The role of flavonoids in the pharmacological treatment of haemorrhoids

SS Singh; MA Strydom; M Balmith; C Megaw; MJ Nell

Authors

SS Singh University of Pretoria https://orcid.org/0009-0000-4676-2658
MA Strydom University of Pretoria https://orcid.org/0000-0001-8144-4970
M Balmith University of Pretoria https://orcid.org/0000-0002-9209-7318
C Megaw University of Pretoria https://orcid.org/0000-0003-1855-336X
MJ Nell University of Pretoria https://orcid.org/0000-0001-9014-2333

Keywords:

flavonoids, micronised purified flavonoid fraction, hemorrhoidal disease, treatment, clinical trials

Abstract

Ethnopharmacological relevance: Flavonoids have been used for many years by traditional medical practitioners. Flavonoids possess a variety of beneficial effects, namely anti-inflammatory and analgesic properties used to treat typical haemorrhoidal disease (HD) symptoms, such as pain, bleeding, and inflammation.

Aim of the study: The aim of the study was to investigate the therapeutic potential of flavonoids in the conservative treatment of HD by analysing the safety and efficacy of flavonoids in the treatment and post-treatment remission of HD and determining if flavonoids are more effective on their own or when combined with other treatments.

Materials and methods: Five databases were searched to conduct this narrative review. The search was conducted using the following keywords namely, "haemorrhoids", "haemorrhoidal disease", "flavonoids", "safety and efficacy", "clinical trial", "treatment" and "therapy". Articles were filtered based on the inclusion and exclusion criteria. Data from 35 selected articles were charted and included in the qualitative synthesis of this narrative review.

Results: Flavonoids were found to be more effective when used in combination with other treatments such as sclerotherapy (SCL) and rubber band ligation (RBL); as well as in combination with other flavonoids. Micronised purified flavonoid fractions (MPFF), such as Daflon^® were the most prescribed flavonoids due to their high efficacy in alleviating symptoms quickly for lower grades of HD. Some studies followed a two-phase dosing system in order to prevent relapse. Flavonoids administered orally displayed minimal sideeffects in comparison to conventional conservative treatments.

Conclusion: Flavonoids have shown to be an effective and safe therapy in the treatment of acute, internal lower grades of HD. Flavonoids can be used synergistically with other conservative measures and procedures. They have been shown to avert relapses, decrease symptoms linked to HD, escalate the recovery time post-surgery, and often act as a bridge therapy.