Techniques in Coloproctology

, Volume 19, Issue 6, pp 339–345 | Cite as

Flavonoids mixture (diosmin, troxerutin, hesperidin) in the treatment of acute hemorrhoidal disease: a prospective, randomized, triple-blind, controlled trial

  • I. GianniniEmail author
  • A. Amato
  • L. Basso
  • N. Tricomi
  • M. Marranci
  • G. Pecorella
  • S. Tafuri
  • D. Pennisi
  • D. F. Altomare
Original Article



The role of a mixture of phlebotonics in the treatment of acute hemorrhoid crisis is investigated to test their efficacy.


One hundred and thirty-four consecutive patients with an acute hemorrhoidal crisis recruited in five colorectal units entered the study. Sixty-six of them were randomized to receive a mixture of diosmin, troxerutin and hesperidin (group A), and 68 a placebo (group B). The main symptoms, the use of oral painkillers and the Bristol scale score were recorded at each scheduled visit and compared using both Student’s t test for independent samples and the ANOVA models for repeated measures. The presence of edema, prolapse and thrombosis were also recorded and compared using the Chi-square test. Furthermore, the trend of proportions during the time of the evaluations was assessed by the Chi-square test for linear trend.


Pain, bleeding and the proportion of patients who reported persistence of edema and thrombosis decreased significantly after 12 days of treatment in group A. After 6 days, the number of paracetamol tablets taken by patients in group A was significantly lower than the amount of flavonoid mixture.


The use of a mixture of diosmin, troxerutin and hesperidin is a safe and effective mean of managing symptoms of acute hemorrhoidal disease. Furthermore, in patients receiving treatment, there was faster control and lower persistence of edema and thrombosis.


Hemorrhoidal crisis Flavonoids Anal pain Anal bleeding Anal itching 


Conflict of interest

Omikron Italia Srl has been involved in the study by generously providing the active drug and placebo to the units, but did not have access to the data either in the recruitment or in the elaboration and interpretation of the data.


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Copyright information

© Springer-Verlag Italia Srl 2015

Authors and Affiliations

  • I. Giannini
    • 1
    Email author
  • A. Amato
    • 2
  • L. Basso
    • 3
  • N. Tricomi
    • 4
  • M. Marranci
    • 5
  • G. Pecorella
    • 6
  • S. Tafuri
    • 7
  • D. Pennisi
    • 6
  • D. F. Altomare
    • 1
  1. 1.General Surgery and Liver Transplantation Unit, Department of Emergency and Organ Transplantation“A. Moro” UniversityBariItaly
  2. 2.Department of ColoproctologySanremo HospitalSanremoItaly
  3. 3.Department of Surgery “P.Valdoni”Policlinico Umberto I° “Sapienza” UniversityRomeItaly
  4. 4.Coloproctology Unit“Casa di Cura Candela”PalermoItaly
  5. 5.Department of Surgery“Casa di Cura Villa Fiorita”PratoItaly
  6. 6.Department of Surgery, Policlinico Vittorio EmanueleUniversity of CataniaCataniaItaly
  7. 7.Department of Biomedical Science and Human Oncology“A. Moro” UniversityBariItaly

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