Haemorrhoids/piles

• Haemorrhoids/Piles

  • Internal, swollen veins which protrude into the anal canal
  • External, swollen veins which extend outside the anus
• Symptoms of haemorrhoids?

  
  

  itching,

  burning, pain,

  swelling

  soreness in the perianal area and anal canal, pain during and immediately after opening the bowels,

  rectal bleeding-bright red spots on the tissue
• Causes of haemorrhoids

  Pregnancy & child birth, increased pressure on the hemorrhoidals vessels/straining

  Constipation, exacerbates symptoms of haemorrhoids, straining

  Overweight

  Poor toilet habits
• Haemorroids REFER symptoms

  symptoms lasting longer than 3 weeks

  Unresponsive to ONE week of OTC treatment

  Blood in stools - dark, deep red, tarry coloured stools ( gastric ulcer/carcinoma suspect)

  abdominal pain

  Nausa & Vomitting

  Altered change in bowel habit ( suspect colorectal cancer)

  pregnant women ( NOT licensed for OTC treatment )

  Severe sharp pain on defecation ( anal fissures suspect)

  medication causing constipation
• Mild local bleeding, specks of blood on toilet paper caused by haemorrhoids can be treated by pharmacist
• 1st line treatment for haemorrhoids?

  Local anaesthetics ( lidocaine, benzocaine) relieves pain, burning and itching. Max 2 weeks due to sensitisation

  • germoloids ( lidocaine & Zinc oxide)
• 2nd line treatment for haemorrhoids

  Astringents ( bismuth, zinc oxide, witch hazel)

  Forms a protective layer over the affected area and help to relieve local irrational and inflammation

  • Anusol ( Zinc & Bismuth & Balsam)
• 3rd line treatment for haemorrhoids?

  anti-inflammagents ( hydrocortisone) reduces inflammation and swelling (>18 years ) max 7 days use

  • anusol plus HC: hydrocortisone & zinc & bismuth & balsam
• Counselling for haemmorrhoids

  Similar dietary advice to constipation to prevent straining