ArticleAnnals of coloproctology2026
Efficacy of escin combined with micronized purified flavonoid fraction in controlling bleeding and preventing recurrence of acute internal hemorrhoids: a randomized controlled trial.
Article in Annals of coloproctology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06748014 (The Efficacy of Aescin in Combination With Micronized Purified Flavonoid Fraction), which is not on this map. Not yet cited in PubMed.
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The trial behind it
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The Efficacy of Aescin in Combination With Micronized Purified Flavonoid Fraction (MPFF) in the Control of Bleeding and Prevent Recurrence of Acute Internal Hemorrhoids, A Randomized Controlled Trial, A Pilot Study
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5 authors.
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Abstract
purposeRecurrence after initial control of acute internal hemorrhoidal bleeding remains a common and clinically relevant challenge. Escin, a venotonic and anti-inflammatory compound, may augment the therapeutic effects of micronized purified flavonoid fraction (MPFF). This study aimed to evaluate whether the addition of escin to MPFF reduces recurrence of acute internal hemorrhoidal bleeding.
methodsIn this double-blind randomized controlled trial, adults with grade 1 or 2 acute bleeding internal hemorrhoids received MPFF 3,000 mg/day for 7 days in combination with either escin 120 mg/day or a matched placebo. Patients who achieved hemostasis subsequently continued MPFF 1,000 mg/day with escin or placebo for 2 months. The primary endpoint was recurrence within 90 days, defined clinically and confirmed by proctoscopy. Secondary outcomes included time to hemostasis, the Short Health Scale for Hemorrhoids (SHSHD), and safety outcomes.
resultsAmong the 108 patients who achieved hemostasis, recurrence occurred in 0% vs. 7.84% at 1 month and 7.02% vs. 23.52% at 3 months in the escin and placebo groups, respectively. Combination therapy was associated with a significantly reduced risk of recurrence (hazard ratio, 3.95; P=0.009). Time to bleeding cessation was shorter in the escin group (median, 2 days vs. 4 days; P<0.001). Improvement in SHSHD scores was greater with escin. No adverse events were observed in either group.
conclusionThe combination of escin and MPFF reduces recurrence and accelerates symptom resolution in acute internal hemorrhoidal bleeding, with a favorable safety profile.
trial registrationClinicalTrials.gov identifier: NCT06748014.
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