Hemorrhoids Flashcards
When to refer hemorrhoids
-no relief after one week of OTC tx
-severe pain
-bleeding
-sensitivity to OTC meds
-change in bowel patterns
-family history IBD
Hemorrhoids non pharma
-eat high-fiber foods
-stool softener/fiber
-inc water consumption
-use topical tx
-soak regularly in warm bath
-analgesics
Hermorrhoids tx options
-anethetics
-astringents
-corticosteroids
-vasoactive aents
Anesthetics for hemorrhoids
-Dibucaine or pramoxine
-often in combo products like prep H
Astringents for hemorrhoids
-whitch hazel (tucks pads)
-dries, soothes, relieves irritation
Corticosteroids for hemorrhoids
-hydrocortisone 1% in cream or suppository
-relieves itching
Vasoactive agents for hemorrhoids
-phenylephrine topical ointment or suppository
-shrinks tissue to relieve discomfort
Supplements
-fish oil
-niacin
-ginger
-st johns wort
-cranberry
-saw palmetto
-echinacea
-melatonin
Fish oil
-use for hypertriglyceridemia
-GI upset, heart burn, fishy taste
-caution w anticoagulants/platelets, active bleed or PUD
Niacin
-treat dyslipidemia (inc HDL dec TG) not really used tho
-FLUSHING (improves after 2 weeks)
-slowly inc dose, pretreat w aspirin, take w meals, use ER formulation, take at bedtime to mitigate flushing
Ginger
-treat NV in pregnancy
-no use in motion sickness
-well tolerated upto 3g/day
-can inc bleeding risk
St. John’s Wort
-treat mild depression
-extensive use, some efficacy
-vivid dreams, HA, dizziness
-GI upset, dry mouth, photodermatitis
-CYP, PGP, Digoxin, HIV meds, Warfarin interactions
Cranberry
-prevent UTI
-caution w aspirin allergy
-can cause kidney stones
-some pt will use juice which is low in cranberry high in sugar
Saw Palmetto
-treat BPH
-inhibits 5-a reductase
-dose NOT dec prostate size or PSA
-Gi upset
Echinacea
-can decrease URTI by 1 day
-must start at onset of symptoms and for 7 days
-no antibacterial or antiviral properties
-GI upset, rash, allergic rx (ragweed, marigold, daisies)
