Hemorrhoids medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Medical Therapy
- There is no medicine that will cure hemorrhoids, but local treatments such as warm sitz baths, using a bidet, extendable showerhead, cold compress, or topical analgesic (such as Nupercainal), can provide temporary relief.
- Consistent use of medicated creams during the early stages of a hemorrhoid flare-up will also provide relief and may stave off further development and irritation.
- However, creams containing steroid preparations weaken the skin and may contribute to further flare-ups. [1][2]
Natural treatments
- Reducing regional pressure in such ways as improving posture and muscle tone, or in severe cases, undergoing a profound psychophysical reeducation, by a method such as the Alexander Technique.
- Taking herbs and dietary supplements that strengthen vein walls, such as butcher's broom, horse chestnut, bromelain, and Japanese pagoda tree extracts. Drinking 99% pure aloe juice can also relieve itching and swelling.
- Topical application of natural astringents and soothing agents, such as Witch hazel (astringent), cranesbill, aloe vera, and honey
- Drinking chamomile tea several times a day
- Eating fiber-rich bulking agents such as plantain and Psyllium seed husks to help create soft stool that is easy to pass to lessen the irritation of existing hemorrhoids.
- Using the squatting position for bowel movements.[3]
The combination of internal and external remedies is particularly recommended, e.g. witch-hazel suppositories combined with frequent cups of strong chamomile tea.[4]
Oral dietary supplementation can help to treat and prevent many complications of hemorrhoids, and natural botanicals such as Butchers Broom, Horse Chestnut, and bioflavonoids can be an effective addition to hemorrhoid treatment.[5]
Butcher's Broom
Butcher’s broom extract, or Ruscus aculeatus, contains ruscogenins that have anti-inflammatory and vasoconstrictor effects. Supplementation with Butcher’s Broom helps tighten and strengthen veins. Butcher’s broom has traditionally been used to treat venous problems including hemorrhoids and varicose veins.[6][7][8][9]
Horse Chestnut
Horse chestnut extract, or Aesculus hippocastanum, contains a saponin known as aescin, that has anti-inflammatory, anti-edema, and venotonic actions. Aescin improves tone in vein walls, thereby strengthening the support structure of the vein. Double blind studies have shown that supplementation with horse chestnut helps relieve the pain and swelling associated with chronic venous insufficiency.[10][11]
Bilberry Bioflavonoid
Bilberry extract, or Vaccinium myrtillus, is an anthocyanoside bioflavonoid. Supplementation with this potent flavonoid protects and maintains venous strength and function.[6][12]
Enema
This Practice is used to clean the rectum. While it is a simple procedure, it can be complicated by hemorrhoids, so in such cases, it should be done by a doctor. In an enema, water is injected into the rectum and then flushed out, cleaning the area.
At-home Treatment
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining. Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains. On average, Americans eat about 15 grams of fiber each day.3 The American Dietetic Association recommends 25 grams of fiber per day for women and 38 grams of fiber per day for men.3 Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel). Other changes that may help relieve hemorrhoid symptoms include
- Drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
- Sitting in a tub of warm water for 10 minutes several times a day
- Exercising to prevent constipation
- Not straining during bowel movements
Over-the-counter creams and suppositories may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.
Outpatient Treatment
If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor’s office or a hospital. Outpatient treatments for internal hemorrhoids include the following:
- Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor.
- Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.
- Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.
Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed. [13]
References
- ↑ http://www.netdoctor.co.uk/medicines/100002157.html
- ↑ http://www.medbroadcast.com/drug_info_details.asp?brand_name_id=946
- ↑ Christine Dimmer, Brian Martin, Noeline Reeves and Frances Sullivan (1996). "Squatting for the Prevention of Hemorrhoids". Townsend Letter for Doctors & Patients (159): 66–70. Unknown parameter
|month=ignored (help) - ↑ K. Kraft and C. Hobbs, Pocket Guide to Herbal Medicine. New York: Thieme.
- ↑ MacKay D (2001). "Hemorrhoids and varicose veins: a review of treatment options" (PDF). Altern Med Rev. 6 (2): 126–40. PMID 11302778.
- ↑ 6.0 6.1 Pizzorno JE and Murray MT, eds., ed. (1998). Encyclopedia of Natural Medicine (revised 2nd edition ed.). CA: Prima Publishing. p. 829.
- ↑ Rudofsky G (1989). "[Improving venous tone and capillary sealing. Effect of a combination of Ruscus extract and hesperidine methyl chalcone in healthy probands in heat stress]". Fortschr. Med. (in German). 107 (19): 52, 55–8. PMID 2668140.
- ↑ Cappelli R, Nicora M, Di Perri T (1988). "Use of extract of Ruscus aculeatus in venous disease in the lower limbs". Drugs Exp Clin Res. 14 (4): 277–83. PMID 3048951.
- ↑ Greenspon J, Williams SB, Young HA, Orkin BA (2004). "Thrombosed external hemorrhoids: outcome after conservative or surgical management". Dis. Colon Rectum. 47 (9): 1493–8. doi:10.1007/s10350-004-0607-y. PMID 15486746.
- ↑ Pittler MH, Ernst E (1998). "Horse-chestnut seed extract for chronic venous insufficiency. A criteria-based systematic review". Arch Dermatol. 134 (11): 1356–60. PMID 9828868.
- ↑ Diehm C, Trampisch HJ, Lange S, Schmidt C (1996). "Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency". Lancet. 347 (8997): 292–4. PMID 8569363.
- ↑ Murray MT. (1996). Encyclopedia of Nutritional Supplements. NY: Three Rivers Press. p. 326.
- ↑ Slavin JL (2008). "Position of the American Dietetic Association: health implications of dietary fiber". J Am Diet Assoc. 108 (10): 1716–31. PMID 18953766.