Renal and rectal disorders

Question 1

What laxatives are used in anal fissure

Answer 1

Bulk forming e.g. ispaghula husk
Osmotic = lactulose

Question 2

What medicines can be used in anal fissure

Answer 2

Short term use of a topical prep containing anaesthetics e.g. lidocaine

Paracetamol/ibuprofen after going to the toilet

Chronic anal fissure - GTN rectal ointment (SE - headaches)
Alternatively - oral/topical diltiazem or nifedipine

Question 3

Are internal haemorrhoids painful

Answer 3

No, until they become strangulated

Question 4

Non-drug treatment for haemorrhoids

Answer 4

Increase fibre, fluid, good hygiene

Question 5

What laxatives can be used in haemorroids

Answer 5

Bulk forming if constipation is present

Question 6

What should we be careful about when using topical preps with anaesthesia

Answer 6

Can cause sensitisation

Question 7

Should you use topical corticosteroids for long term

Answer 7

No, short term use only - can cause thinning

Question 8

Should opioids and NSAIDs be avoided

Answer 8

Yes as can cause constipation