2. Learning Tasks
Define hemorrhoids
List Types of hemorrhoids
Identify causes and risk factors of hemorrhoids
Describe pathophysiology of hemorrhoids
Explain clinical manifestations and diagnostic
measures of hemorrhoids
Identify diagnostic criteria of hemorrhoids
Explain complications of hemorrhoids
Care of a patient with hemrrhoids.
3. Definition and Types of Hemorrhoids
Definition
Hemorrhoids is defined as dilated portions of
veins in the anal canal.
OR
is the naturally swollen or distended vein in
the anal rectal region.
• They are common in both men and women
commonly between 20 to 50 years.
4. Types of hemorrhoid include
Internal hemorrhoids
Those above the internal sphincter (which cannot
be seen on inspection of the perineal area lie above
the anal sphincter
External hemorrhoid
Those appearing outside the external sphincter( lie
below the anal sphincter and can be seen on
inspection on anal region, prolapsed hemorrhoid
can become thrombosed or inflamed or they can
bleed.
5.
6. Causes and Risk Factors of
Hemorrhoid
Causes
• Enlargement of the hemorrhoids veins is caused by
increase of intra-abdominal pressure
The following are the risk factors of hemorrhoid
Any condition that raise the risk of increase intra-
abdominal pressure include;
Pregnancy
Constipation with prolonged straining in defecation
7. Obesity
Congestive heart failure
Prolonged sitting or standing
Low fiber diet
High fat diet
Rectal surgery
Anal intercourse
Older age
8. Pathophysiology of Hemorrhoid
The following statement describes the pathophysiology
of hemorrhoids:
• Tenesmus (feeling of needing to pass stools) increases
intra/abdominal and hemorrhoidal venous pressures,
leading to distension of the hemorrhoidal veins
• When the rectal ampulla is filled with formed stools,
venous obstruction is believed to occur
• As a result of the repeated and prolonged increase in
this pressure and the obstruction, hemorrhoidal veins
become permanently dilated
• As a result of the distension, thrombosis and bleeding
may also occur
9. Clinical Manifestations and Diagnostic
Measures of Hemorrhoid
The following are the signs and symptoms of hemorrhoid:
• Pain on defecation
• Painless bleeding with defecation
• Itching/pruritus
• Enlarged mass at the anus/prolapse of the dilated veins
• Constipation
• Perianal irritation
• Fecal staining of under clothes
• Pain on sitting, standing, or defecating
• Rectal prolapse
10. Diagnostic Evaluation
• History taking
• Physical examination( inspection, palpation
and proctoscopy for internal hemorrhoids
• Visualization of anal canal by using an
anoscope or a proctosigmoidoscopy,
allows visualization of the external
hemorrhoids
11. Complications of Hemorrhoid
The following are the complications of
hemorrhoid
Infections
Anal stricture formation as the lesions
heals
Hemorrhage
12. Pre and Post-operative Care
Preoperative care; Prepare patient for hemorrhoidectomy,
the surgical removal of hemorrhoids, in chronic and severe
cases. The procedure is performed using conventional surgery
or laser surgery
Assist patient to carry out preoperative tests include a
complete blood count and other necessary laboratory
studies
Reducing anxiety:
Identifies specific psychosocial needs and prepared
psychologically to accept surgical treatment for his
hemorrhoids. All questions regarding post-operative pain,
the first bowel movement, and so on, are answered frankly,
and the need for co-operative effort explained
13. Offer enema
Shave and cleansed the perianal area with an
antiseptic detergent
Maintains patient’s privacy while providing care
and by limiting visitors as the patient desires
Remove soiled dressings from the room promptly
to prevent unpleasant odors. Room deodorizers
may be needed if dressings are foul smelling
A sedative may be given to ensure a good night's
sleep
14. Postoperative care
• Relieving pain; During the first 24 hours after
rectal surgery, control of pain is a prime
consideration. Offer prescribed drug therapy
for pain
• Encourage to assume a comfortable position
• Put flotation pads under the buttocks when
sitting help to decrease the pain, as may ice
and analgesic ointments
• Apply warm compresses to promote
circulation and soothe irritated tissues
15. • Sitz baths taken three or four times each day
can relieve soreness and pain by relaxing
sphincter spasm
• Use of topical anesthetic agents twenty-four
hours after surgery may be beneficial in
relieving local irritation and soreness.
Medications may include topical anesthetics (ie,
suppositories), astringents, antiseptics,
tranquilizers, and antiemetics. patients are more
compliant and less apprehensive if they are free
of pain
• Wounds care; Inspected daily during
hospitalization, usually five days.
16. • Encourage diet that promote wound healing
include high in proteins and vitamins, relatively
low in carbohydrates and in saturated fats, and
supplemented by 500 mg. ascorbic acid daily
17. Prevention of Infected Hemorrhoid
Seek medical treatment as soon as symptoms are
experienced
Maintain good person hygiene after each bowel
movement, washing with mild soap and water and
soaking in a warm sitting bath
Following medical advice to make sure the treatment is
effective, and to reduce chances of an infection
Complete prescribed entire course of antibiotics after a
procedure
Increase intake of high-residue diet that contains fruit
and bran along with an increased fluid intake to
promote the passage of soft, bulky stools to prevent
straining
