Treatment of rats anal fistula with glycerin Aloe barbadensis Miller extract

Abstract

Rationale There is a need for a low cost treatment for complex anal fistulas that can heal without causing fecal incontinence, with room for the study of herbal medicines. Objective To evaluate the effect of the glycerin Aloe barbadensis Miller extract in the treatment of anal fistula in rats. Method Thirty Wistar rats underwent peritoneal anesthesia with ketamine and Xylasine, followed by transfixation of the anal sphincter with a steel wire, which remained for 30 days to develop the anal fistula. After this period, the steel wire was removed and three groups with 10 animals were formed: A (control), without treatment; B (seton), in which a cotton seton was introduced; C (therapeutic seton), in which a cotton thread was introduced as a seton, and Aloe barbadensis Miller extract was daily dripped in the seton; after 30 days, the setons of groups B and C were removed, and after two weeks without a seton euthanasia and removal of specimens was conducted, and the fistula closure and the inflammatory process were analyzed. Results Fistula persistence was observed in all animals in Group A, six in Group B and three in Group C ( p = 0.015). The mean local inflammation levels were 0.9 in Group A; 0.8 in Group B, and 0 in Group C ( p = 0.015). Conclusion The use of a seton soaked in a glycerin Aloe barbadensis Miller extract was effective in the healing of anal fistulas in rats, in addition to causing less inflammatory process than the non-phytotherapeutic seton.

Effectiveness of the Aloe Vera extract in the treatment of fistula-in-ano

“…Coelho et al 11 investigated oral wound healing in rats with and without the use of hydroalcoholic extract of Aloe Vera and found no difference between groups. They found that there was also no reduction in the inflammatory process, similar to that observed in the present research, which leads us to question whether the vehicle used could influence the results, since Comparin et al 4 found a reduction in the inflammatory process of anal fistulas in rats using the same plant for treatment, but with glycerin as a vehicle. In the present research, carbopol was used as a vehicle and no decrease in the inflammatory process was observed.…”

“…Although in the present study there was no complete closure of any of the fistulous tracts, the group of animals treated with Aloe Vera obtained significant lumen reduction compared to the other groups, which leads us to infer that the closure was in progress and probably if we extended the treatment for a longer period there could be total closure in these animals. As the number of publications on the use of herbal medicines in anal fistulas is very small, the treatment period has been stipulated based on literature data, 4 but the result obtained here serves as a stimulus for further research to be carried out evaluating the effect of its application over longer periods as well as at different concentrations. Regardless of the projection made here about what could have happened, the fact is that the lumen has been reduced, confirming what had already been reported in similar researches [6][7][8][9] regarding the healing potential of Aloe Vera.…”

“…Another positive finding observed in the present study was the fact that there was a significant reduction in vascular congestion, which was also observed by other authors. 4,6,7 Vascular congestion triggered by the inflammatory cascade is one of the early stages of the inflammatory process, whereas when the infectious/inflammatory condition is resolved, decreased vascular congestion is also one of the early stages of the end of inflammation. 10 Although there was no decrease in inflammatory infiltrate in the animals treated by Aloe Vera compared to the other groups, there was a decrease in vascular congestion, i.e., the initial stage of inflammation reduction occurred, which brings us back to the issue of treatment time.…”

“…The use of medicinal plants for anal fistula treatment has been increasing mainly in experimental research, but with great potential for use in clinical practice. 4 There are few publications in the literature on the use of Aloe Vera for anal fistula treatment, but, similar to what has been seen with other herbal medicines, there is also therapeutic potential for this plant. Because anal fistulas are believed to be the chronic phase of cryptoglandular abscess, local infection control may be helpful for treatment.…”

Tratamento da fístula anal com extrato de Baccharis dracunculifolia. Estudo experimental em ratos.

“…The use of extracts and formulations of medicinal plants from different Brazilian biomes in folk medicine, mainly as anti-inflammatory and healing in the treatment of anal fistulas, has been increasing, especially in experimental researches, but with great potential for use in clinical practice 4 . Among these species, there is Baccharis dracunculifolia (Asteraceae), popularly known as field rosemary.…”