Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice

BO_Qureshi_Hemorrhoid treatment

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The document outlines a presentation by Dr. Waqar Qureshi on adding hemorrhoid treatment to medical service lines, focusing on anorectal disease management. Key topics include common anorectal conditions like hemorrhoids, anal fissures, and abscesses. Hemorrhoids are emphasized, with statistics indicating a high prevalence among Americans over 50 and significant annual spending on over-the-counter products and surgeries—many of which may be unnecessary.<br /><br />Anorectal examinations, including inspection, digital rectal examination (DRE), and anoscopy, are recommended for proper evaluation, confirming that hemorrhoids typically do not cause pain. The etiology of hemorrhoids is attributed to engorged vascular cushions in the anal canal. Classification of hemorrhoids based on Golligher’s system is discussed, ranging from bleeding without prolapse to prolapse that cannot be manually reduced.<br /><br />Initial management strategies include increased fluid and fiber intake, stool softeners, and limiting time on the commode. Non-operative treatments such as rubber band ligation, infrared photocoagulation, and sclerotherapy are outlined. Rubber band ligation involves encircling redundant mucosal tissues and provides better results but may cause complications like pain and urinary retention. Infrared photocoagulation is preferred for patients on anticoagulation therapy, pregnant women, and those with significant IBS symptoms due to its non-invasiveness.<br /><br />For thrombosed external hemorrhoids, immediate intervention within 72 hours is recommended, followed by warm baths and stool softeners. The presentation concludes by emphasizing the importance of thorough anorectal examinations, safe in-office treatments, and considering disorders of defecation like anorectal dyssynergia when diagnosing hemorrhoid-related issues.<br /><br />References for further reading are provided, citing articles authored by Dr. Qureshi related to anorectal disease management and treatment methodologies.

Keywords

hemorrhoid treatment

anorectal disease

Dr. Waqar Qureshi

anal fissures

hemorrhoids prevalence

anorectal examinations

Golligher's classification

rubber band ligation

infrared photocoagulation

anorectal dyssynergia