Introduction

Haemorrhoids are also known as piles. They occur when blood vessels around the anus and rectum swell up and enlarge, creating a hanging lump that can protrude from the anus. This lump may need to be pushed back in after going to the toilet. There are several degrees of piles, in most cases the symptoms are mild and relatively painless and often clear up on their own. In cases where piles are causing some discomfort, for example an itch or soreness around the anus, then non-prescription treatments are available to purchase. If these treatments don’t relieve the discomfort, or you experience pain or bleeding after passing a stool then it is recommended you speak to your GP.

What exactly causes piles is still unclear. What we do know is that they are associated with increased pressure in the blood vessels located in and around the anus. The majority of cases are believed to be caused by excessive straining when using the toilet. This is often due to a low fibre diet resulting in constipation. There are other factors that can increase the likelihood of developing haemorrhoids, these include:

• Pregnancy
• Having a family history of piles
• Being overweight
• Being over 45 years of age
• Regularly lifting heavy weights
• Long periods of sitting down
• Prolonged diarrhoea
• A persistent cough
• Repeated vomiting

There are two main types of piles, these are internal piles and external piles. Internal piles occur above the line inside the anus called the dentate line. External piles will occur below this line. The dentate line is a visible line that marks where the nerves inside the anal canal are able to detect pain. Nerves below the dentate line are capable of detecting pain signals whereas the nerves above it are not.

There are varying degrees of piles, which are classified by their size and severity.

First degree haemorrhoids cannot be seen outside the anus. They develop on the lining inside of the anus and are small in size.

Second degree haemorrhoids are larger in size. These swellings may protrude out from the anus when going to the toilet, before retracting back inside.

Third degree haemorrhoids comprise of one or more soft lumps that hang down from the anus. These can be pushed back inside, known as reducible.

Forth degree haemorrhoids differ from third degree haemorrhoids by being larger in size. They are also irreducible – they cannot be pushed back inside.

What treatments are available for Haemorrhoids & Piles?

Lifestyle changes

Simple lifestyle changes can often be the answer to a mild case of piles, especially if constipation and over-straining were the cause.

• By introducing more fibre into your diet, you can help make your stools softer and easier to pass, which will reduce the amount of straining.
• Do not ignore the call to use the bathroom, it can lead to straining and haemorrhoids.
• Be sure to drink plenty of water as dehydration can lead to constipation and then to piles.
• Exercise helps to keep the bowels moving and thus can ease constipation and therefore piles.

Treatment

Proctosedyl Ointment contains two active ingredients; Cinchocaine Hydrochloride and Hydrocortisone. It is mainly used to treat Haemorrhoids (piles). Proctosedyl Ointment is manufactured in The UK by Sanofi-Aventis and is classified as a prescription-only-medicine (POM).

The active ingredient, Cinchocaine belongs to a group of medicines called local anaesthetics. These medicines work by blocking the pain messages along the nerve fibres at the point of application. This prevents the pain signals from reaching the brain. This will cause a numbing sensation in the area where the ointment has been applied. When treating Haemorrhoids, using a local anaesthetic such as Cinchocaine will numb the pain and itching associated with piles.

The other active ingredient, Hydrocortisone belongs to a category of medicines known as Corticosteroids. These medicines work to reduce and relieve pain and inflammation. Inflammation is caused by an immune response that causes blood vessels to dilate (widen), resulting in the affected area becoming red, painful, itchy and swollen. Hydrocortisone works from within the cell. It actively reduces the substances produced that trigger the inflammation. When Hydrocortisone is used topically to treat Haemorrhoids, it will effectively reduce the painful inflammation and swelling caused by this condition.

When combined in Proctosedyl Ointment, these two active ingredients provide effective short-term relief for the treatment and management of piles and anal itching. Proctosedyl Ointment is suitable for treating external haemorrhoids around the anal area through direct application. If the Haemorrhoids are internal, the ointment can still be applied by using the plastic applicator included with every tube. This applicator or nozzle screws onto the top of the tube, allowing for comfortable insertion into the rectum. If your haemorrhoids are solely internal then suppositories such as Proctosedyl Suppositories, may be a more suitable choice.

Always use Proctosedyl exactly as prescribed. If you are unsure, check your patient information leaflet for further instructions or contact us for further advise from one of our healthcare professionals.

To read the patient information leaflet for the ointment please click here: https://www.medicines.org.uk/emc/medicine/8301

To read the patient information leaflet for the suppositories please click here: https://www.medicines.org.uk/emc/medicine/8302

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Frequency: When required…

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