Risk factors for hemorrhoidal disease among healthy young and middle-aged Korean adults

Comparative Outcomes of Milligan-Morgan (Open) Versus Ferguson (Closed) Hemorrhoidectomy: A Retrospective Study

Introduction The debate remains unresolved about whether an open (Milligan-Morgan) or closed (Ferguson) approach is superior for hemorrhoidectomy. Advocates from both groups state that each has its own set of advantages and disadvantages. In light of this, we intend to share our experience by comparing the two in terms of their post-operative outcomes. This study aims to compare open (Milligan-Morgan) and closed (Ferguson) hemorrhoidectomy in terms of post-operative outcomes. Materials and methods This retrospective study was carried out at the Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A total of 137 patients who underwent hemorrhoidectomy from January 1, 2022, to May 31, 2024, were enrolled. Post-operative outcomes were noted in terms of surgical site infection (SSI), excessive bleeding, and visual analog scale (VAS) pain score. Data were analyzed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, NY, USA). Results A total of 137 patients were enrolled in the study, with 93 (67.9%) undergoing Milligan-Morgan (open) hemorrhoidectomy and 44 (32.1%) undergoing the Ferguson (closed) procedure. The mean age in the open group was 46.87 ± 10.79 years, compared to 44.59 ± 9.06 years in the closed group. Male participants comprised 59 (63.4%) in the open group and 19 (43.2%) in the closed group. SSI was observed in 32 patients (23.3%); 22 (68.8%) were from the open group, and 10 (31.3%) were from the closed group (p-value, 0.905). Hemorrhage was recorded in 34 patients (15.3%), with 21 (61.8%) in the open group and 13 (38.2%) in the closed group (p-value, 0.378). The mean post-operative VAS pain score was 3.76 ± 1.79 for the open technique versus 4.07 ± 1.37 for the closed technique, respectively (p-value, 0.321). Conclusion Though the SSI and hemorrhage rates were higher with the Milligan-Morgan technique than with the Ferguson technique, the mean post-operative VAS score was also higher with the Milligan-Morgan procedure. However, none of the differences was found to be statistically significant.

A Gender Perspective on Coloproctological Diseases: A Narrative Review on Female Disorders

Coloproctological diseases, including both benign and malignant conditions, are among the most common diagnoses in clinical practice. Several disorders affect both men and women, while others are unique to women, or women are at a greater risk of developing them. This is due to anatomical, biological, and social conditions and also due to females' exclusive capabilities of reproduction and pregnancy. In this context, the same proctological disease could differ between men and women, who can experience different perceptions of health and sickness. There is a raised awareness about the impact of different diseases in women and a growing need for a personalized approach to women's health. In this review, we aim to summarize the specific features of the main coloproctological diseases, specifically in the female population. This includes common complaints during pregnancy, conditions linked to vaginal delivery, functional consequences after colorectal resections, and conditions presenting a gender disposition.

Pelvic floor imaging in women with hemorrhoidal disease: An anatomical feasibility study

OBJECTIVE

To compare pelvic floor muscle and organ structures in women with and without hemorrhoidal disease (HD) using magnetic resonance imaging (MRI).

MATERIAL AND METHODS

Pelvic MRI measurements and computer-based medical records of women diagnosed with HD between January 2018 and March 2021 were analyzed. Parameters including pubococcygeal distance, puborectal distance, posterior anorectal angle, obturator internus muscle area, presence of levator ani muscle defect, genital hiatus length, vaginal length, uterocervical angle, cervix-upper vagina angle, and cervix-middle vagina angle were evaluated. The control group consisted of women without HD, matched for age and body mass index.

RESULTS

Puborectal hiatus distance was higher in the HD group (59.2 ​± ​8.7 ​mm vs. 55.5 ​± ​7.1 ​mm, p ​= ​0.03). Similarly, the distance to the M line was greater in the HD group (18.3 ​± ​4.8 ​mm vs. 16 ​± ​4.6 ​mm, p ​= ​0.04). Obturator internus muscle area was found to be lower in the HD group compared to the non-HD group (1721 ​± ​291.4 ​mm2 vs. 1897.5 ​± ​352.5 ​mm2, p ​= ​0.02). Additionally, the presence of unilateral levator ani muscle defect was higher in HD patients (p ​= ​0.03). There was a negative correlation between birthweight and obturator internus muscle area (r ​= ​-0.388, p ​= ​0.02), and a positive correlation with M line distance (r ​= ​0.344, p ​= ​0.04).

CONCLUSION

Levator ani muscle defects and obturator internus muscle area, indicators of pelvic floor dysfunction, are more common in patients with hemorrhoidal disease.

Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management

INTRODUCTION

There are very few French studies on hemorrhoidal disease and its management.

PATIENTS AND METHODS

Prospective single-center study from July to December 2021 including 472 patients.

RESULTS

Bleeding, prolapse and pain were the main reasons for consultation. Treatment modalities were medical (44%),±instrumental (72%), and surgical (17%). After treatment, the bleeding score and prolapse score decreased significantly (P=0.002 and P≤0.0001, respectively), but improvement was more marked in the surgery group with a better rate of "very good satisfaction" (73% vs. 54%, P=0.003). Factors associated with likelihood of surgical treatment were: age>44years, hypertrophic perianal skin tags, high scores (Bristol>5, bleeding>5, prolapse>2), severe impact on quality of life, smoking and reading during bowel movements. We have developed an online application, which aims to assess the risk of requiring hemorrhoidal surgery.

CONCLUSION

Less than 20% of patients who present with hemorrhoidal disease require surgical treatment, but it is associated with better effectiveness despite more complex postoperative consequences that sometimes motivate patient refusal. We have highlighted factors associated with surgical management, which can guide the practitioner in their therapeutic choices.

Incidence and Risk Factors of Perianal Pathology during Pregnancy and Postpartum Period: A Prospective Cohort Study

OBJECTIVE

We aimed to identify the incidence and risk factors of perianal pathology during pregnancy and the postpartum period.

METHODS

A prospective cohort study was conducted in three institutions in Lithuania. A total of 190 patients were examined and interviewed three times (<12, 18-20 weeks of gestation, and during the first 2 months after delivery). They completed a questionnaire including demographic, obstetric, coloproctological, and birth data.

RESULTS

A total of 73 (34.59%) women developed hemorrhoidal disease after delivery, and 120 (56.87%) developed perianal pathology. Multivariate analysis identified a neonatal birth weight ≥3380 g (OR 4.22; 95% CI 1.83-9.71, p < 0.001) and consumption of eggs (OR 3.10; 95% CI 1.13-8.53, p = 0.028) or cereals (OR 2.87; 95% CI 1.32-6.25, p = 0.008) several times per week as significant risk factors for hemorrhoidal disease. Neonatal birth weight ≥3380 g (OR 3.95; 95% CI 1.47-10.59, p = 0.006), maternal BMI ≥ 21.48 (OR 3.58; 95% CI 1.51-8.47, p = 0.004), the duration of the second labor period ≥38 min (OR 2.81; 95% CI 1.09-7.23, p = 0.032), and consumption of flour products several times per week (OR 2.77; 95% CI 1.10-6.98, p = 0.030) were associated with a higher risk of perianal pathology. Daily consumption of fruits and vegetables (OR 0.35; 95% CI 0.15-0.81, p = 0.014) and less frequent consumption of eggs were protective factors (OR 0.18; 95% CI 0.06-0.56, p = 0.003).

CONCLUSIONS

Perianal diseases, especially hemorrhoidal disease, are common during pregnancy and the postpartum period. A neonatal birth weight ≥ 3380 g, a maternal BMI of ≥21.48, duration of the second labor period of ≥38 min, and consumption of flour products and cereals several times a week are risk factors for developing these diseases.

Causal associations between human gut microbiota and hemorrhoidal disease: A two-sample Mendelian randomization study

Hemorrhoidal disease (HEM) is a common condition affecting a significant proportion of the population. However, the causal relationship between the gut microbiota and hemorrhoids remains unclear. In this study, we employed a Mendelian randomization (MR) approach to investigate the potential associations between them. In this study, the exposure factor was determined by selecting summary statistics data from a large-scale gut microbiome whole-genome association study conducted by the MiBioGen Consortium, which involved a sample size of 18,340 individuals. The disease outcome data consisted of 218,920 cases of HEM and 725,213 controls of European ancestry obtained from the European Bioinformatics Institute dataset. Two-sample MR analyses were performed to assess the causalities between gut microbiota and hemorrhoids using various methods, including inverse-variance weighting, MR-Egger regression, MR Pleiotropy Residual Sum and Outlier (MR-PRESSO), simple mode, and weighted median. Reverse MR analyses were performed to examine reverse causal association. Our findings suggest phylum Cyanobacteria (OR = 0.947, 95% CI: 0.915-0.980, P = 2.10 × 10 - 3), genus Phascolarctobacterium (OR = 0.960, 95% CI: 0.924-0.997, P = .034) and family FamilyXI (OR = 0.974, 95% CI: 0.952-0.997, P = .027) have potentially protective causal effects on the risk of HEM, while genus Ruminococcaceae_UCG_002 (OR = 1.036, 95% CI: 1.001-1.071, P = .042), family Peptostreptococcaceae (OR = 1.042, 95% CI: 1.004-1.082, P = .029), genus Oscillospira (OR = 1.048, 95% CI: 1.005-1.091, P = .026), family Alcaligenaceae (OR = 1.048, 95% CI: 1.005-1.091, P = .036) and order Burkholderiales (OR = 1.074, 95% CI: 1.020-1.130, P = 6.50 × 10-3) have opposite effect. However, there was a reverse causal relationship between HEM and genus Oscillospira (OR = 1.140, 95% CI: 1.002-1.295, P = .046) This is the first MR study to explore the causalities between specific gut microbiota taxa and hemorrhoidal disease, which may offer valuable insights for future clinical interventions for hemorrhoidal disease.

Prevalence of Hemorrhoids and the Associated Risk Factors Among the General Adult Population in Makkah, Saudi Arabia

INTRODUCTION

Hemorrhoidal disease is one of the most common benign anorectal conditions. It is described as the symptomatic enlargement and abnormally downward displacement of anal cushions. Its effect on the quality of life of patients is significantly negative and is considered one of the leading causes of lower gastrointestinal bleeding. However, studies that determine the prevalence of and risk factors associated with hemorrhoidal disease are limited. Therefore, this study aimed to evaluate the prevalence of and risk factors for hemorrhoids among the general adult population in the city of Makkah, Saudi Arabia.

METHODS

A descriptive cross-sectional study was conducted with a structured, prevalidated questionnaire and was used with some modifications. It was created using Google Forms (Google, Mountain View, CA) and distributed via social media platforms in Arabic along with the English version of each question. All data from the returned survey were encrypted. IBM SPSS Statistics, version 21 (IBM Corp., Armonk, NY) was used to analyze the data.

RESULTS

A total of 400 participants completed the study questionnaire. Regarding the prevalence of hemorrhoids among the general population in Makkah, 64 participants (16%) reported that they were diagnosed with hemorrhoid disorder. The most reported symptoms among participants with hemorrhoids were pain with defecation (76.2%), discomfort (63.5%), and swelling (55.6%).

CONCLUSION

Hemorrhoids are one of the most common complaints among surgical patients and are more prevalent in men. The risk of hemorrhoids is significantly higher in married women with a history of pregnancy, who are overweight, and who consume low-fiber diets. It is better to practice close follow-up of patients with hemorrhoids to avoid complications, particularly, patients with chronic diseases who are at a high risk.

Translation and validation of Indonesian hemorrhoidal disease symptom score (HDSS) and short health scale hemorrhoidal disease (SHSHD)

Objectives

Hemorrhoidal disease, which affects nearly 40% of people, is characterized by pathological alterations and distal displacement of hemorrhoidal tissue. The short health scale (SHSHD) and the hemorrhoidal disease symptom score (HDSS) are two tools that can be utilized to assess the quality of life of hemorrhoidal patients. The present study aims to translate, modify, and validate the HDSS and SHSHD questionnaires in Indonesian.

Material and Methods

This cross-sectional study assessed the validity and reliability of the HDSS and SHSHD Indonesian adaptation instrument in hemorrhoidal patients from April 15, 2022, and April 1, 2023.

Results

There were 91 study subjects, 55 males and 36 females. The study showed that the subscale interpretations of the R-values and the full scale scored above 0.25, indicating weak to very strong correlations. These results mean that the HDSS and SHSHD questionnaires are valid for use. Based on the study's results, the R-value of each item, domain, and total score ≥0.8 (p <0.05) indicates that the HDSS and SHSHD instruments are reliable.

Conclusion

The Indonesian adaptation of the HDSS and SHSHD demonstrates validity and reliability as an assessment tool for measuring the healthrelated quality of life in Indonesian patients diagnosed with hemorrhoidal disease.

Prevalence, Characteristics, and Treatment of Hemorrhoids During Pregnancy: A Nationwide Population-Based Cohort Study in Taiwan

Background: Hemorrhoids, a gastrointestinal tract disorder, are common during pregnancy. However, large-scale epidemiological studies on hemorrhoids during pregnancy are limited. Therefore, this study used analyzed data from a nationwide population-based database to investigate the prevalence, characteristics, and treatment of hemorrhoids in Taiwan. Materials and Methods: This retrospective population-based study used data from the National Health Insurance Research Database and Taiwan Birth Certificate Application to collect the medical records of women who were pregnant at any time during 2009-2018. Hemorrhoids was defined by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) (455. X) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) (K64.X, O22.4X) with related treatment. Results: We enrolled 1,608,804 deliveries in 1,070,708 women. The proportion of hemorrhoids increased with age in both primipara and multipara women. Of the pregnant women, 31% received oral medication, and 93.2% used the topical ointment to treat their hemorrhoids. Few patients (1.8%) required procedure or surgery during pregnancy, and 41.4% of those patients underwent procedure or surgery in their first trimester. The cumulative incidence of hemorrhoids during pregnancy was significantly higher in women with a history of hemorrhoids and those with multifetal pregnancies. No significant difference in the incidence of hemorrhoids was observed between multiparous and primiparous women. Conclusion: Women with a history of hemorrhoids or those carrying multiple fetuses had an increased risk of hemorrhoids during pregnancy. The most commonly used treatment for hemorrhoids during pregnancy was topical ointments, with only a small proportion (1.8%) of patients requiring procedure or surgery.

Excisional Hemorrhoidectomy Versus Dearterialization With Mucopexy for the Treatment of Grade III Hemorrhoidal Disease: The EMODART3 Multicenter Study

BACKGROUND

Over the past few decades, several surgical approaches have been proposed to treat hemorrhoids.

OBJECTIVE

This multicenter study aimed to compare transanal hemorrhoidal artery ligation and conventional excisional hemorrhoidectomy for grade III hemorrhoidal disease.

DESIGN

Multicenter retrospective study.

SETTINGS

Any center belonging to the Italian Society of Colorectal Surgery in which at least 30 surgical procedures per year for hemorrhoidal disease were performed was able to join the study.

PATIENTS

Clinical data from patients with Goligher's grade III hemorrhoidal disease who underwent excisional hemorrhoidectomy or hemorrhoidal artery ligation were retrospectively analyzed after a 24-month follow-up period.

MAIN OUTCOME MEASURES

The primary aims were to evaluate the adoption of 2 different surgical techniques and to compare them in terms of symptoms, postoperative adverse events, and recurrences at a 24-month follow-up.

RESULTS

Data from 1681 patients were analyzed. The results of both groups were comparable in terms of postoperative clinical score by multiple regression analysis and matched case-control analysis. Patients who underwent excisional hemorrhoidectomy had a significantly higher risk of postoperative complication (adjusted OR = 1.58; p = 0.006). A secondary analysis highlighted that excisional hemorrhoidectomy performed with new devices and hemorrhoidal artery ligation reported a significantly lower risk for complications than excisional hemorrhoidectomy performed with traditional monopolar diathermy. At the 24-month follow-up assessment, recurrence was significantly higher in the hemorrhoidal artery ligation group (adjusted OR = 0.50; p = 0.001). A secondary analysis did not show a higher risk of recurrences based on the type of device.

LIMITATIONS

The retrospective design and the self-reported nature of data from different centers.

CONCLUSIONS

Hemorrhoidal artery ligation is an effective option for grade III hemorrhoidal disease; however, it is burdened by a high risk of recurrences. Excisional hemorrhoidectomy performed with newer devices is competitive in terms of postoperative complications.HEMORROIDECTOMÍA POR ESCISIÓN VERSUS DESARTERIALIZACIÓN CON MUCOPEXIA PARA EL TRATAMIENTO DE LA ENFERMEDAD HEMORROIDAL DE GRADO 3: EL ESTUDIO MULTICÉNTRICO EMODART3ANTECEDENTES:En las últimas décadas se han propuesto varios abordajes quirúrgicos para el tratamiento de las hemorroides.OBJETIVO:Este estudio multicéntrico tiene como objetivo comparar la ligadura de la arteria hemorroidal transanal y la hemorroidectomía por escisión convencional para la enfermedad hemorroidal de grado III.DISEÑO:Estudio retrospectivo multicéntrico.ÁMBITO:Cualquier centro perteneciente a la Sociedad Italiana de Cirugía Colorrectal en el que se realizaron al menos 30 procedimientos quirúrgicos por año para la enfermedad hemorroidal pudo participar en el estudio.PACIENTES:Los datos clínicos de pacientes con enfermedad hemorroidal de grado III de Goligher que se sometieron a hemorroidectomía por escisión o ligadura de arterias hemorroidales se analizaron retrospectivamente después de un período de seguimiento de 24 meses.PRINCIPALES MEDIDAS DE RESULTADO:Los objetivos primarios fueron evaluar la adopción de dos técnicas quirúrgicas diferentes y compararlas en términos de síntomas, eventos adversos posoperatorios y recurrencias a los 24 meses de seguimiento.RESULTADOS:Se analizaron datos de 1681 pacientes. Los 2 grupos resultaron ser comparables en términos de puntuación clínica posoperatoria mediante análisis de regresión múltiple y análisis de casos y controles emparejados. Los pacientes sometidos a hemorroidectomía excisional tuvieron un riesgo significativamente mayor de complicaciones posoperatorias (odds ratio ajustado = 1,58; p = 0,006). Un análisis secundario destacó que la hemorroidectomía por escisión realizada con nuevos dispositivos y la ligadura de la arteria hemorroidal informaron un riesgo significativamente menor de complicaciones que la hemorroidectomía por escisión realizada con diatermia monopolar tradicional. En la evaluación de seguimiento de 24 meses, la recurrencia fue significativamente mayor en el grupo de ligadura de la arteria hemorroidal (razón de probabilidad ajustada = 0,50; p = 0,001). Un análisis secundario no mostró un mayor riesgo de recurrencias según el tipo de dispositivo.LIMITACIONES:El diseño retrospectivo y el carácter autoinformado de los datos de diferentes centros.CONCLUSIÓN:HAL es una opción efectiva para la enfermedad hemorroidal grado III; sin embargo, se ve afectado por un alto riesgo de recurrencias. La hemorroidectomía por escisión realizada con dispositivos más nuevos es competitiva en términos de complicaciones posoperatorias. (Traducción-Dr Yolanda Colorado ).

Clinical efficacy of ultrasound doppler-guided hemorrhoidal artery ligation combined with procedure for prolapse and hemorrhoids in treatment of severe hemorrhoids

Hemorrhoids are a prevalent anorectal condition that affects a wide range of adult populations. The severity of this condition was graded using a validated hemorrhoidal grading system, specifically focusing on grade III and IV cases. This retrospective study aimed to compare the clinical efficacy of a standard Procedure for Prolapse and Hemorrhoids (PPH) with a combined Doppler-guided Hemorrhoidal Artery Ligation (DG-HAL) and a PPH approach in patients with severe hemorrhoids. Conducted from May 2021 to January 2023, the study included patients aged 18-65 with confirmed diagnosis of Grade III or Grade IV hemorrhoids. Patients with a history of anorectal surgery and significant comorbidities were excluded. The control group underwent standard PPH, whereas the observation group received DG-HAL followed by PPH. Clinical outcomes were measured using variables such as the operative duration, intraoperative blood loss, postoperative wound healing time, and length of hospital stay. Efficacy was evaluated using a hierarchical scale and a visual analog scale (VAS) for postoperative pain. The complication rates were also assessed. baseline characteristics were homogeneous between the 2 groups. The observation group demonstrated significantly faster postoperative wound healing and shorter hospital stay (P < .01). The overall therapeutic efficacy in the observation group was 90.0%, which was higher than that of the control group (75.0%; P = .025). The VAS pain scores were also significantly lower in the observation group (P = .002). A marked decrease in complication rates was observed in the observation group (3.3%) compared with that in the control group (17.9%) (P < .05). The combined DG-HAL and PPH surgical approach exhibited superior clinical efficacy in treating severe hemorrhoids. This technique offers high effectiveness, reduced postoperative VAS pain scores, and lower complication rates. The long-term efficacy requires further observation.

Causal association between adiposity and hemorrhoids: a Mendelian randomization study

Background

Hemorrhoids are a very common anorectal disorder affecting a large number of individuals throughout the world. This study aimed to evaluate the causal effects of four adiposity traits including body mass index (BMI), body fat percentage, waist circumference, and waist-to-hip ratio on hemorrhoids by Mendelian randomization (MR).

Methods

We used summary statistics of BMI (N = 461,460), body fat percentage (N = 454,633), waist circumference (N = 462,166), waist-to-hip ratio (N = 212,244), and hemorrhoids (N = 337,199) from large-scale genome wide association studies of European ancestry. Univariable and multivariable MR were carried out to infer causality. The MR Steiger directionality test was used to test the causal direction.

Results

The primary MR analysis using the inverse variance weighted (IVW) method showed that there were positive effects of genetically determined BMI [odds ratio (OR) = 1.005, 95% confidence interval (CI): 1.003-1.008, per standard deviation (SD), p = 7.801 × 10-5], body fat percentage (OR = 1.005, 95% CI: 1.001-1.008, per SD, p = 0.008), waist circumference (OR = 1.008, 95% CI: 1.005-1.011, per SD, p = 1.051 × 10-6), and waist-to-hip ratio (OR = 1.010, 95% CI: 1.003-1.017, per SD, p = 0.003) on hemorrhoids. These findings were robust in multivariable MR adjusting for physical activity. The Steiger directionality test showed evidence against reverse causation.

Conclusion

Our MR study supports a causal role of adiposity in the development of hemorrhoids. Adiposity prevention may be an important strategy for reducing hemorrhoids risk.

Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients

Hemorrhoidal disease (HD) is a chronic multifactorial disease. Increased abdominal pressure, along with hyperperfusion, neovascularization, overexpression of inflammatory mediators, and dysbiosis, contributes to the development of HD. The deterioration of the anchoring connective tissue with reduced collagen content and altered collagen ratios, dilatation of blood vessels and thrombosis, muscle injury, and inflammation gradually lead to clinically manifesting prolapse and bleeding from hemorrhoids. The associations of the ABO blood types with a disease have been investigated for the upper gastrointestinal tract only. This study aimed to evaluate HD clinical manifestations, surgeries carried out, and the status of prolapsed anorectal tissues by exploring the associations with the patients' ABO blood groups. Clinical and various morphological methods, combined with extensive bioinformatics, were used. The blood type 0, grade III and IV HD individuals constituted the largest group in a moderately-sized cohort of equally represented males and females studied and submitted to surgical treatment of hemorrhoids. There were significantly more complaints reported by HD females compared to males (p = 0.0094). The Longo technique appeared mostly used, and there were proportionally more surgeries performed below the dentate line for HD individuals with blood type 0 compared to other blood type patients (24% vs. 11%). HD males were found to present with significantly more often inflamed rectal mucosa (p < 0.05). Loosening and weakening of collagenous components of the rectal wall combined with vascular dilation and hemorrhage was found to differ in 0 blood type HD individuals compared to other types. HD males were demonstrated to develop the ruptures of vascular beds significantly more often when compared to HD females (p = 0.0165). Furthermore, 0 blood type HD males were significantly more often affected by a disease manifested with tissue hemorrhage compared to the 0 blood type HD females (p = 0.0081). Collectively, the local status of chronically injured anorectal tissue should be considered when applying surgical techniques. Future studies could include patients with HD grades I and II to gain a comprehensive understanding of the disease progression, allowing for a comparison of tissue changes at different disease stages.

Herbal remedies used by traditional healers to treat haemorrhoids in Tabora region, Tanzania

CONTEXT

Haemorrhoids are one of the most common gastrointestinal disorders in humans. In Tanzania, particularly in the Tabora region, medicinal plants (MPs) are used by traditional healers (THs) to treat haemorrhoids, but no study has explicitly attempted to compile these treatments.

OBJECTIVE

This study documents MPs used by THs of the Tabora region in Tanzania to treat haemorrhoids.

MATERIALS AND METHODS

A semi-structured questionnaire was used to gather ethnobotanical data from 44 THs on MPs used to treat haemorrhoids, parts used, preparation methods and administration routes. The collected ethnobotanical data were analysed by computing percentage frequencies and relative frequency citations.

RESULTS

Twenty-six MPs belonging to 19 families and 25 genera, used to manage haemorrhoids, were documented. Fabaceae was the dominant family (four species), whereas shrubs constituted a high proportion (38.46%) of the MPs, and the root was the most (30.3%) utilized plant part. Decoction (38.5%) and topical application (53.8%) were the most preferred preparation and administration techniques. Most MP materials (76.9%) were sourced from the wild. Aloe vera (L.) Burm.f. (Asphodelaceae) (68%), followed by Allium sativum L. (Alliaceae) (66%) and Psidium guajava L. (Myrtaceae) (66%) were the most utilized MPs. Among the recorded MPs, 12 are reported for the first time for the treatment of haemorrhoids. The recorded MPs are believed to possess anti-inflammatory properties that aid in managing inflammation associated with bowel diseases, including haemorrhoids.

CONCLUSIONS

This study has documented valuable MPs used to manage haemorrhoids and provides a basis for further studies to discover efficient and affordable anti-haemorrhoid drugs.