Haemorrhoids

Subject: Midwifery III (Theory)

Overview

A hemorrhoid is the engorgement of an anus's superficial veins. During pregnancy, the growing uterus puts pressure on the bladder and rectum, preventing them from producing circulation and obstructing venous return, resulting in hemorrhoids, which is a puerperium condition. Hemorrhoids easily leak fresh blood after feces, which may be followed by proplases, which first appear during stool passage. It is sometimes referred to as Piles. External hemorrhoids, internal hemorrhoids, and internal-external hemorrhoids are the three types of hemorrhoids. Fresh bleeding from the anus, previously painless but now painful and bleeding, bleeding may be visible or not visible, intense anal itching or burning, and so on.

A hemorrhoid is the engorgement of an anus's superficial veins. During pregnancy, the growing uterus puts pressure on the bladder and rectum, preventing them from producing circulation and obstructing venous return, resulting in hemorrhoids, which is a puerperium condition. Hemorrhoids easily leak fresh blood after feces, which may be followed by proplases, which first appear during stool passage. Prolapse happens more easily on extremely light exertion as the anal sphincter becomes less resistive. It is sometimes referred to as Piles.

Types of Hemorrhoids

  1. External Hemorrhoids: Hemorrhoids can be external or distal to the anal sphincter.
  2. Internal Hemorrhoids: Hemorrhoids close to the anal sphincter.
  3. Interno-external Hemorrhoids: Both hemorrhoids could be present at the same time.

Stages or Degree of Hemorrhoids

There are 4 stages or degrees of hemorrhoids. They are:

  1. First-degree Piles: Piles that bleed but do not protrude from the anal hole.
  2. Second-degree Piles: Pile prolapses during stool passage, but they remit (pull back) on their own.
  3. Third-degree Piles: As the condition worsens, the piles do not diminish on their own and must be manually replaced.
  4. Fourth-degree piles: In advanced situations, the Piles may prolapse at any time of day (even without the passage of stool), particularly if the person is weary or exerts himself. These Piles remain prolapsed indefinitely.

Causes

  • Constipation for a long time
  • During labor, the fetus's head compresses the blood vessels of the anal canal.
  • Standing and sitting for an extended amount of time

Signs and Symptoms

  • The anus is still bleeding.
  • Initially painless, it is now painful and bleeding.
  • Bleeding can be obvious or hidden.
  • Itching anal or difficulty defecating

Medical Management

  • Localized care
  • Hot and cold compresses are used.
  • An analgesic ointment is used to relieve discomfort and reduce swelling around external and internal hemorrhoids.
  • To alleviate pain, a Sitz bath is administered.
  • A stool softener is administered to avoid constipation and to reduce discomfort during feces.
  • Symptomatic therapy
  • Personal cleanliness is essential.
  • Drink more fluids.
  • Excessive straining should be avoided during defecation.

Surgical Treatment

  • After surgical haemorrhoidectomy
  • To stop the bleeding, a pressure dressing and an ice pack are used.
  • Stool softeners and sitz baths are advised.
  • Internal ligation can be addressed by vascular ligation.

Nursing Management

  • To relieve pain, provide a sitz bath.
  • To alleviate discomfort, keep your surroundings clean.
  • Avoid taking food-containing species.
  • Manage or avoid constipation by defecating on time, drinking enough fluids, and including fiber-rich foods in your diet.
  • Give mother easily digestible, light, nourishing food.
  • Encourage people to walk.

Patient Teaching

  • Until healing is complete, clean the rectal area after each defecate.
  • To avoid constipation, eat a high-fiber diet and drink enough fluids.
  • Regular exercise and regular bowel movements are especially crucial throughout the post-operative period.
  • Check for rectal bleeding and notify the surgeon immediately if it occurs.
Things to remember
  • Hemorrhoid is the engorgement of an anus's superficial veins.
  • During pregnancy, the growing uterus puts pressure on the bladder and rectum, preventing them from producing circulation and obstructing venous return, resulting in hemorrhoids, which is a puerperium condition.
  • Hemorrhoids easily leak fresh blood after feces, which may be followed by proplases, which first appear during stool passage.
  • It is sometimes referred to as Piles.
  • External hemorrhoids, internal hemorrhoids, and internal-external hemorrhoids are the three types of hemorrhoids.
  • Fresh bleeding from the anus, formerly painless but now painful and bleeding, bleeding may be apparent or not visible, intense anal itching or difficulty defecating, and so on.
Questions and Answers

The engorgement of superficial veins of an anus is known as hemorrhoid . During pregnancy, increasing uterus give pressure to the bladder as well as rectum, the pelvic vein is pressed by it so they are unable to generate circulation and venous return is occluded and cause hemorrhoids so it is one of the disorder of puerperium.

Types of Hemorrhoids

  1. External Hemorrhoids: Hemorrhoids may be external that is distal to anal sphincter.
  2. Internal Hemorrhoids: Hemorrhoids that is proximal to anal sphincter.
  3. Interno-external Hemorrhoids: Both of the hemorrhoids may be present at the same time.

Stages or degree of Hemorrhoids

There are 4 stages or degree of hemorrhoids. They are :

  1. First degree Piles: Piles that bleed but do not bulge out of the anal opening.
  2. Second degree Piles: Piles may prolapse during the passage of stool but they recede (draw back) on their own.
  3. Third degree Piles: As the disease progresses the piles do not recede back on their own and have to be replaced by hand.
  4. 4. Fourth degree piles: In advance cases the Piles may prolapse anytime of the day (i.e. even with out the passage of stool) especially if the person is tired or exerts himself. These Piles remain permanently prolapsed.

Medical management

  • Local treatment
  • Application of hot and cold compress.
  • Analgesics ointment is given temporarily to relief pain and reduce edema around external and internal hemorrhoid.
  • Sitz bath is given to relief pain.
  • Stool softener is given to prevent constipation and to decrease irritation during defecation.
  • Symptomatic treatment
  • Good personal hygiene.
  • Increase fluid intake.
  • Avoid excessive straining during defecation.

Surgical treatment

  • Haemorrhoidectomy: after surgery
  • The pressure dressing and icepack are applied to lessen the bleeding.
  • Stool softener and sitz baths are recommended.
  • ligation: internal ligation may be treated by ligation of vessels.

Nursing management

  • Provide sitz bath to relive pain.
  • Maintain cleanliness to relive discomfort.
  • Avoid to take species, sweat containing food.
  • Manage appropriate measures for constipation or avoid constipation by timely defecation, plenty of fluid intake, fibers food in diet.
  • Give digestible, light nutritious food to mother.
  • Encourage for ambulation.

Patient teaching

  • Clean rectal area after each defecation until healing is complete.
  • Give higher fiber diet and high fluid and intake to avoid constipation.
  • Regular exercise and regular time for passing stool is most important during post operative periods.
  • Check for rectal bleeding and inform surgeon immediately in case of bleeding occurs.

 

 

Signs and Symptoms

  • Fresh bleeding from the anus.
  • Earlier painless but in severity, it is painful and bleeding.
  • Bleeding may be visible or non visible.
  • Heavy anal itching or difficult to defecate.

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