Pharmaceutical Care for Patients with Hemorrhoids for Community Pharmacists

Abstract

“Hemorrhoids” is common abnormality of the lower gastrointestinal tract. This condition is caused by high pressure in the lower gastrointestinal tract that pushes the anal cushion tissues downward, causing pathology to the anus. In cases where no external protruding polyp is found, it is called an internal hemorrhoid. If a protruding polyp is found, it is called an external hemorrhoid. Patient history taking to obtain comprehensive information is an important skill of community pharmacists for providing pharmaceutical care to this group of patients. Important information needed included risk factors that cause the abnormality and symptoms differential diagnosis and indicating severity, response to previous treatment and subsequent improvement of the symptoms.Literature review on treatment showed modest roles of drug therapy. However, in the context of Thai community pharmacy, it is necessary to provide primary care for these patients with medications. This literature review identified an interesting issue on medications that could be dispensed including local anesthetics with astringents, corticosteroids with local anesthetics, corticosteroids with local anesthetics and framycetin sulfate and esculin, and oral medication for hemorrhoids that increase blood flow, reduce inflammation, and strengthen capillaries and small veins. In using these medications, patient's symptoms must be considered, and their efficacy and safety must be closely monitored.