Chapter 29 Hemorrhoids INTRODUCTION Description: A hemorrhoid is a symptomatic dilation of the hemorrhoidal venous plexus resulting in perianal swelling, itching, pain, hematochezia, and fecal soiling. Prevalence: Fifty percent to 80 percent of all Americans. Predominant Age: Adult, more common after pregnancy. Genetics: No genetic pattern. ETIOLOGY AND PATHOGENESIS Causes: Dilated rectal venous plexus with varying degrees of inflammation. Risk Factors: Pregnancy, obesity, chronic cough, constipation, heavy lifting, sedentary work or lifestyle, hepatic disease, colon malignancy, portal hypertension, loss of muscle tone resulting from age, surgery, episiotomy, anal intercourse, or neurologic disease (multiple sclerosis). CLINICAL CHARACTERISTICS Signs and Symptoms • Rectal bleeding • Anal protrusion • Anal itching and pain (especially with thrombosis or ulceration) • Constipation and straining for bowel movement • Rectal incontinence and soiling • Hematochezia and stool mucus • Anal fissure, infection, or ulceration • Hemorrhoidal thrombosis DIAGNOSTIC APPROACH Differential Diagnosis • Colon cancer • Colon polyps • Soiling caused by loss of anal tone (anal intercourse, multiple sclerosis, episiotomy) • Pinworms • Rectocele • Fecal impaction • Anal fissure or fistula Associated Conditions: Liver disease, pregnancy, portal hypertension, and constipation. Workup and Evaluation Laboratory: No evaluation indicated. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Health Maintenance: Ages 65 Years and Older Urinary Incontinence: Bypass, Overflow Acne Inversa (Hidradenitis Suppurativa) Breast: Intraductal Papilloma Stay updated, free articles. Join our Telegram channel Join Tags: Netters Obstetrics and Gynecology Jun 6, 2016 | Posted by admin in GYNECOLOGY | Comments Off on Hemorrhoids Full access? Get Clinical Tree
Chapter 29 Hemorrhoids INTRODUCTION Description: A hemorrhoid is a symptomatic dilation of the hemorrhoidal venous plexus resulting in perianal swelling, itching, pain, hematochezia, and fecal soiling. Prevalence: Fifty percent to 80 percent of all Americans. Predominant Age: Adult, more common after pregnancy. Genetics: No genetic pattern. ETIOLOGY AND PATHOGENESIS Causes: Dilated rectal venous plexus with varying degrees of inflammation. Risk Factors: Pregnancy, obesity, chronic cough, constipation, heavy lifting, sedentary work or lifestyle, hepatic disease, colon malignancy, portal hypertension, loss of muscle tone resulting from age, surgery, episiotomy, anal intercourse, or neurologic disease (multiple sclerosis). CLINICAL CHARACTERISTICS Signs and Symptoms • Rectal bleeding • Anal protrusion • Anal itching and pain (especially with thrombosis or ulceration) • Constipation and straining for bowel movement • Rectal incontinence and soiling • Hematochezia and stool mucus • Anal fissure, infection, or ulceration • Hemorrhoidal thrombosis DIAGNOSTIC APPROACH Differential Diagnosis • Colon cancer • Colon polyps • Soiling caused by loss of anal tone (anal intercourse, multiple sclerosis, episiotomy) • Pinworms • Rectocele • Fecal impaction • Anal fissure or fistula Associated Conditions: Liver disease, pregnancy, portal hypertension, and constipation. Workup and Evaluation Laboratory: No evaluation indicated. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Health Maintenance: Ages 65 Years and Older Urinary Incontinence: Bypass, Overflow Acne Inversa (Hidradenitis Suppurativa) Breast: Intraductal Papilloma Stay updated, free articles. Join our Telegram channel Join Tags: Netters Obstetrics and Gynecology Jun 6, 2016 | Posted by admin in GYNECOLOGY | Comments Off on Hemorrhoids Full access? Get Clinical Tree
