Natural Treatments for Fissure in Ano Used by Traditional Persian Scholars, Razi (Rhazes) and Ibn Sina (Avicenna)

Derakhshan, Ali Reza

doi:10.1177/2156587216650302

Cited by 14 publications

(11 citation statements)

References 52 publications

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“…Previous studies indicated that the treatment modalities that were demonstrated to alleviate inflammation achieved great clinical successes in the management of anorectal diseases ( 7 ). In particular, traditional medicine has proven effective for the clinical control of hemorrhoids and fistula by reducing inflammation ( 24 , 43 ). In the present study, it was demonstrated that Anoac-H, a traditional medicine, exerts its action on bleeding hemorrhoids, possibly by suppressing migration of immune and other cell types.…”

Section: Discussionmentioning

confidence: 99%

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Porwal¹,

Kundu

Bhagwat³

et al. 2021

Mol Med Rep

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Hemorrhoids and fistula are considered the most common anorectal conditions in the general population. These conditions affect the quality of a patient's life by causing pain and bleeding during defecation or even in the resting state. Lower grades of hemorrhoids may be controlled by traditional measures. However, surgery is an effective treatment option in recurrent-lower and higher-grade hemorrhoids. Surgical procedures are associated with various complications, including pain and delayed wound healing. Recurrence of hemorrhoids is also a major concern in the post-operative period. An anal fistula is the connection between the anus and the skin and causes severe pain, swelling, as well as blood and pus discharge. Fistula has serious social and economic consequences. Hence, it is important to understand the pathophysiology and molecular pathology of hemorrhoids and fistula, to identify the molecular targets and to develop pharmacological-interventions. In a previous study by our group, the polyherbal formulation Anoac-H was developed for the treatment of different stages of hemorrhoids and fistula, and it was demonstrated that Anoac-H is an effective formulation for treating hemorrhoids. However, the molecular mode of action of Anoac-H on hemorrhoids and fistula had remained elusive. In the present study, it was determined that this formulation reduces the migration of mesenchymal (fibroblasts) and immune (RAW 264.7) cells without affecting their viability. It was also observed that Anoac-H suppresses the expression of regulated upon activation, normal T cell expressed and presumably secreted (RANTES) and VEGF in fibroblasts and macrophages. Inflammation and elevated expression of RANTES and VEGF were observed in hemorrhoids and fistula. However, inflammation, as well as the expression of RANTES and VEGF, were significantly reduced in treated human hemorrhoid and fistula tissues as compared to untreated ones, confirming the in vitro results.

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Section: Discussionmentioning

confidence: 99%

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Porwal¹,

Kundu

Bhagwat³

et al. 2021

Mol Med Rep

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show abstract

“…Consequently, stress and psychological problems can intensify sympathetic function disorder and provide conditions for or further develop of CAF (15). Using a sitz bath to decrease spasms and pain, and using more effective medicines has been advised in Persian and classical medicine (16). Also, using psyllium (Plantago ovata) as a laxative has been advised in Persian and classical medicine because it increases feces volume (7,17,18).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the LOABAC theory, using topical medicine with anti-inflammatory, antimicrobial, and sedative effects is needed in CAF treatment (9). In Persian medicine, A. vera, A. ampeloprasum (leek), and C. mukul have been considered useful in anus diseases (16). In addition, Astragalus sarcocolla has been advised for wound healing (8,19,20).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a combination of herbal gel versus topical diltiazem (2%) in chronic anal fissure healing: a randomized doubleblind clinical trial

Tavakoli-Dastjerdi

Motavasselian

Emami

et al. 2019

J Herbmed Pharmacol

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Introduction: Chronic anal fissure (CAF) is a common painful ailment that adversely affects quality of life. Nonsurgical treatments such as topical diltiazem are routinely administered to patients with CAF. However, diltiazem is associated with side effects such as headache and allergic reactions, which often lead to discontinuation of the treatment. The aim of this study was to determine the efficacy and safety of a topical Persian herbal remedy with analgesic, antiinflammatory and antiseptic properties versus topical diltiazem (2%) in CAF healing. Methods: In this randomized double-blind clinical trial, 70 patients with CAF were randomly divided into an intervention group receiving topical herbal medicine and control group receiving topical diltiazem (2%) for 6 weeks. Both groups were given lifestyle and dietary advice including adherence to a high-fiber diet, avoidance of spicy foods, use of a laxative (psyllium powder) in case of constipation, and taking sitz baths. Severity of pain, bleeding, and itching were measured at the first visit as well as the first, third, and sixth weeks of treatment. Wound healing and epithelialization were evaluated by anal examination. The treatment and follow-up period was 12 weeks; 6 weeks for assessing the effect of treatment and 6 weeks for examining treatment maintenance and evaluating the percentage of recurrence. Results: The herbal medicine caused significant reduction in pain compared with diltiazem (P < 0.001). The herbal medicine had a significant effect in terms of wound healing at the end of the period (P < 0.001). Recurrence rate was lower in the intervention group (32%) than the control group (56%), though this difference was not significant (P = 0.323) Conclusion: Findings of this clinical trial suggest a higher efficacy of the combination herbal remedy versus topical diltiazem 2% in the management of pain and wound associated with CAF.

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“…Inflammatory cytokines are highly expressed in anorectal diseases and are involved in pain, inflammation and itching (44,(46)(47)(48). Inflammatory mediators, including COX-2, RANTES, VEGF, TNF-α and IL1-β, are known to be highly expressed under different pathological conditions (49,50).…”

Section: Effect Of Anospray On the Expression Of Inflammatory Cytokinesmentioning

confidence: 99%

Herbal medicine AnoSpray suppresses proinflammatory cytokines COX‑2 and RANTES in the management of hemorrhoids, acute anal fissures and perineal wounds

Porwal¹,

Kundu

Bhagwat³

et al. 2021

Exp Ther Med

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Hemorrhoids, anal fistula and fissure are common anorectal complications. Anorectal diseases are associated with severe pain, inflammation, swelling, itching and bleeding. These diseases may be managed with different medical treatments or surgical procedures, depending on their severity. Surgical procedures, however, are highly invasive and are associated with higher costs and the possibility of recurrence. In addition, surgical removal of fistula-in-ano leads to the formation of perineal wounds. Therefore, developing therapeutic interventions that are effective in alleviating inflammation and pain are desirable for the effective management of anorectal diseases. Herbal compounds have previously been indicated to suppress inflammation and pain in different pathological conditions. The aim of the present study was to examine the effects elicited by a polyherbal formulation, AnoSpray ® , on the migration of inflammatory cells and on the expression of inflammatory cytokines in anorectal diseases. The effect of AnoSpray on cell viability and migration was studied using MTT and wound-migration assays, respectively. Furthermore, the effects of AnoSpray on the expression of the inflammatory cytokines regulated upon activation, normal T cell expressed and presumably secreted (RANTES) and VEGF, as well as on cyclooxygenase-2 (COX)-2, were investigated using western blot analysis. The expression of RANTES and COX-2 in human hemorrhoid specimens was also analyzed to corroborate the in vitro findings. The results obtained revealed that AnoSpray did not exhibit any cytotoxic effects; however, it did lead to a significant suppression in the migration of RAW 264.7 and BJ cells. Furthermore, the results suggested that AnoSpray suppressed the expression of the inflammatory cytokines RANTES and VEGF, and also the expression of COX-2. In addition, RANTES and COX-2 were significantly downregulated in the clinical specimens of AnoSpray-treated hemorrhoids compared with the controls. Taken together, the results of the present study suggested that AnoSpray may be a potential therapeutic agent in the treatment of bleeding hemorrhoids, anal fissures and perineal wounds.

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Natural Treatments for Fissure in Ano Used by Traditional Persian Scholars, Razi (Rhazes) and Ibn Sina (Avicenna)

Cited by 14 publications

References 52 publications

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Polyherbal formulation Anoac‑H suppresses the expression of RANTES and VEGF for the management of bleeding hemorrhoids and fistula

Efficacy of a combination of herbal gel versus topical diltiazem (2%) in chronic anal fissure healing: a randomized doubleblind clinical trial

Herbal medicine AnoSpray suppresses proinflammatory cytokines COX‑2 and RANTES in the management of hemorrhoids, acute anal fissures and perineal wounds

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