Hemorrhoids

 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.