Managing Hemorrhoids: Safety of Prolonged Use of Medications

Medication for furunculosis?

Hello, doctor.
Recently, I have been experiencing blood in my stool.
I went to the hospital for an examination, and the doctor informed me that I have hemorrhoids, which are quite mild.
I was prescribed Proctosedyl suppositories to use one each night for 14 days, after which I was to return for a follow-up.
During these 14 days, although I didn't have blood in my stool every time, it occurred almost consistently.
On the follow-up day, the doctor who performed the examination was a substitute who appeared to be an intern.
He acknowledged that I was still experiencing bleeding and instructed me to continue using Proctosedyl for another 14 days, along with taking a stool softener.
However, I noticed that the instructions for Proctosedyl indicated it should only be used for 7 days, and I have already used it for 14 days.
Now, I am being asked to use it for a total of one month.
I asked the substitute doctor if this would cause my skin to become thinner, and he only replied, "It shouldn't," which made me quite anxious.
After returning home, I realized that during my showers, I have been trying to clean my anal area more thoroughly.
Initially, it wasn't painful, but later on, I started to feel discomfort while rinsing.
I'm concerned that the skin around my anus may have become thinner.
Can I use Proctosedyl continuously for one month? If my skin does become thinner, will it return to normal after I stop using the medication? Should I continue taking the stool softener for the full 14 days, or can I stop once the bleeding stops?

A Gao, 20~29 year old female. Ask Date: 2016/02/04

Dr. Cai Xingzhi reply Surgery

Use only when symptoms are present; continuous use is not necessary.
For more details, please consult the surgical outpatient department.

Reply Date: 2016/02/04

More Info

Managing hemorrhoids can be a challenging experience, especially when it involves medication use and concerns about side effects. In your case, it seems you have been prescribed a medication called 保痣寧 (which I assume is a topical treatment for hemorrhoids) for a duration that exceeds the recommended usage period mentioned in the product information. This raises valid concerns about the safety of prolonged use and the potential for skin thinning or other side effects.

Understanding the Medication
保痣寧 is typically used to relieve symptoms associated with hemorrhoids, such as pain, itching, and inflammation. It may contain active ingredients that can help reduce swelling and discomfort. However, many topical medications, especially those containing corticosteroids, can lead to skin thinning (atrophy) if used for extended periods. This is particularly a concern in sensitive areas like the anal region, where the skin is already delicate.

Prolonged Use and Safety
The manufacturer's recommendation of a maximum usage of 7 days is likely based on clinical studies that assess the safety and efficacy of the medication. Using it for longer than recommended can increase the risk of side effects, including skin thinning, which can lead to increased sensitivity, pain, and even secondary infections.

In your case, since you have already used the medication for 14 days and are now advised to continue for another 14 days, it is essential to discuss this with your healthcare provider. You should express your concerns about the potential for skin thinning and ask for clarification on the necessity of extending the treatment. It may be beneficial to seek a second opinion from another healthcare professional, especially if you feel uncomfortable with the current plan.

Skin Thinning and Recovery
If skin thinning occurs, the good news is that the skin can often recover after discontinuing the medication. However, the recovery time can vary depending on the extent of the thinning and individual healing processes. Maintaining good hygiene and avoiding irritants in the area can help promote healing. If you notice persistent pain or discomfort, it is crucial to follow up with your healthcare provider.

Use of Softening Agents
Regarding the use of softening agents, these are typically recommended to prevent straining during bowel movements, which can exacerbate hemorrhoids. It is advisable to continue using the softening agent for the full 14 days or until your bowel movements are consistently soft and painless. If you find that your symptoms improve before the 14 days are up, you may discuss with your doctor whether it is appropriate to stop the softening agent early.

Conclusion
In summary, while it is essential to manage your hemorrhoids effectively, it is equally important to do so safely. Prolonged use of medications like 保痣寧 should be approached with caution, and any concerns about skin thinning or other side effects should be addressed with your healthcare provider. Always prioritize open communication with your medical team to ensure that your treatment plan aligns with your health needs and safety. If you experience any new symptoms or worsening of your condition, do not hesitate to seek medical attention.

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