Hemorrhoids, also known as piles

 Hemorrhoids, also known as piles, are swollen veins in the lower rectum or anus. They can be internal (inside the rectum) or external (under the skin around the anus). Common symptoms include pain, itching, bleeding, and swelling around the anal area. Hemorrhoids are caused by increased pressure in the rectal veins due to straining during bowel movements, constipation, prolonged sitting, pregnancy, and other factors.

Medicines Used in the Treatment of Hemorrhoids (India)

The treatment of hemorrhoids usually involves topical medications, oral treatments, and lifestyle changes. Below is a list of medications used to manage hemorrhoid symptoms, their mechanism of action, and brand names available in India.

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1. Topical Anesthetics

• Mechanism of Action: Topical anesthetics relieve pain and discomfort by numbing the affected area. They block nerve signals that carry pain sensations.
• Common Drugs:
  • Lidocaine
  • Pramoxine
• Brand Names in India:
  • Xylocaine (Lidocaine)
  • Proctofoam HC (Pramoxine)

2. Topical Corticosteroids

• Mechanism of Action: Corticosteroids reduce inflammation, swelling, and itching by inhibiting the release of inflammatory chemicals in the body.
• Common Drugs:
  • Hydrocortisone
• Brand Names in India:
  • Proctosedyl (Hydrocortisone + other agents)
  • Anovate Cream (Hydrocortisone + Lidocaine)

3. Vasoconstrictors

• Mechanism of Action: Vasoconstrictors reduce blood flow to the hemorrhoidal tissues, helping to reduce swelling and discomfort.
• Common Drugs:
  • Phenylephrine
• Brand Names in India:
  • Preparation H (Phenylephrine)

4. Stool Softeners (Laxatives)

• Mechanism of Action: Stool softeners prevent constipation and straining during bowel movements by making stools easier to pass, thus reducing pressure on hemorrhoids.
• Common Drugs:
  • Docusate Sodium
  • Lactulose
• Brand Names in India:
  • Duphalac (Lactulose)
  • Softril (Docusate Sodium)

5. Flavonoid-Based Oral Medications (Venoactive Drugs)

• Mechanism of Action: Flavonoid-based drugs improve venous tone, reduce capillary permeability, and decrease inflammation, helping to reduce the size of hemorrhoids and prevent bleeding.
• Common Drugs:
  • Diosmin
  • Hesperidin
• Brand Names in India:
  • Daflon 500 mg (Diosmin + Hesperidin)

6. Anti-Inflammatory and Astringent Agents

• Mechanism of Action: These agents work by shrinking swollen tissues, soothing irritation, and forming a protective barrier over hemorrhoidal tissue to reduce pain and discomfort.
• Common Drugs:
  • Witch Hazel (Astringent)
  • Zinc Oxide (Anti-inflammatory)
• Brand Names in India:
  • Anovate Cream (Witch Hazel + Zinc Oxide + Lidocaine)

7. Combination Creams and Suppositories

• Mechanism of Action: These creams combine multiple ingredients such as corticosteroids, local anesthetics, vasoconstrictors, and astringents to provide relief from pain, swelling, and itching.
• Common Drugs:
  • Hydrocortisone + Lidocaine
  • Zinc Oxide + Lidocaine + Hydrocortisone
• Brand Names in India:
  • Proctosedyl (Hydrocortisone + Lidocaine)
  • Anovate Cream

8. Sitz Baths and Antiseptic Solutions

• Mechanism of Action: Warm water baths, also known as sitz baths, help soothe the anal area and reduce irritation. Antiseptic solutions help prevent infections in the affected area.
• Common Solutions:
  • Potassium Permanganate
• Brand Names in India:
  • Potassium Permanganate is often available in pharmacies and used as a dilute solution for sitz baths.

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Lifestyle Modifications

In addition to medications, lifestyle changes are often recommended for the treatment and prevention of hemorrhoids:

• High-Fiber Diet: Eating more fiber (fruits, vegetables, whole grains) can prevent constipation and reduce strain on hemorrhoids.
• Hydration: Drinking plenty of water can help soften stools.
• Regular Exercise: Physical activity helps maintain regular bowel movements.
• Avoid Straining: Minimize straining during bowel movements by avoiding prolonged sitting and preventing constipation.

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Conclusion

Hemorrhoids are managed with a variety of topical creams, oral medications, and lifestyle changes aimed at reducing symptoms like pain, swelling, itching, and bleeding. Treatment options include local anesthetics, corticosteroids, vasoconstrictors, flavonoid-based medications, and stool softeners. Many of these medications are available in combination formulations, and brand names are widely available in India.