Conservative treatment
Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids
Stool softeners (psyllium), high-fiber diet, topical analgesics
Avoid laxatives causing liquid stool (can lead to cryptitis and anal sepsis)
Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)
Outpatient surgical referral
Prolapsed hemorrhoid in patient with minimal symptoms can be manually reduced
Emergent surgical consultation and intervention is indicated for:
Continued and severe bleeding
Incarceration and/or strangulation (grade 4 hemorrhoids)
Intractable pain
Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids
Stool softeners (psyllium), high-fiber diet, topical analgesics
Avoid laxatives causing liquid stool (can lead to cryptitis and anal sepsis)
Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)
Outpatient surgical referral
Prolapsed hemorrhoid in patient with minimal symptoms can be manually reduced
Continued and severe bleeding
Incarceration and/or strangulation (grade 4 hemorrhoids)
Intractable pain
When prolapse occurs may develop mucous discharge and pruritus ani
If prolapse cannot be reduced progressive edema and strangulation may result
Other complications: severe bleeding, thrombosis, infarction, gangrene, sepsis
If prolapse cannot be reduced progressive edema and strangulation may result
Other complications: severe bleeding, thrombosis, infarction, gangrene, sepsis
Internal hemorrhoid
Anal fissure
External hemorrhoid
Anal fistula
Anal malignancy
Rectal prolapse
Anal tags
Anorectal abscess