Medical history (history of the patient) represents an important component in the diagnosis of hemorrhoids. Family history Do you have a family history of common conditions associated with a-hemorrhoid (e.g., varicose veins/varicose veins, diverticulosis, hernia/vaginal hernia)? Social history Do you work in an occupation where you are predominantly standing or sedentary? Current medical history/systemic history … Hemorrhoids: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus (diabetes). Hyperuricemia/gout Skin and subcutaneous (L00-L99) Anal eczema – symptom: itching Chronic irritative eczema Toxic exanthema – skin rash due to a toxic reaction (drug-toxic exanthema is the most common) Erythrasma – redness of the skin caused by bacteria of the type Corynebacterium minutissimum, resembling that of … Hemorrhoids: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by hemorrhoids as well: Blood, blood-forming organs – Immune system (D50-D90). Iron deficiency anemia (anemia due to iron deficiency). Cardiovascular system (I00-I99) Anal thrombosis – painful but harmless occlusion of a blood vessel (vein) at the anus. Hemorrhoidal prolapse – prolapse of … Hemorrhoids: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Palpation (palpation) of the abdomen (abdomen), etc. Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation, including … Hemorrhoids: Examination
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Small blood count (Hb (hemoglobin), HK (hematocrit), leukocytes, platelets). Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Fasting glucose (fasting blood glucose). Uric acid
Pathogenesis (development of disease) The mechanism in the development of hemorrhoids is the enlargement of the vascular cushions (superior hemorrhoidal plexus or the corpus cavernosum recti) and their prolapse (prolapse) into the anal canal (last section of the rectum) by increased and difficult defecation (defecation). The latter is now being questioned. Currently, the hemorrhoidal plexus … Hemorrhoids: Causes
General measures Avoid sitting and standing for long periods of time! Avoiding pressing during defecation. Anal hygiene (as a basic therapy) after going to the toilet in the following steps: Rough cleaning with untreated toilet paper (dyed toilet paper contains dyes that may cause allergy). Careful cleaning with water at a comfortable temperature without the … Hemorrhoids: Therapy
Therapeutic target Reduction of symptoms Therapy recommendations Basic therapy: nutritional measures (e.g., high-fiber diet or use of swelling agents for stool regulation, e.g., psyllium, Plantago ovata). lavonoids (citrus bioflavonoids, hesperidin, diosmin, rutin and hydroxymethylrutinosides) as internals: Drug therapy with diosmin/hesperidin can be used for acute hemorrhoidal symptoms and postoperatively [S3 guideline: recommendation grade 0]. Hemorrhoidal … Hemorrhoids: Drug Therapy
Obligatory medical device diagnostics Proctoscopy (rectoscopy; examination of the anal canal and lower rectum/pelvic rectum; in lithotomy, left-sided, or knee-elbow position) – as a basic diagnostic test in addition to physical examinationNote: Assessment of hemorrhoidal stage should not be performed as part of colonoscopy, as this is unreliable based on classification definition [S3 guideline]. Optional … Hemorrhoids: Diagnostic Tests
Note: Primary asymptomatic hemorrhoids should not be treated invasively [S3 guideline]. Surgery is required in only about 5% of all cases. The following recommendations are based on the current S3 guideline. For hemorrhoids of I. to II. degree is performed: Suprahemorrhoidal sclerotherapy (injection or sclerotherapy) – inducing a reduction in the size of hemorrhoids by … Hemorrhoids: Surgical Therapy
To prevent hemorrhoids, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Incorrect diet – low in fiber and liquid and high in fat. Sitting and standing for long periods Sitting working posture Increased pressing during defecation (during bowel movements) due to constipation (constipation) Overweight (BMI ≥ 25; obesity).
The following symptoms and complaints may indicate hemorrhoids: Leading symptoms Anal protrusion Painless bright red bleeding peranal or transanal bleeding (bleeding from the anus (anus)): Blood during defecation or after defecation / defecation (eg, on the toilet paper). Phases of bleeding can sometimes alternate with weeks or months of no symptoms. Dull pain in the … Hemorrhoids: Symptoms, Complaints, Signs
