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Abstract
Hemorrhoids are an abnormal swelling of the blood vessels in the anal canal; treatment is indicated only when they become
symptomatic. Conservative treatment typically consists of increasing dietary fiber, oral fluids to maintain hydration, nonsteroidal anti-inflammatory drugs (NSAIDs), sitz baths and rest. Surgery is indicated when conservative treatment fails;
but, the results are often unsatisfactory and recurrence may occur. However, in the general management of hemorrhoids,
colorectal surgeons agree that severe painful thrombosed hemorrhoids should be excised. The main ingredients of Pilex tablet
are Terminalia chebula, Cassia fistula, Emblica officinalis, which improve appetite, correct hepatic function and have mild laxative
properties thereby facilitating bowel evacuation and reducing local trauma to the hemorrhoidal vessels. The main ingredients
of Pilex ointment are Mimosa pudica, Vitex negundo, Eclipta alba and Solanum nigrum. These herbs possess styptic and antiinflammatory properties and help in regeneration of the vascular endothelium. Pilex tablets orally and ointment locally have
been very favorably reported for the amelioration and treatment of piles in various clinical trials and also established by a
large number of clinicians and surgeons. This review summarizes the effects of the polyherbal formulations Pilex tablets and
ointment in patients of hemorrhoids.
Keywords: Pilex tablets, Pilex ointment, hemorrhoids
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review article
dietary fiber, oral fluids to maintain hydration,
analgesics, sitz baths and rest.3 Increased fiber intake
improves outcomes.10 There is scant evidence to
support use of topical agents and suppositories for
treatment.3 Steroid-containing agents should not be
used for >14 days as they may cause thinning of the
skin.3 Hemorrhoidectomy is indicated for large thirdand fourth-degree hemorrhoids, mixed hemorrhoids
with a prominent external component and incarcerated
internal hemorrhoids requiring urgent intervention.
Hemorrhoids that fail to respond to medical
management may be treated with rubber band ligation,
sclerosis and thermotherapy. Rubber band ligation has
been demonstrated to be the most effective method
to treat symptomatic internal hemorrhoids that have
failed conservative management.11-14 Complications of
this procedure include vasovagal response, anal pain,
bleeding from early dislodgment and pelvic sepsis.15
This review summarizes six clinical studies wherein Pilex
tablets and ointment were evaluated in hemorrhoids.
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Results
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irrespective of the grade of hemorrhoids. Bleeding was
checked in both the groups over a period of 2-3 weeks.
Pilex tablet and ointment are better than Daflon tablet
in reducing inflammation and size of hemorrhoidal
mass in Grades I and II. Pilex tablet and ointment
induced complete remission in most cases with Grade I
hemorrhoids. They also had better efficacy in reducing
pain than Daflon, in terms of early recovery.
Study 3: Role of Pilex tablets and ointment in the
treatment of piles and fissures49
Material and methods: One hundred eight cases of
piles, with/without anal fissures, were treated with
a combination of Pilex tablets and Pilex ointment for
six weeks; for the first two weeks with 2 tablets of
Pilex thrice-daily orally and Pilex ointment applied
locally twice-daily (at bedtime and in the morning
after defecation). For the next four weeks, the dose of
the tablets was reduced to one tablet thrice-daily and
the application of ointment was continued as earlier.
Patients with other associated conditions like fistula-inano and anorectal growths were excluded. Every week,
the patients were assessed regarding subjective feeling,
symptomatic improvement, proctoscopic assessment
of the size of the pile mass and complications, if any.
Bleeding at the time of defecation was the predominant
symptom, followed by pain and heaviness in the
anorectal region (n = 81).
Results: Eighty-two cases of piles of all degrees and 26
cases of fissure-in-ano were treated with Pilex tablets
and ointment. Almost all patients reported subjective
improvement within a week of starting treatment.
An objective improvement was found in all cases of
fissures and in most cases of piles.
Conclusion: In early cases of piles and fissure-in-ano,
Pilex tablets and ointment constitute a good alternative
to surgery. Even in late cases, when surgery is
contraindicated, or is to be postponed, this conservative
regimen can provide adequate remission for a relatively
longer period.
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one tablet thrice-daily for the rest of the course. Pilex
ointment applied per rectum at least thrice a day.
Follow-up: Every week for six weeks; fortnightly for
three months and then monthly for rest of the trial
period (upto 1 year) or as deemed necessary.
All 10 females and 20 males had constipation and used
some laxatives in the form of drugs or diet. These
patients were prescribed easily digestible high residue
diet and antianemic supportive therapy. If there was
no response after a full course of six weeks, a gap of
two weeks was allowed and then Pilex course was
repeated. A total of 4-5 such courses were tried before
declaring trial cases as failed. Failed trial cases were
subjected to other forms of treatment, mainly surgical.
Results
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review article
hemorrhoidal mass of the dilated veins of hemorrhoidal
plexus. Results of the clinical studies reviewed show
rapid and effective relief in symptoms like shrinkage
of hemorrhoidal mass, control of bleeding per rectum,
relief from itching, reduction of pain and discomfort
during defecation, relief from constipation, control
of secondary infection and recurrence and clinical
improvement in local condition. Pilex combination
therapy is safe and effective in the management of
uncomplicated early hemorrhoids as was shown in the
substantial sample size of the patients reviewed.
References
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