COMPARATIVE EVALUATION OF THE EFFICACY OF DIFFERENT SCHEMES OF DRUG CORRECTION OF EXTERNAL HEMORRHOIDS IN PUERPERAS
DOI:
https://doi.org/10.11603/24116-4944.2019.1.10200Keywords:
postpartum period, postpartum complications, external hemorrhoids, drug correction of hemorrhoidsAbstract
The aim of the study – to learn the efficacy of different schemes of drug treatment in the formation of external hemorrhoids in puerperas.
Materials and Methods. We examined 48 women aged 28–45 years with diagnosed external hemorrhoids in the postpartum period. The puerperas were divided into two groups depending on the scheme of drug correction. The patients of the group I received complex therapy, which included a prebiotic (Dufalac), an angioprotector/venotonic (Normoven), and rectal antihemorrhoidal suppositories (Natalsid). The patients in the group II received monotherapy in the form of rectal antihemorrhoidal suppositories (Natalcid). It was also strongly recommended to follow a certain diet during treatment. All puerperas underwent routine clinical and laboratory examination. Monitoring the effectiveness of treatment was performed in 7, 14 days. Dynamic follow–up was also carried out for 12 months to analyze the duration of the therapeutic effect and fix possible recurrences of external hemorrhoids in the examined patients.
Results and Discussion. Improvement of the general condition, well–being and elimination of the main clinical manifestations of external hemorrhoids after 7 days of treatment was noted by the overwhelming majority of women in the group I – 83.3 % and 62.5 % of puerperas in the group II who received monotherapy. After a two–week course of therapy, this index was 95.8 % and 75.0 %, respectively. When conducting a prospective analysis, it was established that when prescribing only drugs of local action, recurrences of the disease were recorded in 16.7 % of cases during a year. In the group of patients who were recommended a treatment regimen that corrects the main pathogenetic mechanisms of the formation of this pathology of the rectum, this figure was only 4.2 %.
Conclusions. In exacerbation or the occurrence of external hemorrhoids in women in the postpartum period, the administration of the complex drug therapy is the most reasonable and rational. It is important not only to eliminate the local manifestations of this pathology of the rectum, but also to correct the various pathogenetic mechanisms of its formation. Thus, physiological sanitation and stimulation of the intestinal peristaltic activity with the help of prebiotics, the appointment of systemic angioprotectors/venotonics, generally contribute to the achievement of long–term remission of the disease. The use of only local preparations with external hemorrhoids has a positive, however, sometimes short-term therapeutic effect.
References
Lohsiriwat, V. (2015). Treatment of hemorrhoids: A coloproctologist’s view. World J. Gastroenterol., 21 (31), 9245-9252. DOI: https://doi.org/10.3748/wjg.v21.i31.9245
Jacobs, D. (2014). Clinical practice. Hemorrhoids. N. Engl. J. Med., 371 (10), 944-951. DOI: https://doi.org/10.1056/NEJMcp1204188
Poskus, T., Buzinskiene, D., Drasutiene, G., Samalavicius, N.E., Barkus, A., Barisauskiene, A., … & Jakaitiene, A. (2014). Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG., 121 (13), 1666-1671. DOI: https://doi.org/10.1111/1471-0528.12838
Avsar, A.F., & Keskin, H.L. (2010). Haemorrhoids during pregnancy. J. Obstet. Gynaecol., 30 (3), 231-237. DOI: https://doi.org/10.3109/01443610903439242
Ahlund, S., Radestad, I., Zwedberg, S., Edqvist, M., & Lindgren, H. (2018). Haemorrhoids – A neglected problem faced by women after birth. Sex Reprod. Healthc. 18, 30-36. DOI: https://doi.org/10.1016/j.srhc.2018.08.002
Abramowitz, L. (2008). Management of hemorrhoid disease in the pregnant woman. Castroenterol. Clin. Biol., 32, 210-214. DOI: https://doi.org/10.1016/j.gcb.2008.04.012
Staroselsky, A., Nava–Ocampo, A.A., Vohra, S., & Koren, G.
(2008). Hemorrhoids in pregnancy. Can Fam. Physician., 54 (2), 189-190.
Gojnic, M., Dugalic, V., Papic, M., Vidakovic, S., Milicevic, S.,
& Pervulov, M. (2005). The significance of detailed examination of hemorrhoids during pregnancy. Clin. Exp. Obstet. Gynecol., 32 (3), 183-184.
Lohsiriwat, V. (2012). Hemorrhoids: from basic pathophysiology to clinical management. World J. Gastroenterol., 18 (17), 2009-2017. DOI: https://doi.org/10.3748/wjg.v18.i17.2009
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
