Tribenoside–lidocaine combination in wound healing of hemorrhoids: a review of literature

Background: Hemorrhoids are one of the most common anorectal disease observed in clinical practice. Symptomatic hemorrhoids can be effectively treated with a pharmacological approach, particularly with topical drugs, associated with dietary and lifestyle changes. this review is to assess the effectiveness of tribenoside 5% + lidocaine 2% combination cream and suppository forms to manage the acute symptomatology of patients with hemorrhoids. Method: Literatures were re trieved by a PubMed search, using different com binations of pertinent keywords (e.g., wound healing, tribeno side, hemorrhoids), without any limitations in terms of publication date and language. Papers which assessed the therapeutic efficacy and tolerability of tribenoside + lidocaine combination in patients with hemorrhoids were se lected for inclusion according to their relevance for the topic, as judged by the authors. Results: Five studies compared tribenoside + lidocaine combination with each of its single components: in 3 studies tribenoside + lidocaine was compared with lidocaine and in 2 studies with tribenoside. Moreover in 6 studies tribenoside + lidocaine has been compared with a corticosteroid containing preparation and 2 studies evaluated the product effectiveness in women with hemorrhoids, as a consequence of pregnancy or delivery. The results of all studies showed that the association tribenoside + lidocaine was significantly superior to lidocaine alone and had a similar clinical efficacy compared to tribenoside and corticosteroids. However, the tribenoside + lidocaine showed a faster relief of subjective symptomatology, than tribenoside and corticosteroids, with the advantage to avoid the possible steroid-related side-effects. Tribenoside + lidocaine has been well tolerated. Conclusion: In conclusion, tribenoside + lidocaine represents a rapid, effective and safe option for treatment of hemorrhoids, and should be recommended as first-line treatment of this disease in clinical practice for its long-lasting healing effects on hemorrhoids with high efficacy and good tolerability. first study was a randomized double-blind study comparing tribenoside+lidocaine cream (n=14) with lidocaine 2% cream (n=14) . The 2nd and 3th were open-label investigations with tribenoside+lidocaine cream (n=60) and suppositories (n=44) The 4th study compared preparations (hydrocortisone triamcinolone prednisolone (n=45)). times daily for 10 days (post-partum) or 20 days (pregnancy). Results were rated as excellent in 15, good in 18 and minimal in 7 patients (globally good or very good results in 82.5% of subjects) . Tolerability was favorable in all cases and no systemic or local adverse effects have been observed. 19