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68wm6 p2 hem fi & fi

Hemorrhoids, Fistulas and Fissures

What are hemorrhoids? varicosities (dilated veins) that may occur inside or outside the anal sphincter
What is a fistula? an abnormal opening on the cutaneous surface near the anus (i.e. from sphincter to skin, or from sphincter to bladder, urethra, vagina ect)
What is an anal fissure? a linear ulceration or laceration of the skin of the anus
What is a Fistulotomy? opening of the fistula tract, incising the fistula with a partial anus division
What is a Fistulectomy? removal of the fistula tract
What causes hemorrhoids? Repeated increased pressure and obstructed blood flow causes permanent dilation to occur (Such as straining at stool with increased intraabdominal and hemorrhoidal venous pressures)
What are external hemorrhoids? Small, reddish-blue lumps at edge of anus outside of anal sphincter.
What is the risk of external and internal hemorrhoids? *Bleeding *Hemorrhoid may become thrombosed (blood in hemorrhoid becomes clotted and infected)
List four predisposing factors for hemorrhoids: *Pregnancy *Chronic constipation *Straining during bowel movements *Diarrhea *Prolonged sitting and standing *Portal hypertension (cirrhosis) *Congestive Heart Failure
What are non-invasived Tx of hemorrhoids? *Bulk Stool softeners *Topical creams and hydrocortisone for pruritis and inflammation *Analgesic ointments *Sitz baths
What is hemorrhoidal rubber-band litigation? the application of tight bands around the hemorrhoid cutting off the blood supply, resulting in necrosis
What is hemorrhoidal sclerotherapy? inserting a sclerosing agent directly into the hemorrhoid
Who are anal fistulas common in? PTs with Crohns disease
What do Anal Fissures usually result from? trauma caused by hard stool that overstretches the anal lining and is aggravated by defecation
What can a PT do to reduce pain from Firtulas and Fissures? *Low bulk diet and encourage high residue *Tucks pads or ice packs to reduce inflammation and pain
What color will ischemic tissue from hemorrhoids be? dark red to black (necrotic)
What is the pain management of bowel movements for PTs with hemorrhoids/fissures/fistulas? Give analgesic before first bowel movement and sitz bath after for pain relief
Created by: Shanejqb