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Gastrointestinal
Haemorrhoids (Piles)
خونی بواسیر
Painless bleeding per rectum with a history of constipation; DRE shows a tortuous, dilated venous mass.
- ICD-10
- —
- Source
- OPD handbook pp.101, 103
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Bleeding per rectum, painless
- History of constipation
Diagnosis
- DRE shows tortuous, dilated venous mass
Treatment
Step 1 of 4
1. Lifestyle modifications
- As for constipation
Step 2 of 4
2. Stool softeners / laxatives
- If constipation: laxatives (Laxoberon / Duphalac)
- If no constipation: stool softeners
Prescription
Sodium picosulphateStimulant laxative
DoseIf constipation
Brand Laxoberon
Also sold as Laxoberon, Skilax
LactuloseOsmotic laxative / stool softener
DoseIf constipation or as softener
Brand Duphalac
Also sold as Duphalac, Lilac
Step 3 of 4
3. Drug of choice: Daflon (diosmin + hesperidin)
- Regimen: Tab Daflon 500 mg, 3+3+3 for 3 days; 2+2+2 for 4 days; 1+1 for 21 days
Prescription
Diosmin + HesperidinVenotonic (haemorrhoids)
Dose3+3+3 × 3 days; 2+2+2 × 4 days; 1+1 × 21 days
Brand Tab Daflon 500 mg
Step 4 of 4
4. Surgical opinion
- Opinion from a surgeon regarding surgical management
Sample prescription from the book (patient details removed)
- Male, 35 y, bleeding per rectum for 5 days, painless, after defecation: Tab Daflon 500 mg 3+3+3 for 3 days, then 2+2+2 for 4 days, then 1+0+1 for 21 days (as written in the sample); Syp Cremaffin 2+2+2 for one month; use isphagol husk; increase vegetables and fruits; make exercise a routine; avoid ghee, oily things and bakery products.