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Hemorrhoids: 1. Chief Complaint
Hemorrhoids: 1. Chief Complaint
1. CHIEF COMPLAINT
•Hemorrhoids
2. HPI
3. ROS
4. SYMPTOMS
•Bright red blood covering the stool
•Pain
•Painful swelling or a hard lump around the anus
5. HISTORY
•FAMILY HISTORY
o Obesity
o Diabetes
o Hypertension
•SOCIAL HISTORY
•PASTMEDICAL HISTORY
o Constipation
o Diarrhea
o Premenstrual syndrome
o Menstruation
o Hypertension
o Portal hypertension
o Obesity
o Pregnancy
o Excessive consumption of alcohol or caffeine
•SURGICAL HISTORY
•CHRONIC CONDITIONS
6. ALLERGIES
7. PHYSICAL EXAMINATION
9. TESTS TO BE ORDERED
•Anoscopy
•Sigmoidoscopy
•Colonoscopy
10.ASSESSMENT /PLAN
•Rubber band ligation
•Hemorrhoidolysis/Galvanic Electrotherapy
•Sclerotherapy
•Cryosurgery
•Laser, infrared or BICAP coagulation
•Hemorrhoidectomy
•Stapled Hemorrhoidectomy
•Enema
•Doppler Guided Hemorrhoidal Artery Ligation
•HAL-RAR
•Transanal hemorrhoidal dearterialization (THD)
•Radiofrequency Coagulation
11.EDUCATION
•Drink more fluids
•Eat more dietary fiber (such as fruits, vegetables and cereals
high in fiber)
•Hemorrhoid sufferers should avoid using laxatives and should
strictly limit time straining during bowel movement.
•Washing the anus with cool water and soap may reduce the
swelling and increase blood supply for quicker healing and may
remove irritating fluid.
•Do Kegel exercises for the pelvic floor
•Avoid alcohol
•Avoid caffeine
12.MEDICATION
•Nupercainal
•Proctosedyl
•Benzocaine
•Benzyl alcohol 5% to 20%
•Dibucaine 0.25% to 1.0%
•Dyclonine 0.5% to 1.0%
•Lidocaine 2% to 5%
•Pramoxine 1.0%
•Tetracaine 0.5% to 5.0%
•Ephedrine sulfate 0.1% to 1.25%
•Epinephrine 0.005% to 0.01%
•Phenylephrine 0.25%
•Aluminum hydroxide gel
•Cocoa butter
•Glycerin
•Kaolin
•Lanolin
•Mineral oil
•White petrolatum
•Starch
•Zinc oxide or calamine
•Calamine 5% to 25%
•Zinc oxide 5% to 25%
•Witch hazel 10% to 50%
•Boric acid
•Hydrastis
•Phenol
•Benzalkonium chloride
•Cetylpyridinium chloride
•Benzethonium chloride
•Resorcinol
•Aluminum chlorhydroxy
•Allantoinate 0.2% to 2.0%
•Resorcinol 1% to 3%
•Menthol 0.1% to 1.0%
•Camphor 0.1% to 3%
•Juniper tar 1% to 5%
13.FOLLOW-UP