Abascal K, Yarnell E. Botanical treatments for hemorrhoids. Altern Complement Med. 2005;11(6):285-289.
Almost one-half of all
Americans have some discomfort from hemorrhoids by the time they reach age 50,
but only 4% seek medical treatment.1 The authors discuss the roles
of butcher's broom (Ruscus aculeatus), horse chestnut (Aesculus
hippocastanum), stoneroot (Collinsonia canadensis), witch hazel (Hamamelis
virginiana), arnica (Arnica spp.), oak (Quercus spp.),
chamomile (Matricaria recutita), gotu kola (Centella asiatica),
calendula (Calendula officinalis), and psyllium (Plantago ovata
seed) in the treatment of hemorrhoids.
cushions of tissue within the anal canal that contain blood vessels and
supporting tissue made up of muscle and elastic tissue, are present in all
individuals.2 Hemorrhoids occur when these cushions enlarge and
cause negative symptoms, e.g., the passage of bright red blood. Two types of
hemorrhoids can occur: internal hemorrhoids, which originate at the top of the
anal canal, and external hemorrhoids, which originate at the lower end of the
canal, near the anus. According to the authors, botanical treatments for
hemorrhoids have been poorly researched.
Butcher's broom has a long
history of clinical use as a treatment for hemorrhoids, and its use for
treating this condition has been approved by the German Commission E.3
The authors cite an open-label multicenter study of 124 patients, in which 69%
of those patients rated butcher's broom as having good or excellent efficacy.
After taking 6 capsules per day of a product containing 150 mg of butcher's
broom for 3 days and then reducing their dose to 4 capsules per day, the
patients reported symptom (pain, local signs, overall severity) improvement.
Horse chestnut contains a mixture
of triterpene saponins (referred to as escins), flavonoids, and tannins. The
German Commission E has approved the use of a standardized horse chestnut
extract (containing 16%-20% anhydrous escin) for treating chronic venous
insufficiency. Although European publications from the late 1800s and early
1900s report that horse chestnut benefits patients who have hemorrhoids, there
are no recent studies on its use as a hemorrhoid treatment. The authors cite a
double-blinded placebo-controlled study of 80 patients suffering from acute
symptomatic hemorrhoids. In 81% of those patients, symptoms were reduced, and
bleeding and swelling were notably reduced. In that study, 40 mg of escin was
administered 3 times daily for up to 2 months.
Stoneroot is used by many
American herbalists, including the authors, as a treatment for symptomatic
hemorrhoids. The only research on stoneroot is constituent studies showing that
it contains flavonoidsand saponins.
Witch hazel has long been
used to treat hemorrhoids. Both European and American herbalists use witch
hazel both as an internal and topical remedy. It is prescribed as a decoction
or as an alcohol-preserved decoction. In pharmacological studies, it has
produced anti-inflammatory, astringent, and vasoconstrictive properties.4
Topical treatments can calm
the inflammation and stop the bleeding and swelling associated with
hemorrhoids. Rudolf Fritz Weiss, MD (a German phytotherapist) recommended using
1-2 teaspoons of arnica tincture per half-liter water as a wet compress.
Alternatively, he recommended the use of an oak bark decoction or a chamomile
infusion, and the use of a witch hazel ointment following the application of
The authors recommend
combining several herbs in compresses, sitz baths, or ointments to provide a
broader range of actions. For topical application, they suggest including herbs
noted for their wound-healing properties (e.g., gotu kola, chamomile, or
calendula), as well as those used internally (stoneroot, butcher's broom, horse
chestnut, and witch hazel).
The authors note the
importance of other issues in the treatment of hemorrhoids. They recommend an
increased intake of fruits and vegetables, as well as increased water intake
and exercise, for a long-term reduction of hemorrhoid symptoms. For those
patients who are constipated, the authors recommend psyllium seed husks.
treatment plan will work effectively on hemorrhoids in the early stages. More
complicated and advanced hemorrhoids are likely to require allopathic
intervention. Nonetheless, botanicals as an adjunct to ligation and surgery
will be helpful for healing and preventing recurrences," conclude the
1Online document at:
www.answers.com/main/ntquery?name=hemorrhoid. Accessed September 2005.
2Madoff RD, Fleshman JW. American Gastroenterological
Association technical review on the diagnosis and treatment of hemorrhoids.
3Abascal K. Yarnell E. Butcher's broom: herb's
potential too often swept under the rug. Alternative & Complementary
M, Goldberg A, Brinckmann J. Herbal Medicine: The Expanded Commission E
Mass: Integrative Medicine Communications; 2000.