Abstract
Objectives: Medicinal herbs have been used to treat hemorrhoidal disease for centuries. Given its anti-oxidant and anti-inflammatory mechanisms, Capsella bursa-pastoris (Shepherd’s purse) may potentially lead to regression of the hemorrhoidal plexuses. In this context, the objective of this study is to investigate the effect of Capsella bursa-pastoris, an affordable and easy-to-use herbal medicine, on the severity and physical examination findings of hemorrhoidal disease in patients, who receive conventional treatment for hemorrhoids.
 Material-Method: This study was designed as a prospective, randomized study. The population of the study comprised symptomatic patients who presented with second and third-degree hemorrhoids to the Internal Medicine and General Surgery departments of Istanbul Medipol University Hospital, İstanbul, Turkey, between October 2021 and February 2022. The patients were randomized into two groups: the control group, that is, the group of patients, who were to receive conservative treatment only for three months, and the study group, that is, the group of patients who were to receive conservative treatment and use herbal tea preparations of Capsella bursa-pastoris for three months. Demographic (age and gender) and baseline and 3-month clinical characteristics were recorded. The study's primary outcome was the changes observed in the symptoms and physical examination findings of hemorrhoidal disease in the study group relative to those in the control group.
 Results: The study sample consisted of a total of 218 patients, who were randomized into the study and control groups, with 109 patients in each group. Significantly older patients were seen in Group CT (39.5 ± 14.6 and 35.5 ± 11.7 years, p=0.030). There was no significant difference between the groups in terms of other characteristics (p>0.05). At the 3rd-month follow-up examination, it was determined that there were significantly fewer patients with bleeding and difficulty during defecation in the study group compared to the control group (p=0.001 for both cases). Patients in the study group had significantly lower VAS scores for pain and the number of affected quadrants compared to those in the control group (p
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