NON SURGICAL TREATMENT OF FIRST DEGREE HEMORRHOIDS: TABLET DAFLON VERSUS INJECTION SCLEROTHERAPY

Abstract

Objective: To compare the therapeutic efficacy of tablet Daflon and injection Sclerotherapy in treatment of first degree hemorrhoids. Design: Randomized control trial.                                                                                                                                                                                                                     Place and Duration of Study: Outpatient department of Surgery, Combined Military Hospital (CMH) Rawalpindi from March 2008 to September 2009.                                                                                                                                                                                                                                                   Patients and Methods: Sixty patients of first degree hemorrhoids with chief complaint of bleeding per rectum were randomized into two groups (30 patients in each group). Severity of bleeding per rectum was assessed by symptom score card. Bleeding episodes of more than five per week was considered as severe, three to five episodes as moderate while less than three per week was considered as mild. Patients in group A were started with tab Daflon 500 mg twice daily for four weeks1. Patients in group B were subjected to single peri-haemorrhoidal injection with 5% Almond oil in phenol. Patients were reviewed after four weeks and the outcome measure was reduction in episodes of bleeding per rectum.  Results: In group A, at presentation 24 patients had mild bleeding, 5 patients had moderate bleeding and 1 patient had severe bleeding. In group B 23 patients had mild bleeding, 5 patients had moderate bleeding and 2 patients had severe bleeding (p ≥ 0.05). At 4 Weeks, 22 (73.3%) patients in Group A and 24 (80%) patients in group B achieved symptomatic relief from bleeding (p ≤ 0.05). 6 (20%) patients in group A had mild bleeding at 4 weeks and 1 (3.3%) patient had moderate bleeding. No patient in group A had severe bleeding at 4 weeks. In group B 5 (16.7%) patients had mild bleeding at 4 weeks, 1 (3.3%) patient had moderate bleeding and 1 patient had severe bleeding (p ≤ 0.05).                                                            Conclusion: Tab daflon is a suitable alternative and effective non invasive treatment in controlling bleeding in first degree hemorrhoids when compared to injection sclerotherapy.