hemorrhoid /hem′əroid/ [Gk, haima + rhoia, flow] , adj., a varicosity in the lower rectum or anus caused by congestion in the veins of the hemorrhoidal plexus. Also spelled haemorrhoid. −hemorrhoidal, adj. ▪ OBSERVATIONS: Internal hemorrhoids originate above the internal sphincter of the anus. If they become large enough to protrude from the anus, they become constricted and painful. Small internal hemorrhoids may bleed with defecation. External hemorrhoids appear outside the anal sphincter. They are usually not painful, and bleeding does not occur unless a hemorrhoidal vein ruptures or thromboses. ▪ INTERVENTIONS: Treatment includes local application of a topical medication to lubricate, anesthetize, and shrink the hemorrhoid. Sitz baths and cold or hot compresses are also soothing. The hemorrhoids may require sclerosing by injection, ligation, or surgical excision. Ligation is increasingly the preferred treatment because it is simple and effective and does not require anesthesia. The hemorrhoid is grasped with a forceps, and a rubber band is slipped over the varicosity, causing tissue necrosis and sloughing of the hemorrhoid, usually within 1 week. ▪ PATIENT CARE CONSIDERATIONS: Straining to defecate, constipation, and prolonged sitting contribute to the development of hemorrhoids. The client is counseled about ways to prevent these predisposing factors. Because pregnancy is associated with an increased incidence of hemorrhoids, pregnant women are advised to avoid constipation.
