Patient discussions

Moist, gentle cleaning following a bowel movement is advised to minimise anal irritation.

Advise patients to avoid excessive straining at stool and to avoid sitting on the toilet for long periods of time.[1][13]​​[14]

Constipation can be a causative factor in haemorrhoid formation and can be avoided by adding fibre and fluids to the diet; consuming 25-30 g of fibre daily is recommended, either with high-fibre foods or with commercial fibre supplements.[1][12]​​[13]​​​[14] 

Following rubber band ligation, advise patients to manage pain with simple analgesics (such as paracetamol), to avoid constipation (low-dose laxatives or stool softeners are often prescribed), to take a high fibre diet, and to keep themselves hydrated.

For the management of pain following surgical haemorrhoidectomy, advise patients to use regular simple analgesics, such as paracetamol or ibuprofen, and to use stool softeners daily to avoid constipation. Chemical sphincter relaxants (e.g., glyceryl trinitrate) applied to the anus confer some benefit. Metronidazole may also be prescribed.[37]

NICE Clinical Knowledge Summaries: haemorrhoids Opens in new window

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