Treatment Protocol of the Most Common Anorectal Pathologies with Association between Micronized Purified Flavonoid Fraction and Sucralfate for Local Application

1. Summary (Aim) The author proposes to test the effectiveness of the combined action of 1Micronized Purified Flavonoid Fraction MPFF associated with topical action "barrier effect" of 2 Sucralfate (as SOS Sucralfate Ointment with Soothing Herbs) for some of the most common anal pathological situations with two main objectives: 1 microcirculation optimization (reduction of edema, congestion and mucous permeability) 2 barrier effect with control of irritative stimuli and reduction of severity of inflammation lesions, with reduction of traumatism due to the transit of the stool and the chemical action of the stool itself reduction of the microbial load in direct contact with the rectal and anal wall reduction of wall permeability (always in synergy with MPFF) 2. Introduction Anus-rectal diseases are numerous and varied in relation to causative factors and morphological and symptomatologic expression, even if usually trivialized by simplistic or frankly incorrect diagnoses including, too often, that of "hemorrhoids" or "hemorrhoidal disease", widely abused terms. The difference between a "real" proctologist and a "surgeon of ass hole" can be understood from how many times "hemorrhoids" are said during the visit and in subsequent diagnostic and therapeutic discussions, including the surgical option: " the measure of proctological competence is inversely proportional to the number of times the term "hemorrhoids" (personal aphorism) is used [1-10]. To be tackled in the best way, each disease requires the identification of the pathogenetic causes, a precise diagnostic framework, a correct setting of the diagnostic-therapeutic process, with a targeted therapy, suitable for the previous concepts. of course, this methodology of behavior is the prerogative of only the most expert Specialists and, in the daily practice of the non-dedicated Doctor, it may be useful to make use of guidelines or protocol schemes, adaptable to different situations, able to mitigate the impact of injuries and related symptoms, even before of a proctological consultation, but with almost complete guarantee, not to add iatrogenic damage to the patient's clinical picture.The author, on the basis of over forty years of experience, in the last two decades completely dedicated to colorectal-anal and perineal pathologies, has developed a treatment protocol useful in the management of acute, subacute and chronic anal disease situations. A broad-spectrum treatment protocol of the most common anal pathological situations is proposed, by means of micronized diosmin or, more precisely, of the Purified and Micronized Flavonoid Fraction (MPFF in the continuation of the treatment) for the known reintegration characteristics of the microcirculation (with reduction of edema and congestion), in association with topical application of an ointment based on Sucralfate and soothing herbs (SOS below), capable of perform a "barrier effect" with protection of mucous, anal and skin tissues, adjuvanted by soothing substances such as Witch hazel, calendula, chamomile. Flavonoids are polyphenolic compounds that are found ubiquitously in fruit and vegetables: they