Hemorrhoids

This research aims to compare the effectiveness of topical lignocaine ointment versus 0.2% glyceryl trinitrate (GTN) ointment for reducing postoperative pain and promoting wound healing in patients undergoing hemorrhoidectomy. Hemorrhoids are swollen veins in the anal area, and pain after surgery can delay recovery and affect comfort. The study focuses on determining which ointment provides better pain relief and wound healing outcomes following hemorrhoid removal surgery. Patients undergoing hemorrhoidectomy will be randomly assigned to one of two groups. One group will receive lignocaine ointment applied locally to the anal wound three times daily after surgery, while the other group will receive 0.2% GTN ointment on the same schedule. Both groups will receive standard postoperative care including sitz baths, stool softeners, and paracetamol for pain relief. The study will follow participants for 3 to 6 months overall, with treatment and monitoring focused on the first month after surgery. Participants will have their pain levels assessed using a visual analog scale (VAS) at various times after surgery, including 6, 12, 24, 48, and 72 hours, as well as at 7, 14, 21, and 28 days. Wound healing time will be tracked up to one month, and patient satisfaction will be measured at 6 weeks using a 5-point scale. Additional monitoring includes recording the time to first analgesic request, analgesia amounts, and any side effects such as wound secretion, itching, bleeding, or headaches. Data will be analyzed to compare outcomes between the two ointments.

Researchers are evaluating how abdominal massage affects gastrointestinal functions in patients who are mechanically ventilated and receiving enteral nutrition in intensive care units. This study aims to assess abdominal massage's impact on bowel movement frequency, gastric residual volume, and abdominal distension. The trial is designed as a prospective, single-blind randomized controlled trial to provide scientific evidence for abdominal massage use in this patient group. Participants are randomly assigned to either an intervention group receiving abdominal massage or a control group receiving standard care without massage. Abdominal massage is performed twice daily for 15 minutes over three days using specific techniques like effleurage, petrissage, and vibration. The massage is given at the bedside in a semi-Fowler position before enteral feeding, with routine nursing care provided to all patients. Throughout the study, researchers monitor bowel movements, gastric residual volume, abdominal distension, and stool consistency using specialized forms and scales twice daily. Data collection includes clinical assessments such as Glasgow Coma Scale and APACHE II scoring. The study lasts three days for each patient, with detailed recording of gastrointestinal function parameters to evaluate the effects of abdominal massage compared to standard care.

Researchers are studying adults with advanced hemorrhoidal disease (grade III-IV) to see if injecting botulinum toxin type A into the internal anal sphincter one week before hemorrhoidectomy can reduce pain after surgery. This is a randomized, double-blind, placebo-controlled clinical trial comparing botulinum toxin A injection with saline injection. The trial aims to understand if relaxing the sphincter before surgery improves recovery and reduces pain. Participants will be randomly assigned to receive either botulinum toxin type A or a saline injection into the internal anal sphincter seven days before their hemorrhoidectomy surgery. The injection is given in four specific areas using a standardized method. After the injection, all participants will have open or closed hemorrhoidectomy with standard surgical care. The study ensures neither patients nor surgeons know which injection was given. During the first week after surgery, researchers will assess pain levels using a visual scale and track opioid use, complications, hospital stay length, bowel function, and patient satisfaction over 30 days. Additional evaluations include fecal incontinence rates, time to first bowel movement, and any unplanned medical visits. The study will monitor recovery closely up to 30 days after surgery to understand the impact of the treatment.

Researchers are evaluating the long-term effectiveness and safety of cap-assisted endoscopic sclerotherapy (CAES) for treating internal hemorrhoids and rectal prolapse. CAES is a new minimally invasive procedure performed during colonoscopy that aims to improve treatment precision and reduce pain and injury. This nationwide, multi-center, prospective cohort study seeks to provide solid evidence to support the wider use of this technique. The treatment involves using a colonoscope with a special cap to fully expose the area being treated. A specially designed long injection needle helps the doctor control the injection angle and depth under direct vision, which may reduce risks. During the procedure, doctors can also diagnose other conditions like tumors or inflammatory bowel disease and provide therapy for lower-gut issues during the same session, lowering medical costs and patient discomfort. Participants will undergo CAES treatment and be followed up regularly to assess outcomes. Researchers will track recurrence rates from the first week to 24 weeks after treatment, as well as improvement and failure rates at multiple points within that period. They will also monitor quality of life, adverse events, symptom severity, and participants' attitudes toward the procedure. The study aims to confirm the long-term safety and benefits of CAES over several months.

Researchers are evaluating the use of a second-generation colon capsule endoscopy system to detect bleeding sources in patients with severe hematochezia, which involves bright red blood per rectum. This study compares this capsule endoscopy with standard diagnostic tests like tagged red blood cell scans and angiography to see if it improves the accuracy and speed of locating bleeding lesions. The study aims to provide a new approach that could change current guidelines and management for patients with this condition. Participants will undergo bowel preparation and then swallow the colon capsule, which records images of the entire gastrointestinal tract for up to 10 hours. Alongside this, patients will receive standard tests such as tagged RBC scans, CT or MRI angiography, and urgent colonoscopy within 48 hours to identify bleeding sources. The study also includes further diagnostic procedures if needed, and specialists will review all results while blinded to the capsule endoscopy findings initially to avoid bias. During the study, researchers will collect medical history, physical exams, lab tests, and details about bleeding and treatments. Safety monitoring will track adverse events daily during hospitalization and weekly for 30 days after discharge. The main outcome measured is the ability of each diagnostic method to locate the bleeding site within 30 days. Follow-up includes monitoring treatments, complications, transfusions, hospital stay, and survival, with data kept confidential and securely managed throughout the study.

Researchers are evaluating the use of a drug retention enema containing triethanolamine cream to prevent acute radiation rectal injury in patients undergoing pelvic or rectal radiotherapy. This real-world, prospective, multicenter study aims to assess both the safety and effectiveness of this treatment in preventing radiation-induced rectal damage. Participants receive a triethanolamine cream retention enema once every night before bed during the course of radiotherapy. After completing radiotherapy, the enema is continued once nightly for an additional three months. The enema is prepared by mixing 15ml of triethanolamine cream with 30ml of normal saline and administered via a special catheter inserted about 15cm into the rectum, with the liquid retained overnight. During the study, researchers will monitor the timing and occurrence of acute and chronic radiation rectal injuries for up to approximately four months. Clinical symptoms will be assessed alongside quality of life measurements using the Inflammatory Bowel Disease Questionnaire (IBDQ). Participants' compliance and cooperation will be closely observed throughout the study period. The study is led by Fujian Cancer Hospital and began in June 2024.

Researchers are investigating the possible link between hemorrhoids and coughing by studying patients who visit a general surgery outpatient clinic with symptoms such as bleeding, pain, itching, fecal leakage, prolapse, and mucus discharge. The study aims to determine if coughing is a contributing factor to hemorrhoids by assessing cough symptoms, including their presence, duration, and frequency, in patients diagnosed with hemorrhoidal disease. This prospective, observational study will gather detailed information on cough severity, comorbid chest diseases, and smoking history among these patients. Patients diagnosed with hemorrhoidal disease will be examined and graded based on mucosal prolapse according to the Goligher classification. Evaluations will include physical exams, height and weight measurements, and questionnaires such as the Leicester Cough Questionnaire and the Cough Visual Analog Scale. Cough duration will be categorized as acute or chronic, and additional data will be collected on chest diseases and smoking status. Patients with cough will be referred for further chest disease evaluation. Participants will provide demographic and clinical information, including cough and hemorrhoid symptoms, comorbidities, and lifestyle factors. The study will measure the relationship between hemorrhoid severity and cough characteristics, along with chest disease presence and smoking history. Data will be collected between March and June 2025, and the primary outcome will focus on cough severity as measured by the Leicester Cough Questionnaire.

This research aims to evaluate how the Enhanced Recovery After Surgery (ERAS) protocol affects the occurrence of postoperative urinary retention (POUR) in patients undergoing surgery for benign anorectal conditions such as chronic anal fissure, hemorrhoids, and fistula-in-ano. The study includes adult patients aged 18 to 90 years but focuses on those up to 65 years old. It compares the ERAS protocol with routine preoperative care to understand its role in reducing urinary retention after surgery. Participants will be randomly assigned to one of two groups: the ERAS pathway or the routine care pathway. The ERAS protocol includes 14 specific items based on existing guidelines, such as preoperative education, dietary restrictions before surgery, administration of saddle anesthesia, and controlled fluid management during surgery. The routine pathway represents standard preoperative procedures that may include some ERAS elements but do not require all 14 items to be followed. Throughout the study, all patients will be monitored by a phone call 72 hours after surgery and followed up in the outpatient department for 30 days. They will be advised to seek care at any time if they experience any complications. The primary measure of success is the incidence of urinary retention within 72 hours after anorectal surgery, with ongoing safety and recovery assessments during the follow-up period.

Researchers are evaluating how listening to standardized music sequences before and after proctologic surgery affects postoperative pain. This study focuses on patients undergoing surgery for hemorrhoids, fistulas, or anal fissures. The trial aims to understand whether preoperative and postoperative music can help manage pain, reduce the need for pain medications, and improve quality of life after surgery. Participants are randomly assigned to one of two groups. One group listens to relaxing, standardized music sessions via the Music Careae app, with a 20-minute session before surgery in the hospital and daily 20-minute sessions at home for 28 days after surgery. The control group receives standard care without music therapy. All music sessions allow participants to choose their preferred style, tempo, and tracks. During the study, participants will be closely monitored for pain and anxiety levels from hospitalization through 28 days post-surgery. Researchers will assess pain intensity immediately after surgery in the recovery room and track analgesic use, healing time, quality of life, patient satisfaction, and hospital stay duration. The study lasts 28 months overall, with each participant followed for 28 days.

Researchers are studying the effects of Ruscus aculeatus L., a plant known for its vasoconstrictor, diuretic, anti-inflammatory, and venotonic properties, on patients with stage II-III hemorrhoidal disease. Hemorrhoidal disease involves deterioration of vascular cushions in the anal canal, causing symptoms like bleeding, discomfort, and pain. This research aims to provide scientific evidence on a new herbal treatment option for hemorrhoids. The study compares the use of Neoven 225 mg capsules containing Ruscus aculeatus L. with a placebo. Participants will take one capsule twice daily with meals for 42 days, receiving a total of 84 capsules. The active capsules contain a mixture of ruscogenin and neoruscogenin compounds. Capsule use will be monitored by phone calls on days 7 and 14, and pill counts at the end of treatment. Participants will be evaluated for quality of life using the Hemorrhoid Severity Score at the end of 42 days. Additional assessments include the Hemorrhoidal Disease Symptom Score and a Visual Analog Scale for symptoms. Researchers will monitor adherence to treatment and the safety of the herbal product throughout the study period, which is led by Sultan Abdulhamid Han Training and Research Hospital.