Hemorrhoids are very common and can cause pain, discomfort, and bleeding. A range of lifestyle changes and treatments have been shown to help manage hemorrhoids, including taking dietary supplements. While fiber and flavonoid supplements are the main types used, researchers are also investigating the effectiveness of other supplements.
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Hemorrhoids are swollen and inflamed veins that develop externally or internally in the lower rectum and anus. Hemorrhoids affect up to 75% of people in the United States, making it a prevalent condition.¹
Hemorrhoids don’t always cause symptoms; approximately 40% of those with hemorrhoids do not have symptoms.²
The symptoms of hemorrhoids can include:
Bleeding during bowel movements
Swelling around the anal area
Pain and discomfort in the anal area
Itching and irritation in the anal area.
The exact cause of hemorrhoids isn’t known, but it is thought to stem from repetitive or prolonged straining. This causes downward stress, leading to the disruption of the supporting elements around the veins. Subsequently, they can elongate, dilate, and engorge, creating the associated symptoms of hemorrhoids.
Potential associations and risk factors of hemorrhoids include:
Chronic diarrhea or constipation
A low-fiber diet
Sitting on the toilet for long periods
People with a family history of hemorrhoids and colorectal cancer and who are between the ages of 45 and 65 are also more likely to get hemorrhoids.
Before starting a supplement, you should always check with your doctor to ensure it is safe for you. Many supplements can interact with other medications or may not be suitable if you have existing medical conditions.
The dietary supplements that may help to treat hemorrhoids include:
Over-the-counter fiber supplements may help with hemorrhoids.
Studies have found that fiber supplementation can reduce the risk of rectal bleeding caused by hemorrhoids by 50% and relieves overall symptoms.³
Fiber bulks up the stool and also helps prevent constipation, one of the most common causes of hemorrhoids.
Some types of fiber supplements include:
Psyllium (Metamucil or Konsyl)
Calcium polycarbophil (Fibercon)
Guar gum (Benefiber).
When taking fiber supplements, drinking enough fluid is essential to ensuring the supplements work as they should.
Phlebotonics include some flavonoids, chemicals in plants with antioxidant and anti-inflammatory properties. They can also strengthen blood vessel walls.
Some flavonoids that have been used to treat hemorrhoids in the form of dietary supplements include:
For example, micronized purified flavonoid fraction (MPPF) Daflon is a combination of the flavonoids hesperidin and diosmin. MPFF can be used to treat hemorrhoids.
A review found that flavonoid treatment (either with rutoside, diosmin, or MPFF) may have a beneficial effect on symptomatic hemorrhoids, although the data was of low quality.⁴
Reduce the risk of hemorrhoids not improving by 58%
Reduce the risk of hemorrhoid symptoms such as bleeding, pain, and itchy skin
Reduce anal discharge and leakage
Reduce the risk of hemorrhoid recurrence.
Keep in mind that although flavonoid supplements have a good safety profile, they haven’t been approved by the Food and Drug Administration (FDA) for treating hemorrhoids and are not commonly used in the US.
Although fiber and flavonoids are the main supplements people use to treat hemorrhoids, others have been investigated too.
Tannins are polyphenols found in plant foods.
Early research suggests that tannins may be an effective treatment option for hemorrhoids. This is due to their anti-inflammatory, astringent, and vasoconstrictive effects.⁵
Probiotics are the healthy, live bacteria found in some foods and supplements. Prebiotics are the fiber that is consumed by probiotics.
Some research has suggested that prebiotic and probiotic supplements may help manage particular hemorrhoid systems, including constipation.⁶
Vitamin C is an antioxidant. Some research has found that vitamin C may help manage hemorrhoids by lowering the anal sphincter tone, which helps to reduce the pain caused by hemorrhoids.⁷
This benefit was revealed in a study where participants consumed a mix of flavonoids in combination with vitamin C and some other herbal substances.
It’s a good idea to limit eating foods that have little or no fiber.
Some of these foods include:
Dairy foods, such as cheese and ice cream
Fast food, pre-prepared foods, and processed foods
Chips and crackers
Alcohol and fatty foods may exacerbate constipation.
However, contrary to popular belief, it has been shown that spicy foods have no adverse effects on hemorrhoids.⁸
Not all hemorrhoids need to be treated. Often, they can be managed with dietary and lifestyle modifications. This is known as “conservative” treatment.
Hemorrhoid treatment can include:
In addition to using supplements, it’s recommended to eat a healthy diet.
It’s important to eat enough fiber. You can increase your fiber intake by eating fruits, vegetables, legumes, nuts, seeds, and whole grains. It’s recommended to get 25–35 grams of fiber each day.
It's also important to drink enough water.
As much as possible, you should avoid straining during bowel movements and sitting on the toilet for long periods.
Over-the-counter medications, such as aspirin or ibuprofen, can help reduce pain and manage the symptoms of hemorrhoids.
Creams or ointments, such as steroid creams, are available over the counter or by prescription. Creams may help reduce pain and itching caused by hemorrhoids.
Topical treatments containing steroids such as hydrocortisone shouldn’t be used for longer than a week.
A sitz bath involves taking a warm soak in shallow water up to the hips. This can reduce pain caused by hemorrhoids.
You should give yourself a sitz bath several times daily for the best results.
In rare cases, surgery may be needed.
Surgery can involve removing the hemorrhoids or using a stapling procedure to block the flow of blood to the hemorrhoid tissue.
Outpatient surgeries can also be performed. The preferred and most effective surgery is rubber band ligation. This involves placing a rubber band around the base of the hemorrhoids. The band cuts off the blood supply and leads to the swollen tissue falling off within a week.
Most dietary supplements can’t cure hemorrhoids but are used to manage symptoms such as swelling, pain, and itching. If you think you have hemorrhoids, it’s recommended to see your doctor so you can rule out other causes, receive an early diagnosis, and discuss whether dietary supplements may help you.
Anecdotal reports on the internet have suggested that fish oil may be good for piles (hemorrhoids), potentially due to omega-3s in fish oil. However, this has yet to be backed up by clinical research.
Citrus fruit contains several compounds that may help with hemorrhoids. These include Vitamin C and fiber.
Flavonoids are generally considered safe when used in a supplement form. Most common side effects are GI related, although agranulocytosis (extreme diminution in white blood cell count that can be fatal) has been reported.
Oral zinc supplements haven’t been studied as a treatment for hemorrhoids. However, zinc oxide cream and zinc oxide suppositories may help with managing the symptoms of hemorrhoids topically to help with pruritus and irritation.
Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the university of Gondar comprehensive specialized hospital, Northwest Ethiopia (2021)
Phlebotonics for haemorrhoids | Cochrane
Evaluation of the efficacy and safety of a compound of micronized flavonoids in combination with vitamin C and extracts of centella asiatica, vaccinium myrtillus, and vitis vinifera for the reduction of hemorrhoidal symptoms in patients with grade II and III hemorrhoidal disease: A retrospective real-life study (2021)
The nature of haemorrhoids (1975)
Eating, diet, & nutrition for hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)