[Common sense of diosmin administration in combined treatment of hemorrhoids]

Rationale and effectiveness of combination therapy of chronic anal fissures and hemorrhoids

Hemorrhoids and anal fissures are a serious medical problem at the intersection of specialties. The disease has a progressive course, there are several stages. In the 3rd and 4th stages, surgical intervention is required, but in the 1st and 2nd stages, i.e. in more than 90% of all cases of the disease, it is enough to correct the lifestyle, physical activity, diet and nature of the diet, as well as conservative drug treatment. The complexity and multifactorial nature of the pathogenesis of hemorrhoidal disease dictate the need for the impact of therapy on the key mechanisms of the development of the disease. This can be achieved by combining agents with different effects and routes of administration to provide potentiation. Treatment of acute and chronic hemorrhoids includes general and local use of painkillers, antiinflammatory, phlebotonic, hemostatic and complex preparations. Among systemic drugs, the leading place belongs to phlebotonic agents of the flavonoid series of plant origin. Their effectiveness is associated with the effect both on the state of the vascular wall with a decrease in venous stasis and improvement of lymphatic outflow, and with an effect on the rheological properties of the blood. There is also a local anti-inflammatory effect of the combination “diosmin + hesperidin”, and in general, a palette of positive properties predetermines the use of these drugs for hemorrhoids. The combination of systemic flavonoids with local agents that provide repair of damaged tissues and have hemostatic effects contributes to an increase in the effectiveness of treatment. The combined use of systemic phlebotonic preparations and local reparative agents, which together provide a complex effect on various pathogenetic mechanisms and symptoms of hemorrhoids and anal fissures, accelerates the achievement of a positive result of treatment and the prevention of recurrence of the disease.

[Modern trends in combined treatment of hemorrhoids: topical form Tribenoside + Lidocaine and phlebotonic Ginkgo biloba + Troxerutin + Heptaminol]

Acute hemorrhoids are the most common reason for referring to coloproctologist in people of working age. In the modern world, food culture and lifestyle are the most prominent factors leading to the risk of hemorrhoids. In the 21st century, it is hard to overestimate an importance of potential employability and active social role regarding socio-economic well-being. This thesis applies to patients suffering from proctological diseases, and those with hemorrhoids prevail among these ones. Minimally invasive treatment and pharmacotherapy defined primary needs of patients, i.e. treatment should be quick, safe and effective. Favorable treatment outcomes are possible only in pathogenetic therapy. In this review, we will define the priorities in effective combined treatment of hemorrhoids.

[Diosmin in the treatment of venous disease: pharmacokinetics and pharmacodynamics (in Russian only)]

The issues of absorption, bacterial intestinal metabolism and hepatic metabolism of diosmin are described. The main metabolites of the drug and the ways of their elimination are indicated. The article describes the main therapeutic targets and mechanisms of influence on the course of disease including effect on the venous wall tone and permeability, lymphatic drainage, inflammation and oxidative stress.