REMEDY : BNSSG referral pathways & Joint Formulary

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BNSSG Paediatric Joint Formulary

1.9 Rectal and anal disorders

Last edited: 20-02-2024

1.9.1 Haemorrhoids

First line drugs Second line drugs Specialist drugs Secondary care drugs



Scheriproct® ointment / suppositories (TLS Green)

  • Licensed in teenagers

Anusol HC (TLS Green)

  • restricted to patients who are 12+

Rectal Sclerosants

Oily phenol injection 5% (TLS Red)


Management of Anal Fissures

Glyceryl trinitrate 4mg/mL (unlicensed) (TLS Amber Specialist Recommended)

Specific indication:

Diltiazem 2% cream / ointment (unlicensed) (TLS Amber Specialist Recommended)

  • If Glyceryl trinitrate 0.4% rectal ointment inappropriate or failed