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Hemorrhoids (Holistic)

About This Condition

The itching and burning caused by hemorrhoids can make it difficult to sit still. How can you ease the discomfort and fight flare-ups? According to research or other evidence, the following self-care steps may be helpful.
  • Choose foods with fiber

    Eat more whole grains, bran, and vegetables, or take fiber supplements such as psyllium—along with plenty of fluids—to ease the passage of stools

  • Try a topical astringent

    Relieve hemorrhoid symptoms by frequently applying a product that contains witch hazel

  • Get relief from flavonoids

    Reduce symptoms with a daily dose of healthful flavonoids; take 1,000 to 2,000 mg of hydroxyethylrutosides or diosmin, or take horse chestnut extract containing 90 to 150 mg of aescin

About

About This Condition

Hemorrhoids are enlarged raised veins in the anus or rectum.

Common hemorrhoids are often linked to both diarrhea and constipation.1 Although the belief that hemorrhoids are caused by constipation has been questioned by researchers,2 most doctors feel that many hemorrhoids are triggered by the straining that accompanies chronic constipation.3 Therefore, natural approaches to hemorrhoids sometimes focus on overcoming constipation.

Symptoms

Symptoms of hemorrhoids may include painful swelling or a lump in the anus that can bleed and become inflamed, often causing discomfort and itching. There may also be bright red blood on the toilet paper, the stool, or in the toilet bowl.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Choose foods with fiber
Eat more whole grains, bran, and vegetables, or take fiber supplements such as psyllium—along with plenty of fluids—to ease the passage of stools.

Populations in which fiber intake is high have a very low incidence of hemorrhoids. Insoluble fiber—the kind found primarily in whole grains and vegetables—increases the bulk of stool. Drinking water with a high-fiber meal or a fiber supplement results in softer, bulkier stools, which can move more easily. As a result, many doctors recommend fiber in combination with increased intake of liquids for people with hemorrhoids. A review of seven placebo-controlled trials concluded that fiber supplementation has a beneficial effect on symptoms and bleeding in people with hemorrhoids.4

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
2 Stars
Flavonoids
600 to 4,000 mg hydroxyethylrutosides daily or 1 to 3 grams of a mixture of 90% diosmin and 10% hesperidin
Supplementing with flavonoids may reduce symptoms. A number of flavonoids have been shown to have anti-inflammatory effects and to strengthen blood vessels

A number of flavonoids have been shown to have anti-inflammatory effects and/or to strengthen blood vessels. These effects could, in theory, be beneficial for people with hemorrhoids. Most,5 , 6 , 7 , 8 but not all,9 double-blind trials using a group of semisynthetic flavonoids (hydroxyethylrutosides derived from rutin) have demonstrated significant improvements in itching, bleeding, and other symptoms associated with hemorrhoids when people used supplements of 600–4,000 mg per day.

Other trials have evaluated Daflon, a product containing the food-derived flavonoids diosmin (90%) and hesperidin (10%). An uncontrolled trial reported that Daflon produced symptom relief in two-thirds of pregnant women with hemorrhoids.10 Double-blind trials have produced conflicting results about the effects of Daflon in people with hemorrhoids.11 , 12 Amounts of flavonoids used in Daflon trials ranged from 1,000 to 3,000 mg per day. Diosmin and hesperidin are available separately as dietary supplements.

Some doctors recommend flavonoid supplements for people with hemorrhoids. However, many different flavonoids occur in food and supplements, and additional research is needed to determine which flavonoids are most effective against hemorrhoids.
2 Stars
Horse Chestnut
Take a standardized herbal extract providing 90 to 150 mg aescin daily
Horse chestnut extracts have been reported to reduce hemorrhoid symptoms.

Horse chestnut extracts have been reported from a double-blind trial to reduce symptoms of hemorrhoids.13 Some doctors recommend taking horse chestnut seed extracts standardized for aescin (also known as escin) content (16–21%), or an isolated aescin preparation, providing 90 to 150 mg of aescin per day.

2 Stars
Psyllium
7 grams three times daily in water, followed by a second glass of water
Taking psyllium, an herb high in fiber, may help relieve constipation.

Constipation is believed to worsen hemorrhoid symptoms, and thus, bulk-forming fibers are often recommended for those with hemorrhoids. A double-blind trial reported that 7 grams of psyllium, an herb high in fiber, taken three times daily reduced the pain and bleeding associated with hemorrhoids.14 Some healthcare professionals recommend taking two tablespoons of psyllium seeds or 1 teaspoon of psyllium husks two or three times per day mixed with water or juice. It is important to maintain adequate fluid intake while using psyllium.
2 Stars
Witch Hazel
Follow label instructions
Frequently applying a product that contains witch hazel, an astringent herb, may help reduce symptoms.

Topically applied astringent herbs have been used traditionally as a treatment for hemorrhoids. A leading astringent herb for topical use is witch hazel,16 which is typically applied to hemorrhoids three or four times per day in an ointment base.

References

1. Johanson JF, Sonnenberg A. Constipation is not a risk factor for hemorrhoids: a case-control study of potential etiological agents. Am J Gastroenterol 1994;89:1981–6.

2. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. Gastroenterology 1990;98:380–6.

3. Deutsch AA, Kaufman Z, Reiss R. Hemorrhoids: a plea for nonsurgical treatment. Isr J Med Sci 1980;16:649–54.

4. Alonso-Coello P, Mills E, Heels-Ansdell D, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol 2006;101:181–8.

5. Sinnatamby CS. The treatment of hemorrhoids. Role of hydroxyethylrutosides, troxerutin (Paroven; Varmoid; Venoruton). Clin Trials J 1973;2:45–50.

6. Clyne MB, Freeling P, Ginsborg S. Troxerutin in the treatment of haemorrhoids. Practitioner 1967;198:420–3.

7. Annoni F, Boccasanta P, Chiurazzi D, et al. Treatment of acute symptoms of hemorrhoid disease with high-dose oral O-(beta-hydroxyethyl)-rutosides. Minerva Med 1986;77:1663–8 [in Italian].

8. Wijayanegara H, Mose JC, Achmad L, et al. A clinical trial of hydroxyethylrutosides in the treatment of haemorrhoids of pregnancy. J Int Med Res 1992;20:54–60.

9. Thorp RH, Hughes ESR. A clinical trial of trihydroxyethylrutoside (“Varemoid”) in the treatment of hemorrhoids. Med J Aust 1970;2:1076–8.

10. Buckshee K, Takkar D, Aggarwal N. Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet 1997;57:145–51.

11. Cospite M. Double-blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566–73.

12. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon) in the treatment of hemorrhoids. Dis Colon Rectum 1992;35:1085–8.

13. Nini G, Di Cicco CO. Controlled clinical evaluation of a new anti-hemorrhoid drug, using a completely randomized experimental plan. Clin Ther 1978;86:545–59 [in Italian].

14. Moesgaard F, Nielsen ML, Hansen JB, Knudsen JT. High-fiber diet reduces bleeding and pain in patients with hemorrhoids. Dis Colon Rectum 1982;25:454–6.

15. Belcaro G, Cesarone MR, Errichi B, et al. Pycnogenol treatment of acute hemorrhoidal episodes. Phytother Res 2010;24:438-44.

16. Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 1994, 268–70.

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