Flavonoids and post haemorrhoidectomy recovery: a systematic review and meta‐analysis

Abstract Background Haemorrhoidectomy is the gold standard for definitive treatment of high‐grade symptomatic haemorrhoids but is often associated with substantial pain. This systematic review aims to explore the potential of flavonoids in alleviating the postoperative symptom burden following excisional haemorrhoidectomy. Methods A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PROSPERO CRD42023472711). Randomized controlled trials (RCTs) published PubMed, MEDLINE, Embase, and Scopus from inception to 1st December 2023 were retrieved. The primary outcome investigated was post‐operative pain. Meta‐analysis was performed using Review Manager version 5.4.1. Results Ten articles with 775 patients were included. The meta‐analysis identified statistically significant decreases in post‐operative pain in favour of the flavonoid groups (Standardized Mean Difference −0.66 [95% confidence intervals (CI) −0.82, −0.52]; P < 0.00001), and bleeding (Odds Ratio 0.13 [95% CI 0.09, 0.19]; P < 0.00001). Conclusion Flavonoids show promise as a means of reducing pain associated with excisional haemorrhoidectomy. Further research is required to investigate topical routes of administration and standardize regimes.