• Reduction in colonic transit time assessed through radiologic technique. [ Time Frame: Day 5 and day 19. ] [ Designated as safety issue: No ]
  

• Daily evaluation of constipation and hemorrhoidal symptoms assessed by questionnaires. [ Time Frame: Daily from day 1 to 5 and from day 15 to 19. ] [ Designated as safety issue: No ]
  
• Health quality improvement assessed by WHOQOL Brief at every followup visit. [ Time Frame: Days 1, 5, 15 and 19. ] [ Designated as safety issue: No ]
  
• Adverse effects assessed by the investigator, blinded to the intervention, at every followup visit, through physical examination and laboratory exams. [ Time Frame: Days 1, 5, 15 and 19. ] [ Designated as safety issue: Yes ]
  

The Imescard compound water smartweed pills are currently registered in Brazil at the National Sanitary Surveillance Agency (ANVISA) as a laxative for the treatment of constipation, and as a supporting drug in hemorrhoid treatment. Though water smartweed (Polygonum hydropiperoides) has been used throughout the years as an antiinflammatory and in hemorrhoidal treatment, there are no reliable pharmacologic and clinical evidence that demonstrate its efficacy. The aim of this study was to assess the clinical efficacy and safety of the drug Imescard compound water smartweed pills in the treatment of chronic constipation and hemorrhoidal disease in a randomized, double-blind, crossover, placebo-controlled clinical trial.

Volunteers underwent a clinical evaluation and laboratory exams at enrollment, and 56 patients met the inclusion criteria and agreed to sign the informed consent form. Participants were then randomized into two groups to receive either Imescard pills or placebo, identical in appearance, once at every 8 hours for five days, followed by a 10-day washout period, and then received the other intervention for another 5-day period.

Followup visits were performed at day 1, 5, 15, and 19. At the beginning of each intervention period(days 1 and 15), patients were given diaries that included two questionnaires for each day of treatment, concerning constipation and hemorrhoidal symptoms, and received the intervention, unaware of its content. Colonic transit time was assessed at the end of each intervention period (days 5 and 19) through standard radiologic technique, and laboratory exams were taken three days later. Clinical evaluation and adverse effects assessment was performed at every visit by blinded investigator, and patients also fulfilled WHOQOL Brief, for life quality assessment.