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, pregnancy, orliver cirrhosis.

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.

Contrary to popular belief, it does not appear that consumption of foods spiced with hot chili peppers causes any discomfort or harm to people with hemorrhoids; a double-blind study found no difference in symptoms following consumption of hot peppers or placebo.11

Bioflavonoids are colorful substances that occur widely in the plant kingdom. Reasonably good, though not indisputable, evidence suggests that the citrus bioflavonoidsdiosmin and hesperidin (in a special micronized combination preparation) may be helpful for hemorrhoids.12

For example, a 2-month, double-blind, placebo-controlled trial of 120 individuals with recurrent hemorrhoid flare-ups found that treatment with combined diosmin and hesperidinsignificantly reduced the frequency and severity of hemorrhoid attacks.1Another 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.2A 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.3Finally, this bioflavonoid combination was found to compare favorably with surgical treatment of hemorrhoids.4However, 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.5

Other sources of bioflavonoids have been studied, as well. For example, in a 4-week, double-blind, placebo-controlled trial of 40 people with hemorrhoids, use of an extract made from the bioflavonoid-rich herb bilberrysignificantly reduced hemorrhoid symptoms as compared to placebo.10 In addition, according to some but not all double-blind studies, the semi-synthetic bioflavonoids known as oxerutinsmay also be helpful for hemorrhoids, including the hemorrhoids that occur during pregnancy.6,7

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, Bilberry, and Oxerutins.