# Haemorrhoids in pregnancy

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- 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.
- Verified date: 2026-08

## 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)

## Treatment metadata

- Lactulose — oral.liquid
- Cinchocaine + Hydrocortisone — topical

## Complete treatment card

```text
HAEMORRHOIDS IN PREGNANCY
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 against 2 sources listed above  (2026-08)

1. LACTULOSE                                              [1st line]
   Adult    15-30 mL once or twice daily, adjusted according to stool consistency - As long as the
            stool needs softening - through the pregnancy and into the early postpartum weeks
   Peds     Adult-only condition - paediatric section not applicable
   Source   Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)
   Why      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.
   Caution  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.
   Egypt    FARCOLAC 667GM/L SYRUP 120 ML    PHARCO               7.50 EGP
            LACTOLINE 50% SYRUP 200ML        ALEXANDRIA           9.25 EGP
            LAEVOLAC 67GM/100ML SYRUP 120 ML SIGMA > FRESE...    12.00 EGP
            SEDALAC 3.35GM/5ML SYRUP 120ML   SEDICO              20.00 EGP
            LAXOLAC 3.35GM/5ML SYRUP 300ML   MUP                 40.00 EGP
            LAXOLAC 3.35GM/5ML SYRUP 120ML   MUP                 50.00 EGP
            DUPHALAC 667GM/L SYRUP 200ML     ABBOTT LABORA...   143.00 EGP
            LACTULOSE-AUG PHARMA 3.35GM/5ML SYRUP 320ML AUG PHARMA                        170.00 EGP
            VILLAPURG 67% SYRUP 120 ML       AL ESRAA PHAR...    12.00 EGP
                -> ? strength differs, ? different route - not oral liquid
            VILLAPURG 67% SYRUP 200 ML       AL ESRAA PHAR...    17.75 EGP
                -> ? strength differs, ? different route - not oral liquid

2. CINCHOCAINE + HYDROCORTISONE                           [add-on - not a substitute]
   Adult    Apply ointment or insert 1 suppository rectally twice daily (morning and night) and
            after defecation x 7 days maximum; if the piles are no better by then, review rather
            than repeat
   Peds     Adult-only condition - paediatric section not applicable
   Source   Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC
            product 1599)
   Why      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.
   Caution  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.
   Egypt    SEDIPROCT TOPICAL CREAM 20 GM    MUP                 42.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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