Local treatment first
Without hesitation, cream, ointment and/or suppositories are used, which, according to a clinical study, relieve 90% of patients. Most of the products are available for self-medication and can be used even in the event of pregnancy (pending, if necessary, medical advice). They contain components that lubricate or promote healing, and sometimes venotonic plant extracts (Titanoréïne, Emoflon, etc.). If pain predominates, references incorporating a local anesthetic may be preferred (Rectoquotane, Sedorrhoid, etc.). In the event of swelling or hemorrhoidal thrombosis, which is often painful, the presence of corticosteroid in the formula is a plus (Ultraproct, Deliproct), but it requires a medical prescription.
In practice : Suppositories relieve burning or tense sensations associated with internal hemorrhoids. Creams or ointments soothe anal pain, but can also be used in case of internal discomfort. In this case, the finger is used rather than the cannula, which can be responsible for injuries. These treatments are applied two or three times a day for ten to twelve days.
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Venotonics as reinforcement
They increase the resistance of the vessels and oppose their dilation, responsible for the hemorrhoidal thrust. The most studied molecules are those derived from plants such as Ginkgo biloba derivatives (in Ginkor Fort) or flavonoids (in Daflon, Veinamitol, etc.). Several studies show that venotonics can reduce bleeding and even pain.
In practice : they are tried in association with the local treatment. If they do not bring the expected relief, the doses are not repeated during a next push. The recommended doses are higher (sometimes double) than those recommended for venous insuffsance, but for a short period, a week at most. No need to continue them any longer, because they do not prevent recurrences.
An analgesic if necessary
The pain can be very important in case of hemorrhoidal thrombosis. This hard, bluish swelling will take between three and six weeks to resolve on its own. It can sometimes be excised under local anesthesia during a consultation.
In practice : paracetamol is useful, but less effective than an anti-inflammatory such as ibuprofen. However, it is advisable to use it only after a medical consultation which will have eliminated any infection (anal abscess). Ibuprofen should also not be taken during pregnancy.
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Mild laxatives in all cases
Improving the frequency and consistency of stools by fighting against constipation reduces pain and bleeding during the crisis and, above all, limits recurrences.
In practice : in addition to enriching your diet with fiber, you can use mild laxatives, such as the drugs prescribed for chronic constipation (Transipeg, Forlax, Spagulax, etc.). Another option is food supplements containing mucilages or fruit pectins, to sprinkle on your diet (OptiFibre, Superdiet Psyllium Blond Bio, etc.). Note however: irritating stools during episodes of diarrhea also promote hemorrhoidal flare-ups. * Gastroenterologist and proctologist.
When to consult?
If the pain is permanent or worsens after a week of self-medication, it is necessary to eliminate another pathology (tumor, abscess, etc.). In the event of frequent recurrences or failure of medication (persistence of bleeding, for example), an “instrumental” procedure is proposed (elastic ligatures, photocoagulation). However, surgery remains a last resort solution, performed whenever possible with minimally invasive techniques.
