eMedicine Specialties > Emergency Medicine > Gastrointestinal

Hemorrhoids: Follow-up

Author: Kyle R Perry, MD, Resident Physician, Department of Emergency Medicine, Detroit Receiving Hospital
Coauthor(s): Adam J Rosh, MD, MS, Assistant Professor, Department of Emergency Medicine, Wayne State University/Detroit Receiving Hospital
Contributor Information and Disclosures

Updated: Sep 9, 2009

Follow-up

Further Outpatient Care

  • After excision of a thrombosed external hemorrhoid, the patient may be discharged home for several hours of bedrest followed by sitz baths tid, stool softeners, and topical or systemic analgesia. The patient should return in 48-72 hours for a wound check.
  • All other patients should be referred to a surgical or rectal clinic for more definitive treatment and sent home with conservative medical therapy.

Deterrence/Prevention

  • Avoid constipation
  • Weight loss
  • Avoid prolonged sitting on the toilet
  • Avoid prolonged sitting at work
  • Improved anorectal hygiene

Complications

  • Thrombosis
  • Secondary infection
  • Ulceration
  • Abscess
  • Incontinence

Prognosis

  • Most hemorrhoids resolve spontaneously or with conservative medical therapy alone.
  • Recurrence rate with nonsurgical techniques is 10-50% over a 5-year period, while that of surgical hemorrhoidectomy is approximately 26%.

Patient Education

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, David R Gurley, MD, Richard Sinert, DO, and Pilar Guerrero, MD to the development and writing of this article.



More on Hemorrhoids

Overview: Hemorrhoids
Differential Diagnoses & Workup: Hemorrhoids
Treatment & Medication: Hemorrhoids
Follow-up: Hemorrhoids
Multimedia: Hemorrhoids
References
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References

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Further Reading

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Keywords

hemorrhoids, hemorrhoid treatment, hemorrhoid causes, hemorrhoid symptoms, anus swellings, piles, cutaneous hemorrhoids, external hemorrhoids, internal hemorrhoids, hemorrhoidal venous plexus, hematochezia, varicosities of the hemorrhoidal venous plexus, thrombosed external hemorrhoid, rectal bleeding, prolapsed hemorrhoid, rectal prolapse

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Contributor Information and Disclosures

Author

Kyle R Perry, MD, Resident Physician, Department of Emergency Medicine, Detroit Receiving Hospital
Kyle R Perry, MD is a member of the following medical societies: American Medical Association, Emergency Medicine Residents Association, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Rosh, MD, MS, Assistant Professor, Department of Emergency Medicine, Wayne State University/Detroit Receiving Hospital
Adam J Rosh, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

William G Gossman, MD, Associate Clinical Professor of Emergency Medicine, Creighton University School of Medicine; Consulting Staff, Department of Emergency Medicine, Creighton University Medical Center
William G Gossman, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eugene Hardin, MD, FAAEM, FACEP, Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM, Director of Emergency Services, Director of Chest Pain Center, Department of Emergency Medicine, Ft Sanders Sevier Medical Center
Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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