Haemorrhoids
Description General Measures Medicine Treatment Referral ICD-10 code: K64.0-5/K64.8-9 DESCRIPTION Varicose veins of the ano-rectal area that are usually accompanied by a history of constipation. Consider a diagnosis of underlying carcinoma in older patients. GENERAL MEASURES High-fibre diet. Counsel against chronic use of laxatives. Avoid straining at stool. MEDICINE TREATMENT Painful haemorrhoid
ICD-10 code: K64.0-5/K64.8-9
DESCRIPTION
Varicose veins of the ano-rectal area that are usually accompanied by a history of constipation. Consider a diagnosis of underlying carcinoma in older patients.
GENERAL MEASURES
- High-fibre diet.
- Counsel against chronic use of laxatives.
- Avoid straining at stool.
MEDICINE TREATMENT
Painful haemorrhoids:
- Bismuth subgallate compound, ointment, topical, applied 2–4 times daily.
OR
- Bismuth subgallate compound suppositories, insert one into the rectum 3 times daily.
AND
Topical anaesthetic:
- Lidocaine 2%, cream, topical, applied before and after each bowel action.
OR
- Amethocaine 1% topical, applied before and after each bowel action.
Constipation:
See: Constipation.
REFERRAL
- For surgical intervention if necessary:
- if the haemorrhoid cannot be reduced
- if the haemorrhoid is thrombosed
- poor response to conservative treatment
- Children.
- Persistent anal bleeding.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024
Chapter 2: Gastro-Intestinal Conditions, 2.5 Anal Conditions, 2.5.2 Haemorrhoids