Hemorrhoids

Question 1

What are some patient factors that warrant referral to MD in patients with hemorrhoids ?

Answer 1

Under 12
Pregnant with severe symptoms
At risk for colorectal cancer (Over 50 with new onset of symptoms, IBD, Family history with colorectal cancer)

Question 2

What are some red flags in hemorrhoids?

Answer 2

Black, tarry stool or blood mixed with stool
Rectal bleeding over 6-8 weeks
Severe pain
Frequent episodes of bleeding hemorrhoids
Unexplained weight loss
Protrusion requiring replacement
Symptoms not improved despite 7 days treatment

Question 3

What are some typical symptoms associated with hemorrhoids?

Answer 3

Anal pruritis, burning or swelling, with or without pain
Bright red blood during/following defecation
Straining with defecation
Constipation or diarrhea
Palpable lump

Question 4

What are some treatments for hemorrhoids?

Answer 4

Fiber is first line (it does not provide acute relief)

OTC or Rx combination product (Anusol)