What medications are used to treat bleeding caused by internal hemorrhoids?

From the Guidelines

Medications for Bleeding Caused by Internal Hemorrhoids Bleeding caused by internal hemorrhoids can be treated with medications such as flavonoids, which have been shown to relieve symptoms 1.

• Topical application of nitroglycerin ointment may be considered to reduce bleeding and alleviate symptoms, although its use is more commonly associated with thrombosed external hemorrhoids 1.
• Oral administration of fiber supplements, such as psyllium, can help reduce hemorrhoidal bleeding and painful defecation 1.
• Rectal suppositories containing flavonoids, such as daflon, may also be prescribed to reduce bleeding and inflammation 1.
• The use of topical muscle relaxants, such as topical nitrates and calcium channel antagonists, has been proposed for the treatment of thrombosed hemorrhoids, but its effectiveness for internal hemorrhoids is less clear 1. It is essential to note that the evidence for these medications is not always strong, and their use may be based on weak recommendations or low-quality evidence 1.
• Additionally, medications such as NSAIDs, topical steroids, and injection of local anesthetics are not recommended for complicated hemorrhoids due to a lack of evidence supporting their use 1.
• Dietary and lifestyle changes, such as increased fiber and water intake, are also recommended as first-line therapy for complicated hemorrhoids 1.

From the Research

Medications for Bleeding Caused by Internal Hemorrhoids

• There are several medications that can be used to treat bleeding caused by internal hemorrhoids, including:
  • Nitroglycerin ointment: This medication is a nitric oxide donor that can help to relax the internal anal sphincter and improve blood flow to the area 2, 3, 4, 5.
  • Nifedipine gel: This medication is a calcium channel blocker that can help to relax the internal anal sphincter and reduce bleeding 6.
• The effectiveness of these medications can vary depending on the individual and the severity of their symptoms.
• Some studies have shown that nitroglycerin ointment can be effective in reducing bleeding and pain associated with internal hemorrhoids, but it can also cause side effects such as headaches 2, 3, 4, 5.
• Nifedipine gel has been shown to be effective in reducing bleeding and pain associated with acute thrombosed hemorrhoids, with minimal side effects 6.
• The optimal dosage and administration of these medications can vary depending on the individual and the severity of their symptoms, and should be determined by a healthcare professional.
• It is also important to note that while these medications can help to treat the symptoms of internal hemorrhoids, they may not address the underlying cause of the condition, and additional treatment may be necessary to prevent recurrence.
• Some studies have compared the effectiveness of different concentrations of nitroglycerin ointment, and found that higher concentrations may be more effective in reducing bleeding and pain associated with internal hemorrhoids 5.
• Other studies have compared the effectiveness of nitroglycerin ointment to other treatments, such as lateral internal sphincterotomy, and found that nitroglycerin ointment may be less effective in some cases 4.