Hemorrhoids: Difference between revisions

Line 9: Line 9:


{{Lower GI bleeding DDX}}
{{Lower GI bleeding DDX}}
==Types==
===External===
*Occur distal to dentate line
*Can be seen at external inspection
**More prominent with Valsalva
*Thrombosed hemorrhoids (bluish-purple discoloration) cause painful defecation
**Non-thrombosed hemorrhoids are usually painless
***If pt c/o pain but hemorrhoids are not thrombosed suspect:
****Perianal/intersphincteric abscesses
****Anal fissures
*Prolapse
**Requires periodic reduction by the pt
====Treatment====
#Usually self-limiting w/ resolution in 1 week
#Thrombosed:
##Consider sitz baths and bulk laxatives if:
###Thrombosis has been present >48 hr
###Swelling has started to shrink
###Pain is tolerable
##Consider excision if:
###Pt is not immunocompromised, child, pregnant woman, has portal HTN, coagulopathic
###Thrombosis is acute (<48 hr)
###Extremely painful
###See [[External Hemorrhoid Excision]]


==See Also==
==See Also==

Revision as of 12:30, 10 June 2015