KEDOKTERAN DAN

ILMU KESEHATAN

INTERNAL
HEMORRHOID
GRADE IV
M.Fatha Hernanda
20234010002
Clinical Educator Doctor

Dr. Welman Pramudyananta, M.Si, Med, Sp.B

Program Studi Pendidikan Profesi Dokter

Fakultas Kedokteran dan Ilmu Kesehatan
Universitas Muhammadiyah Yogyakarta
2023
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DEFINITION
HEMOROID :
Hemorrhoids is widening and
inflammation of the plexus functioning
arteries and veins in the anal canal as a
valve to prevent incontinence flatus and
fluid. Hemorrhoids are divided into
two, namely external hemorrhoids in
the form of widening subcutaneous
veins below or beyond the dentate line
while internal hemorrhoids are
enlarged submucosal vein above the
dentate line.
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ETIOLOGI

1. Idiopatic :
– Hereditary
– Anatomy
– Things that increase intra-abdominal pressure
2.Obstruction of Portal circulation :
– Sirocis hepatic
– Portal Vein Obstruction
– Intraabdominal Tumor
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EXTERNAL/INTERNAL HEMORRHOIDS
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INTERNAL HEMORRHOIDS CLASSIFICATION

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DIAGNOSE
• Anamnesis
• Physical Examination
-Inspection
-palpation ( Rectal Toucher)
• Supportive Examination
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Risk Factors
1. Low Fiber Diet
2. Constipation
3. Elderly
4. Heavy Physical Activity
5. Pregnancy
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Treatments
OPTION 1 : therapeutic abstention : If the discomfort is minim
and if there is no pain described by the patient.

OPTION II : education + medical treatment : Exercises,

transit regulation (fibers, laxatives),analgesics/NSAI if the patient
feels pain, topicals, baths.

OPTION III : instrumental treatment : Infrared

photocoagulation, elastic ligation and sclerosis.

OPTION IV : surgical procedure : hemorrhoidectomy

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PREVENTION
1. High consumption of fiber
2. Drink 6-8 glasses of water a day
3. Changing defecation habits
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Complications of Internal Hemorrhoids

Prolapsus Bleeding
Internal hemorrhoids can Internal hemorrhoids
push through the anal most commonly cause
opening. They can produce painless bleeding during
perianal pain by causing defecation or after. The
spasm of the sphincter covering epithelium is
complex around the damaged by the bowel
hemorrhoids.This spasm movement. Rarely, blood
also results in muscle loss from hemorrhoids
discomfort which is may cause anemia.
relieved with reduction. A
strangulation with necrosis
can also happen and cause
extreme pain
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TERIMAKASIH