Topical Sucralfate Decreases Pain After Hemorrhoidectomy and Improves Healing: A Randomized, Blinded, Controlled Study

Gupta, Pallav; Heda, P. S.; Kalaskar, S.; Tamaskar, V. P.

doi:10.1007/s10350-007-9092-4

Cited by 56 publications

(43 citation statements)

References 16 publications

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“…Unlike Gupta study we evaluated pain intensity at the 1 st and 3 rd days which give more data about early effect of the drugs. 12 In present study, sucralfate had significant effect on pain intensity even in the first post-operative day but against this, study by Mirani et al showed that topical sucralfate ointment (10%) has a significant analgesic effect and can reduce both acute and chronic pain after hemorrhoidectomy but its analgesic effect is not obvious before 24 hours. This difference me be explained by the frequency of application of the treatment as in Mirani study patients applied the ointment every 12 hours only unlike every 6 hours in our study, we think that more frequent application gives better effect.…”

Section: Discussionmentioning

confidence: 46%

Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

Alkhateep

Fareed

2017

Int Surg J

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Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

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Section: Discussionmentioning

confidence: 46%

Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

Alkhateep

Fareed

2017

Int Surg J

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“…Recently Sucralfate has been also used for reducing postoperative pain and promoting wound healing after open hemorrhoidectomy (21), for the healing of burns or skin injuries (22) and in the clinical treatment of vaginal ulceration (23).…”

Section: Discussionmentioning

confidence: 99%

Sucralfate Modulates uPAR and EGFR Expression in an Experimental Rat Model of Cervicitis

Mannari¹,

Santi²,

Migliori³

et al. 2008

Int J Immunopathol Pharmacol

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Sucralfate is a drug used in the treatment of gastric and duodenal ulcer; it is cytoprotective and able to increase the bioavailability of several growth factors, modulating the wound healing process. In this study we tested the possible therapeutic effect of Sucralfate in the treatment of ulcerative lesion occurring in uterine cervix; to investigate such effect we used an experimental rat model of cervicitis in which the uPAR and EGFR expression were evaluated. Cervicitis was induced in wild and ovariectomized wistar female rats by an acetic acid-soaked tampon. The animals were divided into two main groups (4 and 7 days) and Sucralfate was administered topically until the day they were sacrificed. In order to distinguish physiological and drug-induced healing, quantitative and qualitative uPAR and EGFR expression were evaluated by using Western Blot and Immunohistochemistry techniques. Western Blot analysis demonstrated an increased expression of both receptors after 4 days from wounding in wild and ovariectomized animals. In particular in ovariectomized animals the expression of uPAR and EGFR increased after 4 days while it reduced following the administration of Sucralfate. In wild rats the same was observed for uPAR expression, while EGFR was different; in fact, its expression increased significantly at day 4 in the animals treated with the drug and only at day 7 in those untreated. Immunohistochemistry highlighted a noteworthy epithelial colocalization of EGFR and uPAR after 4 days in the animals treated with Sucralfate. We conclude that Sucralfate can promote the healing of ulcerative cervicitis and moreover, it reduces the normal healing time because of its modulatory property on uPAR and EGFR expression.

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“…It is postulated that this occurs due to stimulation of fibroblast growth factor, stimulation of granulation tissues, antibacterial activity or angiogenic properties. 30 Gupta et al showed a significant reduction in pain after haemorrhoidectomy with topical application of 3 grams sucralfate and reduced analgesia requirements especially after 7 and 14 days. 30 They also showed a superior wound healing after application of sucralfate.…”

Section: Local Anaestheticmentioning

confidence: 99%

“…30 Gupta et al showed a significant reduction in pain after haemorrhoidectomy with topical application of 3 grams sucralfate and reduced analgesia requirements especially after 7 and 14 days. 30 They also showed a superior wound healing after application of sucralfate. They concluded that the effects were mediated by sucralfate binding to mucosal surfaces and interaction with surface phospholipids which stimulates prostaglandins and increases mucosal blood flow.…”

Section: Local Anaestheticmentioning

confidence: 99%

A Brief Literature Review on the Management of Post-Haemorrhoidectomy Pain

Uzzaman

Siddiqui

2011

Surgical Techniques Development

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The most commonly encountered complication after haemorrhoidectomy is post-operative pain. Relief of this pain may aid earlier recovery. A literature search was performed examining the different surgical and medical agents for the relief of post haemorrhoidectomy pain using Pubmed, MEDLINE, EMBASE, CINAHL and Cochrane library databases. Pain can be relieved by surgical or medical agents. Surgery incorporates a risk of incontinence. A number of studies examine the role of medical agents.A variety of surgical techniques and medical agents are available to the clinician in the treatment of post haemorrhoidectomy pain. Tailored management to individual patients should ensure appropriate symptomatic control and prompt recovery.

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Topical Sucralfate Decreases Pain After Hemorrhoidectomy and Improves Healing: A Randomized, Blinded, Controlled Study

Abstract: Topical sucralfate significantly reduces pain at Days 7 and 14 after hemorrhoidectomy and promotes faster wound healing compared with that of a placebo.

Cited by 56 publications

References 16 publications

Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

Sucralfate Modulates uPAR and EGFR Expression in an Experimental Rat Model of Cervicitis

A Brief Literature Review on the Management of Post-Haemorrhoidectomy Pain

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