Hemorrhoids

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Hemorrhoids

General Purpose: 

Hemorrhoids, also known as piles, are veins in the anus and lower rectum area that become swollen and inflamed. They can occur as a result of straining during bowel movements, increased pressure during pregnancy, chronic constipation, obesity, and anal intercourse.

They are incredibly common – nearly half of all people will experience hemorrhoids by the age of 50. They can occur internally or externally, and symptoms include pain, burning, itching, bleeding, swelling, anal lumps, and leakage of fecal matter.

Complications rarely occur but when they do, they include anemia (decreased red blood cells and resulting fatigue), and tissue death (gangrene).

Due to their extreme prevalence, researchers continue to explore more effective ways of treating hemorrhoids, including refining both surgical and non-surgical methods of treatment. Researchers are also working to identify better ways to prevent the development of hemorrhoids at high-risk individuals.

What Will Hemorrhoid Clinical Trials Be Like?

The types of tests and assessments used in clinical trials for hemorrhoids will ultimately depend on the specific nature of the study. Provided below is a list of frequent procedures and tests that may be incorporated into clinical trials:

  • Physical exam, including a digital rectal exam (DRE), during which a doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities, as well as a visual inspection of the anus and rectum.
  • Detailed medical history
  • Blood tests to look for signs of infection
  • Sigmoidoscopy, which is a procedure during which the rectum and lower colon are examined using a thin, flexible tube with a tiny light and camera on the end.
  • Colonoscopy, which is a procedure similar to a sigmoidoscopy, however it is used to view the entire colon. Sigmoidoscopy and colonoscopy may be used for individuals with hemorrhoids to rule out the presence of other digestive system diseases, including cancer.
  • Blood tests to evaluate the effectiveness or chemical properties of a medication, if you are participating in a clinical trial that is investigating the use of a new drug.
  • Pain and quality of life assessments, as well as diet, exercise and/or medication diaries, may also be required in some studies, depending on the research question being studied.

Typical Hemorrhoid Clinical Trial Protocol:

Specific examples of clinical trials for hemorrhoids might include the following:

  • A randomized clinical trial to compare the effectiveness of two different treatments for bleeding internal hemorrhoids. In such a trial, half of the patients would be randomly assigned to receive treatment with band ligation (placing rubber bands around the hemorrhoids) or electrocoagulation (using electricity to burn the hemorrhoids).
  • A randomized clinical trial to determine if a newly-developed pain medication is more effective than standard post-operative pain control methods when administered to patients who undergo surgery to treat their hemorrhoids. In this study, half of the patients would receive the new drug while the other half would receive a placebo.
  • An interventional study to determine if a dietary and behavioral lifestyle intervention is more effective at promoting the healing of pregnancy-related hemorrhoids following delivery than standard post-natal care.

A brief word about randomized trials and placebos:

Many clinical trials involve the comparison of an investigational treatment to a “standard” treatment. Some studies determine which therapy a patient receives through a process known as randomization, in which patients are randomly assigned to receive either the investigational treatment or the standard treatment.

On occasion, a trial will investigate the use of a standard treatment plus a new drug or intervention, compared to standard treatment plus a placebo. Placebos are inactive or “sham” treatments that are identical in appearance to the active treatment but have no therapeutic value.

Placebos are necessary to help determine if adverse effects that occur during the clinical trial are the result of the investigational treatment or due to some other factor. They also allow researchers to measure the effects of the active treatment and observe what would have happened without it.

In rare instances where no standard therapy exists, or when a new drug or therapy is being investigated, the investigational treatment might be compared to a placebo alone (such as in the second example provided above). In these types of trials, those patients who are randomized to the placebo group do not receive an active treatment.

It is important to know that placebo-only trials are only conducted when scientifically necessary and when patients have been adequately informed that they may end up receiving the placebo rather than the active treatment.

It is very important to note, however, that no one should ever participate in such a placebo trial when there is a widely available and highly effective standard treatment already in existence for their particular disease or condition.

Trial Eligibility and Medical Information Needed:

The type of clinical trial you may be eligible for often depends on many factors. Therefore, it is important to know many details pertaining to your specific diagnosis when searching for clinical trials. Examples of the details you may want to have on hand include:

  • Your history of hemorrhoids
  • Any underlying illnesses you have
  • Your current medications (including aspirin), vitamins, and dietary supplements
  • Your history of treatment for hemorrhoids

Suggested Search Terms:

Once you are ready to begin your search for hemorrhoid clinical trials, the following terms may be of use when combined with “hemorrhoids”: “prevention,” “management,” “treatment,” “diet,” “exercise,” “disease,” “elderly,” “side effects,” “medication,” “surgery,” “pregnancy,” “childbirth,” and “diagnosis.”

 

 

Current Search Term:

“Hemorrhoids”

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Perianal Nerval Block in Proctological Interventions


Conditions:   Perianal Fistula;   Fissure in Ano;   Hemorrhoids
Interventions:   Drug: Placebo 40 mL Saline 0.9%;   Drug: 40 mL Ropivacain 0.5%
Sponsor:   University Hospital, Basel, Switzerland
Recruiting


Longo's Intervention in the Treatment of Hemorrhoids and Rectal Mucosal Prolapse


Conditions:   Hemorrhoids;   Rectal Mucosa Prolapse
Interventions:   Procedure: 4.5cm suture;   Procedure: 6cm suture
Sponsor:   Hospital de Mataró
Completed


Topical Versus Oral Metronidazole Following Excisional Haemorrhoidectomy


Conditions:   Hemorrhoids;   Postoperative Pain
Interventions:   Drug: Metronidazole Oral;   Drug: Metronidazole Ointment;   Drug: Placebo Oral Tablet;   Drug: Placebo Ointment
Sponsor:   University of Auckland, New Zealand
Not yet recruiting


Study of the Safety and Efficacy of Hydrocortisone Acetate Suppositories, 25 mg in the Treatment of Symptomatic Internal Hemorrhoids


Condition:   Internal Hemorrhoids
Interventions:   Drug: Hydrocortisone Acetate Suppository, 25 mg;   Drug: Placebo (Vehicle) Suppository
Sponsor:   Nivagen Pharmaceuticals Inc.
Not yet recruiting


Ultrasound Guided Caudal Block for Benign Anal Surgery


Conditions:   Anal Fissure;   Anal Fistula;   Hemorrhoids;   Pain, Postoperative
Intervention:   Procedure: Ultrasound Guided Caudal Block
Sponsor:   Universidad de Antioquia
Completed


Evaluation of the Technique LHP (Laser HemorrhoidoPlasty) in Haemorrhoidal Prolapse Mini Invasive Surgery


Condition:   Hemorrhoids
Intervention:  
Sponsor:   Groupe Hospitalier Paris Saint Joseph
Active, not recruiting


Ligation and Hemorrhoidopexy Technique Versus Ligation of Hemorrhoidal Arteries Using Ultrasound for Hemorrhoids


Condition:   Hemorrhoids
Interventions:   Procedure: Ligation and Hemorrhoidopexy;   Procedure: Ultrasound Guided Ligation of Hemorrhoidal Arteries
Sponsors:   Larissa University Hospital;   University of Thessaly
Recruiting


Adding Ketamine to Low Dose Bupivacaine in Saddle Block for Perianal Surgery


Conditions:   Perianal Fistula;   Hemorrhoids
Interventions:   Drug: Ketamine;   Drug: bupivacaine
Sponsor:   Esam Eldin Mohamed Abdalla
Active, not recruiting


Multicenter Prospective Trial on Hemorrhoids


Condition:   Hemorrhoids
Interventions:   Device: Transanal hemorrhoid dearterialization;   Procedure: Ferguson hemorrhoidectomy
Sponsors:   Stony Brook University;   THD America
Recruiting


Post Hemorrhoidectomy Anorectal Pain


Condition:   Hemorrhoid Pain
Intervention:   Behavioral: deep breathing exercises
Sponsor:   Boston Medical Center
Enrolling by invitation


Multi-Drug Analgesia vs. Standard Solution for Anal Surgery


Conditions:   Hemorrhoids;   Fissure in Ano;   Fistula;Rectal
Interventions:   Drug: Multi-drug local anesthetics (Combination);   Drug: Standard local anesthetics (Combination)
Sponsor:   Columbia University
Withdrawn


Validation of Hemorrhoidal Bleeding Score


Condition:   Hemorrhoid Bleeding
Intervention:  
Sponsor:   Groupe Hospitalier Paris Saint Joseph
Recruiting


Effect of Topical Trimebutine on Pain After Hemorrhoidectomy


Condition:   Hemorrhoids
Interventions:   Drug: Trimebutine;   Procedure: Hemorrhoidectomy
Sponsor:   Mansoura University
Suspended


Prospective Randomized Trial About THD Versus Ligasure Hemorrhoidectomy for Grade III and IV Hemorrhoids


Condition:   Hemorrhoids
Interventions:   Device: Transanal hemorrhoidal dearterialization + mucopexy (THD).;   Procedure: Ligasure™ hemorrhoidectomy;   Device: THD anoscope and doppler;   Device: Ligasure Vessel Sealing
Sponsor:   Hospital Universitari de Bellvitge
Active, not recruiting


Pre-Emptive Analgesia in Ano-Rectal Surgery


Conditions:   Hemorrhoids;   Fissure in Ano;   Rectal Fistula;   Anal Condyloma
Interventions:   Drug: Gabapentin;   Drug: Ketamine;   Drug: Acetaminophen;   Drug: Dexamethasone;   Drug: Placebo
Sponsors:   University of Vermont;   American Society of Colon and Rectal Surgeons
Completed


THD Versus Open Haemorrhoidectomy


Condition:   Hemorrhoids
Interventions:   Procedure: Transanal Haemorrhoidal Dearterialization;   Procedure: Open Haemorrhoidectomy
Sponsor:   Holbaek Sygehus
Active, not recruiting


Hemorrhoidal Artery Ligation and Rectoanal Repair Versus Stapled Hemorrhoidopexy


Condition:   Hemorrhoids
Interventions:   Procedure: Hemorrhoidal artery ligation with rectoanal repair;   Procedure: Stapled hemorrhoidopexy
Sponsor:   Cantonal Hospital of St. Gallen
Recruiting


Is Doppler Necessary in Haemorrhoidal Artery Ligation Operation?


Conditions:   Piles;   Bleeding
Intervention:   Procedure: HALO
Sponsor:   Poole Hospital NHS Foundation Trust
Terminated

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