The use of sodium thiosulfate in the treatment of hemorrhoids

Hemorrhoidal disease is one ofthe most common pathologies ofthe anorectal region, its specific weight in the structure of diseases ofthe colon is about 40%. Hemorrhoids are a socially significant disease, most often found in the able-bodied population. The reason for the development of hemorrhoids, on the one hand, is a violation of blood circulation in the cavernous corpuscles, due to which they increase and nodes form, and on the other hand, dystrophic changes in the ligamentous apparatus of hemorrhoids, in connection with which they gradually shift down and begin to fall out of the anal canal. One of the factors provoking the development of hemorrhoidal disease may be the presence of dissinergia of the pelvic floor muscles, which, in accordance with the Roman criteria IV, is part of the functional constipation syndrome. Not only dissinergia, but also high basal pressure in the anal canal (increased tone of the internal anal sphincter) can lead to stool retention. High rates of basal anal pressure can occur as a result of damage to the mucous membrane of the anal canal during straining, which leads to reflex spasm of the anal sphincter (anal continuity reflex). Thus, a vicious circle can form and thereby exacerbate constipation and the course of hemorrhoidal disease. Also, the relationship between dysenergic defecation and hemorrhoidal disease can be justified by the fact that physiotherapy aimed at correcting the work of the pelvic floor muscles contributes to better control over the manifestations of hemorrhoidal disease in complex therapy. The return of symptoms or, in other words, the recurrence of the disease in patients after surgery for hemorrhoids more often occurs with concomitant constipation. In accordance with clinical recommendations for the treatment of hemorrhoids, the use of an adequate amount of fluid and the intake of dietary fiber (fiber preparations) is indicated to normalize the activity of the gastrointestinal tract and eliminate constipation as part of complex therapy. If it is impossible to take dietary fiber, laxatives come to the fore of constipation therapy. This article presents clinical examples of the efficacy and safety of using sodium picosulfate. 

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