Hemorrhoid


Hemorrhoids Overview
External Internal
Non-Thrombosed Thrombosed Rubber Band Ligation
  < 48 hr > 48 hr
  Elliptical excision - Sitz bath
- Bulk Laxative
-Loval Analgesics

Pathophysiology

Diagnosis

Differential Diagnosis

Treatment

  1. Local & nonsurgical usually
  2. Sitz baths 15min TID
  3. After BM
  4. +/- on topical abxs, steroids, or anesthetics (i.e., Anusol)
  5. Avoid bulk laxatives
  6. Stool softeners, add bran/roughage to diet after acute phase
  7. Thrombosed hemorrhoids
  8. Surgery referral for continued bleeding, incarceration/strangulation, intractable pain

Disposition

  1. Home if pain or procedure tolerable
  2. Admit if cont bleed or need more definitive procedure