Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Hemorrhoids ++ 455.0 Internal hemorrhoids without mention of complication455.1 Internal thrombosed hemorrhoids455.2 Internal hemorrhoids with other complication455.3 External hemorrhoids without mention of complication455.4 External thrombosed hemorrhoids455.5 External hemorrhoids with other complication455.6 Unspecified hemorrhoids without mention of complication455.7 Unspecified thrombosed hemorrhoids455.8 Unspecified hemorrhoids with other complication455.9 Residual hemorrhoidal skin tags ++ 315.4 Developmental coordination disorder718.45 Contracture of joint, pelvic region and thigh719.70 Difficulty in walking728.2 Muscular wasting and disuse atrophy728.89 Other disorders of muscle, ligament, and fascia729.9 Other disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ I84 HaemorrhoidsK64.8 Other hemorrhoidsK64.9 Unspecified hemorrhoids ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation16B: Impaired aerobic capacity/endurance associated with deconditioning2 +++ Description ++ Bright red rectal bleeding, usually associated with bowel movementsBulging of the veins around the anus: internal, external, or protrudingSuperficial pain in rectal area, especially with sitting or attempting to evacuate bowels +++ Essentials of Diagnosis ++ Rectal painIncreased rectal pain with attempts at evacuating bowelsBright red bleeding +++ General Considerations ++ Diagnosis for more occult problems may take time and require intensive diagnostic testingRectal bleeding may be indicative of more serious medical problemsPathology in multiple organ systemsGI pathology, especially intestinal, liverCardiovascular pathologyMay 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 severityAs 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 +++ Demographics ++ Common in pregnancyMore common with aging, usually over 50 years of ageHigher occurrence with obesityExact frequency unknown, estimated 4% +++ Signs and Symptoms ++ DiarrheaConstipationLump(s) in anal areaPainless bleedingItchingPain in anal/rectal areaInflammationSwellingFecal leakageDizzinessFaintingLightheadednessBack painLeg painDepressionAnemiaFatiguePallorRapid heart rateWeaknessHeadachesShortness of breathDifficulty concentrating +++ Functional Implications ++ Severe symptoms including rectal, leg, or back painSwelling in anal areaBleeding with need to wear protective padsDecreased exercise toleranceSleep disturbance if condition is stressfulEating disordersConstipation or bowel retention secondary to fear of moving bowelsLimitations in ADLs or IADLsInfection (systemic or local)HeadachesDizzinessFatigue +++ Possible Contributing Causes ++ Bowel strainingGeneticsAnal intercourseChronic constipationChronic diarrhea... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.