Answer: <p>The engorgement of superficial veins of an anus is known as hemorrhoid . During pregnancy, increasing uterus give pressure to the bladder as well as rectum, the pelvic vein is pressed by it so they are unable to generate circulation and venous return is occluded and cause hemorrhoids so it is one of the disorder of puerperium.</p>

Answer: <p>Types of Hemorrhoids</p>
<ol>
<li>External Hemorrhoids: Hemorrhoids may be external that is distal to anal sphincter.</li>
<li>Internal Hemorrhoids: Hemorrhoids that is proximal to anal sphincter.</li>
<li>Interno-external Hemorrhoids: Both of the hemorrhoids may be present at the same time.</li>
</ol>
<p>Stages or degree of Hemorrhoids</p>
<p>There are 4 stages or degree of hemorrhoids. They are :</p>
<ol>
<li>First degree Piles: Piles that bleed but do not bulge out of the anal opening.</li>
<li>Second degree Piles: Piles may prolapse during the passage of stool but they recede (draw back) on their own.</li>
<li>Third degree Piles: As the disease progresses the piles do not recede back on their own and have to be replaced by hand.</li>
<li>4. Fourth degree piles: In advance cases the Piles may prolapse anytime of the day (i.e. even with out the passage of stool) especially if the person is tired or exerts himself. These Piles remain permanently prolapsed.</li>
</ol>

Answer: <p>Medical management</p>
<ul>
<li>Local treatment</li>
<li>Application of hot and cold compress.</li>
<li>Analgesics ointment is given temporarily to relief pain and reduce edema around external and internal hemorrhoid.</li>
<li>Sitz bath is given to relief pain.</li>
<li>Stool softener is given to prevent constipation and to decrease irritation during defecation.</li>
<li>Symptomatic treatment</li>
<li>Good personal hygiene.</li>
<li>Increase fluid intake.</li>
<li>Avoid excessive straining during defecation.</li>
</ul>
<p>Surgical treatment</p>
<ul>
<li>Haemorrhoidectomy: after surgery</li>
<li>The pressure dressing and icepack are applied to lessen the bleeding.</li>
<li>Stool softener and sitz baths are recommended.</li>
<li>ligation: internal ligation may be treated by ligation of vessels.</li>
</ul>
<p>Nursing management</p>
<ul>
<li>Provide sitz bath to relive pain.</li>
<li>Maintain cleanliness to relive discomfort.</li>
<li>Avoid to take species, sweat containing food.</li>
<li>Manage appropriate measures for constipation or avoid constipation by timely defecation, plenty of fluid intake, fibers food in diet.</li>
<li>Give digestible, light nutritious food to mother.</li>
<li>Encourage for ambulation.</li>
</ul>
<p>Patient teaching</p>
<ul>
<li>Clean rectal area after each defecation until healing is complete.</li>
<li>Give higher fiber diet and high fluid and intake to avoid constipation.</li>
<li>Regular exercise and regular time for passing stool is most important during post operative periods.</li>
<li>Check for rectal bleeding and inform surgeon immediately in case of bleeding occurs.</li>
</ul>
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Answer: <p>Signs and Symptoms</p>
<ul>
<li>Fresh bleeding from the anus.</li>
<li>Earlier painless but in severity, it is painful and bleeding.</li>
<li>Bleeding may be visible or non visible.</li>
<li>Heavy anal itching or difficult to defecate.</li>
</ul>