Flavonoids and post haemorrhoidectomy recovery: a systematic review and meta‐analysis

• Published in: ANZ journal of surgery Vol. 94; no. 9; pp. 1480 - 1490
• Main Authors: Pitesa, Renato, Yuen, Wai Yan (Rachel), Hill, Andrew G.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01-09-2024; Blackwell Publishing Ltd
• Subjects: analgesia; Clinical trials; Flavonoids; haemorrhoidectomy; haemorrhoids; Hemorrhoids; Literature reviews; Meta-analysis; Pain; Statistical analysis; Systematic review; meta‐analysis; flavonoids; haemorrhoidectomy; haemorrhoids; analgesia
• ISSN: 1445-1433; 1445-2197; 1445-2197
• DOI: 10.1111/ans.19116

Background
Haemorrhoidectomy is the gold standard for definitive treatment of high‐grade symptomatic haemorrhoids but is often associated with substantial pain. This systematic review aims to explore the potential of flavonoids in alleviating the postoperative symptom burden following excisional haemorrhoidectomy.
Methods
A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PROSPERO CRD42023472711). Randomized controlled trials (RCTs) published PubMed, MEDLINE, Embase, and Scopus from inception to 1st December 2023 were retrieved. The primary outcome investigated was post‐operative pain. Meta‐analysis was performed using Review Manager version 5.4.1.
Results
Ten articles with 775 patients were included. The meta‐analysis identified statistically significant decreases in post‐operative pain in favour of the flavonoid groups (Standardized Mean Difference −0.66 [95% confidence intervals (CI) −0.82, −0.52]; P < 0.00001), and bleeding (Odds Ratio 0.13 [95% CI 0.09, 0.19]; P < 0.00001).
Conclusion
Flavonoids show promise as a means of reducing pain associated with excisional haemorrhoidectomy. Further research is required to investigate topical routes of administration and standardize regimes.
The efficacy of flavonoids in alleviating postoperative symptoms, primarily pain, following haemorrhoidectomy was explored. Ten randomized controlled trials were analysed, revealing statistically significant reductions in pain, bleeding, pruritus, and tenesmus at multiple postoperative checkpoints following flavonoid administration. This review suggests flavonoids hold promise as a therapeutic option for mitigating post‐haemorrhoidectomy pain, and further studies are warranted to explore topical administration and standardize dosages.