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 butchers broom.
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. 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. 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. Finally, this
bioflavonoid combination was found to compare favorably with surgical treatment
of hemorrhoids. 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.
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.
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. 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.