conditions hemorrhoids

RECND584

Hemorrhoids

Condition:Hemorrhoids
Other:Piles
ICD-10 Codes:I84

Naturopathic Treatments

Lifestyle
• use moist toilet paper or towelettes
• do not strain
• increase exercise (promotes regularity)
• avoid standing or sitting too long

Diet
• eat breakfast
• increase soluble fiber
• increase water intake
• avoid spicy food (e.g. cayenne)

Specific Foods
• oatmeal - soluble fiber

Topical Applications
• cold compress
• sitz bath
• honey, olive oil & beeswax
witch hazel (Hamamelis virginiana) pads
chamomile (Matricaria recutita)
marigold (Calendula officinalis)

Botanicals (internal & external)
• psyllium (Plantago ovata)
horsechestnut (Aesculus hippocastanum)
butcher's broom (Ruscus aculeatus)
gotu kola (Centella asiatica)
ginkgo (Ginkgo biloba)

Supplements
• pycnogenol (Maritime pine bark) - mixture of phenolic compounds
• bioflavonoids

Conventional Treatments

analgesics (acetaminophen, ibuprofen)

Surgical interventions:
• prolapsed hemorrhoids may be surgically reduced or relieved from swelling
• thrombosed hemorrhoids need to be treated with surgical removal if swelling and pain are significant

Signs & Symptoms

• painless bleeding (non-severe)
• bright-red blood on outside of stool, or on toilet paper
• may develop into prolapsed (external) hemorrhoids in which internal hemorrhoids extend through the anus and can be felt/seen from outside the anus;
• thrombosed hemorrhoids: when a blood clot occurs in the hemorrhoid, leading to more swelling and pain;
• pruritus ani (anal itching) may occur with prolapsed hemorrhoids

DDx

• fissures
• anal or rectal fistulae
• anal abscesses
• rectal prolapse
• perianal hematoma
• anal tags
• polyps
warts or condylomas

Pathogenesis

• associated with straining movements e.g. constipation, pregnancy;
• voluntary valsalva/downward movements lead to increased pressure in hemorrhoid veins, swelling and inflammation;

Diagnostics

• DRE reveals no abnormalities; internal hemorrhoids are too soft to be felt
• visual confirmation of external hemorrhoids
• history of constipation or any event associated with straining movements
• presentation of clinical symptoms (e.g. bright coloured blood)

Diagnostic Tests
• visual examination of anus
• DRE: to assess for abnormalities
• anoscopy: allows anal and lower rectum visualization
• CBC in cases of severe blood loss

References

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