The aCute HemORrhoidal disease evALuation International Study (CHORALIS): Subanalysis of the effectiveness of conservative treatment during the acute phase of hemorrhoidal disease in Vietnam

Abstract

Background: Although hemorrhoidal disease is common worldwide, real-world evidence on the effectiveness of conservative treatments during the acute phase remains limited. Objective: We aimed to assess the effectiveness of conservative treatment in improving symptoms and quality of life in patients with acute hemorrhoids in Vietnam. Patients and methods: This was a prospective, international, observational, longitudinal study based on a subanalysis of the aCute HemORrhoidal disease evALuation International Study conducted from January 2022 to June 2022 at five major hospitals in Vietnam. The present study included adult patients (≥18 years) diagnosed with acute hemorrhoidal disease (≤48 h since onset) who received conservative treatment and did not require surgical intervention. Results: Among the 202 patients, 53% were male; the mean population age was 40.5 ± 13.7 years, and the mean body mass index was 22.13 ± 2.59 kg/m2. The distribution of hemorrhoid severity was as follows: grade I, 22.3%; grade II, 59.9%; grade III, 12.4%; and grade IV, 5.4%. The mean number of symptoms per patient decreased from 4.6 ± 1.9 at baseline to 1.0 ± 1.5 at week four. At week one, the venoactive drug group showed symptom improvement rates of 63% for pain, 56.8% for discomfort, and 68.2% for bleeding. The Hemorrhoid and Fissure Quality of Life significantly decreased across all domains (p < 0.05). Patient and physician satisfaction with conservative treatment was high, at 88.7% and 87.7%, respectively. Conclusion: Conservative treatment, particularly micronized purified flavonoid fraction–based therapy, improved the clinical symptoms and quality of life in patients with acute hemorrhoids in Vietnam.