Ask the Pharmacist

Q: I’ve battled hemorrhoids and fissures off and on for decades. Is there anything new on the market besides Preparation H and Anusol Plus?

A: Hemorrhoids, also known as piles, are essentially veins that have swollen either in your anus or the lower part of your rectum.

At times, the vessels can get so stretched by the swelling that they bulge and get irritated, particularly when you defecate (have a bowel movement). They can be internal or external and commonly result in bleeding which can be very disturbing to the patient as the loss of blood can appear to be copious.

Despite this, hemorrhoids are very rarely dangerous and will usually clear up in a few weeks with the proper intervention.
Internal hemorrhoids can’t usually be seen or felt since there are very few pain-sensing nerves inside your rectum. Frequently, the only symptom of this type is rectal bleeding of the bright red (i.e. fresh) variety.

External hemorrhoids are just under the skin around the anus where there are far more nerves so they are more likely to hurt than their internal relatives.

Sometimes hemorrhoids prolapse which causes them to bulge and be seen as a moist bump just outside the anal sphincter.

Hemorrhoids are extremely common. Nearly 75 per cent of all adults will experience them at some point in their lives, and they can be an irritating experience. They are usually caused by a build-up of pressure in the lower rectum which subsequently affects the flow of blood in that region, leading to the swollen veins.

Frequent causes include pushing during bowel movements, straining while doing something hard like weight-lifting, being constipated, or having prolonged diarrhea.

They are more common in people who are overweight, pregnant, those with a family history, and in those who sit or stand for long stretches of time.

Fissures, on the other hand, are small tears or cracks in the thin moist tissue that lines the anus. Pain tends to be both more common and severe than it is with hemorrhoids and, like hemorrhoids, bleeding is common.

Causes of fissures are similar to those of hemorrhoids. Traditional therapies involve both creams and suppositories, and are aimed at relieving the pain and soothing the anal tissues.

Treatments requiring a prescription, tend to have a cortisone ingredient added which decreases the inflammation in the area as well, making them more effective than their over-the-counter partners. The downside of cortisone-containing products is that prolonged use of them has been shown to thin the skin of the rectal tissues, making them more likely to be re-injured in the future.

There is a novel new suppository that has come to Canada only in the past few years but has been available in Europe for some time. It is called Proktis-M and it can be purchased without a prescription.

The active ingredient is sodium hyaluronate (SH) which makes it very unique from any other product currently available on the market. Sodium hyaluronate is a naturally-occurring carbohydrate (it is found in our skin and in the fluid within our joints) and when it binds with water, it takes on a gel-like consistency.

It plays a role in all three stages involved in the healing of a wound. Thereby. speeding up the entire process mainly by helping important nutrients to pass into the damaged cells. As such, it is now commonly used in a number of products designed to treat skin ulcers, burns and other serious wounds.

The directions for use are simple and involve inserting a single suppository once daily into the rectum, preferably at bed time as well as after a bowel movement. The suppository contains a few other ingredients, including aloe vera and tea tree oil.

A study in 2015 demonstrated Proktis-M’s effectiveness in the treatment of cancer radiation-induced proctitis. Proctitis is a common and significant side effect of radiation treatment, and the pain experienced by the patient can become so severe that it can cause the treatment to be interrupted. This has obvious ramifications both for the patient’s quality of life and for the effectiveness of the chemotherapy regimen.

Proktis-M was given to 12 of the 23 patients undergoing a standard chemotherapy and radiation treatment regimen for locally-advanced rectal cancer. In the group that received the Proktis-M, both the frequency and severity of proctitis were greatly reduced to the point that all 12 patients were able to complete their cancer treatment uninterrupted; whereas, in the other group, 45 per cent had to stop their radiation for more than 10 days.

These sorts of results with proctitis bode well for Proktis-M’s ability to help with hemorrhoids and fissures as in general, these two conditions are much less severe and easier to treat.

So, if you’ve tried the assorted products that really haven’t changed in 30 years and found them lacking in effect, drop by the pharmacy and pick up a box of Proktis-M and see if it can help resolve your current situation.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts