Phlebotonics for haemorrhoids

Abstract

The evidence suggests that there is a potential benefit in using phlebotonics in treating haemorrhoidal disease as well as a benefit in alleviating post-haemorrhoidectomy symptoms. Outcomes such as bleeding and overall symptom improvement show a statistically significant beneficial effect and there were few concerns regarding their overall safety from the evidence presented in the clinical trials.However methodological limitations were encountered. In order to enhance our conclusion further, more robust clinical trials which take into account these limitations will need to be performed in the future.

Efficacy of Micronized Purified Flavonoid Fraction in the Posthemorrhoidectomy Period Trial: Open-Label Randomized Controlled Trial

“…MPFF is a widely available treatment for hemorrhoidal disease in Russia with a minor prevalence of side effects, and it demonstrated good patient compliance and satisfaction with the treatment. 29 This is the first study to focus on edema and thrombosis of mucocutaneous bridges after HE, and the results demonstrate the potential benefit of MPFF in reducing these events.…”

Efficacy of Micronized Purified Flavonoid Fraction in the Posthemorrhoidectomy Period Trial: Open-Label Randomized Controlled Trial

“…MPFF is a widely available treatment for hemorrhoidal disease in Russia with a minor prevalence of side effects, and it demonstrated good patient compliance and satisfaction with the treatment. 29 This is the first study to focus on edema and thrombosis of mucocutaneous bridges after HE, and the results demonstrate the potential benefit of MPFF in reducing these events.…”

Long-standing hemospermia in a patient with megacava associated to a circumaortic renal vein

“…These drugs have been used with good results in other locations as pelvic varicose vein disease and hemorrhoids. [ 10 ] In our case, the patient felt improvement of symptoms and worsening related with stopping the treatment.…”

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

“…This diverse group of drugs is effective in both acute and chronic cases, as it works to fortify the walls of blood vessels, enhance lymphatic drainage, and regulate capillary permeability. In a Cochrane review and meta-analysis, phlebotonics demonstrated significantly favorable effects on pruritus (odds ratio [OR], 0.23), bleeding (OR, 0.12), discharge and leakage (OR, 0.12), and overall symptom improvement (OR, 15.99) [ 89 , 90 ]. In 3 trials, adjunctive treatment with vasoactive drugs following diathermic hemorrhoidectomy was associated with a reduced risk of bleeding, improved pain management, and alleviation of itching and tenesmus, as well as a shorter healing time [ 91 – 93 ].…”

Efficacy of Micronized Purified Flavonoid Fraction in the Posthemorrhoidectomy Period Trial: Open-Label Randomized Controlled Trial

“…MPFF is a widely available treatment for hemorrhoidal disease in Russia with a minor prevalence of side effects, and it demonstrated good patient compliance and satisfaction with the treatment. 29 This is the first study to focus on edema and thrombosis of mucocutaneous bridges after HE, and the results demonstrate the potential benefit of MPFF in reducing these events.…”

Long-standing hemospermia in a patient with megacava associated to a circumaortic renal vein

“…These drugs have been used with good results in other locations as pelvic varicose vein disease and hemorrhoids. [ 10 ] In our case, the patient felt improvement of symptoms and worsening related with stopping the treatment.…”

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

“…This diverse group of drugs is effective in both acute and chronic cases, as it works to fortify the walls of blood vessels, enhance lymphatic drainage, and regulate capillary permeability. In a Cochrane review and meta-analysis, phlebotonics demonstrated significantly favorable effects on pruritus (odds ratio [OR], 0.23), bleeding (OR, 0.12), discharge and leakage (OR, 0.12), and overall symptom improvement (OR, 15.99) [ 89 , 90 ]. In 3 trials, adjunctive treatment with vasoactive drugs following diathermic hemorrhoidectomy was associated with a reduced risk of bleeding, improved pain management, and alleviation of itching and tenesmus, as well as a shorter healing time [ 91 – 93 ].…”

Efficacy of Micronized Purified Flavonoid Fraction in the Posthemorrhoidectomy Period Trial: Open-Label Randomized Controlled Trial

“…MPFF is a widely available treatment for hemorrhoidal disease in Russia with a minor prevalence of side effects, and it demonstrated good patient compliance and satisfaction with the treatment. 29 This is the first study to focus on edema and thrombosis of mucocutaneous bridges after HE, and the results demonstrate the potential benefit of MPFF in reducing these events.…”

Long-standing hemospermia in a patient with megacava associated to a circumaortic renal vein

“…These drugs have been used with good results in other locations as pelvic varicose vein disease and hemorrhoids. [ 10 ] In our case, the patient felt improvement of symptoms and worsening related with stopping the treatment.…”

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

“…This diverse group of drugs is effective in both acute and chronic cases, as it works to fortify the walls of blood vessels, enhance lymphatic drainage, and regulate capillary permeability. In a Cochrane review and meta-analysis, phlebotonics demonstrated significantly favorable effects on pruritus (odds ratio [OR], 0.23), bleeding (OR, 0.12), discharge and leakage (OR, 0.12), and overall symptom improvement (OR, 15.99) [ 89 , 90 ]. In 3 trials, adjunctive treatment with vasoactive drugs following diathermic hemorrhoidectomy was associated with a reduced risk of bleeding, improved pain management, and alleviation of itching and tenesmus, as well as a shorter healing time [ 91 – 93 ].…”