OBJECTIVE

To analyze experimental data and scientific articles on the possibility of controlling wound healing processes and activating tissue regeneration mechanisms using bacterial components for hemorrhoids and anal fissures management.

KEY POINTS

Accumulated data on the effects of the Escherichia coli (E. coli) bacterial culture suspension (BCS) as a therapeutic agent demonstrate the following positive impacts, which are in demand for the treatment of hemorrhoids and anal fissures: reduction of exudation and inflammation, acceleration of wound healing, tissue regeneration, and immune stimulation. The intricate mechanisms of these effects include complex, complementary reactions of cell receptors in the anorectal area with microbial components: metabolites, enzymes, heat shock proteins, and nucleic acids, NOD-ligands, leading to the production of various cytokines by immunocytes, colonocytes, and endothelial cells of the hemorrhoidal plexus, activation of innate and adaptive immunity mechanisms, dendritic cells, and fibroblasts, enhancing sanogenesis and accelerating the healing of tissue injuries.

CONCLUSION

Based on modern concepts, it can be reasonably argued that the biologically active components of E. coli BCS are capable of exerting both positive local and systemic effects, which deepens the understanding and justification of its use in hemorrhoidal disease and anal fissure. The effectiveness of drugs with E. coli BCS components is confirmed by their application in real clinical practice according to indications, both as conservative therapy and after surgical interventions.