The Fetal Safety of Hydrocortisone-Pramoxine (Proctofoam-HC) for the Treatment of Hemorrhoids in Late Pregnancy

Ebrahimi, Neda; Vohra, S.; Gedeon, C.; Akoury, Hani; Bernstein, Paul S.; Pairaudeau, Nicholas; Cormier, Johanne; Dontigny, Lorraine; Arsenault, Marc-Yvon; Fortin, Claude; Goyet, Martine; Lafortune, Chantal; Lalande, J; Beauchamp, Coralie; Engel, Francis; Fortin, Anne; Taddio, Anna; Einarson, TR; Koren, Gideon

doi:10.1016/s1701-2163(16)34802-2

Cited by 16 publications

(8 citation statements)

References 18 publications

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“…Two studies evaluated the effectiveness of Proctofoam-HCâ, a combination of corticosteroid and a local anaesthetic, in 292 pregnant women [58,59].…”

Section: 5mentioning

confidence: 99%

European Society of ColoProctology: guideline for haemorrhoidal disease

et al. 2020

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Aim The goal of this European Society of ColoProctology project was to establish a multidisciplinary, international guideline for haemorrhoidal disease (HD) and to provide guidance on the most effective (surgical) treatment for patients with HD. Methods The development process consisted of six phases. In phase one we defined the scope of the guideline. The patient population included patients with all stages of haemorrhoids. The target group for the guideline was all practitioners treating patients with haemorrhoids and, in addition, healthcare workers and patients who desired information regarding the treatment management of HD. The guideline needed to address both the diagnosis of and the therapeutic modalities for HD. Phase two consisted of the compilation of the guideline development group (GDG). All clinical members needed to have affinity with the diagnosis and treatment of haemorrhoids. Further, attention was paid to the geographical distribution of the clinicians. Each GDG member identified at least one patient in their country who could read English to comment on the draft guideline. In phase three review questions were formulated, using a reversed process, starting with possible recommendations based on the GDG’s knowledge. In phase four a literature search was performed in MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews. The search was focused on existing systematic reviews addressing each review question, supplemented by other studies published after the time frame covered by the systematic reviews. In phase five data of the included papers were extracted by the surgical resident (RT) and checked by the methodologist (JK) and the GDG. If needed, meta‐analysis of the systematic reviews was updated by the surgical resident and the methodologist using Review Manager. During phase six the GDG members decided what recommendations could be made based on the evidence found in the literature using GRADE. Results There were six sections: (i) symptoms, diagnosis and classification; (ii) basic treatment; (iii) outpatient procedures; (iv) surgical interventions; (v) special situations; (vi) other surgical techniques. Thirty‐four recommendations were formulated. Conclusion This international, multidisciplinary guideline provides an up to date and evidence based summary of the current knowledge of the management of HD and may serve as a useful guide for patients and clinicians.

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“…Two studies evaluated the effectiveness of Proctofoam-HCâ, a combination of corticosteroid and a local anaesthetic, in 292 pregnant women [58,59].…”

Section: 5mentioning

confidence: 99%

European Society of ColoProctology: guideline for haemorrhoidal disease

et al. 2020

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“…Supplemental fiber results in significantly less bleeding episodes from internal hemorrhoids. 32 Witch hazel pads (Tucks) may provide relief from pain and 27 Alonso-Coello et al, 28 Abramowitz et al, 29 Wald, 31 Safik, 32 and Ebrahimi et al 33 Copyright © 2015 Wolters Kluwer Health, Inc. 32 Warm, rather than hot, water is recommended, and women can be instructed to soak 2 to 3 times a day.…”

Section: Treatmentmentioning

confidence: 99%

“…33 However, their use for longer than 1 week is associated with side effects such as contact dermatitis. Women can make less expensive witch hazel pads by purchasing a bottle of witch hazel and soaking makeup removal pads in them.…”

Section: Treatmentmentioning

confidence: 99%

Gastrointestinal Distress in Pregnancy

Zielinski

Searing

Deibel

2015

Journal of Perinatal &Amp; Neonatal Nursing

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Gastrointestinal discomforts are a very common complaint in pregnancy. In fact, most pregnant women will experience at least one discomfort. This article focuses on 5 common conditions that occur in pregnancy: gastroesophageal reflux disease, diarrhea, constipation, hemorrhoids, and pica. While these conditions do occur in men and nonpregnant women, they occur more frequently in pregnancy because of the anatomic and physiologic changes associated with gestation. The type and severity of symptoms can vary from individual to individual, making treatment a challenge for healthcare providers, particularly when caring for pregnant women because the effects of medications and other treatments on the developing fetus are often not extensively studied. While these discomforts are rarely life-threatening, they can cause significant distress and impair quality of life. The goal of this article was to provide a summary of the anatomic and physiological changes during pregnancy that contribute to the increasing incidence of these discomforts and to provide information about each condition including prevalence, symptoms, and treatment modalities.

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“…First-line therapy for both external and internal haemorrhoids includes stool softeners and topical treatment. Proctofoam-HC appears to be both effective and safe when applied in late pregnancy 39. If these therapies fail, excision for external haemorrhoids with trombosis might be necessary.…”

Section: Common Gastrointestinal Diseases During Pregnancymentioning

confidence: 99%

Management of gastrointestinal and liver diseases during pregnancy

Woude

Metselaar

Danese

2014

Gut

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In the majority of patients with chronic gastrointestinal and liver diseases, maintenance therapy is required during pregnancy to control the disease, and disease follow-up or disease control might necessitate endoscopy. Evidence on the safety of drugs and imaging techniques during pregnancy is scarce and sometimes difficult to interpret. In this review we summarise existing literature with the aim of optimising counselling of patients with common chronic gastrointestinal and liver diseases who want to conceive.

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The Fetal Safety of Hydrocortisone-Pramoxine (Proctofoam-HC) for the Treatment of Hemorrhoids in Late Pregnancy

Cited by 16 publications

References 18 publications

European Society of ColoProctology: guideline for haemorrhoidal disease

European Society of ColoProctology: guideline for haemorrhoidal disease

Gastrointestinal Distress in Pregnancy

Management of gastrointestinal and liver diseases during pregnancy

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