Haemorrhoids and Anal Fissures Flashcards
1
Q
what is anal fissures
A
tear/ulcer in anal canal
2
Q
what does anal fissures cause
A
bleeding + pain on defecation
3
Q
anal fissures acute tx
ensure stools pass easily to help with pain
A
- bulk-forming or osmotic laxative
- short term topical = local anaesthetic (lidocaine) or analgesia
4
Q
anal fissures chronic tx
A
- 6WK+ = GTN rectal (high headache s.e)
- topical/oral diltiazem or nifedipine (less s/e)
- specialist = botulinum toxin type A
- surgery - when no response to drug tx
5
Q
what is haemorrhoids
A
swelling of vascular mucosal anal cushions around anus
6
Q
internal haemorrhoid symptoms
A
painless
7
Q
external haemorrhoid symptom
A
itchy and/or painful
8
Q
haemorrhoids tx
A
- increase dietary fibre + fluid or bulk-forming laxative
- pain = paracetamol
- pain + itching = topical preparations (anaesthetics, corticosteroids, lubricants, antiseptics)
9
Q
aim of tx in haemorrhoid
A
maintain easy stools to minimise straining
10
Q
why is opioids and NSAIDs not given in haemorrhoids
A
- opioids cause constipation
- NSAIDs exacerbate rectal bleeding
11
Q
duration of topical anaesthetics e.g. lidocaine
A
few days
12
Q
duration of topical corticosteroids
A
no more than 7DY due to s/e
13
Q
tx of haemorrhoids in pregnancy
A
- bulk-forming laxatives
- no topical tx only simple soothing prep if needed
14
Q
what is a high risk during pregnancy
A
haemorrhoids
