Prevention of exacerbations of chronic hemorrhoids in pregnant women

Background: Hemorrhoids are a common condition during pregnancy, often leading to exacerbations that impair quality of life. This study evaluated the efficacy of prophylactic rectal suppositories containing streptokinase (15,000 IU) and streptodornase (1,250 IU) in preventing exacerbations of chronic hemorrhoids in pregnant women.

Methods: A randomized controlled trial was conducted from January 2017 to December 2018 involving 120 pregnant women with chronic hemorrhoids. Participants were divided into two groups (n=60 each): observation only (Group 1) and prophylactic suppositories (Group 2). Suppositories were administered once daily for 10 days in the second month of each trimester. Symptoms were assessed using a 10-point Visual Analog Scale (VAS) at the end of each trimester. Statistical analysis was performed using IBM SPSS Statistics version 20.

Results: Groups were comparable at baseline (p>0.05). Group 2 showed significantly fewer exacerbations (10 vs. 38 patients, p<0.001) and reduced symptom severity across bleeding, prolapse, itching, and pain (all p<0.01). Mild local reactions occurred in 5 patients in Group 2 but resolved spontaneously.

Conclusion: Prophylactic use of streptokinase-streptodornase suppositories effectively reduces exacerbations and symptom severity with acceptable safety.