Uganda guidelines for the treatment of Haemorrhoids (Piles) and Anal Fissures
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Haemorrhoids Features
Painless rectal bleeding, visible swelling/prolapse at anus (especially at defecation), blood usually coats surface of stool/toiletry, mucous discharge/irritation.
Anal Fissure Features
Pain in passing stool, bleeding at passing of stool.
Investigations
Visual inspection, digital rectal examination. Proctoscopy, sigmoidoscopy, colonoscopy.
Treatment
General Management
Increase fibre/fluid intake, correct constipation. Sitz bath (10-15 mins in lukewarm water with salt) 2-3 times a day. Insert bismuth subgallate compound rectally every 12 hours for 5 days (e.g. Anusol/Sediproct).
Infection / No Response
If signs of infection: Metronidazole 400 mg every 8 hours for 5 days. Analgesics for pain. If no response: Refer to hospital for surgery.
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