Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent

Takano, Masahiro; Iwadare, J.; Ohba, Hidemi; Takamura, Hisao; Masuda, Yoshiko; Matsuo, Keigo; Kanai, Takanori; Ieda, Hiroo; Hattori, Yoshiyuki; Kurata, Satoru; Koganezawa, S.; Hamano, Kimikazu; Tsuchiya, Shuji

doi:10.1007/s00384-005-0771-0

Cited by 81 publications

(91 citation statements)

References 4 publications

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“…In addition, the degree of the fibrosis induced by OC-108 treatment was greater than that by PAO. This is considered attributable to the high effectiveness of OC-108 on the prolapse of severe internal hemorrhoids in the clinical studies (5,6), while the effectiveness of PAO on prolapse is reportedly insufficient (1,2). Furthermore, owing to histologically characteristic changes by PAO treatment such as formation of cavities and vacuoles, the interstitium at the injection site exhibited a spongy structure.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the interstitium at the injection site of OC-108 exhibited a dense structure by forming a granuloma with fibrosis over a long time, which probably contributes to the long-lasting therapeutic effect of OC-108 (6). Next, to clarify the main active components in OC-108, inflammation inducing effects of OC-108, alum, and tannic acid at the injection site were examined using the methods that are useful for quantitative evaluation of inflammatory reactions.…”

Section: Discussionmentioning

confidence: 99%

“…It is pharmaceutically modified from Xiaozhiling, a Chinese agent for the treatment of internal hemorrhoids (3,4). In clinical studies, OC-108 injection therapy for severe internal hemorrhoids proved to be highly effective, not only on bleeding but also for prolapse (5,6), and the effects were comparable to hemorrhoidectomy (6). OC-108 is considered to induce persistent fibrosis (7) leading to sclerosis and retraction of hemorrhoids, although mechanisms of action of the agent have not been fully clarified.…”

Section: Introductionmentioning

confidence: 99%

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Sclerosing Effect of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Granulomatous Inflammation Induced by Aluminum

et al. 2005

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Abstract. OC-108 is a novel sclerosing agent for hemorrhoids, containing aluminum potassium sulfate (alum) and tannic acid as its main ingredients. In clinical studies, OC-108 injection therapy for severe internal hemorrhoids proved to be highly effective, not only on bleeding but also for prolapse, and the effects were comparable to hemorrhoidectomy. The aim of this study was to elucidate the mode of action by administrating the agent s.c. to mice and rats. In response to OC-108 injection, inflammation with necrosis developed at an early stage followed by granuloma formation with fibrosis at the injection site. Necrotic debris with aluminum was observed in the granuloma for a long period. Alum, as well as OC-108, induced vascular permeability, leukocyte infiltration, and granuloma formation; however, tannic acid did not. On the other hand, tannic acid inhibited leukocyte infiltration induced by alum but did not inhibit granuloma formation. These results indicate that OC-108 causes sclerosis and retraction of hemorrhoids through fibrosis associated with granulomatous chronic inflammation induced by the main active ingredient alum and that the adjunct ingredient tannic acid reduces excessive acute inflammation induced by alum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sclerosing Effect of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Granulomatous Inflammation Induced by Aluminum

et al. 2005

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“…There is a fourstep injection technique required with ALTA, so, a syringetype anoscope is recommended. The recurrence rate for ALTA has been reported at 4-16% [86][87][88][89][90] , but recurrence is considered to increase over time. Typical adverse events with ALTA include fever, rectal ulcer, lower abdominal pain, low blood pressure, and bradycardia 89,90) .…”

Section: ) Sclerotherapymentioning

confidence: 99%

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Yamana

2017

J Anus Rectum Colon

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The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.

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“…In clinical studies on severe internal hemorrhoids, injection of OC-108 into the submucosa of hemorrhoids proved to be highly efficacious in curing the cardinal signs of prolapse and bleeding (3,4), and the effects were comparable to those of hemorrhoidectomy (4).…”

Section: Introductionmentioning

confidence: 98%

Hemostatic Action of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Regional Blood Flow Arrest Induced by Acute Inflammation

Ono¹,

Nakagawa²,

Fukunari³

et al. 2006

J Pharmacol Sci

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Abstract. Clinically, hemorrhoidal bleeding and prolapse disappeared immediately after injection of the sclerosing agent OC-108 into submucosa of hemorrhoids. The aim of this study was to elucidate the mechanism of action responsible for the immediate hemostatic effect of OC-108 using anesthetized rats. Subcutaneous injection of OC-108 in rats decreased blood flow at the injection site within 5 min. Aluminum potassium sulfate, one of the main ingredients of OC-108, reduced the skin blood flow. However, tannic acid, another main ingredient, did not. By perfusion of OC-108 on the mesenteric surface, microcirculatory blood flow was arrested without remarkable change in blood vessel diameter, accompanied by increased vascular permeability and venous hematocrit. These results indicate that OC-108 induces regional blood flow arrest with rapid onset, this effect being attributed to the action of aluminum potassium sulfate, and that hemoconcentration due to increased vascular permeability (plasma extravasation), an acute inflammatory reaction, is involved in the mechanisms of the immediate hemostatic action of OC-108.

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Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent

Abstract: OC-108 is a useful alternative treatment for hemorrhoids.

Cited by 81 publications

References 4 publications

Sclerosing Effect of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Granulomatous Inflammation Induced by Aluminum

Sclerosing Effect of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Granulomatous Inflammation Induced by Aluminum

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Hemostatic Action of OC-108, a Novel Agent for Hemorrhoids, Is Associated With Regional Blood Flow Arrest Induced by Acute Inflammation

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