What is the role of topical medications in the treatment of hemorrhoids?

Updated: Sep 24, 2019
  • Author: Kyle R Perry, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Few high-quality data exist regarding the use of topical treatment in patients with hemorrhoids. [29]

The use of topical steroids has not been well-studied in the treatment of thrombosed hemorrhoids; however, these agents can be used to decrease symptoms of pruritus and inflammation. Topical hydrocortisone can sometimes ease internal hemorrhoidal bleeding. It is important to consider the principles of steroid use and the associated side effects, such as mucosal atrophy. As such, the prolonged use of topical steroids should be avoided.

Some authors rarely recommend typical medications (eg, suppository, cream, enema, foam) in the treatment of hemorrhoids. Submucosal veins do not get smaller with anti-inflammatory medications.

Topical nitroglycerine and nifedipine have also been used to relieve symptoms associated with anal sphincter spasm. [30, 31] These agents should also be used with caution because of associated side effects, such as hypotension. Good evidence suggests that high-fiber diets in particular help reduce severity and duration of symptoms.


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