Haemorrhoids – commonest cause of rectal bleeding
Haemorrhoids are also known as piles. These are enlarged vascular cushions in the lower rectum and anal canal. At least 10% of the population have symptomatic haemorrhoids at some time in their life. Haemorrhoids are the commonest cause of rectal bleeding.
Classical position:
- This is corresponds to branches of the superior haemorrhoidal artery.
- Occurring at the 3 o’clock, 7 o’clock and 11 o’clock positions with the patient in the lithotomy position.
- May be asymptomatic
- Rectal bleeding ( you might see fresh blood on toilet paper or drips of blood during defaecation)
- Rectal Prolapse
- Anal itchiness (pruritus ani)
- Anal pain (this is rare. Pain usually present if there is thrombosis)
- First degree – piles remain in the rectum but only manifest by rectal bleeding
- Second degree – piles prolapse on defaecation but will reduce spontaneously
- Third degree – piles prolapse present but require manual reduction
- Digital rectal examination
- Proctosopy – to confirm present of piles and to locate the position of the piles.
- Sigmoidoscopy – to exclude other lesions
- Barium enema – if there is any doubt what might cause the rectal bleeding
- Abdominal examination – to exclude other lesions
- Full blood count – to check for haemoglobin level if bleeding is prolonged or heavy
Treatment
- No treatment is required if patients has no symptom or the symptom is minor.
- Injection of phenol in almond oil (2-3 ml) into the submucosa above the pile. This is suitable for first degree and small second degree piles
- Rubber band ligation of piles.
- Cryosurgery
- Photocoagulation
- Haemorrhoidectomy – suitable for large second degree and third degree piles
- Thrombosed piles treated by bed rest, pain killer and ice packs. The piles may thrombose with cure. Some will remain as skin tags and need excision.
- Subsequent regulation of bowel habit with high fibre diet and bulk laxatives is required.
Complications of haemorrhoidectomy
- Acute urinary retention
- Haemorrhage
- Stricture and anal stenosis might occur if too many skin tags has been excised
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- Churchill’s Pocketbook of Surgery. Andrew T Raftery. 2nd edition. 2001.
- Clinical Medicine by Kumar and Clark. 4th edition.1998.
Tags: complication, haemorhoids, haemorrhoidectomy, health, Surgical, symptoms, treatment
Technorati Tags: complication, haemorhoids, haemorrhoidectomy, health, Surgical, symptoms, treatment
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Hi great article thanks for sharing. Is there any chemicals in a typical garage or any type of poison that could cause rectal bleeding in dogs?
Dave
Hello,
What illnesses cause long term soft stool and minor rectal pain? No bumps, other symptoms, or bleeding.?
Really great post, enjoyed reading it. Thanks,
Rob
Hi Rob, how long have you been having this symptoms?