Medical Treatment Protocol for Bleeding Haemorrhoids in General Practice
1. Dietary advice: increase fluid and fibre intake
2. Medication
- Stool softener e.g. lactulose, colace
- Bulk forming agent e.g metamucil (or equivalent), angiolax
- Local suppository e.g. anusol suppository, faktu suppository
- Local ointment e.g. anusol ointment, faktu ointment
3. Office procedure
- Injection therapy (with phenol in almond oil)
- Rubber band ligation
Referral Guidelines for Consideration of Surgical Treatment of Bleeding Haemorrhoids
1. Iron deficiency anaemia caused by bleeding haemorrhoids and AFTER exclusion of other
colorectal pathology by endoscopy
2. Persistent and significant bleeding after two consecutive attempts at rubber band ligation
within a period of 12 months