Conditions:
Hemorrhoids

Principal Proposed Treatments
  • Citrus Bioflavonoids, Oxerutins
Other Proposed Treatments
  • Horse Chestnut, OPCs (Oligomeric Proanthocyanidins), Gotu Kola, Butcher's Broom, Mesoglycan, Collinsonia, Slippery Elm, Calendula

Hemorrhoids are swollen, inflamed veins in the rectum that can ache and bleed. They are very common and are usually caused by constipation, a low-fiber diet, a sedentary lifestyle, or pregnancy.

The most important interventions for hemorrhoids aim at reversing their causes. Adopting a high-fiber diet, sitting down less, getting plenty of exercise, and maintaining regular bowel habits can make a significant difference.

Medical treatment consists mainly of stool softeners and moist heat. In more severe cases, surgical procedures may be used.

Principal Proposed Treatments for Hemorrhoids

Besides the treatments described in this section, the natural treatments used for varicose veins are also often recommended for hemorrhoids because a hemorrhoid is actually a special kind of varicose vein. These include horse chestnut, OPCs, gotu kola, and butcher's broom.

Bioflavonoids

Bioflavonoids are colorful substances that occur widely in the plant kingdom. A fixed combination of the citrus bioflavonoids diosmin and hesperidin has been investigated as a treatment for hemorrhoids with positive results; related semisynthetic bioflavonoids called oxerutins also appear to be effective.

Reasonably good evidence suggests that the citrus bioflavonoids diosmin and hesperidin (in a special micronized combination preparation) may be helpful for hemorrhoids. A 2-month double-blind placebo-controlled trial of 120 individuals with recurrent hemorrhoid flare-ups found that treatment with combined diosmin and hesperidin significantly reduced the frequency and severity of hemorrhoid attacks.¹ Another double-blind placebo-controlled trial of 100 individuals had positive results with the same bioflavonoids in relieving symptoms once a flare-up of hemorrhoid pain had begun.² A 90-day double-blind trial of 100 individuals with bleeding hemorrhoids also found significant benefits for both treatment of acute attacks and prevention of new ones.³ Finally, this bioflavonoid combination was found to compare favorably with surgical treatment of hemorrhoids.⁴ However, less impressive results were seen in a double-blind placebo-controlled study in which all participants were given a fiber laxative with either combined diosmin and hesperidin or placebo.⁵

Moderate-size double-blind studies also support the use of oxerutins, including the hemorrhoids that occur during pregnancy, although there have been negative studies as well.^6,7

Although it is not known precisely how flavonoids work, it is thought that they stabilize the walls of blood vessels, making them less susceptible to injury.

For more information, including dosage and safety issues, see the full articles on citrus bioflavonoids and oxerutins.

Other Proposed Treatments for Hemorrhoids

Preliminary evidence suggests that an extract made from pig intestines called mesoglycan can improve the symptoms of hemorrhoids.^8,9 For more information, including dosage and safety issues, see the full mesoglycan article.

Collinsonia root (also known as stone root) is a traditional remedy for hemorrhoids. The proper dosage varies according to the preparation and is usually listed on the label. Safety studies have not been performed.

The herb slippery elm is also sometimes used orally for hemorrhoids; topical calendula cream is also a popular treatment. However, there is as yet no real evidence that they work.

Last reviewed March 2002 by Medical Review Board

Back to Top