Comprehensive Review on Hemorrhoids: From Epidemiology to Preclinical Assessment of Anti-Hemorrhoidal Agents
Abstract
The review discusses the etiology, epidemiology, classification, risk factors, assessment, the role of biomarkers in the development of hemorrhoids, operative and non-operative treatment options, post-operative complications of hemorrhoids, preclinical evaluation methods of anti-hemorrhoidal drugs, and different medicinal plants that exhibit anti-hemorrhoidal activity. The dilation and dislocation of normal anal cushions characterizes hemorrhoids. One of the most significant discoveries regarding hemorrhoids is the atypical enlargement and distortion of blood vessels, along with damage and modifications to the anal cavity’s supporting connective tissue. Hemorrhoids are categorized into different classifications based on various factors, Golingher’s classification commonly used, which divides the hemorrhoidal condition into four grades according to prolapse and the development of hemorrhoids. Hemorrhoids are recognized as one of the leading causes of morbidity, affecting millions of populations worldwide and also increasing the economic burden on the healthcare system. Current treatment options for hemorrhoids often involve conservative approaches, including fiber supplements, anti-inflammatory medications, lifestyle changes, and venotonic medicines. Additionally, operative treatments like rubber band ligation, hemorrhoidectomy, and injection sclerotherapy are utilized. Various biomarkers are responsible for the occurrence of hemorrhoids, such as matrix metalloproteinase (MMP), vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), and C-reactive protein (CRP). These biomarkers hold potential as targets for developing new anti-hemorrhoidal agents.
Keywords:
Croton oil, hemorrhoids, hemorrhoidectomy, jatropha oil, piles, prolapse.DOI
https://doi.org/10.25004/IJPSDR.2024.160326References
Mahboubi M. Effectiveness of Myrtus communis in the treatment of hemorrhoids. Journal of integrative medicine. 2017 Sep 1;15(5):351-8. Available from: 10.1016/S2095-4964(17)60340-6
Aigner F, Gruber H, Conrad F, Eder J, Wedel T, Zelger B, Engelhardt V, Lametschwandtner A, Wienert V, Böhler U, Margreiter R. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. International journal of colorectal disease. 2009 Jan;24:105-13. Available from: 10.1007/s00384-008-0572-3
Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A. The prevalence of hemorrhoids in adults. International journal of colorectal disease. 2012 Feb;27:215-20. Available from: https://doi.org/10.1007/s00384-011-1316-3
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiologic study. Gastroenterology. 1990 Feb 1;98(2):380-6. Available from: 10.1016/0016-5085(90)90828-o
Kibret AA, Oumer M, Moges AM. Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Plos one. 2021 Apr 20;16(4):e0249736. Available from: 10.1371/journal.pone.0249736
Rubbini M, Ascanelli S, Fabbian F. Hemorrhoidal disease: is it time for a new classification? International journal of colorectal disease. 2018 Jun;33:831-3. Available from: 10.1007/s00384-018-3060-4
Prasetyo SA, Budiono P, Riwanto I. Prolapsing Hemorrhoids. InBenign Anorectal Disorders-An Update 2022 May 7. IntechOpen. Available from: 10.5772/intechopen.104554
Aigner F, Gruber H, Conrad F, Eder J, Wedel T, Zelger B, Engelhardt V, Lametschwandtner A, Wienert V, Böhler U, Margreiter R. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. International journal of colorectal disease. 2009 Jan;24:105-13. Available from: 10.1007/s00384-008-0572-3
Morgado PJ, Suárez JA, Gómez LG, Morgado Jr PJ. Histoclinical basis for a new classification of hemorrhoidal disease. Diseases of the colon & rectum. 1988 Jun 1;31(6):474-80. Available from: https://doi.org/10.1007/BF02552621
Cintron J, Abcarian H. Benign anorectal: hemorrhoids. The ASCRS textbook of colon and rectal surgery. New York: Springer-Verlag, Inc. 2007;2:156-77.
Fleshman J, Madoff R. Hemorrhoids. Current surgical therapy. Philadelphia: Elsevier; 2004;8:245–52.
Corman M. Hemorrhoids. In: Brown B, McMillan E, LaPlante MM, editors. Colon and rectal surgery. New York: Lippincott Williams and Wilkins, Inc; 2002;5:177–248.
Haas PA, Fox TA, Haas GP. The pathogenesis of hemorrhoids. Diseases of the colon & rectum. 1984 Jul;27:442-50. Available from: 10.1007/BF02555533
Djibe. Internal and external hemorrhoids. Wikipedia. 2023
Sakr M, Saed K. Recent advances in the management of hemorrhoids. World. 2014;3. Available from:10.5412/wjsp.v4.i3.55
Shama P., Shaikh S., Akhtar H., Manzoor A. A review of hemorrhoids according to Unani and modern system of medicine. Indian Journal of Unani Medicine. 2021;14:26-34. Available from: https://doi.org/10.53390/ijum.v14i1.5
Kibret AA, Oumer M, Moges AM. Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Plos one. 2021 Apr 20;16(4):e0249736. Available from: 10.1371/journal.pone.0249736
Mao L, Ma L, Liu N, Chen B, Lu Q, Ying C, Sun X. Self-reported health problems related to traditional dietary practices in postpartum women from urban, suburban and rural areas of Hubei province, China: the'zuò yuèzi'. Asia Pacific journal of clinical nutrition. 2016 Jan;25(1):158-64. Available from: https://doi.org/10.1002/adfm.202300952
Poskus T, Buzinskienė D, Drasutiene G, Samalavicius NE, Barkus A, Barisauskiene A, Tutkuviene J, Sakalauskaite I, Drasutis J, Jasulaitis A, Jakaitiene A. Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014 Dec;121(13):1666-71. Available from: 10.1111/1471-0528.12838
Ganz RA. The evaluation and treatment of hemorrhoids: a guide for the gastroenterologist. Clinical Gastroenterology and Hepatology. 2013 Jun 1;11(6):593-603. Available from: 10.1016/j.cgh.2012.12.020
Ng KS, Holzgang M, Young C. Still a case of “no pain, no gain”? An updated and critical review of the pathogenesis, diagnosis, and management options for hemorrhoids in 2020. Annals of coloproctology. 2020 Jun;36(3):133. DOI: 10.3393/ac.2020.05.04
Wieszczy P, Kaminski MF, Løberg M, Bugajski M, Bretthauer M, Kalager M. Estimation of overdiagnosis in colorectal cancer screening with sigmoidoscopy and faecal occult blood testing: comparison of simulation models. BMJ open. 2021 Apr 1;11(4):e042158. Available from: 10.1136/bmjopen-2020-042158
Saito Y, Oka S, Kawamura T, Shimoda R, Sekiguchi M, Tamai N, Hotta K, Matsuda T, Misawa M, Tanaka S, Iriguchi Y. Colonoscopy screening and surveillance guidelines. Digestive Endoscopy. 2021 May;33(4):486-519. Available from: 10.1111/den.13972
Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S, Buckley JS. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997 Jan 1;112(1):17-23.
Murai S, Kawai K, Sonoda H, Nozawa H, Sasaki K, Murono K, Emoto S, Yokoyama Y, Anzai H, Ishihara S. Computed tomographic colonography versus double-contrast barium enema for the preoperative evaluation of rectal cancer. Surgery Today. 2022 May 1:1-8. Available from: 10.1007/s00595-021-02411-5
Ray-Offor E, Amadi S. Hemorrhoidal disease: Predilection sites, pattern of presentation, and treatment. Annals of African medicine. 2019 Jan 1;18(1):12-6. Available from: 10.4103/aam.aam_4_18
Wang L, Ni J, Hou C, Wu D, Sun L, Jiang Q, Cai Z, Fan W. Time to change? Present and prospects of hemorrhoidal classification. Frontiers in Medicine. 2023;10. Available from: 10.3389/fmed.2023.1252468
Jacobs D. Clinical practice. hemorrhoids. The New England journal of medicine. 2014 Sep 4;371(10):944-51. Available from: 10.1056/NEJMcp1204188
Rubbini M, Ascanelli S. Classification and guidelines of hemorrhoidal disease: present and future. World journal of gastrointestinal surgery. 2019 Mar 3;11(3):117. Available from: 10.4240/wjgs.v11.i3.117
Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and Treatment Options. Am Fam Physician. 2018 Feb 1;97(3):172-179. PMID: 29431977
Lunniss PJ, Mann CV. Classification of internal haemorrhoids: a discussion paper. Colorectal Disease. 2004 Jul;6(4):226-32. Available from: 10.1111/j.1463-1318.2004.00590.x
Dekker L, Han-Geurts IJ, Grossi U, Gallo G, Veldkamp R. Is the Goligher classification a valid tool in clinical practice and research for hemorrhoidal disease?. Techniques in Coloproctology. 2022 May;26(5):387-92 Available from: 10.1007/s10151-022-02591-3
Lee JH, Kim HE, Kang JH, Shin JY, Song YM. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean journal of family medicine. 2014 Sep;35(5):227. Available from: https://doi.org/10.4082/kjfm.2014.35.5.227
Lorder PB, Kamm MA, Nicholls RJ. Hemorrhoids: pathology, pathophysiology and etiology. Br J Surg. 1994;81(7):946-54. Available from: 10.1002/bjs.1800810707
Pigot F, Siproudhis L, Allaert FA. Risk factors associated with hemorrhoidal symptoms in specialized consultation. Gastroenterologie clinique et biologique. 2005 Dec 1;29(12):1270-4. Available from: 10.1016/s0399-8320(05)82220-1
Lohsiriwat V, Wilson VG, Scholefield JH, Dashwood MR. Regional distribution of nitric oxide synthase in human anorectal tissue: a pilot study on the potential role for nitric oxide in haemorrhoids. Current Vascular Pharmacology. 2020 Jan 1;18(1):43-9. Available from: https://doi.org/10.2174/1570161116666180730101532
Gokce AH, Gokce FS, Durmus S, Hajiyeva R, Ersoz F, Gelisgen R, Uzun H. The effect of nitric oxide, endothelial nitric oxide synthetase, and asymmetric dimethylarginine in hemorrhoidal disease. Revista da Associação Médica Brasileira. 2020 Sep 11;66:1128-33. Available from: https://doi.org/10.1590/1806-9282.66.8.1128
Serra R, Gallelli L, Grande R, Amato B, De Caridi G, Sammarco G, Ferrari F, Butrico L, Gallo G, Rizzuto A, de Franciscis S. Hemorrhoids and matrix metalloproteinases: a multicenter study on the predictive role of biomarkers. Surgery. 2016 Feb 1;159(2):487-94. Available from: https://doi.org/10.1016/j.surg.2015.07.003
Kisli E, Kemik A, Sümer A, Kemik Ö. Matrix metalloproteinases in pathogenesis of hemorrhoidal disease. The American Surgeon. 2013 Nov;79(11):1181-4. Available from: https://doi.org/10.1177/000313481307901122
Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Frontiers in immunology. 2018 Apr 13;9:342848. Available from: https://doi.org/10.3389/fimmu.2018.00754
Porwal A, Kundu G, Bhagwat G, Nimma R, Chowdhury J. Turmocin Plus Suppresses Vascular Endothelial Growth Factor (VEGF) and Macrophage Infiltration in the Management of Perineal Wounds, Anal Fistula, Acute Anal Fissures and Haemorrhoids.. Available from: 10.18311/jnr/2024/33298
Ferrante M, Pierik M, Henckaerts L, Joossens M, Claes K, Van Schuerbeek N, Vlietinck R, Rutgeerts P, Van Assche G, Vermeire S. The role of vascular endothelial growth factor (VEGF) in inflammatory bowel disease. Inflammatory bowel diseases. 2006 Sep 1;12(9):870-8. Available from: https://doi.org/10.1097/01.mib.0000235095.01608.10
Ferrara N, Gerber HP. The role of vascular endothelial growth factor in angiogenesis. Acta haematologica. 2001 Jan 24;106(4):148-56. Available from: https://doi.org/10.1159/000046610
Alonso-Coello P, Mills ED, Heels-Ansdell D, López-Yarto M, Zhou QI, Johanson JF, Guyatt G. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Official journal of the American College of Gastroenterology| ACG. 2006 Jan 1;101(1):181-8. Available from: 10.1111/j.1572-0241.2005.00359.x
Acheson AG, Scholefield JH. Management of haemorrhoids. Bmj. 2008 Feb 14;336(7640):380-3. Available from: 10.1136/bmj.39465.674745.80
Ratto C, Orefice R, Tiso D, Martinisi GB, Pietroletti R. Management of hemorrhoidal disease: new generation of oral and topical treatments. European Review for Medical & Pharmacological Sciences. 2020 Sep 15;24(18). Available from: 10.26355/eurrev_202009_23053
Johanson JF. Nonsurgical treatment of hemorrhoids. Journal of Gastrointestinal Surgery. 2002 Jun;6(3):290-4. Available from: 10.1016/s1091-255x(01)00081-6
van Tol RR, Bruijnen MP, Melenhorst J, van Kuijk SM, Stassen LP, Breukink SO. A national evaluation of the management practices of hemorrhoidal disease in the Netherlands. International journal of colorectal disease. 2018 May;33:577-88. Available from: 10.1007/s00384-018-3019-5
Brown SR. Haemorrhoids: an update on management. Ther Adv Chronic Dis 8 (10): 141–147. Available from: 10.1177/2040622317713957
Ding Z, Xuan J, Tang G, Shi S, Liang X, An Q, Wang F. Rubber band ligation versus coagulation for the treatment of haemorrhoids: a meta-analysis of randomised controlled trials. Postgraduate medical journal. 2023 Sep;99(1175):946-53. Available from: 10.1016/S0140-6736(21)01640-8
Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. American Journal of Gastroenterology (Springer Nature). 1992 Nov 1;87(11).
Cocorullo G, Tutino R, Falco N, Licari L, Orlando G, Fontana T, Raspanti C, Salamone G, Scerrino G, Gallo G, Trompetto M. The non-surgical management for hemorrhoidal disease. A systematic review. Il Giornale di Chirurgia-Journal of the Italian Surgical Association. 2017 Jan 1;38(1):5-14. Available from: 10.11138/gchir/2017.38.1.005
Thomson WH. Banding and injection of piles. Annals of the Royal College of Surgeons of England. 2001 Sep;83(5):361.
Senapati A, Nicholls RJ. A randomised trial to compare the results of injection sclerotherapy with a bulk laxative alone in the treatment of bleeding haemorrhoids. International journal of colorectal disease. 1988 Jun;3:124-6. Available from: 10.1007/BF01645317
Santos G, Novell JR, Khoury G, Winslet MC, Lewis AA. Long-term results of large-dose, single-session phenol injection sclerotherapy for hemorrhoids. Diseases of the colon & rectum. 1993 Oct 1;36(10):958-61. Available from: 10.1007/BF02050633
Seow-Choen F, Ho YH, Ang HG, Goh HS. Prospective, randomized trial comparing pain and clinical function after conventional scissors excision/ligation vs. diathermy excision without ligation for symptomatic prolapsed hemorrhoids. Diseases of the colon & rectum. 1992 Dec 1;35(12):1165-9. Available from: 10.1007/BF02251970
Mushaya CD, Caleo PJ, Bartlett L, Buettner PG, Ho YH. Harmonic scalpel compared with conventional excisional haemorrhoidectomy: a meta-analysis of randomized controlled trials. Techniques in coloproctology. 2014 Nov;18:1009-16. Available from: 10.1007/s10151-014-1169-1
Fleshman J. Advanced technology in the management of hemorrhoids: stapling, laser, harmonic scalpel, and ligasure. Journal of Gastrointestinal Surgery. 2002 May 1;6(3):299-301. Available from: 10.1016/s1091-255x(01)00083-x
Filingeri V, Gravante G, Baldessari E, Grimaldi M, Casciani CU. Prospective randomized trial of submucosal hemorrhoidectomy with radiofrequency bistoury vs. conventional Parks’ operation. Techniques in coloproctology. 2004 Mar;8:31-6.
Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complications of operative therapy. Diseases of the colon & rectum. 1992 May 1;35(5):477-81. Available from: 10.1007/BF02049406
Pillant-Le Moult H, Aubert M, De Parades V. Classical treatment of hemorrhoids. Journal of visceral surgery. 2015 Apr 1;152(2):S3-9. Available from: 10.1016/j.jviscsurg.2014.09.012
Rakinic J, Poola VP. Hemorrhoids and fistulas: new solutions to old problems. Current problems in surgery. 2013 Nov 25;51(3):98-137. Available from: 10.1067/j.cpsurg.2013.11.002
Pescatori M, Gagliardi G. Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures. Techniques in coloproctology. 2008 Mar;12(1):7-19. Available from: 10.1007/s10151-008-0391-0
De la Garza M, Counihan TC. Complications of hemorrhoid surgery. Seminars in Colon and Rectal Surgery. 2013;24:96-102. Available from: https://doi.org/10.1053/j.scrs.2013.02.008
Romaguera VP, Sancho-Muriel J, Alvarez-Sarrdo E, Millan M, Garcia-Granero A, Frasson M. Postoperative complications in hemorrhoidal disease and special conditions. Reviews on Recent Clinical Trials. 2021 Feb 1;16(1):67-74. Available from: 10.2174/1574887115666200406114218
Leventoglu S, Mentes B, Balci B, Kebiz HC. New techniques in hemorrhoidal disease but the same old problem: anal stenosis. Medicina. 2022 Mar 1;58(3):362. Available from: 10.3390/medicina58030362
Cabrini DA, Moresco HH, Imazu P, Silva CD, Pietrovski EF, Mendes DA, Prudente AD, Pizzolatti MG, Brighente IM, Otuki MF. Analysis of the potential topical anti-inflammatory activity of Averrhoa carambola L. in mice. Evidence-Based Complementary and Alternative Medicine. 2011 Jan 1;2011. Available from: 10.1093/ecam/neq026
Dhaswadikar SR, Parmar KM, Kamble SK, Kathuria I, Dhobi M, Birajdar A, Prasad SK, Itankar PR. Anti-hemorrhoidal potential of standardized leaf extract of Dolichandrone falcata. Phytomedicine Plus. 2022 Feb 1;2(1):100172.
Azeemuddin M, Viswanatha GL, Rafiq M, Thippeswamy AH, Baig MR, Kavya KJ, Patki PS, Shyam R. An improved experimental model of hemorrhoids in rats: evaluation of antihemorrhoidal activity of an herbal formulation. International Scholarly Research Notices. 2014;2014.
Kusumawati I, Rullyansyah S, Rizka AF, Hestianah EP, Matsunami K. Histomorphometric study of ethanolic extract of Graptophyllum pictum (L.) Griff. leaves on croton oil-induced hemorrhoid mice: A Javanese traditional anti-hemorrhoid herb. Journal of Ethnopharmacology. 2022 Feb 10;284:114765.
Zaruwa MZ, Ubana MA, Muhammad BY, Bamidele TO, Eleojo E. Studies on the Effect of Tephrosia linearis (Wild) Pers. Aqueous Extract on Jatropha curcas Oil Induced Hemorrhoids in Rats. Savanna.;4(1):54-7.
Nallajerla SK, Ganta S. Evaluation Of Anti-inflammatory Mediated Anti-hemorrhoidal Activity of Lawsonia inermis on Croton Oil Induced Hemorrhoidal Rats. Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Anti-Inflammatory and Anti-Allergy Agents). 2022 Mar 1;21(1):62-73. Available from: 10.2174/1871523021666220330143845
Zhang H, Yao XY, Zhang DF, Yang JJ, Zhu BG, Shen DX, Ruan KF, Wang Y, Peng JL. Anti-hemorrhoidal activity of Lian-Zhi-San, a traditional Chinese medicine, in an experimental hemorrhoidal model in rats. Journal of Integrative Medicine. 2021 Jan 1;19(1):42-9. Available from: 10.1016/j.joim.2020.09.006
Said O, Khamaysi I, Kmail A, Sadiq O, Saied B, Fulder S, Abofarekh B, Masalha M, Amin R, Saad B. Anti-Inflammatory, Antimicrobial, and Vasoconstriction Activities of an Anti-Hemorrhoidal Mixture of Alchemilla vulgaris, Conyza bonariensis, and Nigella sativa: In Vitro and Clinical Evaluations. Immuno. 2022 Jan 26;2(1):132-50. Available from: 10.3390/immuno2010010
Shahwar D, Raza MA, Saeed A, Riasat M, Chattha FI, Javaid M, Ullah S. Antioxidant potential of the extracts of Putranjiva roxburghii, Conyza bonariensis, Woodfordia fruiticosa and Senecio chrysanthemoids. African Journal of Biotechnology. 2012;11(18):4288-95. Available from: 10.5897/AJB11.2564
Chand SS, Silawat N, Jain NK. Phytochemical And Pharmacological Screening Of Isolated Compound Of Dolichandrone Falcate Leaves For Anti Inflammatory Activity. Journal of Pharmaceutical Negative Results. 2022 Dec 31:4870-8.
Faujdar S, Sati B, Sharma S, Pathak AK, Paliwal SK. Phytochemical evaluation and anti-hemorrhoidal activity of bark of Acacia ferruginea DC. Journal of Traditional and Complementary Medicine. 2019 Apr 1;9(2):85-9. Available from: 10.1016/j.jtcme.2018.02.003
Küpeli E, Yesilada E. Flavonoids with anti-inflammatory and antinociceptive activity from Cistus laurifolius L. leaves through bioassay-guided procedures. Journal of ethnopharmacology. 2007 Jul 25;112(3):524-30. Available from: 10.1016/j.jep.2007.04.011
Alemu BK, Misganaw D, Mengistu G. Wound healing effect of Acokanthera schimperi schweinf (Apocynaceae) methanol leaf extract ointment in mice and its in-vitro antioxidant activity. Clinical pharmacology: advances and applications. 2020 Dec 31:213-22. Available from: 10.2147/CPAA.S288394
Dönmez C, Yalçın FN, Boyacıoğlu Ö, Korkusuz P, Akkol EK, Nemutlu E, Balaban YH, Çalışkan UK. From nutrition to medicine: assessing hemorrhoid healing activity of Solanum melongena L. via in vivo experimental models and its major chemicals. Journal of Ethnopharmacology. 2020 Oct 28;261:113143. Available from: 10.1016/j.jep.2020.113143
Shim SY. Pandanus fascicularis lam extract inhibits pro-inflammatory cytokines production in LPS-stimulated RAW 264.7 cells. Preventive nutrition and food science. 2019 Sep;24(3):344. Available from: 10.3746/pnf.2019.24.3.344
Ashraf J, Baig SG, Ahmed S, Hasan MM. Analgesic, anti-inflammatory and diuretic activities of Macrotyloma uniflorum (Lam.) Verdc. Pakistan Journal of Pharmaceutical Sciences. 2018 Sep 1;31(5):1859-63.
Nakitto AM, Byaruhanga YB, Wagner AE, Muyonga JH. Morphological characteristics, bioactive compounds content, and antioxidant activity of different accessions of African eggplant (Solanum anguivi Lam.). Available from:10.5073/JABFQ.2021.094.027
Sulistiarini R, Puranti A, Prabowo WC. Phytochemicals and anti-hemorrhoidal activities of Tapak Liman (Elephantopus Scaber) leaves. J Adv Biotechnol Exp Ther. 2023;6(2):436-444.
Mahmoudi A, Seyedsadeghi M, Miran M, Ahari SS, Layegh H, Mostafalou S. Therapeutic effect of Achillea millefolium on the hemorrhoids; A randomized double-blind placebo-controlled clinical trial. Journal of Herbal Medicine. 2023 Jun 1;39:100657. Available from: 10.1016/j.hermed.2023.100657
Mihai DP, Seremet OC, Nitulescu G, Ivopol M, Sevastre AS, Negres S, Ivopol G, Nitulescu GM, Olaru OT. Evaluation of natural extracts in animal models of pain and inflammation for a potential therapy of hemorrhoidal disease. Scientia Pharmaceutica. 2019;87(2):14. Available from: 10.3390/scipharm87020014
Küçükkurt I, Ince S, Keleş H, Akkol EK, Avcı G, Yeşilada E, Bacak E. Beneficial effects of Aesculus hippocastanum L. seed extract on the body's own antioxidant defense system on subacute administration. Journal of ethnopharmacology. 2010 May 4;129(1):18-22. Available from: 10.1016/j.jep.2010.02.017
Nassiri‐Asl M, Hosseinzadeh H. Review of the pharmacological effects of Vitis vinifera (Grape) and its bioactive compounds. Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 2009 Sep;23(9):1197-204. Available from: 10.1002/ptr.2761
Ilhan M, Dereli FT, Tümen I, Akkol EK. Anti-inflammatory and antinociceptive features of Bryonia alba L.: as a possible alternative in treating rheumatism. Open Chemistry. 2019 Jan 5;17(1):23-30. Available from: https://doi.org/10.1515/chem-2019-0003
Zhao J, Maitituersun A, Li C, Li Q, Xu F, Liu T. Evaluation on analgesic and anti-inflammatory activities of total flavonoids from Juniperus sabina. Evidence-Based Complementary and Alternative Medicine. 2018 Oct;2018. Available from: 10.1155/2018/7965306
Amiri MM, Garnida Y, Almulla AF, Abduljabbar AS, Jalil AT, Mazaheri Y, Ebrahimi Y, Shariatifar N. Herbal therapy for hemorrhoids: An overview of medicinal plants affecting hemorrhoids. Advancements in Life Sciences. 2023 Apr 14;10(1):22-8.
Nallajerla SK, Ganta S. Croton Oil-induced Hemorrhoidal Rats: Evaluation of Anti-inflammatory Mediated Anti-hemorrhoidal Activity of Tridax procumbens Whole Plant. Current Bioactive Compounds. 2023 Aug 1;19(7):17-28. Available from: 10.2174/1573407219666230207105946
Ayun NQ, Elya B. Anti-inflammation of soursop leaves (Annona muricata L.) against hemorrhoids in mice induced by croton oil. Pharmacognosy Journal. 2020;12(4). Available from: 10.5530/pj.2020.12.112
Dey YN, Wanjari MM, Kumar D, Lomash V, Jadhav AD. Curative effect of Amorphophallus paeoniifolius tuber on experimental hemorrhoids in rats. Journal of ethnopharmacology. 2016 Nov 4;192:183-91. Available from: 10.1016/j.jep.2016.07.042
Apaydin Yildirim B, Aydin T, Kordali S, Yildirim S, Cakir A, Yildirim F. Antihemorrhoidal activity of organic acids of Capsella bursa‐pastoris on croton oil‐induced hemorrhoid in rats. Journal of food biochemistry. 2020 Sep;44(9):e13343. Available from: 10.1111/jfbc.13343
Ratnasari Y, Susanti S, Dhiani BA. Anti-inflammation and anti-platelet aggregation activities of the ethanolic extract of Graptophyllum pictum leaves in wistar rats. PEER REVIEW. 2020. Available from: 10.12928/pharmaciana.v10i2.15769
Dubey T, Bhanukiran K, Prasad SK, Hemalatha S. Optimization of Extraction Process and Anti-Hemorrhoidal Activity of Blumea lacera (Burm. f.) DC. Leaves in Croton Oil-induced Hemorrhoid Model. Pharmacognosy Magazine. 2023 Sep;19(3):709-19. Available from: https://doi.org/10.1177/09731296231170936
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