{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:09:19Z","timestamp":1790161759145,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Integrative and Complementary Medicine"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Anecdotal reports and preliminary clinical observations suggest potential benefits of homeopathic medicines in hemorrhoids, but high-quality evidence remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate whether individualized homeopathic medicinal products (IHMPs) are superior to placebo in reducing anorectal symptom severity and improving quality of life over 3 months in adults with hemorrhoids, and to assess their safety and tolerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Three-month, double-blind, randomized (1:1), placebo-controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Surgery, PG3, and research outpatients of a tertiary homeopathic medical college hospital in West Bengal, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>One hundred and thirty-four adults with grade I\u2013III hemorrhoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>\n                      IHMPs (verum;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 67) or identical-looking placebos (control;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 67) both administered alongside standard concomitant care including sitz baths, pelvic floor exercises, and dietary advice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>The primary outcome was the change in the Anorectal Symptom Severity and Quality-of-Life (ARSSQoL) total score over 3 months. Secondary outcomes included ARSSQoL subscales, numeric rating scales (NRSs), and EQ-5D-5L questionnaire and visual analog scale. Outcomes were assessed monthly for up to 3 months. The primary analysis compared model-based estimates of change over time between groups using repeated measures analysis of variance; the secondary analyses comprised multivariate linear mixed models, Bayesian hierarchical modeling, and sensitivity analyses under intention-to-treat and per-protocol frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After 3 months, IHMPs demonstrated significantly greater improvement than placebo in ARSSQoL total (mean group difference \u22126.5, 95% confidence interval \u22128.7, \u22124.2;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), with large effect sizes. Most ARSSQoL subscales, NRSs, and EQ-5D-5L scores favored IHMPs. Multivariate and Bayesian analyses confirmed consistent intervention-by-time effects, with a high probability of directional superiority for IHMPs in symptom reduction and self-rated health, while sensitivity analyses showed the findings to be robust to protocol deviations. Kent\u2019s repertory was the most frequently used in remedy selection.\n                      <jats:italic toggle=\"yes\">Nitricum acidum<\/jats:italic>\n                      emerged as the most effective remedy. No treatment-related serious adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this randomized, double-blind trial, IHMPs were associated with greater reductions in the ARSSQoL improvements in quality of life compared with placebo over 3 months. Although the magnitude and consistency of effects across multiple analytic approaches suggest potential clinical relevance, the absence of a validated minimal clinically important difference for the ARSSQoL warrants cautious interpretation. Further independent replications and methodological refinement of outcome thresholds are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27683605261435779","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T03:18:48Z","timestamp":1775186328000},"page":"874-890","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Hemorrhoids with Individualized Homeopathic Medicinal Products: A Double-Blind, Randomized, Placebo-Controlled Trial"],"prefix":"10.1177","volume":"32","author":[{"given":"Ankit","family":"Saha","sequence":"first","affiliation":[{"name":"Department of Repertory, D. N. 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De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munmun","family":"Koley","sequence":"additional","affiliation":[{"name":"East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, under Department of Health &amp; Family Welfare, Government of West Bengal, Parganas, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6782-3701","authenticated-orcid":false,"given":"Shubhamoy","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Pathology &amp; Microbiology, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangita","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Organon of Medicine and Homoeopathic Philosophy, D. N. 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