4.8
Hemorrhoids: natural remedies and the evidence behind them
Hemorrhoids are swollen veins in or around the rectum and anus that can cause pain, itching, and discomfort.
7 options · 2 graded A · 2 graded B · 3 traditional or ungraded
What's bothering you most about your hemorrhoids right now?
Everything feels swollen, heavy, and congested — I want to support the veins themselves
Diosmin (with Hesperidin)
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleOral flavonoid studied for hemorrhoid symptoms
- Why this matches
- If you want to calm swelling and reduce flare-up symptoms from the inside, this oral flavonoid works on the vein walls behind hemorrhoidal discomfort.
- Why try it
- Micronized flavonoids (diosmin with hesperidin, also called MPFF) support venous tone and reduced capillary leakiness. In a meta-analysis of randomized trials in hemorrhoidal disease, they were associated with less bleeding, pain, and itching and better overall symptom relief.
- Dose or use
- Taken orally; a common approach is a higher short course during a flare, then a lower daily dose. Follow product labeling or your clinician's guidance.
- Time to results
- Acute symptoms may ease within days; steadier benefit over weeks
- Key study
- Systematic Review and Meta-Analysis (2020, PMID 32399811): Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis. Pooled randomized trials of MPFF (diosmin with hesperidin) reported benefit for bleeding, pain, pruritus, discharge, and overall improvement.
- Caution
- Generally well tolerated; mild digestive upset can occur. Check with your doctor if pregnant, nursing, or taking other medication.
Horse Chestnut Extract (Aesculus hippocastanum)
Centuries of traditional use· Human evidence not yet assessed (Evidence grade not assigned · Traditional use long-standing)Long-standing traditional stapleVenotonic herb for swelling and heaviness
- Why this matches
- If swelling and a heavy, congested feeling are part of your discomfort, horse chestnut targets the vein walls that drive it.
- Why try it
- Its active compound aescin is traditionally used to strengthen vein walls and reduce swelling in vein-related conditions, the same mechanism relevant to hemorrhoids.
- Dose or use
- Taken orally as a standardized extract; follow product labeling and choose products labeled free of esculin.
- Time to results
- Typically 2–6 weeks of consistent use
- Key study
- Traditionally used for venous complaints; its specific benefit for hemorrhoids has not been confirmed in controlled clinical trials cited here.
- Caution
- Raw horse chestnut is toxic — use only standardized extracts. Avoid with blood thinners or during pregnancy without medical advice.
Curcumin
Centuries of traditional use· Human evidence not yet assessed (Evidence grade not assigned · Traditional use long-standing)Long-standing traditional stapleTraditionally used to ease inflammation
- Why this matches
- If everyday swelling and discomfort are your focus, curcumin has a long traditional history as an anti-inflammatory herb.
- Why try it
- Traditionally used to help calm inflammatory processes in the body, which may support comfort during hemorrhoid flare-ups.
- Dose or use
- Follow product labeling; consult a healthcare practitioner.
- Time to results
- Typically 2–6 weeks of consistent use
- Key study
- Traditionally used for this condition; this specific use has not been confirmed in controlled clinical trials.
- Caution
- May interact with blood-thinning medications; consult your doctor if pregnant or on anticoagulants.
I want to stop flare-ups before they start — softer stools and less straining
Psyllium Husk
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleBulk fiber that softens stool
- Why this matches
- If you want softer, easier bowel movements and less straining, psyllium adds gentle bulk that addresses the main driver of flare-ups.
- Why try it
- A bulk-forming soluble fiber that absorbs water to soften and add bulk to stool, easing the straining that worsens hemorrhoids. In a meta-analysis of randomized trials, fiber lowered the risk of persistent hemorrhoid symptoms and bleeding.
- Dose or use
- Start with about 1 teaspoon in a full glass of water once daily and increase gradually; always take with plenty of water.
- Time to results
- Softer, more regular stools within a few days to a week
- Key study
- Systematic Review and Meta-Analysis (2006, PMID 16405552): Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Pooled randomized trials found fiber (including bulk fibers such as psyllium) reduced the risk of persistent symptoms and bleeding.
- Caution
- Always take with enough fluid to avoid choking or blockage, and increase the dose slowly to limit gas and bloating.
Fiber Deficiency
Supported by smaller clinical studies· Centuries of traditional use (Evidence grade B · Traditional use long-standing)Long-standing traditional stapleLow fiber is a common contributor to straining
- Why this matches
- If you want fewer flare-ups, looking at your fiber intake addresses a common contributing factor — too little fiber can lead to hard stools and straining.
- Why try it
- A low-fiber diet is linked to hard, hard-to-pass stools and constipation, a major contributor to hemorrhoid symptoms and bleeding; getting enough fiber may help soften stools and reduce straining.
- Dose or use
- Build toward roughly 25–35 g of fiber a day from vegetables, fruit, legumes, and whole grains, increasing gradually alongside more water.
- Time to results
- Bowel regularity often improves within one to two weeks
- Key study
- Systematic Review and Meta-Analysis (2006, PMID 16405552): Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Increasing dietary fiber was associated with a lower risk of persistent symptoms and bleeding, supporting adequate fiber intake.
- Caution
- Increase fiber slowly and drink more water to avoid gas, bloating, or cramping.
I'm in real pain right now — a painful flare-up or recovering from a hemorrhoid procedure
Diosmin (with Hesperidin)
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleOral flavonoid studied for hemorrhoid symptoms
- Why this matches
- If you want to calm swelling and reduce flare-up symptoms from the inside, this oral flavonoid works on the vein walls behind hemorrhoidal discomfort.
- Why try it
- Micronized flavonoids (diosmin with hesperidin, also called MPFF) support venous tone and reduced capillary leakiness. In a meta-analysis of randomized trials in hemorrhoidal disease, they were associated with less bleeding, pain, and itching and better overall symptom relief.
- Dose or use
- Taken orally; a common approach is a higher short course during a flare, then a lower daily dose. Follow product labeling or your clinician's guidance.
- Time to results
- Acute symptoms may ease within days; steadier benefit over weeks
- Key study
- Systematic Review and Meta-Analysis (2020, PMID 32399811): Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis. Pooled randomized trials of MPFF (diosmin with hesperidin) reported benefit for bleeding, pain, pruritus, discharge, and overall improvement.
- Caution
- Generally well tolerated; mild digestive upset can occur. Check with your doctor if pregnant, nursing, or taking other medication.
Acupuncture
Supported by smaller clinical studies· Centuries of traditional use (Evidence grade B · Traditional use long-standing)Long-standing traditional stapleClinically reviewed for post-hemorrhoid pain
- Why this matches
- If pain — particularly after a hemorrhoid procedure — is your main concern, acupuncture has been evaluated specifically for this.
- Why try it
- Supported by a systematic review and network meta-analysis of acupuncture methods for postoperative pain in mixed hemorrhoids, suggesting it may meaningfully reduce discomfort during recovery.
- Dose or use
- Delivered by a licensed acupuncturist over a short course of sessions; discuss timing around any hemorrhoid procedure with your provider.
- Time to results
- Typically noticeable within 1–4 sessions
- Key study
- Systematic review (2022, PMID 36199772): Three Acupuncture Methods for Postoperative Pain in Mixed Hemorrhoids: A Systematic Review and Network Meta-Analysis.
- Caution
- Seek a licensed acupuncturist; let them know about any bleeding concerns or blood-thinning medications.
Witch Hazel
Not yet assessed· We have not reviewed the literature for this one (Evidence grade not assigned · Traditional use recognised)Recognised traditional useClassic topical astringent for relief
- Why this matches
- If swelling, itching, and everyday irritation are what bother you most, witch hazel is the classic topical you apply right where you feel it.
- Why try it
- An astringent rich in tannins, traditionally used to tighten irritated tissue and calm the itching and swelling around hemorrhoids.
- Dose or use
- Dab a witch hazel liquid or medicated pad onto the area a few times a day; follow product labeling.
- Time to results
- Often soothing within minutes to a few days
- Key study
- Traditionally used for hemorrhoids as a topical astringent; this use has not been confirmed in controlled clinical trials cited here.
- Caution
- For external use only; stop if it causes stinging or a rash, and avoid applying to broken or actively bleeding skin.
The itching, burning, and surface irritation — I want something soothing, fast
Witch Hazel
Not yet assessed· We have not reviewed the literature for this one (Evidence grade not assigned · Traditional use recognised)Recognised traditional useClassic topical astringent for relief
- Why this matches
- If swelling, itching, and everyday irritation are what bother you most, witch hazel is the classic topical you apply right where you feel it.
- Why try it
- An astringent rich in tannins, traditionally used to tighten irritated tissue and calm the itching and swelling around hemorrhoids.
- Dose or use
- Dab a witch hazel liquid or medicated pad onto the area a few times a day; follow product labeling.
- Time to results
- Often soothing within minutes to a few days
- Key study
- Traditionally used for hemorrhoids as a topical astringent; this use has not been confirmed in controlled clinical trials cited here.
- Caution
- For external use only; stop if it causes stinging or a rash, and avoid applying to broken or actively bleeding skin.
Curcumin
Centuries of traditional use· Human evidence not yet assessed (Evidence grade not assigned · Traditional use long-standing)Long-standing traditional stapleTraditionally used to ease inflammation
- Why this matches
- If everyday swelling and discomfort are your focus, curcumin has a long traditional history as an anti-inflammatory herb.
- Why try it
- Traditionally used to help calm inflammatory processes in the body, which may support comfort during hemorrhoid flare-ups.
- Dose or use
- Follow product labeling; consult a healthcare practitioner.
- Time to results
- Typically 2–6 weeks of consistent use
- Key study
- Traditionally used for this condition; this specific use has not been confirmed in controlled clinical trials.
- Caution
- May interact with blood-thinning medications; consult your doctor if pregnant or on anticoagulants.
What kind of help fits you best?
I'd rather fix the root cause through my diet and daily habits
Psyllium Husk
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleBulk fiber that softens stool
- Why this matches
- If you want softer, easier bowel movements and less straining, psyllium adds gentle bulk that addresses the main driver of flare-ups.
- Why try it
- A bulk-forming soluble fiber that absorbs water to soften and add bulk to stool, easing the straining that worsens hemorrhoids. In a meta-analysis of randomized trials, fiber lowered the risk of persistent hemorrhoid symptoms and bleeding.
- Dose or use
- Start with about 1 teaspoon in a full glass of water once daily and increase gradually; always take with plenty of water.
- Time to results
- Softer, more regular stools within a few days to a week
- Key study
- Systematic Review and Meta-Analysis (2006, PMID 16405552): Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Pooled randomized trials found fiber (including bulk fibers such as psyllium) reduced the risk of persistent symptoms and bleeding.
- Caution
- Always take with enough fluid to avoid choking or blockage, and increase the dose slowly to limit gas and bloating.
Fiber Deficiency
Supported by smaller clinical studies· Centuries of traditional use (Evidence grade B · Traditional use long-standing)Long-standing traditional stapleLow fiber is a common contributor to straining
- Why this matches
- If you want fewer flare-ups, looking at your fiber intake addresses a common contributing factor — too little fiber can lead to hard stools and straining.
- Why try it
- A low-fiber diet is linked to hard, hard-to-pass stools and constipation, a major contributor to hemorrhoid symptoms and bleeding; getting enough fiber may help soften stools and reduce straining.
- Dose or use
- Build toward roughly 25–35 g of fiber a day from vegetables, fruit, legumes, and whole grains, increasing gradually alongside more water.
- Time to results
- Bowel regularity often improves within one to two weeks
- Key study
- Systematic Review and Meta-Analysis (2006, PMID 16405552): Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Increasing dietary fiber was associated with a lower risk of persistent symptoms and bleeding, supporting adequate fiber intake.
- Caution
- Increase fiber slowly and drink more water to avoid gas, bloating, or cramping.
I'm happy taking a daily supplement that works from the inside
Diosmin (with Hesperidin)
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleOral flavonoid studied for hemorrhoid symptoms
- Why this matches
- If you want to calm swelling and reduce flare-up symptoms from the inside, this oral flavonoid works on the vein walls behind hemorrhoidal discomfort.
- Why try it
- Micronized flavonoids (diosmin with hesperidin, also called MPFF) support venous tone and reduced capillary leakiness. In a meta-analysis of randomized trials in hemorrhoidal disease, they were associated with less bleeding, pain, and itching and better overall symptom relief.
- Dose or use
- Taken orally; a common approach is a higher short course during a flare, then a lower daily dose. Follow product labeling or your clinician's guidance.
- Time to results
- Acute symptoms may ease within days; steadier benefit over weeks
- Key study
- Systematic Review and Meta-Analysis (2020, PMID 32399811): Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis. Pooled randomized trials of MPFF (diosmin with hesperidin) reported benefit for bleeding, pain, pruritus, discharge, and overall improvement.
- Caution
- Generally well tolerated; mild digestive upset can occur. Check with your doctor if pregnant, nursing, or taking other medication.
Psyllium Husk
Supported by controlled trials· Centuries of traditional use (Evidence grade A · Traditional use long-standing)Long-standing traditional stapleBulk fiber that softens stool
- Why this matches
- If you want softer, easier bowel movements and less straining, psyllium adds gentle bulk that addresses the main driver of flare-ups.
- Why try it
- A bulk-forming soluble fiber that absorbs water to soften and add bulk to stool, easing the straining that worsens hemorrhoids. In a meta-analysis of randomized trials, fiber lowered the risk of persistent hemorrhoid symptoms and bleeding.
- Dose or use
- Start with about 1 teaspoon in a full glass of water once daily and increase gradually; always take with plenty of water.
- Time to results
- Softer, more regular stools within a few days to a week
- Key study
- Systematic Review and Meta-Analysis (2006, PMID 16405552): Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Pooled randomized trials found fiber (including bulk fibers such as psyllium) reduced the risk of persistent symptoms and bleeding.
- Caution
- Always take with enough fluid to avoid choking or blockage, and increase the dose slowly to limit gas and bloating.
Horse Chestnut Extract (Aesculus hippocastanum)
Centuries of traditional use· Human evidence not yet assessed (Evidence grade not assigned · Traditional use long-standing)Long-standing traditional stapleVenotonic herb for swelling and heaviness
- Why this matches
- If swelling and a heavy, congested feeling are part of your discomfort, horse chestnut targets the vein walls that drive it.
- Why try it
- Its active compound aescin is traditionally used to strengthen vein walls and reduce swelling in vein-related conditions, the same mechanism relevant to hemorrhoids.
- Dose or use
- Taken orally as a standardized extract; follow product labeling and choose products labeled free of esculin.
- Time to results
- Typically 2–6 weeks of consistent use
- Key study
- Traditionally used for venous complaints; its specific benefit for hemorrhoids has not been confirmed in controlled clinical trials cited here.
- Caution
- Raw horse chestnut is toxic — use only standardized extracts. Avoid with blood thinners or during pregnancy without medical advice.
Curcumin
Centuries of traditional use· Human evidence not yet assessed (Evidence grade not assigned · Traditional use long-standing)Long-standing traditional stapleTraditionally used to ease inflammation
- Why this matches
- If everyday swelling and discomfort are your focus, curcumin has a long traditional history as an anti-inflammatory herb.
- Why try it
- Traditionally used to help calm inflammatory processes in the body, which may support comfort during hemorrhoid flare-ups.
- Dose or use
- Follow product labeling; consult a healthcare practitioner.
- Time to results
- Typically 2–6 weeks of consistent use
- Key study
- Traditionally used for this condition; this specific use has not been confirmed in controlled clinical trials.
- Caution
- May interact with blood-thinning medications; consult your doctor if pregnant or on anticoagulants.
I'd rather skip the pills — something I apply directly or a hands-on treatment
Acupuncture
Supported by smaller clinical studies· Centuries of traditional use (Evidence grade B · Traditional use long-standing)Long-standing traditional stapleClinically reviewed for post-hemorrhoid pain
- Why this matches
- If pain — particularly after a hemorrhoid procedure — is your main concern, acupuncture has been evaluated specifically for this.
- Why try it
- Supported by a systematic review and network meta-analysis of acupuncture methods for postoperative pain in mixed hemorrhoids, suggesting it may meaningfully reduce discomfort during recovery.
- Dose or use
- Delivered by a licensed acupuncturist over a short course of sessions; discuss timing around any hemorrhoid procedure with your provider.
- Time to results
- Typically noticeable within 1–4 sessions
- Key study
- Systematic review (2022, PMID 36199772): Three Acupuncture Methods for Postoperative Pain in Mixed Hemorrhoids: A Systematic Review and Network Meta-Analysis.
- Caution
- Seek a licensed acupuncturist; let them know about any bleeding concerns or blood-thinning medications.
Witch Hazel
Not yet assessed· We have not reviewed the literature for this one (Evidence grade not assigned · Traditional use recognised)Recognised traditional useClassic topical astringent for relief
- Why this matches
- If swelling, itching, and everyday irritation are what bother you most, witch hazel is the classic topical you apply right where you feel it.
- Why try it
- An astringent rich in tannins, traditionally used to tighten irritated tissue and calm the itching and swelling around hemorrhoids.
- Dose or use
- Dab a witch hazel liquid or medicated pad onto the area a few times a day; follow product labeling.
- Time to results
- Often soothing within minutes to a few days
- Key study
- Traditionally used for hemorrhoids as a topical astringent; this use has not been confirmed in controlled clinical trials cited here.
- Caution
- For external use only; stop if it causes stinging or a rash, and avoid applying to broken or actively bleeding skin.
Evidence grades describe the strength of published research for Hemorrhoids, not a promise of results. Nothing here is medical advice — talk to your clinician before starting anything, especially alongside prescription medication.