The pathogenesis of hemorrhoids is multifactorial. Predisposing factors include heredity, portal hypertension, straining to defecate, and pregnancy. Internal hemorrhoids are classified into four groups.

• First-degree internal hemorrhoids do not protrude, cannot be palpated by digital examination, and require anoscopy for diagnosis. 
• Second-degree hemorrhoids protrude with defecation, but reduce spontaneously. 
• Third-degree hemorrhoids protrude and require manual reduction. 
• Fourth-degree hemorrhoids are irreducibly prolapsed.

COMPOSITION:

Calcium dobesilate: 40 mg, lidocaine hydrochloride: 20 mg, dexamethasone acetate: 0.25 mg, antiox. (E 320, E 310), macrogol 300, propyleneglycol. Exipients for 1 g of ointment.

INDICATIONS & USAGE:

Internal & external hemorrhoids. Anal pruritus, anal eczema, anitis, perianitis, cryptitis, papillitis, acute hemorrhoidal thrombosis & anal fissures. Pre- and postoperative treatment in cases of hemorroidectomy.

DOSAGE AND ADMINISTRATION:

2-3 times daily.

In the morning and at bedtime apply, if possible after defecation. If the ointment is preferred, use the cannula by screwing it to the tube. Insert the cannula as deep as possible in the anus then press gently the tube while withdrawing it. In this case, the tube is sufficient for 8 applications. In case of external hemorrhoids or anal pruritus, apply a thin layer of the ointment several times a day. The duration of the treatment is generally of some days. The doctor must be informed if, after 1or 2 weeks of treatment, the symptomatology has not improved. The treatment should not be repeated without previous medical advice.