From the Guidelines
Oral flavonoids are recommended to relieve symptoms in patients with complicated hemorrhoids, as suggested by the most recent and highest quality study 1. When considering oral medications for hemorrhoids, it's essential to prioritize a comprehensive approach that includes dietary and lifestyle changes, such as increased fiber and water intake, and adequate bathroom habits 1. Some key points to consider when managing hemorrhoids with oral medications include:
- Increasing fluid intake to 6-8 glasses of water daily
- Consuming a high-fiber diet of 25-30g daily
- Engaging in regular physical activity
- Using fiber supplements like Metamucil, Citrucel, or Benefiber to soften stool and reduce straining
- Managing discomfort with pain relievers like acetaminophen or ibuprofen for short-term use
- Considering prescription medications like oral diosmin/hesperidin combinations for more severe cases, as they can strengthen vein walls and improve circulation 1. It's crucial to note that oral medications typically work more slowly than direct topical treatments and may not be suitable for all patients. If symptoms persist beyond one week despite these measures, medical evaluation is recommended.
From the Research
Effective Oral Medications for Hemorrhoids
There are several oral medications that can be used to treat hemorrhoids, including:
- Stool softeners, which can help relieve symptoms by softening the stool and making it easier to pass 2
- Fiber supplements, which can help increase the bulk of the stool and reduce the risk of constipation 3, 4
- Venotonic drugs, which can help improve blood flow and reduce swelling 3
- Nonsteroidal anti-inflammatory drugs (NSAIDs), which can help reduce pain and inflammation 2, 4
- Topical nitroglycerine, which can help relax the anal sphincter and reduce pain 4
Treatment Approaches
The treatment approach for hemorrhoids often depends on the severity of the symptoms and the grade of the hemorrhoids. Some common treatment approaches include:
- Medical management, which includes the use of oral medications and topical preparations 2, 4
- Office-based treatments, such as rubber band ligation and infrared photocoagulation 4
- Surgical treatments, such as excisional hemorrhoidectomy and stapled hemorrhoidopexy 2, 3, 5, 4
- Lifestyle modifications, such as increasing fiber and water intake, and avoiding straining during bowel movements 3, 4
Current Research
There is ongoing research into the effectiveness of different treatment approaches for hemorrhoids, including a randomized controlled trial comparing rubber band ligation and sclerotherapy for symptomatic grade 1-2 hemorrhoids 6. This study aims to determine which treatment method is the most effective, gives fewer complications, and is experienced by the patient as the best option.