From the Guidelines
The best treatment for hemorrhoid discharge is a combination of increasing fiber intake, using topical corticosteroids, and practicing good hygiene. According to the American Gastroenterological Association medical position statement 1, the cornerstone of medical therapy for hemorrhoids is adequate intake of fiber and water. Topical corticosteroids and analgesics are useful for managing perianal skin irritation due to poor hygiene, mucus discharge, or fecal seepage.
Some key points to consider in the treatment of hemorrhoid discharge include:
- Increasing fiber intake to 25-30 grams daily to soften stool and reduce straining during bowel movements
- Drinking plenty of water (6-8 glasses daily) to help prevent constipation
- Using over-the-counter medications like hydrocortisone cream (0.5-1%, applied up to 3-4 times daily for no more than 7 days) to reduce inflammation and itching
- Practicing good hygiene, including keeping the anal area clean and dry, to prevent infection and irritation
- Avoiding straining during bowel movements and not sitting for prolonged periods to prevent worsening of symptoms
It's also important to note that prolonged use of potent corticosteroid preparations can be harmful and should be avoided 1. Additionally, some studies have shown that oral micronized, purified flavonoid fraction (MPFF) can increase venous tone, lymphatic drainage, and capillary resistance and normalize capillary permeability, which may be beneficial in reducing hemorrhoidal symptoms 1. However, more research is needed to fully understand the effectiveness of MPFF in treating hemorrhoid discharge.
In severe cases, procedures like rubber band ligation or surgical removal may be necessary to treat hemorrhoid discharge. If discharge is accompanied by severe pain or heavy bleeding, medical attention should be sought immediately.
From the Research
Treatment Options for Hemorrhoid Discharge
- Hemorrhoids can be managed conservatively with dietary changes, stool softeners, and local hydrocortisone creams 2
- For persistently bleeding or painful internal hemorrhoids, the technique of band ligation is recommended 2, 3
- Rubber band ligation is the interventional treatment of choice for grade I-II hemorrhoids 4
- Surgical procedures such as stapled hemorrhoidopexy (Longo) and Hemorrhoidal Artery Ligation (HAL) may be considered for grade III-IV hemorrhoids 4
- Injection sclerotherapy and rubber band ligation have been shown to be efficient, inexpensive, and safe methods for the treatment of bleeding hemorrhoids 3
Conservative Management
- A fiber-enriched diet is the primary treatment option, recommended in the perioperative period as well as a long-term prophylaxis 4
- Topical ointments or suppositories and/or flavonoids may be used as further treatment options 4
- Dietary measures that increase the intake of fluids and fiber, such as bran, can help manage early symptoms 5
Surgical Interventions
- Closed type of hemorrhoidectomy is effective and safe for large prolapsing or acutely thrombosed hemorrhoids 5
- Stapled hemorrhoidopexy (Longo) is particularly advisable for circular hemorrhoids and may be employed in the emergency situation of an acute anal prolapse 4
- Hemorrhoidal Artery Ligation (HAL) and Recto-Anal Repair (RAR) may be considered for grade III and IV hemorrhoids 4