Managing Internal Hemorrhoids: Medication and Treatment Guidance

Medications for Internal Hemorrhoids Issues

Hello Dr.
Chang,
I previously sought treatment for hemorrhoids after experiencing a prolapse of an internal hemorrhoid (asymptomatic and no blood in stool).
The doctor diagnosed it as a Grade III hemorrhoid and manually reduced it, prescribing a week’s supply of Laxatan capsules and a tube of Yizhi Kang ointment.
Now, after a week, I have finished the Laxatan capsules, and the hemorrhoid has slightly reduced in size.
Currently, during bowel movements, the internal hemorrhoid still prolapses but retracts on its own afterward.
I have a few questions for the doctor:
1.
Should I return for a follow-up appointment to obtain more Laxatan capsules, or is it sufficient to continue using the Yizhi Kang ointment?
2.
If I continue with the ointment, how long should I apply it, and under what circumstances can I stop using the medication?
Thank you, doctor.

hiraku, 30~39 year old female. Ask Date: 2023/05/30

Dr. Zhang Shuhao reply Surgery

1.
Laxatan capsules can help reduce swelling during hemorrhoid flare-ups, but if prolapse occurs easily after the swelling subsides, it indicates that the hemorrhoids themselves are large, and the medication may have limited effectiveness; surgical intervention may need to be considered.
2.
Topical medications and warm sitz baths are both methods to manage symptoms; apply medication until there is no swelling, pain, or bleeding.

Reply Date: 2023/05/30

More Info

Managing internal hemorrhoids can be a challenging process, especially when dealing with symptoms such as prolapse and discomfort during bowel movements. Based on your description, it seems you have been diagnosed with grade III internal hemorrhoids, which can indeed cause significant discomfort and may require ongoing management. Here’s a comprehensive approach to your questions regarding medication and treatment guidance.

1. Continuation of Medication: Since you have completed the course of Laxitan capsules (which are typically used to soften stools and ease bowel movements), it’s important to assess whether you still need them. If you are experiencing difficulty with bowel movements or if your stools remain hard, it may be beneficial to continue using a stool softener or laxative as prescribed by your doctor. However, if your bowel movements are regular and soft, you might not need to continue the Laxitan. It’s advisable to consult your physician for a follow-up appointment to discuss your current symptoms and determine whether you should resume the medication.

2. Topical Treatment with Yizhi Kang Ointment: The Yizhi Kang ointment is likely a topical treatment aimed at reducing inflammation and discomfort associated with hemorrhoids. You can continue applying the ointment as directed. Typically, such ointments can be used after each bowel movement or as needed for relief. The duration of use can vary; generally, you should continue applying the ointment until the symptoms, such as pain, itching, or bleeding, have resolved. If you notice improvement and the hemorrhoids are no longer protruding or causing discomfort, you may consider tapering off the ointment. However, if symptoms persist or worsen, it’s crucial to seek further medical advice.

3. When to Seek Further Medical Attention: If your internal hemorrhoids continue to prolapse during bowel movements or if you experience increased pain, bleeding, or any other concerning symptoms, it is essential to return to your healthcare provider. They may recommend additional treatments, such as rubber band ligation, sclerotherapy, or even surgical options if conservative measures fail.
4. Lifestyle Modifications: In addition to medication, consider implementing lifestyle changes that can help manage and prevent the recurrence of hemorrhoids. This includes:
- Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains to promote regular bowel movements and prevent straining.

- Hydration: Drink plenty of water to help keep stools soft.

- Regular Exercise: Engage in regular physical activity to improve bowel function.

- Avoid Straining: When using the bathroom, try to avoid prolonged sitting or straining, which can exacerbate hemorrhoids.

5. Monitoring Symptoms: Keep a close eye on your symptoms. If you notice any changes, such as increased bleeding or pain, or if the hemorrhoids do not improve with treatment, it is crucial to follow up with your healthcare provider.
In summary, while you may continue using the Yizhi Kang ointment, it is essential to assess the need for Laxitan based on your bowel habits. Regular follow-up with your physician is important to ensure that your treatment plan is effective and to make adjustments as necessary. Remember, managing hemorrhoids often requires a multifaceted approach, including medication, lifestyle changes, and possibly further medical interventions.

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