09-27-2010, 09:57 AM
My answer will be B: Banding!
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sami 3 - sami2004
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09-28-2010, 08:31 AM
First degree hemorrhoids bleed but do not prolapse outside of the anal canal; second degree prolapse outside of the anal canal, usually upon defecation, but retract spontaneously. Third degree hemorrhoids require manual placement back inside of the anal canal after prolapsing, and fourth degree hemorrhoids consist of prolapsed tissue that cannot be manually replaced and is usually strangulated or thrombosed.
Treatment Medical management is the initial treatment of choice for grade I internal and nonthrombosed external hemorrhoids. It consists of sitz baths (bid/tid); a high-fiber diet; adequate fluid intake; stool softeners; topical and systemic analgesics; proper anal hygiene; and in some cases, a short course of topical steroid cream. # Grade II or III hemorrhoids are initially treated with nonsurgical procedures. i.e banding and Infrared coagulation ( these two procedure not used if * AIDS * Immunodeficiency disorders * Coagulopathy * Irritable bowel disease * Pregnancy * Immediate postpartum period * Rectal wall prolapse * Large anorectal fissure or infection * Tumor # Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy. So definitely ans should be AAAA
09-28-2010, 09:14 AM
ANSWER IS (A) Internal hemorrhoids are highly vascularized
submucosal cushions located in the anal canal. They are classified as first degree if no prolapse is present; second degree if prolapse occurs with spontaneous reduction; third degree if they require manual reduction; and fourth degree if they are irreducible. Treatment is based on the symptoms and degree of prolapse. Nearly all patients with first- and seconddegree hemorrhoids should initially be placed on a trial of conservative measures including a bowel management program with high fiber diet to avoid straining and constipation, frequent warm baths, and an anti-inflammatory topical cream. If symptoms continue, both rubber band ligation (a small rubber band is placed at the neck of the hemorrhoid resulting in eventual death and detachment of tissue) and infrared coagulation (controlled burn of the vessels at the neck of the hemorrhoid) are good alternatives to surgical therapy. For refractory first- and second-degree hemorrhoids, most third-degree and all fourth-degree hemorrhoids, surgical hemorrhoidectomy is the treatment of choice. A thrombosed external hemorrhoid is a blood clot resulting in painful swelling of the tightly held anoderm. In most cases conservative management is indicated. Excision is reserved for patients with debilitating pain or signs of necrosis. |
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