Using suppositories for pain relief and treatment of hemorrhoids

Review of suppositories for hemorrhoids: top 10 most effective

Treatment of hemorrhoids must be carried out immediately after the first signs of the disease appear. The most effective remedy for hemorrhoids in the early stages is suppositories. They quickly soothe pain, relieve itching and burning. The inserted suppository melts, resulting in an active effect of its components on inflammation.

But before you begin treatment for hemorrhoids, you need to come for an examination by a proctologist and get a recommendation on the use of certain suppositories. Let's look at the most inexpensive and effective suppositories for hemorrhoids in detail: with prices, reviews, recommendations for use.

How to choose the best product?

Treatment is prescribed by a doctor taking into account the severity of the disease. The choice of suppositories and ointments for hemorrhoids depends on the predominant symptom - bleeding, pain, itching, inflammation of the skin around the anus:

1. Preparations for oral administration. Excellent results in the treatment of hemorrhoids are achieved by combination therapy, combining symptomatic drugs to relieve local discomfort and drugs for oral use. These are medicines in the price category of up to 200 rubles, such as Troxevasin (an analogue of Troxerutin), from 400 to 500 rubles - Venarus, Venadiol, Ginkor Forte in capsules or gel form. Drugs in the price category from 650 to 850 rubles have similar properties - Diosmin (analogous to Vazoket), Phlebodia, Hesperidin + Diosmin (analogous to Detralex).
2. For severe pain syndrome, suppositories and ointments for hemorrhoids with anesthetics are indicated - lidocaine, neomycin, anesthesin, benzocaine, Cinchocaine, Lauromacrogol - these are pain-relieving suppositories Relief Advance, Emla (Lidocaine + Prilocaine cream), Proctosedyl M, Olestesin, Nigepan.
3. When there is an inflammatory process around the anus on the skin, Ichthyol (ichthyols), Levomikol, as well as NSAIDs (non-steroidal anti-inflammatory drugs, see ointments for pain) are indicated, the most popular among them are Diclofenac and Ibuprofen suppositories. If inflammation is accompanied by itching and there are no contraindications to the use of corticosteroids, then you can use suppositories with hormonal agents - Proctosedyl, Gepotrombin G, Ultroproct, Aurobin ointment.
4. Bleeding - drugs that stop bleeding are used, venotonics to strengthen the walls of blood vessels, vasoconstrictor drugs to relieve swelling (adrenaline, tribenosyl, phenylephrine hydrochloride) - Relief, Procto-glivenol.
5. For uncomplicated hemorrhoids, anticoagulants are indicated that dissolve formed blood clots and stop thrombus formation - suppositories with heparin (Hepatrombin G, Nigepan), heparin ointment.

Modern methods of treating hemorrhoids

Etiology

Hemorrhoids (from the Greek haimorrois) literally mean “bleeding.” This disease, known since time immemorial, is still explained ambiguously and sometimes contradictorily, which fully reflects the level of our knowledge about it. Most researchers recognize that the sources of bleeding are cavernous formations, which under normal conditions are formed during intrauterine development.

The first group of hemorrhoidal formations, the defeat of which leads to the formation of external hemorrhoids, is located at the exit from the anal canal, in the subcutaneous tissue.

The second group of cavernous formations, located in the submucosal layer of the rectum, above the dentate line, is the source of the development of internal hemorrhoids.

There are anastomoses between the external and internal cavernous formations, the functional purpose of which is not entirely clear, if only because with an increase in intra-abdominal pressure, as a rule, external rather than internal nodes thrombose. Along with the external and internal sphincter, the cavernous plexuses are part of the obturator apparatus of the rectum. Their ability to increase in volume due to filling with blood allows for an ideal sealing of the intestine. Indirect evidence of this assumption is the ordered arrangement of hemorrhoidal formations around the circumference of the intestine; it corresponds to 3, 7 and 11 o'clock. Unfortunately, this delicate mechanism is very vulnerable and there are many reasons for this. The immediate cause of hemorrhoids is a violation of the blood supply to the cavernous veins, which can be caused by increased arterial blood flow, but more often by a slowdown in venous outflow. The dilated vein forms a “bag of blood”, which is called a hemorrhoid. In recent years, much attention has been paid to studying the condition of the ligamentous apparatus of the submucosal layer of the rectum, the violation of which leads to the prolapse of internal hemorrhoids. Therefore, from the point of view of modern pathophysiology, both variants of the development of the disease should be considered not only as equivalent, but, possibly, as complementary.

Prevalence . Data on the prevalence of hemorrhoids are very contradictory; for example, in Russia this figure ranges from 130–145 cases per 1000 adults [1]. Statistical data provided by foreign researchers is only about 4.4% [2, 3]. The inconsistency of the indicators is most likely due to the difference between morbidity and negotiability, which is indirectly confirmed by data from examinations of US residents, which stated that 80% of people who had hemorrhoids did not complain [4].

Classification of hemorrhoids . The classification was proposed by the State Scientific Center of Coloproctology [1]. It includes the symptoms of the disease, its clinical manifestations and anatomical changes. According to the course of the disease, chronic and acute types of hemorrhoids are distinguished. In shape - internal, external, combined. The chronic course of internal hemorrhoids is divided into 4 stages. It should be emphasized that the clinical symptoms of the disease correspond to the morphological changes occurring in the longitudinal muscle, which fixes cavernous formations in the submucosal layer of the rectum.

In the first stage: bleeding and discomfort are clinically noted, hemorrhoids do not fall out of the anal canal, the vascular pattern of the mucous membrane is enhanced, anatomically - changes in the longitudinal muscle are insignificant.

In the second - bleeding, prolapse of nodes, itching, mucous discharge; prolapsed nodes are automatically reset into the anal canal; histologically in the fibromuscular framework there is unexpressed dystrophy, the number of elastic fibers predominates.

In the third - bleeding, prolapse of nodes, anal itching, mucous discharge. Prolapsed hemorrhoids require manual assistance to reposition them into the anal canal; At the same time, morphological changes in muscle tissue indicate a loss of elasticity, which proves the predominance of dystrophy processes.

In the fourth - bleeding, itching, discomfort, incontinence of the anal sphincter, severe pain; constant prolapse and inability to manually reduce hemorrhoids into the anal canal; which corresponds to complete degeneration of the fibromuscular framework that holds the nodes in the anal canal.

Complications of hemorrhoids . The most common complication of hemorrhoids is thrombosis of hemorrhoids. As a rule, the lesion occurs in the external nodes and quite often thrombosis is the first manifestation of the disease. Precipitating moments for the development of thrombosis most often include pregnancy, childbirth, long air travel, lifting heavy weights, and acute stool disorders. If patients seek help in the first 2 days from the onset of the disease, an enlarged bluish (at an early stage) hemorrhoid, covered with skin and partially mucous, is easily visually detected. More often, the appearance of a node is accompanied by pain, especially intense if two or more nodes are affected. If the size of the node is significant (usually more than 2 cm) with pronounced tension in the mucosal tissue, an area of ​​necrosis appears on it; after rejection of the latter, bleeding develops, sometimes parts of the blood clot may partially come off and the size of the prolapsed formation may decrease significantly. The skin part of the node becomes swollen and hyperemic. Clinically, as a rule, in this case, the patient notes a decrease in pain. Digital examination should begin with examination of the wall of the anal canal opposite to the thrombosed node, which makes the examination more gentle. A digital examination can reveal signs of thrombosis of the internal hemorrhoid. Examination of the anal canal using instruments is carried out only by proctologists.

More rare complications include the formation of a hematoma with a sharp increase in pressure and damage to the wall of the venous vessel. If an internal hemorrhoid prolapses, it may become strangulated. If necrosis of the internal node occurs, massive bleeding is possible, so the patient should be shown to a proctologist. In the event of strangulation of several prolapsed nodes or the occurrence of stool disorders, a purulent process may occur in the perirectal tissue.

Differential diagnosis

Clinical manifestations of hemorrhoids do not differ in the specificity of symptoms. In case of acute hemorrhoids or its complications, these are acute paraproctitis, anal fissure, cryptitis, rectal prolapse. In the case of chronic hemorrhoids, the development of a tumor of the rectum or anal canal should first be excluded. The group of patients who have been suffering from hemorrhoids for a long time, who have come to us due to increased bleeding or unstable stools, is of particular concern in terms of oncological diseases. In case of any treatment of a patient with hemorrhoids to a therapist or general practitioner, it is necessary to refer him for a consultation with a proctologist.

Conservative treatment

The choice of treatment method is usually determined by the stage of the disease or the nature of the complications that have developed.

A special diet for patients with hemorrhoids is not required, except in certain cases. For thrombosis of hemorrhoids, a protein-vegetable diet with a high fiber content and the exclusion of fried and spicy foods, spices, and alcohol is recommended. In patients with concomitant diseases of the colon (irritable bowel syndrome, diverticular disease or nonspecific colitis), the diet should be aimed at normalizing stool. In case of thrombosis of hemorrhoids, accompanied by constipation, patients should be prescribed microenemas to cleanse the intestines. Patients leading a sedentary lifestyle, without exacerbation, should be recommended to play sports, with the exception of weightlifting and cycling. Patients should pay special attention to performing hygienic measures. During the acute period of the disease, it should be recommended to take a cool shower 2-3 times a day and always after stool, and it is necessary to wash not only the skin of the perineum and anus, but also the anal canal itself. In cases where water procedures are not available, the use of special wet sanitary napkins should be recommended.

Systemic drugs . In the conservative treatment of hemorrhoids, one of the leading roles belongs to drugs containing bioflavonoids (diosmin and hesperidin). The use of the latter in the treatment of hemorrhoids is traditional, but with the creation of modern biotechnologies it was possible to obtain Detralex, a micronized drug, which made it more bioavailable and increased the effectiveness of treatment by about 30%. Bioflavonoids have several properties: first of all, they are able to increase venous tone, enhance lymphatic drainage, reduce vascular fragility and improve microcirculation. First of all, the listed qualities make it necessary to use Detralex in the event of thrombosis of hemorrhoids. The drug is prescribed 2 tablets 3 times a day for the first four days, then 1 tablet 4 times for up to 7 days. In addition, Detralex is able to reduce and prevent the development of hemorrhoidal bleeding and exacerbation of hemorrhoids. For preventive purposes, it is recommended to take the drug for up to 6 months, 2 tablets per day. The use of micronized bioflavonoids (the source of which are natural sources, for example, red grape seeds) is possible even during pregnancy, although not for a long time (up to 7 days). The drug is well tolerated and rarely causes allergic reactions. To date, the drug “Phlebodia 600” has been successfully used, which has a prolonged effect, which allows it to be taken once a day. In patients with thrombosis of hemorrhoids, accompanied by severe pain, it is possible to use non-steroidal anti-inflammatory drugs and analgesics, but it is extremely difficult to assess the effectiveness of their effects, so the question of their use should be decided individually in each specific case.

Local therapy . Local treatment is prescribed to relieve inflammation and analgesia. Among the drugs of the first group, we can recommend Posterisan Forte ointment (or suppositories of a similar name). The drug contains a suspension of E. coli culture and hydrocortisone. E. coli metabolites can enhance local immune responses, accompanied by the release of cytokines, especially intraleukin-1. In addition, a suspension of bacterial culture causes the formation of specific immunoglobulin A, which forms a delicate film on the intestinal mucosa, acting as a local protective barrier. Hydrocortisone, which is the second component of the drug, helps to quickly suppress inflammation and accelerates the processes of tissue regeneration induced by a suspension of Escherichia coli culture. The drug is administered rectally 2 times a day; in case of severe inflammatory process, for example, in patients with nonspecific colitis, the frequency of administration can be increased taking into account the frequency of stool. The maximum duration of treatment does not exceed three weeks. If it is necessary to continue therapy, it is possible to use Posterizan suppositories or ointments containing exclusively a suspension of bacterial culture.

Among the drugs that have a complex effect, we recommend Relief Advance suppositories. The composition includes 10% benzocaine, which has a rapid analgesic effect, in addition, shark liver oil containing fat-soluble vitamins, free fatty acids, squalene and alkylglycerol, which are powerful reparants, which allows them to be recommended even for use in the postoperative period in patients who underwent surgery for hemorrhoids. The frequency of administration is 3–5 times a day. The drug is highly effective, well tolerated and rarely produces adverse reactions.

Surgical treatment of hemorrhoids

External hemorrhoids . In addition to conservative treatment of thrombosed hemorrhoids in the first 24–48 hours, until inflammatory changes in the skin part of the node occur, surgical intervention is possible. It is usually performed under local anesthesia and involves removing the hematoma or thrombotic masses, although there is an opinion that it is necessary to remove the entire node along with the affected vein [5]. This tactic is justified in the presence of one (less often two) large nodes or in severe pain. Unfortunately, such operations can not be performed often, because the majority of patients consult a doctor already in the presence of severe inflammation, which sharply intensifies the pain syndrome that existed until that moment. Surgical removal of large external nodes is justified in case of difficulties arising with hygiene, persistent anal itching or after previous thrombosis, although in recent years many patients have turned to a proctologist for aesthetic reasons.

Internal hemorrhoids . Currently, there is a fairly large selection of minimally invasive treatments, used mainly for isolated internal hemorrhoids of stages I–II. True, sometimes the indications for their use can be expanded, mainly in elderly and senile people with severe concomitant diseases. Minimally invasive interventions include: infrared photocoagulation, latex ring ligation and, finally, transanal ligation under Doppler control. The first two of these methods have long been used in clinical practice, and their strengths and weaknesses are well known, so we will dwell in more detail on the last method.

Ligation of hemorrhoidal arteries under Doppler control . The essence of the method is based on the fact that Doppler examination reveals the distal branches of the superior hemorrhoidal artery, supplying blood to the internal hemorrhoids. The necessary equipment is an electronic unit and an anoscope with a Doppler sensor. The method can be used for stages I–III of the disease. The procedure can be carried out in a hospital within one day. The procedure lasts 20–40 minutes, does not require general anesthesia, restrictions on physical activity for about two weeks. Temporary disability is not required for patients. There are no problems with stool in the early postoperative period.

Operation Longo . Prolapse of the mucous membrane of the anal canal with internal hemorrhoidal plexuses, caused by damage to the muscular and ligamentous apparatus of the latter, is accompanied by a disruption of their blood supply and a change in the anatomical relationships between the external and internal nodes. This prerequisite served as the basis for the creation of the Longo operation, which involves tightening the prolapsed mucosa, restoring the anatomical position of the hemorrhoidal plexuses and normalizing their blood flow. The Longo method has been used in clinical practice since 1993, in our country for the last 5 years. The intervention is performed with a disposable set of instruments. The operation is indicated for stages II–IV of hemorrhoids. In our opinion, the advantages of this procedure are most convincing for circular prolapse of nodes. The operation can be performed under conduction or local anesthesia.

Advantages of the method; the duration of the operation is 10–20 minutes, the hospitalization period does not exceed one day, the pain syndrome is well relieved without the use of narcotic analgesics, there is no need for dressings, the patient can return to work in 5–10 days.

Bipolar coagulation of hemorrhoids using the LigaSure device . A modern alternative to classical hemorrhoidectomy is the method of bipolar coagulation of hemorrhoids, which is successfully used in stages III–IV of the disease. The method is based on the principle of bipolar coagulation using a modernized generator equipped with a feedback unit that allows tissue differentiation. In this case, the usual burn of the tissue does not occur, but welding occurs due to the polymerization of its own collagen and instead of the usual scab, the wound is covered with a collagen film. The intervention can be performed under spinal or epidural anesthesia. The intervention technique is simple. The reliability of polymerization guaranteed by the method makes it possible to coagulate vessels up to 7 mm in diameter. The duration of the operation is about 20 minutes. The duration of postoperative treatment is determined by the size of the wound defects of the anal canal. Pain syndrome in the postoperative period is less pronounced than during traditional surgery.

Literature

1. Vorobyov G.I., Shelygin Yu.A., Blagodarny L.A. Hemorrhoids. M.: Publishing house "Mitra-Press", 2002. 192 p.
2. Johanson JF, Sonnenberg A. The prevalence of hemmhoroids and chronic constipation // Gastroenterology. 1990, 98; 380–386.
3. Bayer I., Myslovaty B., Picovsky BM Rubber Band ligation of hemorrhoids: covenient and economic treatment // J. Clin. Gastroentrol. 1966; 23:50–52.
4. Haas PA, Haas GP, Schmaltz S., Fox TA Jr. The prevalence of hemorrhoids // Dis. Colon Rectum. 1983; 29: 435–439.
5. Corman MI Colon and Rectum surgery, 3rd ed.Philadelphia, Pa: JB Lippincott. 1993: 54–115.

K. E. Mayat , Candidate of Medical Sciences European Medical Center , Moscow

How to use suppositories correctly?

Much in the treatment of hemorrhoids depends on how correctly suppositories are used. Before using candles, carefully read the instructions supplied with them. Among the general recommendations are:

1. Bowel movement. You can do this with an enema. It is necessary to have a bowel movement so that the intestinal walls are cleared of feces and the effect of all active substances is complete.
2. Necessary water procedures. After washing, you need to dry yourself well with a towel. Do not rub the inflamed area of ​​skin, but make several blotting movements.
3. Correct administration of the suppository. Insert the candle into the anus, lying on your side and tucking your knees towards you. Inject shallowly. After administration, turn over on your back and lie for thirty minutes.

You also need:

• try to avoid constipation. To do this, you can use laxatives;
• It should be applied in the morning and evening once or twice a day. Period of use – one or two weeks;
• If the condition worsens or symptoms appear that are not associated with hemorrhoids, you need to clarify the diagnosis again.

You should also know that it is best to do the procedure immediately before bed.

Troxevasin

Troxevasin ointment relieves the symptoms of hemorrhoids. In addition, it is a local anesthetic, astringent and anti-inflammatory agent. The drug combines troxerutin and magnesium stearate and is used externally:

• to relieve burning, itching around the anus;
• with inflammation of hemorrhoids;
• anal thrombophlebitis;
• inflammation of the rectum.

A local drug as an anti-inflammatory, decongestant. Troxerutin has a protective effect on veins, reduces the permeability of capillary walls, reduces swelling and exudation.

The gel should not be used if you have an individual intolerance to active substances or fillers, or an allergy to troxerutin. Like all medicines, Troxevasin ointment can cause side effects, such as hypersensitivity reactions and local skin irritation. Skin reactions may occur - rash, redness. However, the expected benefits are greater than the harm associated with the occurrence of undesirable effects.

Information on how to use the drug is in the instructions. The ointment is applied with uniform and gentle massage movements in a thin layer (approximately 2.5 g or half a teaspoon) twice a day (morning and evening) until completely absorbed. It is advisable to reapply to the affected area of ​​skin after defecation.

What are they?

Classification of candles:

Painkillers:	based on components with a pronounced analgesic and calming effect. Includes anesthesin, benzocaine, lidocaine, belladonna extract, propolis and other active substances. These remedies are used to relieve pain in the anus.
Hemostatic:	designed to relieve bleeding, a common symptom of hemorrhoids. There are candles that contain adrenaline or ice.
Disinfectants:	used in case of infection of wounds due to hemorrhoids. These medications include antibiotics that eliminate most pathogens.
Anti-inflammatory:	They relieve the inflammatory process of the disease well and have a partial analgesic effect.
Venotonic:	restore blood vessels and capillaries, strengthen their walls, and prevent fragility. Thanks to this, hemorrhoids decrease in size, reducing the likelihood of developing new lumps.
Healing:	used for the appearance of anal fissures, they have a regenerating, restorative effect.
Combined:	have several effects at once, combining antiseptic, anti-inflammatory, analgesic effects.

For each patient, suppositories are selected depending on which symptom of the disease predominates. This may be itching, bleeding, swelling, pain, inflammation and other manifestations.

Thrombolytic

Heparin ointment – ​​about 50-70 rubles. Heparin suppositories exist in combinations with other active ingredients.

The active substance is sodium heparin - a direct anticoagulant. It prevents the development of a dangerous complication - the formation of blood clots in hemorrhoids. Thrombi are blood clots that fill the lumen of varicose veins, stretching their walls and causing pain. Heparin at a dose of 1000 units most effectively dissolves blood clots and prevents their formation.

Nigepan - a combination of heparin with anesthesin

The more expensive drugs “Nigepan” (243 rubles) and “Hepatrombin G” (208 rubles) contain a combination of heparin with anesthesin or prednisolone, laumacrogol. And the range of their effects is wider - additional analgesic, anti-edematous and venosclerotic effects. These suppositories will help fight hemorrhoids more effectively.

Benefits of candles

Most patients suffering from damage to the veins of the rectum prefer suppositories against hemorrhoids for the treatment of pathology. This dosage form has many advantages:

• achieving a therapeutic effect immediately after administration of the suppository;
• availability of drugs. Many suppositories are relatively inexpensive, but at the same time have good effectiveness;
• ease of use. Inserting a suppository does not require special knowledge or skills;
• possibility of use among all patient groups, including children and pregnant women;
• no negative effect on the gastric mucosa and liver;
• a small number of undesirable effects.

Rectal suppositories for hemorrhoids are used more often for the internal form of the disease, but even for the external form of the disease, suppositories have a good therapeutic effect.

Detailed list of suppositories

To quickly get rid of the symptoms of the disease, an integrated approach to treatment is necessary. As a rule, patients are advised to adhere to a diet and regularly follow all the specialist’s instructions. Very often, patients are interested in the question, which medications are most effective for the internal form of hemorrhoids?

There are several types of antihemorrhoidal drugs: “Relief”, “Relief Advance”, “Relief Ultra”

Antihemorrhoidal suppositories of combined action

• Relief. It has a vasoconstrictor effect directly in the affected area. After using the drug, blood circulation is restored, swelling, inflammation and pain are eliminated. The drug is most effective at the initial stage of the disease, when the severity of symptoms is insignificant.
• Relief Advance. Has a local antispasmodic effect. Prescribed for anal canal fissures and intense pain syndrome.
• Relief Ultra. It has anti-inflammatory, regenerative, antihistamine effects. The drug is effective in the chronic course of the disease.
• Proctoglivenol. Suppositories contain 2 active substances - lidocaine and tribenoside. The drug has anti-inflammatory, antiallergic and antispasmodic effects.
• Nigepan. The suppositories contain benzocaine and heparin, so they are prescribed for thrombosis of the venous plexuses and severe pain.

Suppositories for hemorrhoids during pregnancy and breastfeeding

In the group of drugs for the treatment of hemorrhoids in the form of suppositories, practically nothing is recommended for use during lactation and pregnancy, especially during its 1st trimester, when the formation of organs and systems of the fetus occurs.

However, there is a group of suppositories for which these conditions are not an absolute contraindication - Natalsid, suppositories with belladonna extract. Posterizan, glycerin suppositories for hemorrhoids, Olestezin, Nigepan, suppositories with sea buckthorn oil, Betiol, Neo-Anuzol.

Used to a limited extent (in the 2nd and 3rd trimesters, as well as during breastfeeding) are suppositories Relief and Relief Advance, Ultraproct, Gepatrombin G. When using them, you need to analyze the effect of their use and the possible risk to the child’s health.

Peculiarities

Relief suppositories, reviews of which indicate their high effectiveness, belong to the group of drugs used to treat hemorrhoids. Today they are represented by several types of suppositories. Suppositories differ in composition, but all have a pronounced anti-inflammatory, healing and analgesic effect. This allows you to quickly relieve unpleasant symptoms of the disease.

Relief candles are produced in a torpedo shape, which simplifies their use. Suppositories may be white or have a slightly yellowish tint. Since different drugs contain different basic and additional substances, this makes it possible to ensure the effectiveness of the drug in different cases.

Top 10: short list

A short list of drugs and prices for the most effective suppositories for hemorrhoids:

• Relief - price of the drug - from 280 rubles.
• Gepatrombin G - price of suppositories - from 105 rubles.
• Proctosan - average price - from 230 rubles.
• Anuzol - price - from 45 rubles.
• Natalsid - cost - from 240 rubles.
• Aurobin - price - from 220 rubles.
• Proctosedyl - average cost - from 320 rubles.
• Proctoglivenol - price - from 400 rubles.
• Ultraproct - the price of the drug is from 450 rubles.
• Candles with sea buckthorn - price from 50 rubles.

Trying to determine which suppositories are best for hemorrhoids, many patients act by trial and error. However, only a doctor can determine and prescribe the best drugs on an individual basis.

Indeed, sometimes, when taking cheap suppositories for hemorrhoids, the patient does not notice any improvement. In order for suppositories for internal hemorrhoids to be effective, it is important to take into account all manifestations of the disease and the individual characteristics of the patient’s health.

Clinical prognosis

The overall clinical prognosis is always favorable. Modern proctological methods make it possible to successfully treat internal hemorrhoids even at the most advanced stages.

The disease can pose a threat to life only if the hemorrhoids become necrotized with the addition of blood poisoning, but this is only possible in the case of a long, persistent and conscious refusal of the patient to receive medical care.

Surgeon-coloproctologist, surgeon of the highest category. Rakhmatullin Andrey Albertovich

Gepatrombin G

Hepatrombin suppositories are a combination drug with prednisolone, which produces an antithrombotic, venosclerosing, anti-inflammatory effect.

Prednisolone relieves inflammation and provides an antiallergic effect. Heparin is an anticoagulant that has antithrombotic, anti-inflammatory, antiexudative effects, ensures regeneration of connective tissue in hemorrhoids, and prevents blood coagulation. Lauromacrogol – produces a local anesthetic, sclerosing effect.

Hepatrombin suppositories are contraindicated for syphilis, tuberculosis, skin tumors, high sensitivity, tendency to bleeding, skin lesions of a viral, bacterial, fungal nature, as well as in the first months of pregnancy. You can use such suppositories for no more than one week, 1-2 supp. in a day,

When using, allergies and redness of the skin may occur. If the drug is used frequently and for a long time, systemic side effects are likely to develop.

Price – from 170 rub.

Levomekol

Levomekol is a combined drug for external use. Among its properties are anti-inflammatory, bactericidal and restorative. Often, exacerbations of hemorrhoids are accompanied by some kind of infection (since the intestines contain various microbes that can penetrate inflamed hemorrhoids, as well as injured tissues, during the process of defecation).

As a result, an infectious process develops, a complication of which can be purulent inflammation. The components contained in the ointment clean the damaged surface, and also accelerate the process of its healing and restoration of the mucous membrane.

Relief candles

Relief suppositories are a popular medicinal product that has gained the trust of consumers due to its effectiveness. There are two types of this medicine, which have different effects:

1. Relief ultra. This product contains hydrocortisone acetate, zinc sulfate, shark liver oil. Ultra Relief constricts blood vessels, gives an antiallergic effect, reduces itching, heals wounds and erosions, and has an immunomodulatory effect. Contraindications: bacterial, viral, fungal infections in the anal area, neoplasms, tuberculosis, severe diabetes, hypernatremia, hypersensitivity. Do not take during pregnancy and lactation.
2. Relief advance. The main active ingredients are shark liver oil and benzocaine. Relief Advance relieves pain, inflammation, itching, irritation, heals wounds, and has an immunomodulatory effect. Contraindications: thromboembolism, granulocytopenia, hypersensitivity to the components. Use with caution during pregnancy and lactation.

Sea buckthorn candles

Sea buckthorn suppositories are a hypoallergenic remedy that is suitable for every patient with hemorrhoids.

Even pregnant women are prescribed this drug by doctors. The effect of this medicine is quite mild. You need to place 1 suppository rectally before going to bed every day. Improvement will come after a week or two. Children are not recommended to use more than 1 candle per day. In adults, the dosage can be increased to 2 suppositories. In this case, the course of treatment should last at least 10 days.

Reviews from patients who used sea buckthorn suppositories to treat hemorrhoids confirm the effectiveness of the product. Sea buckthorn suppositories are completely safe. They are prescribed to patients of all ages (even the elderly). They will not affect the development of the fetus during pregnancy at any stage.

Vishnevsky ointment

Vishnevsky ointment can be used to treat the external form of the disease. The presented medicine helps eliminate various ailments of the human body, but Vishnevsky must be used correctly, strictly following the instructions. Only then will the ointment have the necessary effect.

1. First, you should put lotions on the external nodes with the addition of a solution of potassium permanganate. Such actions must be performed within three days.
2. Then you are allowed to start using Vishnevsky’s composition. The ointment should be added to a compress and applied to the sore spot. Do not remove the compress from Vishnevsky for 12 hours.

Vishnevsky's drug is absolutely safe, so it can be used to treat the disease by pregnant women and nursing mothers. The only negative is its smell, but this is a temporary phenomenon.

Natalsid

A natural medicine whose effect is due to a natural ingredient – ​​sodium alginate. This substance stops bleeding, heals wounds, relieves pain, and relieves inflammation. In addition, intestinal function is further normalized.

Contraindications include the following conditions:

• intolerance to components;
• age restrictions (prohibited under 14 years old).

When diagnosed with internal hemorrhoids, treatment is carried out for 1-2 weeks, the frequency of use is 1 suppository 2 times a day. Customer reviews confirm that suppositories are well tolerated, only in some situations allergic reactions may occur.

Proctosan

Proctosan is an effective suppository for hemorrhoids for men and women. The medicine has a positive effect on the rectal mucosa, relieves itching, burning, pain, and inflammation. Bufexamak as part of suppositories reduces swelling and local hyperemia in the disease. Lidocaine is a good pain reliever, its effect is felt immediately after insertion of the suppository. Titanium dioxide prevents bleeding and has an astringent effect. Thanks to bismuth subgalate, a film is formed on the surface of the rectum, protecting inflamed areas from pathogenic bacteria.

Suppositories are used 2 times a day. To achieve optimal effect, it is recommended to give a cleansing enema before the procedure. After this, you need to insert a candle into the anus. Course – 8–10 days.

Price 350 rubles.

Painkillers

“Delladonna extract”, rectal suppositories – 48 rubles.

The action of the suppositories is due to the content of belladonna alkaloids - atropine, hyoscyamine, scopolamine. These substances act on smooth muscle fibers, promoting their relaxation. This is an important mechanism for eliminating muscle spasm of the anal sphincter, which develops in response to irritation of the nerve endings. In the rectum, such irritating factors are feces caked due to constipation and the remains of gastric juice, which is an aggressive solution of hydrochloric acid and various enzymes. Their effect on the damaged rectal mucosa causes sharp pain, and then severe spasm of the anal sphincter.

Suppositories with belladonna, when used immediately after bowel movement, relieve this painful spasm

“Anuzol” – 80 rubles.

"Anuzol" for rectal use contains several active components in the best ratio. These are the active substances of belladonna extract, a mixture of zinc and bismuth sulfate salts. Zinc sulfate reduces tissue inflammation due to its active astringent effect. In addition, the substance causes coagulation of proteins in pathogenic bacteria, as a result of which they die, and the place where the suppositories are used is protected from infection.

The combined action of the components relieves discomfort and has a pronounced anti-inflammatory effect. It is good to use Anuzol to relieve spasmodic pain and heal microtraumas of the rectal mucosa.

“Betiol” – 63 rubles.

The combination of belladonna extract with ichthyol allows us to recommend “Betiol” in the treatment of hemorrhoids, both to combat pain and to treat inflammation, microtrauma and anal fissure. Ichthyol has established itself as an excellent antiseptic and wound-healing agent. When introduced into the anus, it comes into contact with the mucous membrane and is well absorbed into the local bloodstream, causing vasoconstriction, thereby reducing swelling and the production of pus during infection. It has an antiseptic effect, preventing the spread of the infectious and inflammatory process to the pelvic organs.

Ichthammol can also act as the main medicinal substance in suppositories

The name of the drug is “Ichthyol”, rectal suppositories with a dosage of 200 mg. Price – from 79 rub. Even in this monocomposition, it has a mild analgesic effect, regulates vascular tone, restores microcirculation, eliminates inflammation and swelling of perihemorrhoidal tissues.

In addition to the antispasmodic effect, suppositories can also have a direct analgesic effect by blocking the production of pain impulses in nerve cells. The group of medications includes local anesthetics - novocaine, benzocaine.

Procto-Glyvenol

This medicine contains lidocaine and tribendide. Lidocaine has a local analgesic effect on the anal area, and tribendide reduces capillary permeability, improves microcirculation of the muscular and mucous layer of the rectum, and also has an effective anti-inflammatory effect. An improvement in the condition and a significant reduction in pain occurs 1.5-2 hours after the administration of the Procto-Glivenol suppository into the rectum. Swelling and inflammation of the mucous membrane are also significantly reduced.

1. This drug is used with extreme caution if there is a history of any allergic reactions, especially to local anesthetic drugs or other components included in the Procto-Glivenol suppositories; it is also necessary to notify the attending proctologist about this, since this fact is an absolute contraindication to use of the drug "Procto-Glivenol".
2. This medicine is not prescribed to children under 12 years of age and to pregnant women in the early stages (in the first trimester of pregnancy). With extreme caution and under the constant dynamic supervision of a physician, this drug is prescribed to patients with liver and kidney diseases.

Adverse reactions are observed extremely rarely, mainly when doses and contraindications are ignored. But with long-term use of Procto-Glivenol rectal suppositories, discomfort, irritation, minor pain, itching and burning sensation in the rectum, as well as intestinal disorders in the form of constipation or diarrhea may occur. If you have any of the symptoms, you should immediately stop using this type of suppository and consult a doctor.

Heparin ointment

Heparin ointment has been on the pharmacological market for quite some time and is used not only for the treatment of varicose veins of the rectum. The effect of the medicine is much broader: varicose veins of the lower extremities with and without complications, thrombophlebitis, lymphangitis, trophic ulcers, etc. At the same time, heparin ointment has all the advantages of a medicinal product designed to reduce the severity of hemorrhoid symptoms:

1. The analgesic effect of the drug is provided by the local anesthetic present in the ointment - benzocaine.
2. Due to the main active ingredient - the direct anticoagulant heparin, an antithrombotic and anticoagulant effect is achieved (heparin prevents the formation of blood clots and promotes the resorption of existing ones);
3. Due to the vasodilating properties of benzonicotinic acid, which is part of the heparin ointment, heparin is absorbed more quickly to its destination;
4. The anti-inflammatory effect is also based on the action of heparin supplied to the site of inflammation.

Heparin ointment is used for external and internal uncomplicated and complicated hemorrhoids. It is also indicated in case of thrombosis of the hemorrhoidal plexus. However, damage to the integrity of the skin and bleeding are the main contraindications to the use of this medication. Heparin ointment is prescribed with extreme caution if the patient has a history of pathology of the hemostatic system, accompanied by a decrease in blood clotting and a tendency to bleeding, as well as during pregnancy and lactation (although data on the penetration of heparin into human milk have not yet been obtained).

Anuzol

The composition includes zinc sulfate, bismuth tribromophenolate, bismuth oxide complex, belladonna leaf extract. When used, suppositories with belladonna anesthetize, dry, and have an antispasmodic, astringent, anti-inflammatory, and antiseptic effect.

It should be taken into account that this drug is contraindicated in breastfeeding and pregnancy, high sensitivity, heart failure, intestinal atony, prostate adenoma, angle-closure glaucoma, myasthenia gravis, tachyarrhythmia.

Antihemorrhoidal suppositories with belladonna should be administered 1-2 times a day, 1 pc. To relieve pain, you should not take more than 7 supp. per day. against hemorrhoids. These medications for hemorrhoids can cause allergic reactions, dry mouth, burning in the anal area, diarrhea, constipation, palpitations, visual disturbances, drowsiness, insomnia, dizziness, and headaches.

If an overdose occurs, nausea, vomiting, convulsions, urinary retention, agitation, and decreased sweating may develop.

Rectal suppositories are cheap - from 60 rubles.

Proctosedyl

This drug contains several active ingredients - hydrocortisone, the antibiotic framycetin, heparin, etc. It has a bactericidal, anti-inflammatory effect, helps prevent blood clots, relieves itching and irritation. Well tolerated by patients.

Contraindications: individual intolerance to components, fungal, viral, tuberculous lesions of the anus, arterial hypertension, heart failure. It is forbidden to prescribe to women during pregnancy, as well as during lactation, and children under 12 years of age.

Ultraproct

The composition includes Ultraprocta cinchocaine and fluocortolone.

Fluocortolone is a hormonal component that acts quickly and for a long time. Cinchocaine - acts as a local anesthetic.

Cannot be used for tuberculosis and syphilis in the anorectal area and for hypersensitivity. The drug is not prescribed to children, adolescents, and early pregnant women.

Use once a day, after bowel movement. It must be administered rectally, deeply. If the disease is severe, up to 3 suppositories can be used on the first day.

Price – from 640 rub.

Propolis based suppositories

To make propolis suppositories at home, you need to purchase propolis, cocoa butter and lanolin, as well as 2 ml syringes at the pharmacy.

1. Take 2 ml syringes without needles and cut off the lower narrow part. Leave several syringes intact.
2. Pull the pistons 3 cm and place all syringes horizontally in the jar. The cut part should face up.
3. Place propolis in the refrigerator for 10 minutes, then chop.
4. Combine lanolin and cocoa in a mug and put on low heat.
5. Add crushed propolis and mix everything.
6. Do not allow the mixture to boil by turning the stove on and off.
7. Keep on fire for half an hour.
8. Fill the cut forms with a whole syringe and place in the refrigerator to harden.

Be sure to store candles in the refrigerator. The course of treatment is 2 weeks.