Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Hemorrhoids and perianal pain
from Chief complaints and diagnoses
Published online by Cambridge University Press: 18 December 2009
Edited by
Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Summary
This chapter addresses perianal painful conditions encountered in the ED setting. Laxatives are the initial therapy for perianal pain from a variety of conditions. Topically applied nitroglycerin is widely recommended for pain caused by either anal fissures or thrombosed external hemorrhoids. The utility of NSAIDs in post-hemorrhoidectomy pain is demonstrated by trials of perioperative administration of agents such as ketorolac and diflunisal. For patients with chronic anal fissure or painful external hemorrhoids who fail nitroglycerin therapy, or who have intolerable side effects to the drug, calcium channel blockers have been recommended as an alternative means to reduce anal tone and relieve symptoms. Perianal pain may also be the presenting complaint for patients with Condylomata acuminatum.The systemic condition lichen sclerosus, usually treated with potent topical corticosteroids, causes perianal (and vulvar) pain that can be significantly alleviated with topical 1% pimecrolimus cream.
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- Emergency Department AnalgesiaAn Evidence-Based Guide, pp. 232 - 242Publisher: Cambridge University PressPrint publication year: 2008