The influence of supportive therapy with a six-component myophlebotropic preparation on the reduction of symptoms in patients with symptoms of hemorrhoidal disease.

<b>Introduction:</b> Hemorrhoidal disease is the most common disease treated in proctology ambulatories. Conservative treatment is the basic form of treatment for this disease. One of the elements of treatment may be preparations with myoand phlebotropic effects.<b>Aim:</b> To assess the effect of a multi-ingredient myophlebotropic dietary supplement used as an adjunct on the rate and effectiveness of symptom relief in patients with stage II and III hemorrhoidal disease.<b>Material and method:</b> Patients with stage II and III hemorrhoidal disease with clinical symptoms such as pain, burning, itching and bleeding were qualified for the study. The patients were divided into two groups. The control group (Group I) of 29 patients receiving standard local treatment plus placebo and the study group (Group II) of 32 patients receiving the same local treatment and a six-component myophlebotropic product. Symptoms were analyzed at the time of inclusion in the study (day 0), after 4 and 10 days of therapy. The severity of hemorrhoidal disease and the feeling of relief were assessed on the day of inclusion (W0) and after 30 days of therapy.<b>Results:</b> There were no statistical differences between the groups in terms of disease advancement, age, gender, and duration of symptoms. Compared to the moment of inclusion in the study (W0), after 4 days (W1), after 10 days (W2) of taking the multi- -component product, there was a statistically significant improvement in the VAS scale: spontaneous pain and pain during defecation. In the qualitative assessment (yes/no), there were statistically significantly fewer cases of burning in the anus and itching. The treatment did not affect the rate of spontaneous bleeding, which was low at the beginning of the study, but significantly reduced the rate of bleeding during defecation. After 30 days of observation, it was found that the improvement in the severity of hemorrhoidal disease symptoms was significantly higher in the group using the tested preparation. Relief after a month of the study (one-question method) was noted in the group of patients receiving the tested product.<b>Conclusions:</b> The tested six-component myophlebotropic product proved to be effective in reducing the severity of symptoms such as spontaneous pain, pain during defecation, burning/burning in the anus and bleeding during defecation. Statistical significance was demonstrated in the symptom's relief and reduction in the severity of hemorrhoidal disease.

[Clinical assessment of the closure of a temporary diverting ileostomy]. / Ocena wyników wlasnych odtworzenia ciaglosci przewodu pokarmowego przez zamkniecie czasowej ileostomii petlowej.

UNLABELLED: Closure of the temporary diverting ileostomy is technically easy procedure but may have its own side effects, such as obstruction and anastomotic leak. The aim of this study was designed to assess the results of the closure of the protective ileostomy in the group of patients' operated on for inflammatory bowel disease and other inflammatory conditions with inflammatory exudate and to compare them with those who underwent surgery for uncomplicated colorectal cancer and precancerous conditions. Radiological examination of the efferent ileostomy loop was performed preoperatively to assess its influence on surgical strategy and postoperative complications resulting from the disturbances of passage of the intestinal contents. MATERIAL AND METHODS: This is a retrospective review of 48 patients divided into 2 groups: patients who suffered from inflammatory bowel disease or peritonitis (group I, n = 16) and patients with uncomplicated malignant disease or precancerous conditions of the gastrointestinal tract (group II, n = 32). Moreover, 18 patients (group A) without preoperative radiological assessment were compared with 30 patients (group B) in whom such examination was carried out. Statistical analysis was performed by using of the U-Mann-Whitney, the Fisher's exact and Student's t-tests. The differences were considered significant for levels of less than 0.05. RESULTS: Postoperative complications (obstruction and anastomotic dehiscence) occurred in 9 patients (18.7%). Seven patients (14.6%) were reoperated on: 6 patients in group 1 (37.5%) and 1 patient in group II (3.1%), (p = 0.013). Out of all postoperative complications that required secondary surgery, 22.2% of them occurred in patients who did not have preoperative radiological examination performed and 10% of them had patients in whom radiological assessment was done. Radiological findings revealed efferent ileostomy loop stenosis in 4 patients (13.3%) what influenced the operative strategy. CONCLUSIONS: Postoperative complications rate was high (18.7%). Closure of the temporary diverting ileostomy in patients with inflammatory bowel disease or any other inflammatory conditions within the peritoneal cavity are at the increased risk of complications than in those with malignant diseases or precancerous conditions. Preoperative radiological examination of the efferent ileostomy loop is useful in planning of surgical approach and influences improved treatment results.