Hemorrhoids, also known as piles, are swollen veins located around the anus or in the lower rectum.

1. TOPIC :
HEMORROIDS

2. DEFINITION
• Hemorrhoids (HEM-uh-roids), also called piles,
are swollen veins in anus and lower rectum,
similar to varicose veins. Hemorrhoids can
develop inside the rectum (internal
hemorrhoids) or under the skin around the
anus (external hemorrhoids).

3. EPIDEMIOLOGY
• Symptomatic hemorrhoids are thought to
affect at least 50% of the population at some
time during their lives, and around 5% of the
population is affected at any given time. Both
sexes experience about the same incidence of
the condition, with rates peaking between 45
and 65 years.
• They are more common in those of higher
socio-economic status.

5. CLASSIFICATION
✓ Internal hemorrhoids—Situated above the
pectinate line.
✓ External hemorrhoids—Situated below the
pectinate line.
✓ Internoexternal hemorrhoids— Situated both
above and below the pectinate line.

8. DIFFERENTIAL DIAGNOSIS
• Anal Fissures
• Solitary Rectal Ulcer Syndrome
• Colorectal And Anal Cancer
• Rectal Prolapse
• Polyps

9. DIAGNOSIS
• Physical examination.
• Proctoscopy.
• Flexible sigmoidoscopy
• Evaluation under anaesthesia in acute pain
• Anal manometry
--If h/o soiling & incontinence

10. CONSERVATIVE TREATMENTS
• High fiber diet to reduce constipation.
• Oral or local analgesics to treat pain.
• Topical steroids agents to reduce local swelling
or treat contact dermatitis (hydrocortisol).
• Therapies to reduce sphincter spasm.
• Venoactive agents to increase venous tone of
hemorrhoidal tissues.
• Sitz baths also help to relieve irritation and
pruritus.
• Change of toilet habits.

11. HOMOEOPATHIC MANAGEMENT
• Aesculus hippocastanum
When this remedy is needed, hemorrhoids are
sore and aching, with a swollen feeling. Pain may
last for hours after the bowels have moved.
People who need this remedy often have the
sensation of a lump, or a feeling that a lot of
small sharp sticks are inside the rectum, poking
them. Sharp and shooting pains may be felt in the
rectum and back. A person who needs this
remedy may also have low back problems.

12. • Nux vomica
Relieves hemorrhoids caused by a sedentary
lifestyle, and overeating and drinking, especially
of spicy and rich foods and alcohol.
• Pulsatilla Nigricans
When this remedy is indicated, hemorrhoids are
itchy and uncomfortable, with sticking pains.
They are likely to protrude, with improvement
after lying down. Warmth often aggravates the
symptoms. This is a very helpful remedy for
hemorrhoids that appear during pregnancy or
around the menstrual period.

13. • Aloe Socotrina
Hemorrhoids that are swollen and protrude "like
a bunch of grapes" and are soothed by cold soaks
or compresses may be helped with this remedy.
Hemorrhoids may alternate with diarrhea, and
the person may have a lot of flatulence.
• Graphites
Relieves constipation without urges, very large
and dry stools, with feeling of heaviness in the
lower abdomen, and often associated with anal
itching and burning and hemorrhoids.