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Home Formulary 1.0 Gastro intestinal System 1.7 Local preparations for anal and rectal disorders 1.7.1 Soothing haemorrhoidal preparations

1.7.1 Soothing haemorrhoidal preparations

ChoiceDrug
Encourage self-care with OTC products as appropriate
1st choiceAnusol® cream, ointment or suppositories
2nd choiceXyloproct® ointment (contains lidocaine 5%)

Prescribing Notes

  • Topical haemorrhoidal products are widely used despite lacking evidence.   There are some reported benefits to their use and the general opinion is that they may provide short-term symptomatic relief.
  • Local anaesthetic ointments can be absorbed through the rectal mucosa therefore excessive application should be avoided.
  • Preparations containing local anaesthetics should be used for short periods only (no longer than a few days) since they may cause sensitisation of the anal skin.
  • Patients with pruritus ani (itching around the anal canal)/excoriation should avoid applying creams and ointments where possible as this often causes additional irritation. They should be advised to reduce their caffeine intake, clean with water and avoid soaps/wipes/baby wipes and excessive rubbing with toilet paper. If this fails they can be prescribed Perinal® spray (hydrocortisone with lidocaine) on a when required basis.

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