Hemmorhoids Flashcards
1
Q
definition
A
swollen or inflamed veins of the anus and lower rectum
2
Q
pathophysiology?
A
- increased intraabdominal pressure via straining, constipation, pregnancy, ascites
- leads to dilation of submucosal vascular tissue and weakening of supportive connective tissue
- lead to descent and prolapse of hemmorhoid
3
Q
what to elicit on history?
A
- bowel habits, straining
- fiber and fluid intake?
4
Q
when to refer for colonoscopy
A
- normal screening
- 40y w/ FHx of colon cancer
- Fe deficiency anemia
5
Q
Non surgical management
A
mild disease (bleeding but no prolapse)
- increased fiber intake
- sitz bath
- laxatives and stool softeners to reduce straining
- Rx topical steroids
- Rx topical lidocaine for THROMBOSED VEINS
6
Q
surgical management
A
mod-severe disease (internal hemm or acute thrombosis)
- can be office based such as rubber band ligation
- hemmorhoidectomy gen surg referral
