Brief Answer:
initial conservative treatment

Detailed Answer:
Hi, thanks for using healthcare magic

Hemorrhoids are swollen blood vessels in the lower rectum.

They can be associated with pain, bleeding and itching in the anal region.

There are 4 grades of hemorrhoids and the treatment varies slightly according to the grade.

Grade 1: the hemorrhoids may bleed commonly but do not protrude out of the anus

GRade 2: the hemorrhoids protrude out of the anus on straining but return after straining ceases

Grade 3; the hemorrhoids protrude with or without straining and have to be manually returned into the anus

Grade 4: the hemorrhoids are chronically prolapsed and cannot be reduced

For all the grades, conservative treatement is initiated first. This reduces the inflammation and swelling.

This consists of : (1) diet with high fiber content

(2)adequate fluid intake -at least 8 glasses

(3)use of stool softeners such as ducolax

(4)use of warm sitz baths 2 to 3 times a day for 10 to 15 minutes- this reduces swelling and discomfort

(5)topical and oral pain killers

(6)short term use of a topical steroid such as hydrocortisone to reduce the inflammation

(7) when cleaning dab not wipe to reduce trauma to the area

In terms of grade specific treatment:
GRADE 1: this is treated with conservative treatment, also avoid spicy and fatty foods

GRADE 2 and 3: these are also initially treated conservatively unless the grade 3 symptoms are very bad

GRADE 3 and 4: surgical treatment

I hope this helps, feel free to ask any additional questions

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