A randomized comparative study of micronised flavonoids and rubber band ligation in the treatment of acute internal haemorrhoids

Background: Haemorrhoids is a common disease affecting people of all ages and both sexes. Though there is a consensus on the treatment of 3rd and 4th degree haemorrhoids, there is still confusion regarding the ideal treatment for Ist and IInd degree haemorrhoids. Aims: To compare the safety, efficacy, advantages and disadvantages of Rubber Band Ligation and Micronized Flavonoids in the treatment of acute internal haemorrhoids and the compliance and acceptability in patients. Settings and Design: One hundred patients of acute internal haemorrhoids, with chief complaint of bleeding per rectum due to internal haemorrhoids, presenting in the outdoor patient department of a tertiary care hospital were randomly subjected to Rubber Band Ligation or Daflon 500 mg (50 each). Methods and Materials: One hundred patients of acute internal haemorrhoids were treated with Rubber Band Ligation or Daflon 500 mg (50 each). The outcome measures were relief from bleeding and the total days taken for it. Statistical analysis used: Categorical data was compared by the standard error of difference in proportions and the changes were compared by the t test. Significance was defined by P<0.05. Results: 84% of patients on Daflon 500 and 60% of patients undergoing Rubber Band Ligation were completely cured (P<0.01) on the 7 day but this statistical significance was lost during consequent follow-up. Conclusions: Daflon gives rapid relief from symptoms of acute internal haemorrhoids as compared to Rubber Band Ligation but the long duration of treatment and its high cost leads to poor patient acceptability and compliance.