TOPIC :HEMORRHOIDS 

Faculty :Ayub khan

Presentation by :Group: A
Group leader: Sibghatullah
Group members:
Ghulam Raza Yogeshwar
Objectives
At the end of this presentation the learners will be able to:
Define hemorrhoids.
•
• Describe Pathophysiology of hemorrhoids.
•
• Identify types of hemorrhoids.
• Enlist signs, symptoms and causes of hemorrhoids.
•
• Explain medical diagnosis and treatment.
Definition of Hemorrhoids
Hemorrhoids are painful, swollen veins in the lower portion of
the rectum or anus.
 PATHOPHYSIOLOGY
■ Hemorrhoids located in the wall of the rectum
and anus. are dilated, twisted (varicose) veins
■ Hemorrhoids occur when the veins in the rectum
or anus become enlarged; they may eventually
bleed.
■ Hemorrhoids may also become inflamed or may
develop a blood clot (thrombus). They are also
known as piles.
■ The vessels of the anal cushions swell and the
supporting tissues increase in size.
Etiology
■ Hemorrhoids may be caused by:
• Straining during bowel movements
• Constipation
• Sitting for long periods of time
• Anal infections
• Pregnancy
• Certain diseases such as liver cirrhosis
• Obesity
• Genetics
• Low fiber diet
Classification
Depending on anal origin within anal canal
& relation to dentate line hemorrhoids
divided into:

1. Internal hemorrhoids
2. External hemorrhoids
• Internal hemorrhoids occur just
inside the anus, at the
beginning of the rectum
• External hemorrhoids occur at
the anal opening and may hang
outside the anus
Sign & symptoms

• Anal itching
• Rectal pain
• One or more hard tender lumps near the anus
• Bleeding
Physical examination
Investigation
Conservative Treatment
Increase dietary fiber
•
• Oral fluids
•
• NSAID
•
• Sitz bath
•
• Rest
•
Non-surgical
Hemorrhoidectomy

Surgical removal of hemorrhoid is called hemorrhoidectomy.

Prevention
• Drink plenty of water, at least eight glasses per day.
• Eat high fiber diet of fruits, vegetables, and whole grains.
• Empty bowels as soon as possible after the urge occur.
• Regular exercise.
 Nursing diagnosis For Hemmorrhoids
• Pain (acute or chronic) related to rectal swelling.
• Constipation related to ignore the urge to defecate due to pain
during defecation
•
• Anxiety related to plan surgery
•
• Impaired Urinary Elimination related to the fear of
postoperative pain
• Risk for infection related to inadequate primary defenses.
• Deficient knowledge related to the lack of information about
Nursing intervention For hemmorrhoids
As needed, provide warm sits baths to reduce local pain and
swelling
•
• Check for signs and symptoms of anal infection, such as
increases pain and foul smelling anal drainage.
•
• Teach the patient about hemorrhoidal development,
predisposing factors, and tests.
• Emphasize the need for good anal hygiene.
Conti…
Encourage the use of toilet paper without dyes or perfumes.
•
• Provide the patient with high fiber diet and encourage
adequate fluid intake and exercise to prevent constipation
• Prepare the patient for surgery if necessary
• Monitor the patient’s pain level and the effectiveness of the
prescribed medications
References

■ https://www.slideshare.net/vidyaveer/hemorrhoids-2
■ Dozois EJ, Pemberton JH (2006). Hemorrhoids and other
anorectal disorders. In MM Wolfe et al., eds., Therapy of
Digestive Disorders, 2nd ed., pp.
■ 945-958. Philadelphia: Saunders Elsevier.
■ Hull TL (2006). Hemorrhoids section of Diseases of the
anorectum. In M Feldman et al., eds., Sleisenger and
Fordtran’s Gastrointestinal and Liver Disease, 8th ed., vol. 2,
pp. 2833-2852. Philadelphia: Saunders Elsevier.