EFFECT OF FIBER SUPPLEMENTS ON INTERNAL BLEEDING HEMORRHOIDS

Background/Aims: The aim of this study is to assess prospectively the effect of fiber additions on internal bleeding hemorrhoids. Materials and Methods: Fifty patients with bleeding internal hemorrhoids are stu died and randomized in two groups. Patients in the study group were tr eated with a commercially available preparation of Plantago Ovata and those in the control group were treated with a placebo. Endoscopy was performed on every patient before and after treatment to establish: a) the degree of hemorrhoidal prolapse, b) the number of congested hemor rhoidal cushions and c) contact bleeding hemorrhoids. Results: During the 15 days of treatment, the average number of bleeding episodes was 4.8+/-3.8 for the study group versus 6.4+/-3 for the control group (n. s.). During the following 15 days, it decreased to 3.1+/-2.7 in the st udy group versus 5.5+/-3.2 (p<0.05) in the control group and in the la st 10 days of treatment a further reduction to 1.1+/-1.4 was found in the study group versus 5.5+/-2.9 (p<0.001). The number of congested he morrhoidal cushions diminished from 2.6+/-1 to 1.6+/-2.2 after fiber t reatment (p<0.01) and no differences were found in the control group. In the fiber group, hemorrhoids bled on contact in 5 out of 22 patient s before treatment and in none after treatment; no differences were fo und in the control group. No modification of the degree of prolapse wa s observed after treatment. Conclusion: Addition of dietary fiber may improve internal bleeding hemorrhoids although with no immediate effec t. Fiber addition should be ensured in patients who refuse invasive tr eatment, waiting for a more defined form of treatment, or with contrai ndications.