ABOUT
ALMORANAS
Almoranas is a condition in which the increased pressure in the veins weaken the muscles and connective tissues in the hemorrhoids which cause them to distend.
Swollen and inflamed veins around the anus or lower rectum often a result of straining to have a bowel movement. Other factors include pregnancy, aging, and chronic constipation.

SIGNS & SYMPTOMS
External almoranas are found under the skin around your anus.
- Discomfort or pain
- Itching or irritation in the anus
- Bleeding
- Swelling around your anus
Internal almoranas lie inside the rectum.
- Painless bleeding during bowel movement
- A hemorrhoid pushing through the opening of the anus, causing pain and irritation.
Thrombosed almoranas occurs when blood forms a clot in the external hemorrhoid.
- Severe pain
- Inflammation
- Tender lump near the anus

SIGNS & SYMPTOMS
External almoranas are found under the skin around your anus.
- Discomfort or pain
- Itching or irritation in the anus
- Bleeding
- Swelling around your anus
Internal almoranas lie inside the rectum.
- Painless bleeding during bowel movement
- A hemorrhoid pushing through the opening of the anus, causing pain and irritation.
Thrombosed Almoranas occurs when blood forms a clot in the external hemorrhoid
- Severe pain
- Inflammation
- Tender lump near the anus


TREATMENT
INTERNAL ALMORANAS
- Only MPFF
- Sclerotherapy
- Infrared coagulation
- Rubberband ligation
- Hemorrhoidal Artery Ligation
- Hemorrhoidectomy
- Stapled Hemmorhoidopexy
EXTERNAL ALMORANAS
- Phlebotropic agent
- Laxatives4
- Analgesics (acetaminophen)
- NSAID/corticosteroid (pregnancy)
- Ointment (steroids +/lidocaine)
- Hot sitz baths
- Removing the clot
GRADES5
Clinical Signs
visible solely with anoscopy, almoranas protrude on straining, not prolapsed
Symptoms
bleeding, sensation of discomfort
Clinical Signs
prolapse at the anal margin during straining, almoranas return when straining ends
Symptoms
variable discharge, pruritus
Clinical Signs
prolapse during defecation or straining, requires manual reduction
Symptoms
oozing, frank prolapse
Clinical Signs
irreducible prolapse or recurs immediately after manual reduction
Symptoms
pain
RISK FACTORS6
Lack of erect posture
Familial tendency
Chronic diarrhea
Colon malignancy
Hepatic disease
Obesity

GRADES5
Clinical Signs
visible solely with anoscopy, almoranas protrude on straining, not prolapsed
Symptoms
bleeding, sensation of discomfort
Clinical Signs
prolapse at the anal margin during straining, almoranas return when straining ends
Symptoms
variable discharge, pruritus
Clinical Signs
prolapse during defecation or straining, requires manual reduction
Symptoms
oozing, frank prolapse
Clinical Signs
irreducible prolapse or recurs immediately after manual reduction
Symptoms
pain
RISK FACTORS6
Lack of erect posture
Familial tendency
Chronic diarrhea
Colon malignancy
Hepatic disease
Obesity

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