Condition
Hemorrhoids
Hemorrhoids are swollen blood vessels in and around the rectum and anus that can itch, bleed or hurt. The evidence is strongest for fiber and diosmin, and a pooled analysis of 22 trials found a diosmin-based blend lowered bleeding, pain and swelling after hemorrhoid surgery, with horse chestnut moderate. That blend result mostly applies to people recovering from surgery, and the horse chestnut evidence comes from work on vein problems more broadly.
Sources: PMID 22419768
- Supplements studied
- 3
- Graded outcomes
- 1
- Trials
- 2
- People studied
- 642
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Hemorrhoid Symptoms Meta-analysis (22 RCTs, n=2335): MPFF improved clinical efficacy post-hemorrhoidectomy, reduced bleeding rate (0.9% vs 6.1%, p=0.03), pain score, and edema score. Dose: 3000mg/day for 3 days then 1500mg/day for 4 days. | Improves (the measure goes down) | Moderate effect |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Hemorrhoids Symptoms | Improves (the measure goes down) | 1 study | 72 people | |||
Studies that measured hemorrhoids symptoms | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Hemorrhoids Symptoms | Improves (the measure goes down) | 1 study | 570 people | |||
Key findings
- Hemorrhoid SymptomsImproves (the measure goes down)
The Hemorrhoids Support protocol
2 primary supplements · 3 supporting supplements
- Fiber Supplement20–35 g total fiber daily (supplement + diet)
- Diosmin/Hesperidin (Flavonoids)500 mg diosmin + 50 mg hesperidin twice daily
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The supplement graded A or B for Hemorrhoids. Each opens third-party tested products for that supplement.
- Grade A
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Studies cited
17 studies from PubMed
- Is There a Difference in the Clinical Efficacy of Diosmin and Micronized Purified Flavonoid Fraction for the Treatment of Chronic Venous Disorders? Review of Available Evidence
- Phlebotonics for venous insufficiency
- Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis
- Efficacy of micronized purified flavonoid fraction (Daflon) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials
- Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF)
- Therapeutic potential of micronized purified flavonoid fraction (MPFF) of diosmin and hesperidin in treatment chronic venous disorder
- Flavonoids for treating venous leg ulcers
- Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids
- From symptoms to leg edema: efficacy of Daflon 500 mg
- Clinical benefits of Daflon 500 mg in the most severe stages of chronic venous insufficiency
- The effect of Cissus quadrangularis (CQR-300) and a Cissus formulation (CORE) on obesity and obesity-induced oxidative stress
- Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids
- Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study
- Clinical evaluation of cissus quadrangularis and moringa oleifera and osteoseal as osteogenic agents in mandibular fracture
- Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency
- Horse chestnut seed extract for chronic venous insufficiency
- Double blind study of reparil in proctology