Zachowawcze leczenie choroby hemoroidalnej

*Małgorzata Kołodziejczak

Summary
Conservative treatment of hemorrhoidal disease can be used in most patients with hemorrhoidal disease as initial treatment, in all stages of disease as adjunctive treatment, in stage I and II as primary treatment, and as supplementary treatment in stage III and IV in case of lack of patient’s consent to operation, in the acute stage of hemorrhoidal disease, in pregnant and puerperal women, in patients with immune deficiency, in patients with active phase of ulcerative colitis or Leśniowski-Crohn disease and following scheduled excision of hemorrhoids. The fundamental element of conservative treatment is change in life-style which includes anti-constipation diet, some diet limitations, as well as change of some habits. In pharmacotherapy medicines with local and systemic activity are used. Widely used in treatment of hemorrhoidal disease, both in acute as chronic phase, are oral drugs containing flavonoids, saponines, rutin and chestnut extracts. They have anti-edematous, anti-inflammatory, anti-aggregation activity, increase venous tonus, decrease fragility of vessels and act at the level of small veins and capillary vessels. Locally applied drugs contain various components, most frequently analgesics, steroids, vasoconstricting drugs, antibiotics, styptic agents and other anti-inflammatory drugs. In patients with increased tonus of sphincter muscles the pharmacological sphincterotomy can be used consisting in decreasing the tonus of internal sphincter muscle and improvement of blood supply to the anal canal. Locally applied drugs include calcium canal blockers and nitroglycerine containing preparations, also custom formulated multi-component medicines. While making decision on treatment method each patient should be dealt with individually taking into consideration stage of disease, patient’s profession, lifestyle, as well as financial capacity to buy specific drug.

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