Product Monograph
Hemorrhoids, also called piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term "hemorrhoid" is often used to refer to the disease.

The signs and symptoms of hemorrhoids depend on the type present - Internal hemorrhoids often result in painless, bright red rectal bleeding when defecating External hemorrhoids often result in pain and swelling in the area of the anus. If bleeding occurs it is usually darker.

While the exact cause of hemorrhoids remains unknown, a number of factors which increase pressure in the abdomen are believed to be involved. This may include constipation, diarrhea and sitting on the toilet for a long time.

Hemorrhoids are also more common during pregnancy.

The first known mention of the disease is from a 1700 BC Egyptian papyrus.
Anal Fissure and Fistula
An anal fissure is a narrow tear that extends from the muscles that control the anus (sphincters) up into the anal canal. These tears usually develop when anal tissue is damaged during a hard bowel movement or when higher-than-normal tension develops in the anal sphincters. An anal fistula is a tubelike passage (tract) from the anal canal to a hole in the skin near the anus. This may occur after rectal surgery, after an abscess in the rectal area, or as a complication of a bowel disease
Medical Treatment
Nifedipine= The effect of topical nifedipine in treatment of chronic anal fissure:Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonocity is a special treatment for fissure healing. For this purpose chronic anal fissures were conventionally treated by anal dilatation or by lateral sphincterotomy. However, both of these methods may cause a degree of incontinence in some patients. The uptake of medical therapies that create a reversible chemical sphincterotomy has recently become widespread. The aim of this prospective clinical trial study was to assess the effectiveness of nifedipine in healing anal fissure, a calcium channel blocker that reduces sphincter pressure.

Lidocaine= This combination medication is used to treat minor pain, itching, swelling, and discomfort caused by hemorrhoids and other problems of the anal area (e.g., anal fissures, itching). This medication contains lidocaine, an anesthetic that works by temporarily numbing the area. Lidocaine is a local anesthetic. It is sold in fluid, oral and semi-strong form.

Lidocaine is used exclusively or in combination with different cures in hemorrhoid ointments. Its main function is to numb the spot where it is applied in order to give a brisk and successful pain relief.

Lidocaine treatment contains just a little amount of the active agent since it is effortlessly assimilated through the skin and broad retention can lead systemic symptoms. But, it is protected in the low dosages in which it is provided in creams or ointments.

Lidocaine delivers its anesthetic impact by obstructing the voltage gated sodium directs in the cell films of neurons. This activity influences the polarization of the neurons and blocks the transmission of signals between neurons.
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