Conservative Treatment of Hemorrhoids: Results of an Observational Multicenter Study

Abstract

IntroductionThis study was conducted to determine the frequency of complaints in a cohort of patients with symptomatic hemorrhoidal disease (HD) treated with micronized purified flavonoid fraction (MPFF, Detralex). MPFF was selected for conservative treatment in this population owing to its proven effects on hemorrhoidal symptoms in a large number of patients.MethodsThis multicenter, non-interventional study was part of the international CHORUS survey (Chronic venous and HemORrhoidal diseases evalUation for improvement of Scientific knowledge), conducted in nine centers in different regions of Russia with the participation of 80 coloproctologists. The study enrolled consecutive patients with complaints of hemorrhoids. All were prescribed MPFF-based conservative treatment. The effect of treatment on HD clinical signs and symptoms was assessed at two follow-up visits performed 5–7 days and 25–30 days after enrollment. Surgical and minimally invasive treatment could be performed from day 7 onwards if required.ResultsA total of 1952 patients were enrolled. Over the entire period of observation, MPFF-based conservative treatment was effective in 1489 (76.3%) patients in eliminating the main clinical manifestations of disease, i.e., bleeding and prolapse of internal nodes. Invasive treatment was performed in 68 (3.5%) patients with grade IV hemorrhoids and was combined with MPFF conservative treatment in 395 (20.2%) patients with grades I–III hemorrhoids.ConclusionConservative therapy with MPFF was beneficial for relieving hemorrhoidal symptoms in the majority of patients. MPFF-based treatment was most effective in patients with grade I and II hemorrhoids before irreversible degenerative changes in ligaments of the hemorrhoidal plexuses have occurred. It was also beneficial in preventing disease relapse in patients with more advanced HD and for promoting optimal conditions in the postoperative period.FundingServier.

Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)

“…Surgical options such as hemorrhoidectomy, stapled hemorrhoidopexy, or hemorrhoidal artery ligation may be the initial step in patients with Grade III or IV hemorrhoids or in those who are refractory to or cannot tolerate office procedures . However, conservative therapy can still play a role, creating favorable conditions for a smooth postoperative recovery . Adherence to these guideline recommendations is important to avoid repetitive and prolonged treatment and severe complications in Grade IV disease.…”

“…20,22 However, conservative therapy can still play a role, creating favorable conditions for a smooth postoperative recovery. 23 Adherence to these guideline recommendations is important to avoid repetitive and prolonged treatment and severe complications in Grade IV disease.…”

Comprehensive assessment of using micronised purified flavonoid fraction in the correction of disorders associated with ADMA-like preeclampsia in experimen

“…У женщин с варикозным расширением вен таза введение исследуемого препарата дает положительный клинический результат [20]. Описанные фловоноиды оказывают положительный эффект при варикозной экземе [21], снижают уровень маркеров оксидативного стресса при хронической венозной недостаточности [22], опубликованы данные о положительных эффектах при консервативном лечении геморроя на различных стадиях [23,24] [34]. Снижение гипергликемии диасмином при стрептозотоцининдуцированном сахарном диабете объясняется его активирующим действием на имидазолиновые рецепторы и выделение β-эндорфина [35,36].…”

Chinese Classical Prescription(Liang-Xue-Di-Huang Decoction)for Hemohhhoidal Disease:study protocol for a randomized controlled trial

“…Each of these treatments has drawbacks, such as mild gastrointestinal disturbances [2] . There is still no evidence from well-designed studies to support the use of any of the over-the-counter preparations [8] .…”