Hemorrhoids: Clinical study of an A. millefolium ointment for the treatment of grade 1 and 2 internal hemorrhoids
The term hemorrhoids is used to describe pathologies resulting from abnormalities of a part of the anorectal anatomy called the “hemorrhoidal pad.”
Inflammation and tissue destruction are the mechanisms involved in hemorrhoids; however, the pathophysiology and etiology of hemorrhoids are not yet fully understood. Bleeding, prolapse, itching, anus discomfort or a combination of symptoms are observed in patients.
The prevalence of hemorrhoids is relatively high, especially in the population of men and women over the age of 50. Hemorrhoids generally do not pose a serious health risk, but because they affect quality of life, treatment is based on symptom control.
The choice of treatment usually depends on the patient’s complaints and the degree of prolapse of the hemorrhoid tissue. Medicinal plants have always been one of the main remedies for hemorrhoids, and some of them have been documented in scientific publications.
Achillea millefolium L., as a perennial plant, is one of the best known species, and its traditional use for medicinal purposes has been widespread for more than 3,000 years. The wide range of pharmacological activities of A. millefolium, such as its antiulcer, anti-inflammatory, antimicrobial, and antioxidant properties, are due to the presence of various chemical compounds.
It has been shown that A. millefolium extract reduces the expression of inflammatory cytokines, cyclooxygenase-2 (COX-2) and interleukin-6 (IL-6), and decreases the level of free radicals.
One of the chemical constituents of this plant are flavonoids, which are venotonic agents that can increase vascular tone and decrease vascular capacity and capillary permeability
Based on the traditional use of this herb for various disorders, including hemorrhoids, and the pharmacological properties mentioned, the efficacy of A. millefolium ointment for the treatment of grade 1 and 2 internal hemorrhoids was evaluated in a randomized double-blind placebo-controlled clinical trial.
The hydroalcoholic extract of A. millefolium was prepared and formulated as a 5% ointment. The study was conducted in 54 patients diagnosed with grade 1 and 2 internal hemorrhoids who were referred to the Kowsar Clinic in Ardabil from Sept. 21, 2020 to Dec. 21, 2020.
The patients were randomly assigned into two groups of treatment and placebo and received the ointments three times a day for ten days. All patients were recommended lifestyle modifications and laxative administration. Symptoms (pain, discomfort during defecation, bleeding intensity, bleeding frequency and itching) were compared before and after treatment.
The mean score of pain, discomfort during defecation, severity and frequency of bleeding after treatment in the treatment group was significantly lower than that in the placebo group (p˂ 0.05).
There was no significant difference in itching between the two groups (p = 0.069).
According to the results, the ointment containing 5% hydroalcoholic extract of A. millefolium reduced most symptoms of grade 1 and 2 internal hemorrhoids, so it can be evaluated in further studies as a new and promising safe treatment.
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