Nakhla Nardine, Hospattankar Ashok, Siddiqui Kamran, Bridgeman Mary Barna
Professional Practice Department, School of Pharmacy, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada.
US Medical Affairs, Haleon, Warren, NJ 07059, USA.
Pharmacy (Basel). 2025 Jul 30;13(4):105. doi: 10.3390/pharmacy13040105.
Hemorrhoidal disease remains a prevalent yet often overlooked condition, affecting millions worldwide and imposing a substantial healthcare burden. Despite the availability of multiple treatment options, gaps persist in patient education, early symptom recognition, and optimal treatment selection. Recent advancements are evolving the pharmacist's role in hemorrhoid management beyond traditional over-the-counter (OTC) and prescription approaches. The 2024 American Society of Colon and Rectal Surgeons (ASCRS) guidelines introduce updates on the use of phlebotonics, a class of venoactive drugs gaining recognition for their role in symptom management, yet largely underutilized in U.S. clinical practice. In parallel, novel clinical tools are reshaping how pharmacists engage in assessment and care. The integration of digital decision-support platforms and structured evaluation algorithms now empowers them to systematically evaluate symptoms, identify red flag signs, and optimize patient triage. These tools reduce diagnostic variability and improve decision-making accuracy. Given their accessibility and trusted role in frontline healthcare, pharmacists are well-positioned to bridge these critical gaps by adopting emerging treatment recommendations, leveraging algorithm-driven assessments, and reinforcing best practices in patient education and referral. This narrative review aims to equip pharmacists with updated insights into evidence-based hemorrhoid management strategies and provide them with structured assessment algorithms to standardize symptom evaluation and treatment pathways. By integrating these innovations, pharmacists can enhance treatment outcomes, promote patient safety, and contribute to improved quality of life (QoL) for individuals suffering from hemorrhoidal disease.
痔病仍然是一种普遍但常被忽视的疾病，影响着全球数百万人，并带来了沉重的医疗负担。尽管有多种治疗选择，但在患者教育、早期症状识别和最佳治疗选择方面仍存在差距。最近的进展正在使药剂师在痔病管理中的作用超越传统的非处方（OTC）和处方方法。2024年美国结肠和直肠外科医师协会（ASCRS）指南介绍了静脉活性药物的使用更新，这类药物因其在症状管理中的作用而受到认可，但在美国临床实践中大多未得到充分利用。与此同时，新型临床工具正在重塑药剂师进行评估和护理的方式。数字决策支持平台和结构化评估算法的整合现在使他们能够系统地评估症状、识别警示信号并优化患者分诊。这些工具减少了诊断的变异性，提高了决策的准确性。鉴于药剂师在一线医疗保健中的可及性和受信任的角色，他们非常适合通过采用新出现的治疗建议、利用算法驱动的评估以及加强患者教育和转诊方面的最佳实践来弥合这些关键差距。这篇叙述性综述旨在为药剂师提供关于循证痔病管理策略更新的见解，并为他们提供结构化评估算法，以规范症状评估和治疗途径。通过整合这些创新，药剂师可以提高治疗效果，促进患者安全，并为痔病患者改善生活质量（QoL）做出贡献。
