1. Definition of "hemorrhoids."


  1. They are dilated veins in swollen tissue around the anus.

  2. Hemorrhoids can be internal or external.

  3. Prolapsed hemorrhoids may come out during defecation and spontaneously return.


  1. Factors that may increase the risk of hemorrhoids.


  1. Straining at stool because of constipation.

  2. Pregnancy and obesity.

  3. Heavy lifting.

  4. Prolonged sitting and standing.

  5. Familial tendency.

  6. Congestive heart failure.

  7. Cirrhosis of the liver.


  1. Signs and symptoms of hemorrhoids.


  1. External hemorrhoids:

  1. Enlarged mass at the anus.

  2. Inflammation.

  3. Severe pain.

  4. Bleeding with bowel movements.

  1.  Internal hemorrhoids:

  1. Pain.

  2. Bleeding with bowel movements.

  3. Itching in perianal area.

  4. Constipation.


  1. Measures to prevent or control.


  1. Prevent constipation to avoid straining at stool.

  1. Increase fluids to at least 6-8 glasses per day.

  2. Use stool softeners or laxatives as needed.

  3. Increase fiber in diet. (Provide "Fiber in the Diet" handout.)

  4. Never delay urges to evacuate stool.

    1. Use warm compresses or sitz baths.

    2. Apply topical ointments as ordered.

    3. Gently wash and dry perineal area after each bowel movement.

    4. Use only white, unscented toilet paper.

    5. Surgical intervention may be necessary.


  1. Possible complications of hemorrhoids.


  1. Iron deficiency anemia.

  2. Anal fissures (cracks in mucosa).

  3. Bleeding.

  4. Blood clots within hemorrhoids (painful lump near anus).

  5. Strangulated hemorrhoids (blood supply is cut, manifested by severe pain, extreme edema, and inflammation).