Effect of fiber supplements on internal bleeding hemorrhoids. Maintenance bran therapy for prevention of symptoms after rubber band ligation of third-degree haemorrhoids. High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Fybogel in haemorrhoid treatment. The use of bulk evacuant in patients with haemorrhoids. Evaluation of a bulk-forming evacuant in the management of haemorrhoids.
The aim of this study is to assess prospectively the effect of fiber additions on internal bleeding hemorrhoids.
                Fifty patients with bleeding internal hemorrhoids are studied and randomized in two groups. Patients in the study group were treated 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 hemorrhoidal cushions and c) contact bleeding hemorrhoids.
                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 study group versus 5.5 +/- 3.2 (p < 0.05) in the control group and in the last 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 hemorrhoidal cushions diminished from 2.6 +/- 1 to 1.6 +/- 2.2 after fiber treatment (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 patients before treatment and in none after treatment; no differences were found in the control group. No modification of the degree of prolapse was observed after treatment.
                Addition of dietary fiber may improve internal bleeding hemorrhoids although with no immediate effect. Fiber addition should be ensured in patients who refuse invasive treatment, waiting for a more defined form of treatment, or with contraindications. Proctoscopically diagnosed third-degree haemorrhoids were treated with rubber band ligation (RBL) in 92 patients, who were randomly assigned to management with or without twice-daily intake of unprocessed bran for 18 months. RBL was performed maximally five times at 2-week intervals. Patients who were symptom-free 10 weeks after first banding were considered cured and were enrolled in a follow-up study. The two treatment groups did not differ in regard to clinical or proctoscopic characteristics. The number of RBL required for cure was lower in the bran-treated group (p less than 0.01). The intergroup difference in cure rate 10 weeks after the first treatment was not significant (85% v. 91%). During the follow-up period symptoms recurred in 45% of the RBL group, but in only 15% of the RBL + bran group (p less than 0.01). A high-fiber diet thus increased the long-term cure rate among patients with third-degree haemorrhoids initially cured by RBL. nan nan Fifty-three patients with symptomatic haemorrhoids have been studied in a double-blind cross-over trial of a bulk forming agent (ispaghula husk) against a placebo. Although only 11 per cent of patients ocmplained of constipation, a significant benefit in symptoms and improved bowel habit was demonstrated. nan
The use of fiber shows a consistent beneficial effect for relieving overall symptoms and bleeding in the treatment of symptomatic hemorrhoids.