Hemorrhoids

00:01 Hemorrhoids. And what are hemorrhoids? These are enlargements, varicosities of the venous plexus.

00:09 There would be two types as the picture shows here.

00:12 The internal and the external.

00:14 The internal as a rule of thumb tends to be painless whereas the external tends to be painful.

00:22 You must be paying attention to the pectinate line anatomically.

00:26 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.

00:35 Now the internal hemorrhoids at times could actually then prolapse.

00:40 Keep that in mind. And may actually look like external hemorrhoids.

00:44 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.

01:01 With the hemorrhoids, at some point in time especially the external, may then give the patient extreme discomfort.

01:11 Diagnosis: Visual examination.

01:14 Management: You allow for the patient to sit in a sitz bath.

01:18 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].

01:31 Salt water takes care of inflammation, sitz baths is taking care of the inflammation of hemorrhoids.

01:38 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.

01:52 With high fiber, you can perhaps even prevent colorectal cancer.

01:56 Surgery for refractor cases and we have sigmoidoscopy taking place where you go in and then you will be cauterizing.