Side Effects and Treatment for Hemorrhoids and Bowel Issues

Are there any side effects?

Hello Dr.
Lin, I have had irregular bowel habits for a long time, experiencing both diarrhea and constipation.
I have also had instances of rectal bleeding after bowel movements, but two days ago, the amount of bleeding increased.
Additionally, my stool has been a darker coffee color than usual, which has caused me concern.
I visited a gastroenterologist who stated that 99.9% of rectal bleeding is related to hemorrhoids (I seem to have an external hemorrhoid, which is a protruding tissue near the anal area that is not painful).
He recommended that I start with medication and, if there is no improvement, to undergo further examination.
The medications prescribed are as follows: 1.
Xylmol suppository, 2.
Proctosedyl ointment, 3.
Magnesium oxide.
However, after using them for a day, I noticed blood when wiping after urination, and the amount of bleeding during bowel movements has not decreased; the color remains a dark coffee color.
The stool has become thinner and has mixed with the color of the Xylmol suppository (which is white).
I would like to ask Dr.
Lin the following questions: 1.
Is it normal for there to be blood even when not having a bowel movement, indicating the medication's effectiveness? 2.
Is it normal for the stool to have the color of the Xylmol suppository during bowel movements, or could I be using it incorrectly, resulting in residual medication? 3.
The doctor prescribed a week's worth of medication; should I wait until I finish the medication before returning for a follow-up? 4.
The Proctosedyl ointment can be used for more than a week according to my usage, but the product instructions state not to exceed 7 days.
Should I stop using it after a week? 5.
The Proctosedyl ointment comes with a tube for internal use, but since I have already used the Xylmol suppository, I am only applying it externally.
Should I use the Proctosedyl ointment internally as well? I would greatly appreciate your answers.

aul, 30~39 year old female. Ask Date: 2009/11/26

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
The medications for hemorrhoids should provide pain relief, promote the healing of skin wounds, and cause vasoconstriction to stop bleeding.
If bleeding or pain persists, further treatment is necessary.

2.
Suppositories are primarily absorbed through the rectum, and some liquid may leak out.

3.
If you have any questions, you can consult a physician or pharmacist.

4.
Please refer to the medication's instruction leaflet; if symptoms do not improve, you should seek medical attention.
If symptoms improve, there is no need to continue applying the medication.

5.
Suppositories and ointments with applicators used rectally should have similar effects; it is recommended to use one or the other.

Wishing you good health,
Dr.
Lin Ming-Hui, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2009/11/26

More Info

When it comes to understanding the side effects and treatment options for hemorrhoids and bowel issues, it's essential to consider both the symptoms and the medications prescribed. Based on your description, it seems you are experiencing a combination of hemorrhoidal bleeding and changes in bowel habits, which can understandably cause concern.

1. Bleeding During Bowel Movements: The presence of blood during bowel movements can often be attributed to hemorrhoids, especially if you have a history of constipation and straining. Hemorrhoids can become inflamed and bleed, particularly when there is increased pressure during bowel movements. However, if you notice blood outside of bowel movements, it may indicate irritation or damage to the anal area, which can occur with frequent wiping or other factors.

2. Color of Stool: The deep coffee color of your stool can be concerning. This could indicate the presence of digested blood, which may suggest a more serious issue, such as gastrointestinal bleeding. However, if the color change is accompanied by the use of medications like Xylmol suppositories, it could also be a result of the medication itself. It is important to monitor these changes closely.

3. Medication Efficacy: Regarding your questions about the medications prescribed:
- Xylmol Suppositories: It is not uncommon to see some residual color from the suppository in your stool. This does not necessarily mean that the medication is ineffective; it may just be that the suppository has not fully dissolved or absorbed. If you continue to see blood, it may indicate that the hemorrhoids are still irritated or that there is another underlying issue.

- Proctosedyl Ointment: This medication is typically used for external and internal hemorrhoids. While it is effective for symptom relief, it is crucial to follow the instructions on the packaging. If the label states not to use it for more than seven days, it is advisable to adhere to that guideline to avoid potential side effects or complications from prolonged use.

4. Follow-up with Your Doctor: It is essential to maintain communication with your healthcare provider. If your symptoms do not improve after the course of medication, or if they worsen, you should return for a follow-up appointment sooner rather than later. Your doctor may want to perform further evaluations, such as a colonoscopy, to rule out other causes of bleeding.

5. Use of Proctosedyl Ointment: If you have already been using the Xylmol suppositories, you can still use the Proctosedyl ointment externally. However, if you choose to use it internally, ensure that you do so according to the instructions provided. If you have any doubts about the application, consult your healthcare provider for clarification.

In conclusion, while hemorrhoids are a common cause of rectal bleeding, it is crucial to monitor your symptoms closely. If you experience persistent bleeding, changes in stool color, or any new symptoms, seek medical attention promptly. Your health and comfort are paramount, and addressing these issues early can prevent complications. Always follow your healthcare provider's recommendations and do not hesitate to ask questions about your treatment plan.

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