hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx

HEMMRRHOIDS

1. HEMORRHOIDS PRESENTED BY:- APURVA DWIVEDI

2. DEFINATION Haemorrhoids Are the dilated portion of haemorrhoidal veins in the anal canal. It may be : INTERNAL – occur above the internal sphincter. EXTERNAL – occur outside the external sphincter.

3. Stages Of The Hemorrhoids

4. 1 Stage:  Hemorrhoid Nodes Are Slightly Enlarged, But Not Exposed To The Anus. Patients Usually Complain Of Tingling And Itching In The Area Of The Anus, And Also Bleed. 2 Stage:  Hemorrhoid Nodules Are Significantly Increased, Dark Blue In Color And Very Painful. When Strain And Performance Of Defecating. 3 Stage:  Hemorrhoid Nodules Are Constantly Visible. With Slight Hand Pressure, They Can Return To Its Former Position. 4 Stage : All Other Condition Are Present. Have Blood Clot. Thrombosed Hemorrhoid Are Formed.

5. Causes Of Haemorrhoid's Weaken supportive tissue. Straining during defecation Prolonged sitting & standing. Obesity Pregnancy Heavy lifting Portal hypertension Constipation

6. PATHOPHYSIOLOGY

7. CLINICAL MANIFESTATION Bright red bleeding, pruritis, prolapse & pain. Internal hemorrhoids may be asymtomatic but when internal hemorroid become constricted or enlarge bleeding & prolapse occur, patient will report chronic dull pain. Blood on toilet paper or out side of stool after defecation. External hemorrhoids reddish, blue seldom bleed, pain on palpation, itching, burning, intermitten pain.

8. DIAGNOSTIC EVALVATION

9. Management High fiber diet & increase fluid intake Hydrophillic bulk forming agent. Mucilloid may be help Anti inflammatory agent or astringent, suppositories & anesthetic may be used to shrink the mucous membranes. Stool softener to keep stool soft Sitz bath& warm compress to relieve pain Exercise help to relieve constipation Natural fiber underwear

10. Non Surgical Treatment Rubber band ligation to remove necrotic tissue Infrared coagulation to stop bleeding Cryotherapy rapid freezing the haemorrhoids Laser treatment to affix the mucosa in the under lying muscle. Sclero therapy: is the inserting the solution directly to haemorrhoidal tissue.

11. SURGICAL MANAGEMENT Anal dilation : anal sphincter muscle is stretched or dilated to reduce straining to pass the stool Stapled hemorrhoidectomy : uses a special device to internally staple & excise internal hemorrhoidal tissue. Hemorrhoidectomy : is the surgical excision of haemorrhoid when there is prolapsed.

12. NURSING MANAGEMENT Teaching measures to prevent constipation. Avoidance of prolonged standing or sitting Proper use of OTC drugs Need to seek medical care if symptom severe Sitz bath 2 to 3 times each day for 7 to 10 days. Keep anal area clean packing may be inserted into the rectum to absorb drainage. T-binder may hold the dressing in place. Assess for rectal bleeding Privacy should be provided Pain medication may be given before bowel movement. Regular check up is important.

13. Home Remedies Fruits & vegetables: reddish/ carrot/ lemon/ spinach/ mint leave

14. Onion

15. Bitter Ground

16. Sesame Seed/ Till

17. Figs

18. Coriander Seeds

19. THANK YOU