title: Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids: randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to assess the role of micronized purified flavonidic fraction in the management of bleeding nonprolapsed hemorrhoids.
  
  
  METHODS
  Patients were randomly assigned to receive ispaghula husk alone, rubber band ligation plus ispaghula husk, or micronized purified flavonidic fraction plus ispaghula husk. Other colorectal diseases were excluded by colonoscopy. Blinded observers noted the time for bleeding to stop completely, recurrences, and treatment complications.
  
  
  RESULTS
  A total of 162 patients were randomly assigned with no significant differences in the age and gender distributions among the groups. Hemorrhoidal bleeding was relieved most expediently in the micronized purified flavonidic fraction plus ispaghula husk group (ispaghula husk alone n = 66, mean (standard error of the mean) 10.6 (2.3) days; rubber band ligation plus ispaghula husk n = 57, 5.6 (1.1) days; micronized purified flavonidic fraction plus ispaghula husk n = 39, 3.9 (1.2) days; P = 0.03). However, there were no significant differences in the recurrences at six months of follow-up (ispaghula husk alone n = 8 (12 percent); rubber band ligation plus ispaghula husk n = 12 (21 percent); micronized purified flavonidic fraction plus ispaghula husk n = 2 (5.1 percent); P = 0.075). No complications or side-effects were noted.
  
  
  CONCLUSIONS
  micronized purified flavonidic fraction used with fiber supplements rapidly and safely relieved bleeding from nonprolapsed hemorrhoids.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital, Singapore.
authors.forename: Y H
authors.initials: YH
authors.lastname: Ho
authors.forename: M
authors.initials: M
authors.lastname: Tan
authors.forename: F
authors.initials: F
authors.lastname: Seow-Choen
mesh_terms: D000328:Adult; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004145:Diosmin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000601:surgery; D006484:Hemorrhoids / Q000188:drug therapy* / Q000601:surgery; D006569:Hesperidin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011620:Psyllium / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D016037:Single-Blind Method; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D004043:Dietary Fiber; D004338:Drug Combinations; D010936:Plant Extracts; D019343:Citric Acid; C018299:citric acid, ispaghula husk, sodium bicarbonate drug combination; D004145:Diosmin; D011620:Psyllium; D017693:Sodium Bicarbonate; D006569:Hesperidin