Hemorrhoids

Hemorrhoids also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins 

Symptoms:

  • Itching around the anus
  • Discomfort or pain immediately after opening bowels
  • Feelings bowels are not empty
  • Anal discharge
  • Spots of bright red blood after passing stool
Causes
  • Pregnancy
  • Childbirth
  • Irregular eating habits
  • Poor toilet habits
  • Overweight
Aim of treatment
  • Reduce symptoms
  • Pain
  • Bleeding
  • Swelling
  • Promote healing
  • Prevent recurrence.

Non-Pharmacological Treatments

Increasing dietary fibre and fluid intake

Perianal hygiene is helpful to aid healing and reduce irritation and itching

Pharmacological Treatment

Astringents: Prepartion H, Anusol

Form a protective layer over the affected area and help relieve local irritation and inflammation: 

Hydrocortisone reduces inflammation

Should not be used in under 18s or pregnant women

Long-term use of corticosteroid creams can cause ulceration or permanent damage due to thinning of the perianal skin and should be avoided. 

Continuous or excessive use carries a risk of adrenal suppression and systemic corticosteroid effects: Should not be used for longer than 7 days

Local anaesthetic: Germoloids cream

Helps with relieving pain, burning and itching

Should not be used longer than 2 weeks (causes sensitisation)

Symptom control:If
Constipation:
A bulk-forming laxative can be prescribed

Pain: A simple analgesic such as paracetamol can be used for pain relief.  Avoid: Opioid analgesics should be avoided as they can cause constipation. NSAIDs should be avoided if rectal bleeding is present