he moor roid

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1. Solve the food particles into the molecular shape to digest.

2. Absorb the products of digestion in the form of small molecules

into the bloodstream.

3. Elimination of undigested food and other absorbed and waste

products from the body (Smeltzer, 2002; 984).

The composition of the digestive tract consists of: oris (mouth), pharynx

(throat), esophagus (throat), ventrikulus (stomach), intestinum minor (small

intestine) consists of duodenal (intestinal 12 fingers), yeyenum and ileum,

intestinum major (large intestine ) consists of the cecum, ascending colon,

transverse colon, descending colon and sigmoid colon, rectum and anus.

(Syaifuddin, 1997; 75)

a) colon

The large intestine or colon-shaped hollow muscular tube with a length

of about 1.5 m which extends from the cecum to anus canal with a

diameter of 6.5 cm. The large intestine has no villi, no circular folds,and its diameter is wider, shorter length, and power regangnya larger

than the small intestine. (Sloane, 2004; 294) Bowel function is:

1. Absorb 80% - 90% of water and electrolytes from the

remaining kimus kimus and change from a liquid to

semi-solid mass.

2. The large intestine produces only mucus. Secretions do

not contain digestive enzymes or hormones.

3. A number of bacteria in the colon can digest cellulose

and produce small amounts of nutrients for the body

fewer calories every day.

2 Hemorrhoid | by 5th group


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4. Large intestine to excrete the waste in the form of

feces.

(Sloane, 2004; 295).

The parts of the colon is as follows:

1. cecum

In the cecum and appendix are ileoseikal valve attached

to the tip of the cecum. Cecum occupies approximately

the first 2-3 inches of the colon. Flow control valve

ileoseikal kimus and ileum to the cecum and prevent

backflow of faecal material from the colon into the

small intestine. (Price, 2006; 456)

2. Kolon

The colon is the large intestine from the cecum to the

rectum. The colon has three divisions:

a. ascending colon

Ascending colon extends from the cecum to the

lower edge of the liver on the right and flipped

horizontally to the hepatic flexure.

b. Kolon Tranversum

Tranversum colon crosses the abdomen stretches

under the liver and stomach until ketepi lateral left

kidney, where he turned down the flexure splenik.

c. descending colon

Extending down the left side of the abdomen

(Sloane, 2004; 294)

d. Sigmoid Colon



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Krista started as high as the sigmoid colon and form

a curve-shaped iliac S. curve of the bottom turn left

when united with the rectal sigmoid colon (Price,

2006; 456).

Picture 1.2Colon

b)The rectum

Extending from the sigmoid colon to the anus (the mouth to the outside

of the body). Last 1 inch of the rectum called the anal canal and is

protected by a muscular sphincter ani externus and internus spingter.

The length of the rectum and anus canal is about 15 cm. (Price, 2006;

456).



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Picture 1.3Rectum

c) Anus

Is part of the digestive tract that connects the rectum to the outside

world. Located in the pelvic floor, the walls are reinforced by two

sphincters:

1. the internal sphincter ani, is controlled by the

autonomic nervous

2. the external sphincter ani, is controlled by the nervous

system of voluntary.

Defecation is controlled by external and internal anal sphincter.

Defecation reflex integrated in the sacral spinal cord segments of the

second and fourth. External and internal sphincter muscle relaxes at the

anus up over the masses interested in the stool. Defecation can be

inhibited by the contraction of the external sphincter muscle voluntar

and levator ani. If defecation is not perfect, the rectum to relax and

defecation desire disappears. The water still continues to be absorbed

from the mass of feces, so the stools become hard and cause more

difficulty defecation. Excessive pressure on the stool causing venous

congestion hemoroidalis causing internal and external hemorrhoids

(varicose veins rectum). (Price, 2006: 458-459).



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B. Basic Concept of Haemorrhoids

Hemorrhoid is the swelling or distention of the veins in the anorectal area.

Common but less attention except when it causes pain and bleeding. Other

literature states that the external hemorrhoids are the venous varices and / or of the

internal anal canal is caused by the pressure on the rectal veins.

"Hemorrhoid are dilated, engorged veins in the lining of the rectum".

Hemorrhoids are enlarged veins around the rectum and protrusion. (Potter, 1997;

1374). "Hemorrhoid are dilated varicose veins of the anus and rectum".

Hemorrhoids are dilated varicose veins in the anus and rectum. (Reeves, 1999;

162). Hemorrhoidal plexus is dilated (veins webbing) veins around the rectal and

anal. (Jackson, 2000; 142).

Picture 2.1 haemorrhoids



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CHAPTER II

PATOPHYSIOLOGY AND CLASSIFICATION

A. Pathophysiology



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Venous distension was initially normal structures in the anal region, because

the veins are functioning as a valve that can help support the weight, but when

distended persistent disruption will occur.

One of the predisposing factors that may cause venous distension is increased

intra-abdominal pressure. This condition leads to an increase in portal venous

pressure and systemic venous pressure, which will then be transmitted to the

anorectal area. Elevation of repeated pressure will push the vein separated from

the surrounding muscles so that the veins have prolapse. Circumstances that can

cause repetitive elevations include obstipasi / constipation, pregnancy and portal

hypertension. Could be a prolapsed hemorrhoids, developed into a thrombus or

hemorrhage.

Hemorrhoids result from venous congestion caused by the backflow of venous

disorders hemoroidalis. Chronic liver disease accompanied by portal hypertension

often lead to hemorrhoids because of the superior vena hemoroidalis drain blood

into the portal system. In addition the portal system has no valves, so easy going

back flow.

B. Classification

1. Based on the origin / point of cause:

a) Internal Hemorrhoids

Hemorrhoids are derived from the superior and medial veins

hemoroidales, located above the anorectal line and covered by anal

mucosa. These hemorrhoids remain inside the anus.

b) External Hemorrhoids

Hemorrhoids are due to the dilatation (widening of blood vessels)

inferior vena hemoroidales, located below the anorectal line and

covered by the intestinal mucosa. These hemorrhoids from the anus

(external hemorrhoids).



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Picture 3.1 Internal and Eksternal Haemorrhoids

2. Internal hemorrhoids are classified again according to its development:

a. Level 1: usually asymptomatic and not visible, less bleeding, bruising

can go back spontaneously.

b. Level 2: fresh red bleeding symptoms during defecation (bowel

movements) a lump can be seen around the edge of the anus and can

return spontaneously.

c. Level 3: The hemorrhoids prolapse, occurs after defecation and

infrequent bleeding, prolapse can come back with help.

d. Level 4: prolapse and difficult to re-occur spontaneously.



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CHAPTER III

ETIOLOGY AND CLINICAL APPEARANCES

A. Etiology

Hemorrhoids can occur due to dilatation (widening), inflammation

(inflammation) or swelling of the veins caused hemoroidalis:

1. Chronic Constipation: hard bowel movements, so it should be

pushing.

2. Pregnancy: due to suppression of the fetus on the abdomen.

3. Chronic diarrhea.

4. Old age.

5. Sitting for too long

6. Sexual intercourse peranal.

7. In some individuals the sphincter ani hypertrophy (swelling of the

muscle / valve rectum), obstruction (blockage) functional due to

spasm (cramps), and narrowing of the anorectal canal (the anal

canal, the tip end of the colon).

B. Clinical appearances of hemoroids



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1. Painless bleeding during bowel movements you might notice

small amounts of bright red blood on your toilet tissue or in the

toilet bowl

2. Itching or irritation in your anal region

3. Pain or discomfort

4. Swelling around your anus

5. A lump near your anus, which may be sensitive or painful

6. Leakage of feces

Hemorrhoid symptoms usually depend on the location. Internal hemorrhoids

lie inside the rectum. You usually can't see or feel these hemorrhoids, and they

usually don't cause discomfort. But straining or irritation when passing stool can

damage a hemorrhoid's delicate surface and cause it to bleed. Occasionally,

straining can push an internal hemorrhoid through the anal opening. This is

known as a protruding or prolapsed hemorrhoid and can cause pain and irritation.

External hemorrhoids are under the skin around your anus. When irritated,

external hemorrhoids can itch or bleed. Sometimes blood may pool in an external

hemorrhoid and form a clot (thrombus), resulting in severe pain, swelling and

inflammation.



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CHAPTER IV

NURSING PROCESS

1. Assessment

a. The identity of patients

b. The main complaint

Patients present with complaints of continuous bleeding during

defecation. There are bumps on the anus or pain during defikasi.

c. history of disease

d. History of present illness

Patients found to have only a few weeks the lumps out and a few daysafter the Chapter there is blood dripping out.

e. Past medical history

Have never previously suffered from hemorrhoids, heal / repeat. In

patients with hemorrhoids when not in doing the surgery will return

RPD, can also connect with other illnesses such as liver cirrhosis.

f. Family history of disease

Are there any members who suffer from the disease keluaga



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g. social history

Disease in question to be asked.

h. physical examination

Activity / rest

Symptoms: weakness, fatigue

Signs: tachycardia, tachypnea / hyperventilation (in response to

activity)

i. circulation

Symptoms: weakness / weak pulse periver

Symptoms: Skin color is pale, cyanosis (depending on the amount of

blood loss) skin membrane

j. elimination

Symptoms: change in bowel habit

k. characteristic changes

Symptoms: abdominal tenderness, distention

l. Stool characteristics: bright red blood (fresh blood)

Akonstipasi can occur

nutrition:

Symptoms: Weight loss

m. anorexia

Symptoms: pale conjunctiva, pale face, looks weak

n. sleep patterns

Symptoms: Changes in sleep patterns

Pain in the anus during sleep

Signs: face looks tired, eye bags appear darko. mobilization

Symptoms: limiting the activity

Signs: face looks anxious, a lot of sitting and lying positions changed

2. Nursing Diagnosis

a. pre Operative



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1) Risk of nutritional deficiencies (deficiency) associated with the

outbreak of the venous plexus hemmoroidalis characterized by

bleeding that continues - chapter time basis.

2) Disruption of comfort associated with the anal or rectal mass, rectal

area marked lumps, pain and itching in the anal region.

3) Personal hygene of the rectum is less related to the mass that comes

out on the external area.

b. Postoperative

1) Disruption of comfort (pain) in the surgical wound associated with

the stitches on the wound and their installed wind chimney.

2) Resikol occurrence of wound infection related to inadequate primary

defenses

3) Lack of knowledge related to the lack of information about home

care.

Preoperatif

No. Nursing

Diagnosis

Goal and

ExpectedOutcomes

Interventions Rationale

1. Risk of

nutritional

deficiencies

associated

with the

outbreak of thevenous plexus

hemmoroidalis

characterized

by bleeding

that continues

- CHAPTER

time basis.

After

nursing

actions for

3 x 24

hours, the

risk ofnutritional

deficiencies

are met.

KH:

1. There is

no anemis,

1. Observed

signs anemis

2. Low-fiber

diet during

the rest or

theoccurrence

of bleeding

3.Berikan

explanation

of the

importance

of diet cure

1. Sign - a sign

anemis suspected of

iron deficiency (Hb

falls)

2. May reduce the

stimulation of theanal region so there is

no bleeding.

3. Education about

diet, helping to

increase the

participation of

patients in a state of



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2. bleeding

stops

3.BB not

go down.

the disease.

4. Apply ice

to the area of

hemorrhage

5. give

medication

or treatment

in

accordance

with

physician

orders

illness.

4. Patients with

rupture of the venous

plexus hemoriodalis

need a drug that can

help the prevention of

bleeding

mememrlukan

periodic assessment

of the response.

5. Patients with

venous rupture flexus

hemmoroidalis need a

drug that can help the

prevention of

bleeding requiring

penilayan to periodic

drug response.

2. Disruption of

comfort

associated

with the anal

or rectal mass,rectal area

marked lumps,

pain and

itching in the

anal region

After

nursing

actions for

2 x 24

hours,impaired

sense of

comfort

terratasi.

KH:

1.Nyeri

1. Give

randam

sitting

2. Give the

lubricant at

the time of

going

Chapter

1. Lowering of local

discomfort, reduce

edema and promote

healing.

2. Assist in theconduct of defikasi so

it does not need

straining.

3. Reducing anal

stimulation and

undermines feces.

4. The force of



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reduced

2.Rasa less

itchy

3.Massa

smaller.

3. Give the

rest of the

diet randah

4. Instruct

patients not

to stand or

sit bannyak

(must be in

balance).

5.

Observation

of patient

complaints

6. Provide an

explanation

of the onset

of pain and

describe

briefly

7. Give the

patient

suppositories

gravity will affect the

onset of hemorrhoids

and sitting can

increase intra-

abdominal pressure.

5. Help evaluate the

degree of discomfort

and lack of

effectiveness of

actions or states of

complications.

6. Education about

the patient's

participation helps to

prevent / reduce pain.

7. Can soften the

stool and can reduce

the patient to avoid

straining during

defikasi.

3. . Deficits in

personal

hygene anal

mass

associated

with the exit

After

nursing

actions for

2 x 24

hours, anal

hygiene.

1. Give your

bath with the

solution sit

permagan

1/1000% in

the morning

1. Improve hygiene

and facilitate the

healing of prolapse.

2. Inflammation of

the rectum indicate

an infection of the



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18/30

stitches on the

wound and

their installed

wind chimney.

met.

KH:

1.Tidak there

is pain in the

surgical

wound, 2.

patients can

perform light

activity.

3. 0-1 pain

scale.

4. clients

seemed to

relax.

bandage every

morning

according to

aseptic

techniques

3. Exercise road

as early as

possible

4. Observations

of the rectal

area if there is

bleeding

5. Chimney

anus is released

according to

doctor's advice

(orders)

6. Provide an

explanation of

the purpose of

installation of

flue-anus (anus

patients from

cross

contamination

during the

dressing change.

Acted as a wet

dressing of

external

contamination

and cause

discomfort.

3. reduce

problems that

occur due to

immobilization.

4. Bleeding on

the network, or

local imflamasi

infection can

increase the pain.

5. Improve the

physiological

function of the

anal and giving

comfort to the

patient's anal

region because

there is no

blockage.

6. Knowledge of

the benefits of

the chimney can



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to funnel to

drain the

remnants of the

bleeding that

occurs in order

to get out).

make the patient

understand the

anus to funnel

anus to cure the

wound.

2. The risk of

wound

infection

related to

inadequate

primary

defenses

After nursing

actions for 2

x 24 hours,

the risk of

infection is

resolved.

KH:

1. there are

no signs of

infection

(dolor, calor,

rubor, tumor,

fungsiolesa).

2.

inflammation

of the wound

dry.

3. the LAB:

- leukocytes

- platelets

1. Observation

of vital signs

every 4 hours

2. Obserpasi

bandage every

2-4 hours,

check for

bleeding and

odor.

3. Replace

packing with

aseptic

technique

4. Clean the

perianal area

after each

depfikasi

5. Provide low-

fiber diet / rest

and drink

enough

1. TD includes

autonomic response,

respiration, pulse

denagan related

complaint / pain

relievers. Abnormalities

in vital signs need

further observation.

2. Early detection of the

infection process and /

supervision oprasi

wound healing that

existed before.

3. Prevent the spread

and limit the wide

spread of infection or

cross contamination.

4. reduce / prevent

contamination of the

wound area.

5. reduce the stimulation

to the anus and prevent

straining at defikasi.



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3. Lack of

knowledge

related to the

lack of

information

about home

care.

After nursing

actions for 3

x 24 hours,

lack of

knowledge of

the top.

KH:

1. client did

not ask many

questions

about the

disease.

2. patients

can express

or understand

about home

care.

3. understand

the client's

family about

the disease

process.4. clients

show a calm

face

1. Discuss the

importance of

the

management of

low-residual

diet.

2.

Demontrasikan

treatment of

anal area and

ask the patient

menguilanginya

3. Give soak

sitting to order

4. Bersihakan

anal area welland dry

completely after

defecation.

5. Give the

dressing

6. Discuss the

symptoms of

1. Rationalization:

Knowledge of the diet is

useful to involve the

patient in home diet plan

that suits are

recommended by

nutritionists.

2. Understanding will

enhance cooperation in

the patient's therapy

program, promotes

healing and repair

process of the disease.

3. Improve the

cleanliness and comfort

in the anal area (wound

or polaps).

4. Protect against

contamination of the

anal area germs that

come from the rest of

the bowel to avoid

infection.

5. Protect the wound

from outside

contamination.

6. Early recognition of

symptoms of infection

and immediate



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wound infection

to be reported

medicine.

7. Discuss

difekasi

maintain

software using

stool softeners

and laxatives

foods natural.

8. Explain the

importance of

avoiding lifting

heavy objects

and straining.

intervention can prevent

progression of a serious

situation.

7. Prevent straining

during difekasi and

soften the stool.

8. Intra-abdominal

pressure lowering

unnecessary and muscle

tension.

3. Diagnostic tests

a. Physical examination of the inspection and rektaltouche (digital rectal).

On digital rectal examination, early-stage internal hemorrhoids can not

be felt because the venous pressure in it is not too high and usually

painless. Hemorrhoids can be felt if very large. If hemorrhoids are

prolapsed, mucous membrane will thicken. Thrombosis and fibrosis in

the palpability feels solid with a wide base. Digital rectal examination

to rule out the possibility of rectal carcinoma.

b. Inspection with binoculars is anoscopy or rectoscopy. In this way it can

be seen that the internal hemorrhoids do not bulge out. Anoskop

included to observe the four quadrants. The patient in lithotomy

position. Anoskop and penyumbatnya inserted in the anus as deep as

possible, the stopper is removed and the patient was told to breathe

long. Internal hemorrhoids seen as a vascular structure protruding into



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the lumen. When people are asked to push a little hemorrhoid will

enlarge the size and protrusion or prolapse will be more obvious. The

number of bumps, degree, location, size and other conditions such as

polyps in the rectum, fissure ani and malignant tumors must be

considered.

c. examination proktosigmoidoskopi, Proktosigmoidoskopi needs to be

done to ensure that complaints are not caused by inflammation or

malignancy in high-level process, since hemorrhoids is a physiological

condition or signs that accompany it. Stool should be checked for occult

blood.

d. X-rays (colon inloop) and / or colonoscopy.

e. Examination of blood, urine, feces as investigations

4. Medical Treatment

a. Medical management

Hemorrhoidal symptoms and discomfort can be eliminated by good

personal hygiene and avoid excessive straining during defecation. High-

fiber diet containing fruit and chaff may be the only action needed, if

these measures fail, laxatives that function mengapsorpsi water as it

passes through the intestines may help. Bed rest is an act that allows the

magnification is reduced. There are various types of actions nonoperatif

for hemorrhoids. Infrared photocoagulation, bipolar diathermy, and

laser therapy is the latest technique used to embed the mucosa into the

underlying muscle. Sclerosant injection is also an effective solution for

small and bleeding hemorrhoids. This procedure helps prevent prolapse.b. management Surgikal

1)Surgical therapy: Surgical therapy for selected patients who have

chronic complaints and in patients with degree III and IV

hemorrhoids. Surgical therapy can also be done with recurrent

bleeding and anemia that can not be cured by other therapies are

more modest. IV degree hemorrhoids sufferers who experienced

thrombosis and severe pain can be helped immediately by



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hemoroidektomi. Principles to be considered in hemoroidektomi is

excision is only performed on the network that is really overkill.

Excision may be performed on anoderm economical and normal skin

does not interfere with the anal sphincter. Excision of this tissue

must be combined with reconstruction of the tunica mucosa because

of a deformity of the anal canal due to mucosal prolapse. There are

three surgical approaches are currently available conventional

surgery (using a knife and scissors), laser surgery (laser beam for

cutting tools) and the surgical stapler (using the principle of stapler).

2) Conventional Surgery

Currently there are three techniques commonly used operations are:

1. Techniques Milligan Morgan

This technique is used for hemorrhoids bulge in three main

points. Hemorrhoidal mass base just above the linea

mucocutaneous dicekap with hemostats and diretraksi of the

rectum. Catgut sutures and placed proximal to the plexus

transfiksi hemoroidalis. Important to prevent the installation of

suture through the internal sphincter muscle. The second hemostat

is placed distal to the external hemorrhoids. An elliptical incision

is made with a scalpel through the skin and the tunica mucosa

around internus and externus plexus hemoroidalis, who was

released from the underlying network. Haemorrhoids excised as a

whole. When the dissection reached transfiksi cat gut suture the

excised skin under ekstena hemorrhoids. After securinghemostasis, the rectal mucosa and skin was closed longitudinally

with a simple tack. Usually no more than three groups of

hemorrhoids are removed at one time. Rectal stricture may be a

complication of excision of the tunica mucosa of the rectum is too

much. So it is better to take too little rather than take too much

tissue.



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2. Whitehead techniques

Surgical technique that is used for hemorrhoids that this circular

is to peel the entire hemorrhoids with mucosal release of

submucosal resection and held against the mucosa of the circular

area. Then try again the continuity of the mucosa.

3. Langenbeck technique

In the Langenbeck technique, the internal hemorrhoids radier

clamped by the clamp. Perform tack under the clamp with the

paint chromic gut No. 2/0. Then excision of tissue above the

clamp. After the clamp is released and baste under the clamp jaws

tied up. This technique is more often used because it is easy and

does not contain the risk of secondary scarring is usually caused

stenosis. In conducting the necessary operations of the narcotics

because this sphincter to be completely paralyzed.

3) Laser Surgery

In principle, this same surgery with conventional surgery, only using

a laser cutter tool. When the laser cut, etched tissue vessels that are

not a lot of bleeding, not a lot of injuries and with minimal pain. At

the laser surgery, pain is reduced because of nerve pain seared

participate. In the anus, there are a lot of nerve. In the conventional

surgery, when post-operative pain will be felt at all because at the

time of cutting the tissue, nerve fibers nerve fibers did not open due

to shrink while the sheath to shrink. Whereas in laser surgery, nervefibers and nerve sheath attached together, such as seared so that

nerve fibers do not open. To hemoroidektomi, required laser power

12-14 watts. Once the tissue is removed, the incision antiseptic

soaked. Within 4-6 weeks, the wound will dry up. This procedure

can be done only by an outpatient basis.

4) surgicalStapler



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The tools used in accordance with the principles of

stapler. This tool forms such as flashlights, consisting of a circle in

front of and driving force behind it.

Basically hemorrhoids is a natural tissue found in the anal

canal. Its function is to cushion during bowel movements.

Cooperation and m.sfingter hemorrhoidal tissue to dilate and

constrict to ensure control and sewage discharge from the rectum.

PPH technique reduces tissue prolapsed hemorrhoids by pushing it

to the top of the line mucocutaneous hemorrhoidal tissue and

restore it to its original anatomic position because of hemorrhoidal

tissue is still required as a cushion during defecation, so it does not

need to be removed all.

At first the prolapse of hemorrhoidal tissue is pushed

upwards by a tool called a dilator, and then sewn into the tunica

mucosa of the anal wall. Then the stapler device is inserted into the

dilator. Removed from the stapler inserted a titanium bracelets of

the suture and implanted in the upper anal canal to strengthen the

position of the hemorrhoidal tissue. Part of excess hemorrhoidal

tissue into the stapler. By turning the screw located at the tip of the

tool, the tool will cut off the excess network automatically. The

truncated hemorrhoidal tissue with the blood supply to tissues is

interrupted so that the hemorrhoidal tissue to deflate by itself. The

advantage of this technique is to return to the anatomical position,

does not interfere with the function of the anus, no anal discharge,

pain minimal because of the actions carried out the sensitive, rapidaction takes place around 20-45 minutes, patients recover more

quickly so that inpatient care in hospitals are increasingly short .

5. Complications

1. thrombosis occurred

Because hemorrhoids out so that the old - old blood will clot and

thrombosis occurs.

2. Inflammation



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If blisters occur because of hemorrhoidal venous pressure of infection and

inflammation can occur because there are a lot of dirt germs - bacteria.

3. the occurrence of bleeding

On the degree of blood dripping and gushing out. Acute bleeding in

general are rare, only occurs when the rupture is the major blood vessels.

Hemorrhoids can form a shortcut portal portal systemic hypertension, and

if this kind of bleeding hemorrhoids it can be so much blood. More often is

chronic and if recurrent bleeding can cause anemia because of the number

of red cells produced could not offset the amount that comes out. Chronic

anemia occurs, so it often does not cause complaints in patients with even

very low Hb due to the mechanism of adaptation. If the hemorrhoids out,

and can not go anymore (inkarserata / pinched) will easily happen that the

infection can cause sepsis and can lead to death.

The Theraphy

Ambulatory hemorrhoid therapy with radiofrequency coagulation

Background:

Despite availability of numerous surgical and non-surgical options for the

treatment of hemorrhoids like sclerotherapy, rubber band ligation,

cryosurgery, infrared photocoagulation, bipolar diathermy, and electro

coagulation, none of these therapies has been acclaimed as the ultimate.

Coagulation of hemorrhoids using a radio-frequency device is a new therapy

to be added to the list.

Patients and Methods:

In the present retrospective study, the early and long -term effects of

radiofrequency coagulation on patients presenting with hemorrhoids is

described. An Ellman radiofrequency generator was used for this procedure.

In a separate, randomized, and blinded study, a comparative evaluation was



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carried out between radiofrequency coagulation and rubber band ligation in

terms of their effectiveness and patient comfort.

Results:

Two hundred and forty patients with Grade I and II hemorrhoids were treated

by radiofrequency coagulation technique and were followed up for a period of

16 months. While 33 patients reported persistence or recurrence of bleeding,

only few complained of pain or discomfort. The comparative study showed

that though rubber band ligation is an effective procedure, its pain quotient is

greater than the radiofrequency coagulation.

Conclusion:

This study shows that radiofrequency coagulation is an easy and effective

alternative to conventional techniques employed in the treatment of bleeding

hemorrhoids. It is easy to perform, is less painful, and has a low rate of

complications. However, further results based on a longer follow-up of larger

number of patients and its comparison with other conventional treatment

techniques are called for.



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CHAPTER V

CONCLUSION AND SUGGESTIONS

A. Conclusion

Hemorrhoids are distended veins in the anorectal area. Common but less attention

except when it causes pain and bleeding. The term hemorrhoids more commonly

known as piles or haemorrhoids by the community. Result is the emergence of a

hemorrhoidal discomfort. Hemorrhoids are not only annoying aspect of health, but

also aspects of cosmetic and even social aspects. Haemorrhoids result in

complications, such as thrombosis occurs, inflammation, and going

perdarahan.Hemoroid can also cause anxiety in the sufferer due to ignorance

about the disease and its treatment.



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B. advice

Need intensive counseling about the disease, the disease process and treatment in

patients with hemorrhoids. Informed about the prevention-prevention ofhemorrhoids by:

1. Eating foods high in fiber, vitamin K, and vitamin B12.

2. Suggest to sit or not much activity menenkan buttocks area.

3. Suggest to not too strong when straining as it can add a large

hemorrhoids.

4. Suggest that eating less spicy foods which can irritate hemorrhoids.

5. Suggest to hemoroidektomi hemorrhoids have reached the stage

when the third-degree internal hemorrhoids to prevent infection.



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BIBLIOGRAPHY

Syvia Anderson Price, 1991. Patofisiologi Konsep Klinik Proses-ProsesPenerbit buku Kedokteran EGC, Jakarta.

Doenges Moorhouse Geissle, 1999. Rencana Asuhan Keperawatan Ed. 3

Penerbit Buku Kedokteran EGC, Jakarta.

Susan Martin Tucker, 1998. Standar Perawatan Pasien, Edisi V Vol 2.

Penerbit Buku Kedokteran EGC, Jakarta.

http://nersferdinanskeperawatan.wordpress.com/2010/05/19/asuhan-

keperawatan-pada-klien-dengan-hemorrhoid/

he moor roid

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