Use of enzyme and heparin paste in acute haemorrhoids.
BACKGROUND
While treating acutely inflammed piles, surgeons in general prefer to stick to the conservative method of treatment. This includes bed rest in a Trendelenburg's or jack-knife position, administration of liquid diet, stool softeners, antibiotics, and anti-inflammatory drugs along with warm Sitz baths and local application of glycerin and magnesium sulphate paste. We introduced an additional method in treating acutely inflammed piles. Ten tablets of trypsin and chymotrypsin (Chymoral forte, Elder Pharmaceuticals India) were powdered and were mixed with 30 grams of heparin (Thrombophobe, German Remedies Ltd, Germany) ointment. This paste was applied to the inflammed pile mass. In all, 67 received this in patient treatment with an average hospital stay of 2 days. The results were compared using chi2 test with similarly placed 22 patients who were treated with the conventional method only.


RESULTS
In the patients receiving the application of the enzyme paste, local pain was reduced to a great extent, the defecation was comfortable, there was negligible local pruritus, and the routine body movements of the patient were painless. Local signs observed in the form of the size of the piles, perianal edema, and tenderness, were also found to be significantly reduced.


CONCLUSIONS
The results of this study demonstrate that the additional use of a heparin-enzyme paste applied directly over the pile masses significantly improves the healing and resolution of acutely inflammed hemorrhoids. The effectiveness of the traditional conservative method of treatment could be gainfully supplemented by use of the pharmaceutical preparation suggested in this study.
D000287:Administration, Topical; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002918:Chymotrypsin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006484:Hemorrhoids / Q000188:drug therapy*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009824:Ointments; D014357:Trypsin / Q000008:administration & dosage / Q000627:therapeutic use*
D000925:Anticoagulants; D009824:Ointments; D006493:Heparin; D002918:Chymotrypsin; D014357:Trypsin