Hemorrhoids:
Definition:
- Swollen and inflamed blood vessels in the rectum or anus.
Causes:
- Chronic constipation or diarrhea.
- Straining during bowel movements.
- Pregnancy.
- Obesity.
- Prolonged sitting or standing.
- Low-fiber diet.
Types:
1. Internal hemorrhoids: Located inside the rectum, usually painless.
2. External hemorrhoids: Located under the skin around the anus, can be painful.
Pathophysiology:
- Increased pressure on the rectal veins causes them to swell.
- Weakness in the connective tissue supporting the veins.
- Straining during bowel movements exacerbates the condition.
Signs & Symptoms:
- Bright red blood in the stool or on toilet paper.
- Itching or irritation around the anus.
- Pain or discomfort during bowel movements.
- Swelling or lump around the anus.
Diagnostic Evaluation:
- Physical examination of the anus and rectum.
- Digital rectal examination.
- Sigmoidoscopy or colonoscopy to assess internal hemorrhoids.
- Anoscopy for a closer examination of the anal canal.
Pharmacology Management:
- Topical creams or ointments containing hydrocortisone to reduce inflammation and itching.
- Suppositories with astringents or anesthetics for symptom relief.
- Fiber supplements or stool softeners to prevent constipation.
Non-Pharmacology Management:
- Increasing fiber intake through diet to soften stools and reduce straining.
- Drinking plenty of fluids to avoid dehydration.
- Regular exercise to improve bowel function.
- Avoiding prolonged sitting or standing.
- Warm baths (sitz baths) to soothe the area.
Nursing Management:
- Assessment of symptoms and discomfort levels.
- Educating the patient about dietary changes and fluid intake.
- Encouraging regular exercise and promoting mobility.
- Providing comfort measures like sitz baths or ice packs.
- Monitoring and managing potential complications like bleeding.
Nursing Diagnosis:
- Acute Pain related to inflammation and swelling.
- Constipation related to inadequate dietary fiber.
- Risk for Impaired Skin Integrity related to itching and scratching.