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EFFICACY OF EUPHORBIA PROSTRATA EXTRACT IN EARLY GRADES OF SYMPTOMATIC HAEMORRHOIDS

Background Haemorrhoids are a common cause of bleeding per rectum, peri-anal discomfort and pain. Pharmacological agents that can act rapidly and non-invasively to control symptoms are of immense value as opposed to invasive treatment. Previous studies on Euphorbia prostrata extract lack control groups and show controversy over the degree of improvement of symptoms. Our aim was t o assess the efficacy, quality of life and side effects of E. prostrata in treatment of early symptomatic haemorrhoids. Methods A case control study was conducted on 48 consecutive patients from June 2012 to May 2013 at University Surgical Clinic of National Hospital of Sri Lanka. An interviewer-administered, structured questionnaire with COloRectal Evaluation of Clinical Therapeutics Scale (CORECTS) was used on 23 cases and 25 controls with first and second degree haemorrhoids. Each patient was followed-up for 12 weeks. Paired-samples t test was used for data analysis . Results There was significant improvement in pain and bleeding in both controls (t=3.05, df=17, p=0.007) and cases (t=4.78, df=22, p=0.000) after first 2 weeks. Treatment group showed significant improvement in swelling (t=4.24, df=21, p=0.000) and discomfort (t=3.20, df=22, p=0.004) following first 2 weeks. There was no significant improvement in itching or quality of life in both the groups. Gastrointestinal discomfort and constipation was seen in 4.3% of cases. Conclusion E. prostrata significantly reduces swelling and discomfort after first 2 weeks of treatment. Gastrointestinal discomfort and constipation were reported by a few patients.