrhoids )
• Under the skin around the Anus ( External
hemorrhoids)
• ¾ Adults will have hemorrhoids.
• Sometime they don’t cause any symptoms but
cause
• Itching
• Discomfort
• Bleeding

13. INTERNAL HEMORRHOIDS
• Lie inside the Rectum
• Usually we can’t see/feel these hemorrhoids
• Straining/irritation when passing the stool can
damage a hemorrhoid’s surface &cause
bleeding.
• Straining can push internal hemorrhoids
through anal opening.
• This is known as protruding/ prolapsed causes
pain and irritation.

15. EXTERNAL HEMORRHOIDS
• These are under the skin around your perianal
region.
• When hemorrhoids gets irritated it causes
itching & bleeding.

16. THROMBORED HEMORROIDS
• It is an outcome of external hemorrhoid.
• Sometimes blood may pull out in an external
hemorrhoid and form clot.(thrombus)
 Causes severe pain
 Don’t cause bleeding(coz it forms as clot)
 Swelling
 Inflammation
 Hard lump near your Anus

18. CAUSES:
Straining during Bowel movements
Sitting for long periods of time on Toilet
Chronic diarrhea/constipation
Obesity
Pregnancy
Anal intercourse
Low-fiber diet

19. CLINICAL FEATURES:
• Painless Bleeding during bowel movements
(you may notice some small amount of Blood
in feces)
• Itching / irritation in Anal region
• Pain /discomfort
• Swelling
• A lump near the Anus ( Sensitive and painful)

20. DIAGNOSIS:
• Digital examination
(We can see unusual growth in the Rectum)
• Visual inspection
(Examine the lower portion of your colon and Rectum
with Anoscope, Proctoscope or Sigmoidoscope)
• Colonoscopy

21. TREATMENT:
CONSERVATIVE
 Eat high-Fiber foods
 Use hydrocortisone
 Soak regularly in a warm bath
 Keep the anal area clean
 Don’t use dry toilet paper
 Take oral pain relievers
Ex : Acetaminophen , Aspirin /Ibuprofen

22. SURGICAL
• Hemorrhoid Removal (Hemorrhoidectomy)
(Remove excessive tissue that causes Bleeding)
• Hemorrhoid Stapling.
• Rubber band ligation

25. COMPLICATION
Anemia
Due to chronic Blood loss
Strangulated hemorrhoids
causes extreme pain

26. PREVENTION
Eat high-Fiber foods
Drink plenty of fluids
Consider Fiber supplements
Don’t strain
Defecate as soon as you feel the urge
Exercise
Avoid long periods of sitting

29. Thank you