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Even though the exact mechanism of action is not known, phlebotonics are thought to increase venous and lymphatic drainage, normalize capillary permeability and decrease inflammation in the hemorrhoidal cushions.4,1113 In a Cochrane review of 24 randomized controlled trials, Perera et al14 found that phlebotonics improved the outcomes of: Although phlebotonics give better results than placebo in the short-term management of hemorrhoids, there is a paucity of long-term data