Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.

1. Haemorrhoid
Prepared by
Mr. Abhay Rajpoot
HOD (Dep. of Medical Surgical)
abhayrajpoot5591@gmail.com

2. INTRODUCTION
Haemorrhoids also called piles, are swollen veins in your
anus and lower rectum, similar to varicose veins.
Haemorrhoids can develop inside the rectum (internal
haemorrhoids) or under the skin around the anus (external
haemorrhoids)

4. Hemorrhoids
Hemorrhoids
Hemorrhoids are
painful, swollen veins
in the lower portion
of the rectum or
anus.

6. Pathophysiology
• Hemorrhoid cushions are a part of normal human
anatomy and only become a pathological disease
when they experience abnormal changes.
• There are three cushions present in the normal
anal canal.
• They are important for continence, contributing
to at rest 15-20% of anal closure pressure and act
to protect the anal sphincter muscles during the
passage of stool.

7. Causes
• Straining during bowel movements
• Constipation
• Sitting for long periods of time
• Anal infections
• Pregnancy
• Certain diseases such as liver cirrhosis
• Obesity
• Genetics
• Low fiber diet

8. Types
There are two types of
hemorrhoids i.e.
• Internal hemorrhoids
occur just inside the
anus, at the beginning of
the rectum
• External hemorrhoids
occur at the anal opening
and may hang outside
the anus

9. Sign and symptoms
External haemorrhoids
•Itching or irritation in your anal region
•Pain or discomfort
•Swelling around your anus
•Bleeding
Internal haemorrhoids
•Painless bleeding during bowel movements. You might notice
small amounts of bright red blood on your toilet tissue or in the
toilet.
•A hemorrhoid to push through the anal opening (prolapsed or
protruding hemorrhoid), resulting in pain and irritation.

10. Diagnostic Evaluation
• Visual examination
• Anoscopy
• Endoscopic image
• Sigmoidoscopy

11. Treatment
 Conservative Treatment
•
•
Increase dietary fiber
Oral fluids
• NSAID
•
•
•
Sitz bath
Rest
Steroids ointments or creams

12. Conti…
 Fixative Procedures
The goal of nonsurgical procedures
used to treat hemorrhoids is called fixative procedures.
 Hemorrhoidectomy
Surgical removal of hemorrhoid is
called hemorrhoidectomy.

13. Rubber band ligation of hemorrhoid

14. Prevention
•
•
Drink plenty of water, at least eight glasses
per day
Eat high fiber diet of fruits, vegetables, and
whole grains
• Empty bowels as soon as possible after the
urge occurs
• Regular exercise

15. Nursing Diagnosis for Hemorrhoids
• Pain (acute or chronic) related to rectal
swelling
• Constipation related to ignore the urge to
defecate due to pain during defecation
• Anxiety related to plan surgery
• Impaired Urinary Elimination related to the
fear of postoperative pain.

16. Conti….
• Risk for infection related to inadequate
primary defenses.
• Deficient knowledge related to the lack of
information about home care.

17. Nursing Intervention for
Hemorrhoids
• As needed, provide warm sitz baths to reduce
local pain and swelling
• Check for signs and symptoms of anal
infection, such as increases pain and foul
smelling anal drainage.
• Teach the patient about hemorrhoidal
development, predisposing factors, and tests.

18. Conti…
• Emphasize the need for good anal hygiene.
• Encourage the use of toilet paper without
dyes or perfumes.
• Provide the patient with high fiber diet and
encourage adequate fluid intake and exercise
to prevent constipation.

19. Conti….
• Prepare the patient for surgery if necessary
• Monitor the patient’s pain level and the
effectiveness of the prescribed medications.