Diabetes Q&A by Dr. Mathur

Answer:

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Some simple treatments for hemorrhoids in patients with diabetes are as follows:

• Eat plenty of high-fiber foods including bran, fresh fruits and vegetables. Psyllium-containing products also may be used to add fiber to the diet.

• Avoid straining during defecation or sitting on the toilet for a prolonged period of time. In general, do not sit for prolonged periods of time. Ice compresses may ease the swelling.

• Sitting in warm water for approximately 15 minutes at a time may ease the symptoms. Adding Epsom salt to the water helps relieve the inflammation. Sitz baths taken several times a day will also provide a soothing effect.

• Avoid any foods or drinks that seem to make the discomfort from hemorrhoids worse.

• If you have diabetes, so not use over-the-counter products that contain a vasoconstrictor (for example, ephedrine, epinephrine, phenylephrine HCI). This includes Preparation H. Although it does not contain phenylephrine, Preparation H hydrocortisone 1% itch contains hydrocortisone-a steroid that can cause the blood sugar to rise if absorbed in large amounts.

Other options for patients with diabetes include astringents, protectants, and topical anesthetics .

Astringents cause the tissues overlying the hemorrhoids to dry and provide relief from burning and itching but not from pain. Witch hazel is recommended for external use, providing temporary relief of itching, discomfort, irritation and burning. Zinc oxide and calamine also act as astringents.

Protectants form a physical barrier over the skin and mucous membranes, thereby decreasing inflammation and preventing water loss. Recommended protectants include aluminum hydroxide gel, cocoa butter, glycerin in aqueous solution, lanolin, mineral oil, zinc oxide, calamine, and topical starch.

Anesthetics relieve the sensation of pain and burning by blocking sensation in areas where they are placed for a short period. Anesthetics should be used externally on the perianal area because this is where the nerve endings are most concentrated. Active ingredients often found in local anesthetics include benzocaine, dibucaine, lidocaine, pramoxine and tetracaine.