Systemic and local therapy of chronic hemorrhoids: Results of the prospective comparative study “VITA”

Introduction. Conservative therapy for hemorrhoids is one of the most discussed and controversial in coloproctology. Considering the high prevalence of this disease, the use of effective pathogenetical and symptoms relieve pharmacotherapy remains especially relevant. Aim. To compare the effectiveness of complex therapy and monotherapy for chronic hemorrhoids. Materials and methods. A prospective observational study was conducted on the effects of different approaches with the use of the Venarus and Venaproct Alium to the treatment of patients with hemorrhoids (“VITA”). The complex therapy group was treated with standardized dosages of systemic bioflavonoids hesperidin 100 mg and diosmin 900 mg, and sodium alginate rectal suppositories for topical use. The monotherapy control group received only therapy with Venarus. The study was conducted from June 20, 2023 to May 31, 2024 and included 80 patients with chronic hemorrhoids. The dynamics of hemorrhoids symptoms, the quality oflife, adherence to the therapy, the frequency of repeated disease exacerbations was compared depending on treatment approaches. Results. Conservative pharmacotherapy was effective in both groups, however, in the complex therapy group, the effect of decreased symptoms of “blood discharge during defecation” and “presence of enlarged external hemorrhoids” was more pronounced. Statistically significant differences between groups recorded at 14 days (p = 0.009) for the symptom “blood discharge during bowel movements” and 85% of patients receiving complex therapy had no complaints about the presence of enlarged external hemorrhoids by the 14th day (p < 0.001) and 87% by the 30th day of treatment (p < 0.001). Discussion. Pharmacotherapy of hemorrhoids, given the prevalence of symptoms of bleeding and prolapse of nodes, should be aimed at their effective elimination. The combination of systemic and topical therapy for hemorrhoids offers an integrative approach that can significantly improve the treatment effect. Conclusion. Considering the absence of differences in patient adherence to the treatment, the effect of complex therapy compared to monotherapy of hemorrhoids symptoms decrease, indicates the advisability of using complex treatment with the Venarus and Venaproct Alium.