Should Hem Relief be taken along with Atenolol for internal hemorrhoids?

Brief Answer: Hem Relief gets the OK Detailed Answer: Dear XXXXXXX Thanks for your query. The advantage of Hem Relief is that it has a very clear composition: ginger root, witch XXXXXXX and horse chest nut, all which have been extensively studied in natural medicine. All of them have been used in venous insufficiency of the legs (eg. varicose veins) and have proven to be effective; hemorrhoids are varicose veins in the rectum, so it seems reasonable to think that the same benefits could be observed in that part of the circulation. They do not appear to have major interactions with the medications you mentioned, so I think it is reasonable to combine; since you have ITP, if you have less bleeding episodes, your platelets will also look better. Hope this helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic Cardiology

Brief Answer: Anuice no, sucralfate only in UC Detailed Answer: Thanks for the follow up; I honestly would not insert any device in my anal canal except a colonoscope for diagnostic purposes; the sucralfate (Carafate) has only been shown to be effective in rectal bleeding due to ulcerative colitis, and even then inferior to other treatments. Best regards

Brief Answer: Consider ligation Detailed Answer: Have you spoken to a proctologist or a gastroenterologist regarding the possibility of ligation of the internal hemorrhoids? They can actually place bands to occlude them, and decrease chances of bleeding, just like they do for esophageal varices. Of course, it would be a bit off my area of expertise, but I have had patients with prominent hemorroids have such procedure. You may be a candidate given the aggravating factor of your ITP In terms of topical agents, really no great solutions for that; avoiding constipation at all costs is paramount as you well know, as well as appropiate hydration. Best regards