1. NURSING DIAGNOSIS
   1. Pain related to swelling and inflammation, especially if hemorrhoids are external
   3. Recurrence related to insufficient bulk and fiber in diet
   5. Deficient fluid volume related to inadequate intake and/or diarrhea
   7. Impaired skin integrity due to swelling, bleeding, and repetitive wiping that delays healing.
2. NURSING INTERVENTION
   1. Include more fiber in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber.
   3. Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal.
   5. Exercise regularly.
   7. Avoid laxatives, except bulk-forming laxatives such as Fiberall, Metamucil, etc. Other types of laxatives can lead to diarrhea, which can worsen hemorrhoids.
   8. When you feel the need to have a bowel movement, don't wait too long to use the bathroom.
3. TREATMENT
   1. Nonsurgical treatment relives pain swelling and pressure.
   2. Topical medicines like cream, lotions and suppositories soothe and shrink tissue.
   3. Sitz baths are comforting.
   4. Hot and cold applications are used.
   5. For thrombosed hemorrhoids ice packs are applied for a few hours then warm packs.
4. SURGICAL TREATMENT
   1. 1. Ligation- Tying off with rubber bands, blood supply is stopped, tissue shrinks and dies, then falls off.
   2. 2. Sclerotherapy- An agent is injected into the tissue around the hemorrhoids, causing them to shrink. The results are temporary.
   3. 3. Thermocoagulation and Electrocoagulation- use of different types of devices to remove the hemorrhoid.
   4. 4. Laser Surgery- effective but more expensive and risky.
5. PATHOPHYSIOLOGY
   1. Hemorrhoids are dilated veins in the Rectum. They may be above the Sphincter muscles of the anus (internal hemorrhoids) or below these muscles (external hemorrhoids).
   2. Topic
   3. If blood clots form in external hemorrhoids, they become inflamed and very painful.
   4. Topic
   5. Hemorrhoids containing clotted blood are said to be Thrombosed.
6. SIGNS AND SYMPTOMS
   1. The most common symptoms of hemorrhoids are rectal pain and itching. Bleeding may occur with defecation, especially if the hemorrhoids are internal.
   2. Topic
   3. External hemorrhoids are easy to see and appear red or bluish.