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Thread: Hemorrhoids

  1. #1
    Senior Member martha's Avatar
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    Hemorrhoids

    First let me explain that I've never had nor seen a hemorrhoid. But in doing husband's dig stim, there is a new "protrusion" at the edge of the opening that is rather large and I noticed some blood on my glove. He just had a colonscopy two weeks ago with a clean bill of health (after colon cancer Sept last year). Is this a hemorrhoid and if so do we treat it with Prep H or does he need to see a doctor right away?
    Thanks.

    martha

  2. #2

    Not to worry

    Martha, it is good that you are so vigilant in observing changes in your husband's condition, but vitually EVERYONE with SCI eventually gets hemorroids. They are caused by a combination of sitting all the time, bowel care techniques, constipation and abnormal pelvic floor muscle tone.

    They are not an emergency condition. A small amount of blood during bowel care is not a reason for concern. If bleeding occurs between bowel programs, or is more than a tablespoon (which looks like a LOT of blood), or if it causes them to be anemic, or if they then to get inflammed and cause AD, then they need to be treated.

    Normally, when bowel care is done, if they protrude, put on some lubricant and push them gently back inside. You can use a hemorroid ointment, but this will not make them go away. Mostly hemorroid ointments help with discomfort, and if he does not have sensation there is not much purpose. Be sure you are being gentle with the dig stim, and that his stool is soft to formed. The harder the stool, the more problems with hemorroids.

    If the condition gets worse, they can be treated. Generally the "rubber band" treatment is easiest and most effective, and can be done in a physician's office. While fancier treatments such as sclerosing injections, cryosurgery and lasar therapy can also be done, there are some studies indicating they are no more effective in treatment or prevention of reoccurance, and much more expensive.

    By the way, we generally encourage spouses to avoid being the person who assists with bowel care as it can interfere with maintaining a healthy sexual relationship after SCI. You may want to explore your options in this area and talk it over with your husband. (KLD)

  3. #3
    I have had what your describing several times,and after a day or two they go away,will mine did anyway.And i agree completely with KLD and the bowelcare/primary caregiver thing ive seen bad things happen to relationships,but you could be one of the exceptions and if you are i pray someday i will find someone like you.

    .........\/PEACE
    ~Shaun~

  4. #4
    Senior Member martha's Avatar
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    Whew!

    KLD & Shaun, thanks so much for yet another education and for the peace of mind. I tend to worry about every change since we don't know what to expect yet. I understand your points about the caregiver role, but for now I'm the only option. And trust me Shaun, you DON'T want someone like me! I don't know you and I can already tell you that you deserve better than that! ;-)

    martha

  5. #5

    Hemorrhoids

    I had one removed about a month ago using rubberband technique. Most blood was gone immediately. I have several others smaller ones remaining. Removal did not hurt at all. (it was harder to get into position).

  6. #6
    Senior Member martha's Avatar
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    Could be pressure sore?

    The hemorrhoids seem to be improving, but in the "fun never stops" category, I think he may be getting a pressure sore. But again, since I don't know what they look like, I'm not sure. This is a series of dark red spots with two or three red lines across the mid portion of the butt. I slathered on bacitracen (sp) the last two nights for lack of any other better idea and I've made him sleep on his side for the past two nights, but of course being up in his chair during the chair does require sitting on it. I'm surprised because I turn him every 2-3 hours during the night so I didn't think he'd be susceptible to sores. Does this sound like the beginnings of a sore? Thanks again.

    martha

  7. #7

    Martha

    It sure sounds like the beginning of one to me,i would keep a close eye on that even keep him off it if you guys can till it clears up.You will find there a lot easier to prevent than heal...
    .......\/PEACE
    ~Shaun~

  8. #8

    Pressure ulcer

    From what you describe, this is a sitting (not lying down) pressure ulcer. It is important to know the different bony areas where pressure ulcers are most likely to occur and from which positions so that you can problem solve how to prevent them and what to do.

    Pressure ulcers on the middle of the bottom (called the ischium) rarely occur in bed unless the person spend a lot of time in a hospital bed with the head raised all the way. These are sitting ulcers, and indicate that the person is either not doing frequent enough pressure reliefs (every 15 minutes is recommended) or is on an inappropriate cushion, or is propping or elevating their legs too much, putting all of the leg weight on their ischiums instead of their thighs (where it belongs). Ulcers on the sides of the hips (trochanter) or sacrum (tailbone and area just above this) are usually from lying down too long in one position or on the wrong surface, although trochanter ulcers can also be caused by a wheelchair that is too small (arm rests or wheel rub) and coccyx (tailbone) sore can be caused by a slumped "pelvic sitting" position in the wheelchair.

    Red marks should fade in 20-30 minutes, and should "blanche" (turn briefly white when pressed). If they do not, then this is a stage I pressure ulcer. Tissue death has already started. Any pressure applied to the area until they completely fade will cause a stage I to turn into a stage II or deeper where skin is broken.

    If your husband's stage I ulcers are over his ischiums, he must NOT sit at all, but stay in bed until the area is faded. Meanwhile, look at his cushion and weightshifts to see if something needs modification. If it occurs again, get a cushion and seating re-evaluation. (KLD)

  9. #9
    Senior Member martha's Avatar
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    How Long?

    Thanks KLD (and Shaun). If this is a stage I and he stays in bed, how long do they typically take to heal? I'm sure everyone is different, but any guesstimate at all would be helpful.
    many thanks.

    martha

  10. #10

    Stage I ulcers

    Martha, it can take anwhere from a day to weeks for a stage I to completely fade, depending on the damage already done. The more cells already dead, which need to re-grow, the longer it will take. This is why it is important to inspect skin twice daily and jump on these problems immediately at the first sign of redness. If you can catch it when it is still blanching and fades in less than 30 minutes (pre-ulcer) you can then problem solve before it gets to the Stage I pressure ulcer. (KLD)

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