PATHOPHYSIOLOGY OF HEMORRHOIDS Hemorrhoids are dilated portions of veins in the anal canal.– Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, vol. 1, edition 12, pg. 1109 surgery is the last resort to removing the hemorrhoids. To relieve discomfort. Management first used is the non-surgical treatments. bipolar diathermy. In external hemorrhoids. then edema. avoid excessive straining upon defecation. The thrombosis then further causes ischemia. Procedures include Nd: YAG laser. nurses should emphasize on good personal hygiene. laser therapy and injection of sclerosing agents. Applying a warm compress. Upon defecation. To reduce engorgement. cryosurgical hemorrhoidectomy. giving sitz baths. an increased pressure in the hemorrhoidal tissue occurs. rubber-band ligation procedure and stapled hemorrhoidopexy. patients can be given bulk-forming agents such as psyllium. analgesic ointments and suppositories and reinforcing bed rest can also be applied. After other non-surgical treatments were deemed unsuccessful. This causes the hemorrhoids to either bleed or prolapsed. application of witch hazel. The patient handled with the diagnosis underwent hemorrhoidectomy. The structures of the wall slide down the anal canal. At pregnancy. where the external hemorrhoids were excised and the skin affected was cauterized. Such structures include the hemorrhoidal and vascular tissues. This either initiates hemorrhoids or aggravates existing ones. They should also encourage patients to have a high-residue diet (fruit & bran) as well as increasing their oral fluid intake. which often causes the bright red bleeding upon defecation. a thrombosis within the hemorrhoid causes inflammation. medical management performed initially is the non-surgical treatments. . Such treatments are done to prevent prolapsed and they include infared photocoagulation. The common signs of both internal and external hemorrhoids are pain and itching. In internal hemorrhoids.THE PATHOPHYSIOLOGY OF HEMORRHOIDS Hemorrhoids usually manifests from excessive straining at defecation because of constipation or during pregnancy. and the hemorrhoids worsen. the mucosa of the anal lining is sheared. Hemorrhoids is seen in individuals 30 years old and older. When such interventions don’t work. pain is not very much experienced until they enlarge. The lack of oxygen in the hemorrhoidal tissue then causes necrosis. There are two types of hemorrhoids: internal hemorrhoids and external hemorrhoids. Often. surgery is the last resort. Closed Hemorrhoidectomy Open Hemorrhoidectomy In an open hemorrhoidectomy. a combination of open and closed technique is utilized. Surgeons may opt for open hemorrhoidectomy when the location or amount of disease makes wound closure difficult or the likelihood of postoperative infection high. but here the incision is left open. . Surgical hemorrhoidectomy is the most effective treatment for hemorrhoids. hemorrhoidal tissue is excised in the same manner as in a closed procedure. though it is associated with the greatest rate of complications. Significant postoperative pain is common. Surgical hemorrhoidectomy is required for patients who do not respond to other forms of therapy. as is urinary retention and constipation.HEMORRHOIDECTOMY In the treatment of hemorrhoids. A hemorrhoidectomy is surgery to remove internal or external hemorrhoids that are extensive or severe. SURGICAL SUITE November 24. 2012 SUBMITTED BY: GROUP 32A-BSN308 Reloj. SUBMITTED TO: Erlinda Ramos. MAN . Cecille P.FAR EASTERN UNIVERSITY INSTITUTE OF NURSING LEVEL IV CASE STUDY THE MEDICAL CITY . RN.