Effectiveness of the Aloe Vera extract in the treatment of fistula-in-ano

• Main Authors: Antonio Luis Cavasana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Felipe dos Santos Guimarães, Fernanda Helene Reis Barros, Gattass Carneiro Orro de Campos, Guilherme Apolinário Laureano Leme, Lucas Dutra Madrid da Silva, Lucas Marques Wahl, Nathália Barreto de Almeida Gutterres, Rosemary Matias, Sara Jéssica Falcão Câmara, Sandro Endrick de Oliveira Santos
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2020-01-01
• Series: Journal of Coloproctology
• Online Access: http://www.sciencedirect.com/science/article/pii/S223793631930111X

Rationale: Considering that anal fistulae are still challenging regarding their treatment due to the risk of fecal incontinence in the most complex cases and the increasing use of phytotherapeutic drugs such as Aloe Vera in medicine, even with proven healing effectiveness, there is interest in researching this drug in the treatment of anal fistulae. Objective: To evaluate the efficacy ofAloe Vera extract in the treatment of anal fistulae in rats. Method: Thirty male Wistar rats weighing 250–300 g were submitted to anal fistula and after 30 days were divided into three groups: Control Group (GCo) (n = 5), Carbopol Group (GCa) (n = 5), and Aloe Vera Group (GAV) (n = 10). In the GCo no treatment was performed, while in the others a daily infusion of 0.3 mL of solution (Carbopol only in GCa and Carbopol plus Aloe Vera extract in the GAV) was performed through the external orifice of the fistula for 30 days. Afterwards, euthanasia was performed and specimens were removed for histological study. It was evaluated the closure of the fistulous tract, the area of the remaining tract, the inflammatory infiltrate and the degree of vascular congestion. The results were submitted to statistical treatment by Kruskall–Wallis test, considering p < 0.05. Results: There was no complete closure of the fistulous tract in any of the animals. The mean area of the remaining tract was 847.2 μm in the GCo, 565.6 μm in the GCa and 377.8 μm in the GAV (p < 0.05). The mean of the inflammatory infiltrate score was 2.4 in the GCo, 2.4 in the GCa and 2.3 in the GAV (p > 0.05), while in the evaluation of vascular congestion, we observed a mean of 1.6 in the GCo, 1.4 in GCa and 1.1 in GAV (p < 0.05). Conclusion: The extract of Aloe vera was able to reduce the lumen of the fistulous tract and reduce the degree of vascular congestion; however, it did not allow the complete closure of the fistulous tract nor diminished the inflammatory process. Resumo: Racional: Considerando que o tratamento das fístulas anais tem risco de incontinência fecal e o crescente uso do Aloe Vera na medicina, há interesse em se pesquisar este fármaco. Objetivo: Avaliar a eficácia do extrato de Aloe vera no tratamento das fístulas anais em ratos. Método: Utilizou-se 30 ratos Wistar, os quais foram submetidos à criação de fístula anal e após 30 dias distribuídos em três grupos: Controle (GCo), Carbopol (GCa) e Aloe Vera (GAV). No GCo nenhum tratamento foi realizado, enquanto nos outros realizou-se infusão diária de 0,3 mL de Carbopol GCa e Carbopol mais extrato de Aloe Vera no GAV por 30 dias. Foram retirados os espécimes para estudo histológico, avaliou-se o fechamento do trajeto fistuloso, a área do trajeto remanescente, o infiltrado inflamatório e o grau de congestão vascular. Resultados: Não houve fechamento completo do trajeto fistuloso em nenhum dos animais. A média da área do trajeto remanescente foi 847,2 μm no GCo; 565,6 μm no GCa e 377,8 μm no GAV (p < 0,05). A média do escore de infiltrado inflamatório foi 2,4 no GCo; 2,4 no GCa e 2,3 no GAV (p > 0.05), enquanto na avaliação da congestão vascular observou-se média 1,6 no GCo; 1,4 no GCa e 1,1 no GAV (p < 0,05). Conclusão: O extrato de Aloe Vera foi capaz de diminuir o lumen dos trajetos fistulosos e reduzir o grau de congestão vascular, porém, não permitiu o fechamento completo dos trajetos fistulosos nem diminuiu o processo inflamatório. Keywords: Rats, Rectal fistula, Phytotherapeutic drugs, Aloe vera, Palavras-chave: Atos, Fístula retal, Drogas fitoterapêuticas, Aloe Vera