Hemorrhoids

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Hemorrhoid disease is due to enlargement or thrombosis of the veins in the external or internal hemorrhoidal plexus. 

Clinical presentation 

• Painless anal rectal piles
• Painless bleeding –post defecation
• Pain
• Pruritus
• Prolapse

Investigations Endoscopy (Anoscopy, or proctosigmoidoscopy) for evidence of characteristic anal recta piles.

Treatment 

Depends on severity of the disease

Grade I hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods

Grade II or III hemorrhoids are initially treated with nonsurgical procedures (sclerotherapy, band ligation

Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy

Pharmacological Treatment 

A: benzyl benzoate 1.25%, bismuth oxide 0.875%, bismuth subgallate 2.25%, hydrocortisone acetate 0.25%, Peru balsam 1.875%, zinc oxide 10.75% (PR) suppository  one or twice a day 

OR 

S: (Euphobia prostrate extract 100mg + Calcium dobesilate 500mg) (PO) 24hourly (chewable do not swallow) 

AND 

S: (Prednisolone hexanoate 1.3mg +Cinchocaine hydrochloride 1mg) Suppository 24hourly 5-7days