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Pg1}{\bkmkend Pg1}\par\pard\ql \li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb0\sl-276\slmult0 \par\pard\ql\li5900\sb80\sl-276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB\ul0\nosupersub\cf2\f3\fs24 \ul0\nosupersub\cf1\f2\fs24 2 \par\pard\ql \li5012\sb144\sl-276\slmult0 \up0 \expndtw-3\charscalex100 TINJAUAN PUSTAKA \par\pard\li2268\sb0\sl-276\slmult0\par\pard\li2268\sb0\sl-276\slmult0\par\pard\li2268\sb0\sl-276\slmult0\par\pard\li2268\sb145\sl-276\slmult0\fi0\tx2988 \up0 \expndtw-3\charscalex100 2.1.\tab \up0 \expndtw-3\charscalex100 Definisi Hemoroid\par\pard\qj \li2268\ri1501\sb1\sl-415\slmult0\fi720 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf3\f4\fs24 Plexus\ul0\nosupersub\cf2\f3\fs24 hemoroid merupakan pembuluh darah normal yang terletak pada \up0 \expndtw0\charscalex104 mukosa rektum bagian distal dan \ul0\nosupersub\cf3\f4\fs24 anoderm\ul0\nosupersub\cf2\f3\fs24 . Gangguan pada hemoroid terjadi \up0 \expndtw-1\charscalex100 ketika \ul0\nosupersub\cf3\f4\fs24 plexus vaskular\ul0\nosupersub\cf2\f3\fs24 ini membesar. Sehingga kita dapatkan pengertiannya dari \up0 \expndtw0\charscalex100 \u8220?hemoroid adalah dilatasi \ul0\nosupersub\cf3\f4\fs24 varikosus vena\ul0\nosupersub\cf2\f3\fs24 dari \ul0\nosupersub\cf3\f4\fs24 plexus hemorrhoidal inferior\ul0\nosupersub\cf2\f3\fs24 dan \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 superior\ul0\nosupersub\cf2\f3\fs24 \u8221? (Dorland, 2002). \par\pard\qj \li2268\ri1505\sb7\sl-413\slmult0\fi708 \up0 \expndtw0\charscalex100 Hemoroid adalah kumpulan dari pelebaran satu segmen atau lebih vena \line \up0 \expndtw-1\charscalex100 hemoroidalis di daerah anorektal. Hemoroid bukan sekedar pelebaran vena \line \up0 \expndtw0\charscalex102 hemoroidalis, tetapi bersifat lebih kompleks yakni melibatkan beberapa unsur \line \up0 \expndtw-4\charscalex100 berupa pembuluh darah, jaringan lunak dan otot di sekitar anorektal (Felix, 2006). \par\pard\li2268\sb0\sl-276\slmult0\par\pard\li2268\sb267\sl-276\slmult0\fi0\tx2988 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 2.2.\tab \up0 \expndtw-3\charscalex100 Etiologi Hemoroid\par\pard\qj \li2268\ri1507\sb4\sl-420\slmult0\fi720 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf2\f3\fs24 Menurut Villalba dan Abbas (2007), etiologi hemoroid sampai saat ini \line \up0 \expndtw-4\charscalex100 belum diketahui secara pasti, beberapa faktor pendukung yang terlibat diantaranya \line \up0 \expndtw-5\charscalex100 adalah: \par\pard\ql \li2695\sb99\sl-276\slmult0 \up0 \expndtw-1\charscalex100 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Penuaan \par\pard\ql \li2695\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Kehamilan \par\pard\ql \li2695\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 c.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Hereditas \par\pard\ql \li2695\sb124\sl-276\slmult0 \up0 \expndtw-4\charscalex100 d.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Konstipasi atau diare kronik \par\pard\ql \li2695\sb144\sl-276\slmult0 \up0 \expndtw-4\charscalex100 e.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Penggunaan toilet yang berlama-lama \par\pard\ql \li2695\sb144\sl-276\slmult0 \up0 \expndtw-5\charscalex100 f.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Posisi tubuh, misal duduk dalam waktu yang lama \par\pard\ql \li2695\sb124\sl-276\slmult0 \up0 \expndtw-2\charscalex100 g.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Obesitas. \par\pard\qj \li2268\sb0\sl-413\slmult0 \par\pard\qj\li2268\ri1504\sb38\sl-413\slmult0\fi708 \up0 \expndtw0\charscalex100 Faktor-faktor tersebut berkaitan dengan kongesti vaskular dan prolapsus \up0 \expndtw-3\charscalex100 mukosa (Schubert dkk, 2009). Selain itu dikatakan ada hubungan antara hemoroid \up0 \expndtw0\charscalex102 dengan penyakit hati maupun konsumsi alkohol (Mc Kesson Health Solution \up0 \expndtw-3\charscalex100 LCC, 2004). \par\pard\ql \li7854\sb0\sl-230\slmult0 \par\pard\ql\li7854\sb0\sl-230\slmult0 \par\pard\ql\li7854\sb0\sl-230\slmult0 \par\pard\ql\li7854\sb0\sl-230\slmult0 \par\pard\ql\li7854\sb199\sl-230\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf5\f6\fs20 Universitas Sumatera Utara \par\pard\sect\sectd\fs24\paperw11900\paperh16820{\shp{\*\shpinst\shpleft0\shptop0\shpright11900\shpbottom16820\shpwr3\shpfblwtxt0\shpz-10000\shplid1{\sp{\sn shapeType}{\sv 75}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn pib}{\sv 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