{ "schema_version": 1, "kind": "condition", "id": "haemorrhoids-in-pregnancy", "name": "Haemorrhoids in pregnancy", "category": "chronic", "sources": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599) · Fontem RF, Eyvazzadeh D. Internal Hemorrhoid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- . [Updated 2023 Jul 31]. Bookshelf ID: NBK537182. PMID: 30725867.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599)", "verified_date": "2026-08", "treatments": [ { "id": 870, "generic": "Lactulose", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": null, "adult_dose": "15-30 mL once or twice daily, adjusted according to stool consistency", "adult_duration": "As long as the stool needs softening - through the pregnancy and into the early postpartum weeks", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)", "rationale": "Constipation is what makes piles in pregnancy, and softening the stool is the treatment that actually changes the outcome. Lactulose is not absorbed, which is why it is the laxative of choice here.", "cautions": [ "Fibre, fluids, and not straining or sitting long on the toilet do more than any ointment. This is the part of the consultation worth spending time on.", "May cause flatulence and abdominal cramps initially.", "Stimulant laxatives such as senna can provoke uterine cramping and are second choice in pregnancy; an osmotic agent is the safer starting point." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - this entry is a condition of pregnancy.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FARCOLAC 667GM/L SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTOLINE 50% SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 9.25, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAEVOLAC 67GM/100ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > FRESENIUS KABI", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 67000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEDALAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 20.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 300ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LAXOLAC 3.35GM/5ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUPHALAC 667GM/L SYRUP 200ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ABBOTT LABORATORIES", "price_egp": 143.0, "pack_count": null, "unit_price": null, "strength_mg": 667000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LACTULOSE-AUG PHARMA 3.35GM/5ML SYRUP 320ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 170.0, "pack_count": null, "unit_price": null, "strength_mg": 3350.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "VILLAPURG 67% SYRUP 200 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA", "price_egp": 17.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "haemorrhoids-in-pregnancy" }, { "id": 871, "generic": "Cinchocaine + Hydrocortisone", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply ointment or insert 1 suppository rectally twice daily (morning and night) and after defecation", "adult_duration": "7 days maximum; if the piles are no better by then, review rather than repeat", "dose_source": "Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599)", "rationale": "Short-term relief of the pain and itch while the stool is being softened. It numbs and calms the area; it does not shrink the pile, and it is added to the laxative rather than used instead of it.", "cautions": [ "The label says topical corticosteroids should not be used extensively in pregnancy, meaning large quantities or prolonged courses. A short 7-day course to a small area is how it is used here.", "Hydrocortisone may pass into breast milk. The label prefers it avoided while breastfeeding unless the benefit to the mother clearly justifies it.", "LIMIT TO 7 DAYS MAX: prolonged rectal corticosteroid use causes mucosal atrophy and systemic absorption.", "Cinchocaine sensitises on repeated use - a rash that appears after a few courses is often the anaesthetic, not the piles.", "A sudden, exquisitely painful lump at the anal margin is a thrombosed external pile. Within the first 72 hours it can be excised under local anaesthetic; after that it is managed with analgesia and settles on its own.", "Do not simply assume rectal bleeding in pregnancy is piles. Look, and if bleeding persists after delivery, examine properly.", "Most haemorrhoids of pregnancy settle within weeks of delivery. Surgery is deferred until then." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - this entry is a condition of pregnancy.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "SEDIPROCT TOPICAL CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 42.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "haemorrhoids-in-pregnancy" } ] }