Which of the following is true about hemorrhoids?
Hemorrhoids diagnosed by DRE
External hemorrhoids are proximal to dentate line
Internal hemorrhoids bleed profusely and painless
Internal hemorrhoids are covered by anoderm
Hemorrhoids- Are Normal anatomical cushions- Made of* Venules* Aerioles* Smooth muscle fibers* Elastic tissuesLocation of hemorrhoids- 3' o clock- 7'O clock- 11'0 clockPathophysiology- On constipation due to Excessive straining |Abnormal descent of anatomical cushions |Injury by hard fecal matter |Bleeding PR* Mc cause of bleeding PR - Hemorrhoids* Mc cause of significant lower GI bleed - Colonic diveicula* Mc cause of occult lower GI bleed - Angiodysplasia/ Vascular ectasia Clinical Presentation- Painless bleeding- Amount of bleeding - 3 to 5 ml to a max of 10 mlDiagnosis- They Cannot be palpated, therefore hemorrhoids cannot be diagnosed by DRE- Diagnosis of hemorrhoids - by proctoscopy Internal Hemorrhoids External Hemorrhoids - Location - above dentate line (Pain insensitive region)- Painless bleeding- Treatment - depends on the degree - Location - below dentate line(pain sensitive region)- Painful bleeding- Aka 5- days painful self-curing lesion- Recurrent thrombosis in externalhemorrhoids leads to semi- RIPE blackcurrant- Treatment - Excision
GIT