 The drug Imescard compound water smartweed ointment is currently registered at the brazilian National Sanitary Surveillance Agency ANVISA as a topic hemorrhoidal treatment. Its composed by adrenalin, which produces vasoconstriction, benzocaine, an anesthetic, hamamelis, which is believed to have a desiccative and astringent activity, and water smartweed Polygonum hydropiperoides, commonly used in the treatment of this condition, with, however, little or no evidence other than tradition to support its use. The aim of this study was to assess the clinical efficacy and safety of this drug in the treatment of hemorrhoidal disease in adults, in a randomized, double-blind, placebo-controlled clinical trial. 