European Journal of Biomedical and Pharmaceutical Sciences

THE POTENTIAL OF LOCAL ENZYME THERAPY IN COMPREHENSIVE NON-SURGICAL TREATMENT OF ACUTE HEMORRHOIDS

Denis Mak Chi*, Guangcan Chen Li, Qi Hao Hou, Lo Yau, Yanting Lou

ABSTRACT

Acute hemorrhoids represent a common proctological condition characterized by pain, bleeding, and inflammation, often requiring hospitalization for conservative management. This original prospective randomized study aimed to evaluate the efficacy of adding local enzyme therapy with rectal suppositories containing streptokinase (15,000 IU) and streptodornase (1,250 IU) to standard non-surgical treatment according to international guidelines. A total of 120 patients with acute hemorrhoids were divided into two groups of 60 each. Group 1 received standard treatment, including dietary modifications with high-fiber intake, oral venotonics (diosmin 600 mg twice daily), topical hydrocortisone cream, and non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. Group 2 received the same regimen supplemented with enzyme suppositories applied rectally based on disease severity: for severe cases, one suppository three times daily for the first three days, twice daily for the next three days, and once daily for the following three days; for moderate to mild cases, one suppository twice daily for the first three days, followed by once daily for four days or twice daily for two days. Outcomes included hospital stay duration, incidence of severe disease progression, complications, pain intensity assessed via Visual Analog Scale (VAS), and quality of life measured by the Hemorrhoidal Disease Symptom Score (HDSS). Results demonstrated superior efficacy in Group 2, with a mean hospital stay of 4.2 ± 1.1 days compared to 7.5 ± 2.3 days in Group 1 (p < 0.001), fewer severe cases (10% vs. 25%, p < 0.05), reduced complications (5% vs. 18%, p < 0.01), and better pain and quality of life dynamics. Local enzyme therapy significantly enhanced non-surgical management, suggesting its potential as an adjunctive treatment.

Keywords: Acute hemorrhoids, non-surgical treatment, enzyme therapy, streptokinase, streptodornase, pain management, quality of life.