Hemorrhoids
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Introduction
Hemorrhoids are vascular cushions lining the vascular canal. They are normal; everyone has them. Their function is thought to relate to anal intercourse
The Case of...
Causes and Risk Factors
- Congeintal predisposition, potentially due to CTD
- chronic constipation and straining
- anal intercourse
Pathophysiology
An external hemorrhoid can thrombose.
Internal hemorrhoids
- Grade I: dilated internal
- Grade II: dilated internal,
- Grade III:
- Grade IV:
Signs and Symptoms
- history
- physical exam
History
Bright red blood with straining, dripping into the bowl, on the outside of stool, or on the tissue
itchiness due to
pain is very common, suggesting thrombosis of the hemorrhoids
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
Consequences and Course
Lifestyle measures
High-fibre diet with adequate hydration
Medications
Steriods are contraindicated
topical creams and ointments for flares
Procedures
Banding
sclerotherapy
surgery is reserved for cases with very large grade 3 or grade 4 hemorrhoids with large external components.
The Case of...
Additional Resources
Topic Development
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