From the Guidelines
For hemorrhoids, the most effective treatment approach is to start with non-operative management, including dietary and lifestyle changes, such as increased fiber and water intake, alongside adequate bathroom habits, as recommended by the World Journal of Emergency Surgery in 2021 1.
Treatment Approach
The treatment of hemorrhoids depends on their severity, and medical therapy is most appropriate for first-degree hemorrhoids, with the cornerstone being adequate intake of fiber and water, as stated by the American Gastroenterological Association in 2004 1.
- Topical corticosteroids and analgesics can be useful for managing perianal skin irritation due to poor hygiene, mucus discharge, or fecal seepage.
- Prolonged use of potent corticosteroid preparations should be avoided due to potential harm.
Medication Recommendations
- For symptomatic relief, topical medications containing hydrocortisone (0.5-1%) can reduce inflammation and itching, and should be applied up to four times daily for no more than 7 days.
- Witch hazel pads or creams provide cooling relief and mild astringent effects.
- Products containing lidocaine (up to 5%) offer temporary pain relief.
- Oral pain relievers like acetaminophen or ibuprofen can help manage discomfort.
- Stool softeners such as docusate sodium (100mg once or twice daily) prevent constipation that can worsen hemorrhoids.
Lifestyle Changes
- Increasing fiber intake to 25-30g daily is essential for recovery and prevention.
- Drinking plenty of water and avoiding straining during bowel movements are also crucial.
Further Evaluation
If symptoms don't improve within 1-2 weeks or if bleeding occurs, medical evaluation is necessary as prescription treatments or procedures may be required, as suggested by the American Gastroenterological Association in 2004 1.
Complicated Hemorrhoids
In patients with complicated hemorrhoids, non-operative management is recommended as first-line therapy, with dietary and lifestyle changes, and flavonoids may be administered to relieve symptoms, as suggested by the World Journal of Emergency Surgery in 2021 1.
From the Research
Medication for Hemorrhoids
The following medications are prescribed for hemorrhoids:
- Stool softeners
- Topical over-the-counter preparations
- Topical nitroglycerine 2
Treatment Options
Treatment options for hemorrhoids include:
- Medical management
- Dietary modifications (e.g., increased fiber and water intake)
- Behavioral therapies (sitz baths)
- Office-based treatment of grades I to III internal hemorrhoids with rubber band ligation
- Open or closed (conventional) excisional hemorrhoidectomy
- Stapled hemorrhoidopexy
- Hemorrhoidal artery ligation 2, 3, 4
Surgical Interventions
Surgical interventions for hemorrhoids include: