Gastroenterology Book

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Hemorrhoid

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  1. Definition
    1. Dilation of anorectal vessels
  2. Epidemiology
    1. Most common anorectal condition
    2. Affects 50% of patients over age 50 years
  3. Anatomy
    1. See Rectal Anatomy
    2. Positions for internal and External Hemorrhoids
      1. Right Anterior
      2. Right Posterior
      3. Left Lateral
  4. Types
    1. Internal Hemorrhoids (above Dentate Line)
    2. External Hemorrhoids (below Dentate Line)
  5. Causes
    1. Erect posture
    2. Back flow
      1. Abdominal pressure
      2. Constipation and straining at Defecation
    3. Pregnancy
    4. Diarrhea (Relative risk 2.1)
    5. Obesity (Relative risk 1.7)
    6. Family History
    7. Portal Hypertension
    8. Anatomic abnormalities
      1. No hemorrhoidal venous valves
      2. Intrinsic weakness of anal blood vessels
  6. Symptoms
    1. Pruritus Ani
    2. Rectal bleeding
    3. Rectal Pain (External Hemorrhoid)
    4. Prolapsed hemorrhoid
    5. Fullness or mass sensation
  7. Signs
    1. Visual inspection
    2. Digital Rectal Exam
    3. Anoscopy (Ives Slotted Anoscope)
  8. Differential Diagnosis
    1. Fissure
    2. Perirectal Abscess
    3. Rectal Fistula
    4. Condyloma
    5. Rectal carcinoma
  9. Management
    1. See Hemorrhoid Management
  10. References
    1. Pickard in Dornbrand (1992) Ambulatory Care, p. 225-6
    2. Schrock in Feldman (1998) Sleisenger GI, p. 1964-7
    3. Hulme-Moir (2001) Gastroenterol Clin North Am 30:183
    4. Hussain (1999) Prim Care 26(1):35

Hemorrhoids (C0019112)

Definition (MSH)Swollen veins in the lower part of the RECTUM or ANUS. Hemorrhoids can be inside the anus (internal), under the skin around the anus (external), or protruding from inside to outside of the anus. People with hemorrhoids may or may not exhibit symptoms which include bleeding, itching, and pain.
Definition (NCI)An enlarged or swollen blood vessel, usually located near the anus or the rectum.
ConceptsDisease or Syndrome (T047)
ICD9455, 455.6
BasqueHEMORROIDEAK
DanishHaemorider
DutchHemorroiden
EnglishHaemorrhoid, Haemorrhoids, HEMORRHOID, Hemorrhoids, Piles
FinnishPERAPUKAMAT
FrenchHemorrhoides, Hemorroides
GermanHaemorrhoiden
Hebrewtxorim
Hungarianaranyer
ItalianEmorroidi
NorwegianHEMORROIDER
PortugueseHemorroidas
SpanishHemorroides
SwedishHEMORROJDER
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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