Hemorrhoids. And what are hemorrhoids?
These are enlargements, varicosities of the venous plexus.
There would be two types as the picture shows here.
The internal and the external.
The internal as a rule of thumb tends to be painless
whereas the external tends to be painful.
You must be paying attention to the pectinate line anatomically.
And if you are proximal to the pectinate line
this is then referred to as being your internal hemorrhoids, and then distal to it,
this will be external hemorrhoids.
Now the internal hemorrhoids at times could actually then prolapse.
Keep that in mind. And may actually look like external hemorrhoids.
Intermittent bleeding with stool. What are the risk factor for hemorrhoids?
Once again chronic constipation, portal hypertension, and pregnancy,
all causing increase pressure therefore the varicosities.
With the hemorrhoids, at some point in time especially the external,
may then give the patient extreme discomfort.
Diagnosis: Visual examination.
Management: You allow for the patient to sit in a sitz bath.
Whenever you have inflammation in the throat
maybe perhaps you have heard about the age old resolution
of drinking salt water and gurgling. [GURGLING SOUND].
Salt water takes care of inflammation,
sitz baths is taking care of the inflammation of hemorrhoids.
If it's constipation, management here?high fiber, in general, high fiber
is preventing a lot of things, to the point where remember,
with high fiber you are preventing diverticular disease.
With high fiber, you can perhaps even prevent colorectal cancer.
Surgery for refractor cases and we have sigmoidoscopy taking place
where you go in and then you will be cauterizing.