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Condition/Disorder Synonym

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  • Hemorrhoids

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ICD-9-CM Codes

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  • 455.0 Internal hemorrhoids without mention of complication

  • 455.1 Internal thrombosed hemorrhoids

  • 455.2 Internal hemorrhoids with other complication

  • 455.3 External hemorrhoids without mention of complication

  • 455.4 External thrombosed hemorrhoids

  • 455.5 External hemorrhoids with other complication

  • 455.6 Unspecified hemorrhoids without mention of complication

  • 455.7 Unspecified thrombosed hemorrhoids

  • 455.8 Unspecified hemorrhoids with other complication

  • 455.9 Residual hemorrhoidal skin tags

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Associated Physical Therapy Diagnoses

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  • 315.4 Developmental coordination disorder

  • 718.45 Contracture of joint, pelvic region and thigh

  • 719.70 Difficulty in walking

  • 728.2 Muscular wasting and disuse atrophy

  • 728.89 Other disorders of muscle, ligament, and fascia

  • 729.9 Other disorders of soft tissue

  • 780.7 Malaise and fatigue

  • 781.2 Abnormality of gait

  • 782.3 Edema

  • 786.0 Dyspnea and respiratory abnormalities

  • 786.05 Shortness of breath

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ICD-10-CM Codes

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  • I84 Haemorrhoids

  • K64.8 Other hemorrhoids

  • K64.9 Unspecified hemorrhoids

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Preferred Practice Patterns

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Key Features

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Description

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  • Bright red rectal bleeding, usually associated with bowel movements

  • Bulging of the veins around the anus: internal, external, or protruding

  • Superficial pain in rectal area, especially with sitting or attempting to evacuate bowels

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Essentials of Diagnosis

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  • Rectal pain

  • Increased rectal pain with attempts at evacuating bowels

  • Bright red bleeding

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive diagnostic testing

  • Rectal bleeding may be indicative of more serious medical problems

    • Pathology in multiple organ systems

    • GI pathology, especially intestinal, liver

    • Cardiovascular pathology

  • May result in secondary problems such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, weight gain (secondary to reduced physical activity due to discomfort or bleeding), indicating the need for physical therapy intervention depending on severity

  • As hemorrhoids may refer pain to the back, they should be considered in the differential diagnoses when an individual is referred to PT for back pain

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Demographics

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  • Common in pregnancy

  • More common with aging, usually over 50 years of age

  • Higher occurrence with obesity

  • Exact frequency unknown, estimated 4%

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Clinical Findings

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Signs and Symptoms

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  • Diarrhea

  • Constipation

  • Lump(s) in anal area

  • Painless bleeding

  • Itching

  • Pain in anal/rectal area

  • Inflammation

  • Swelling

  • Fecal leakage

  • Dizziness

  • Fainting

  • Lightheadedness

  • Back pain

  • Leg pain

  • Depression

  • Anemia

  • Fatigue

  • Pallor

  • Rapid heart rate

  • Weakness

  • Headaches

  • Shortness of breath

  • Difficulty concentrating

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Functional Implications

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  • Severe symptoms including rectal, leg, or back pain

  • Swelling in anal area

  • Bleeding with need to wear protective pads

  • Decreased exercise tolerance

  • Sleep disturbance if condition is stressful

  • Eating disorders

  • Constipation or bowel ...

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