Abstract

ALVES, Filipe Fontes; GUEDES, Filipa Martins; SOUSA, Joana Oliveira  and  ABREU, Carolina Macedo. Flavonoids for symptomatic hemorrhoids: an evidence-based review. Rev Port Med Geral Fam [online]. 2020, vol.36, n.3, pp.266-273. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i3.12581.

Objective: Hemorrhoids result from the swelling of the hemorrhoidal venous plexus and may result in symptoms such as pain, itching, mucous discharge, bleeding, and discomfort due to prolapse. One of the therapeutic options is oral flavonoids. Its effectiveness remains a controversial point of debate. As such it is our goal to determine, through an evidence-based review, whether the use of flavonoids for symptomatic control is a valid therapeutic option. Data sources: National Guideline Clearinghouse, NICE Guidelines Finder,The Cochrane Library, DARE, Bandolier, MEDLINE, and bibliographic references of the selected articles were reviewed. Review methods: Definition of the inclusion criteria through the PICO methodology: Population - individuals with symptomatic hemorrhoids; Intervention - Flavonoids; Comparison - Placebo; Outcome - Efficacy for symptomatic control. Survey of clinical guidelines, systematic reviews, and randomized clinical trials using the MeSH terms ‘Hemorrhoids’ and ‘Flavonoids’, published in the last 10 years, in Portuguese, Spanish, French, and English. The American Academy of Family Physician’s Strength of Recommendation Taxonomy scale was applied to grade de evidence. Results: The search indicated 13 articles, two of which fulfilled the inclusion criteria, with high scientific quality and from which the conclusions were drawn, all favorable to the use of flavonoids, but with variable benefit according to the symptom explored. Conclusions: The available evidence suggests that there is a benefit in the use of flavonoids to control symptomatic hemorrhoids (versus placebo). Its use is recommended for the control of pain and bleeding (strength of recommendation A). It is necessary to consider limitations such as the subjectivity of symptom evaluation performed by patients; the influence of diet; flavonoids comprising a vast group of drugs; there being no standard dose for treatment. Additional studies are needed to clarify these issues.

Keywords : Hemorrhoids; Flavonoids.

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