Bursitis

Aescin is the active triterpenoid saponin from horse chestnut (Aesculus hippocastanum) with well-documented venotonic, anti-inflammatory, and anti-edematous properties. A double-blind, placebo-controlled RCT in 72 hemorrhoid patients showed improvement in 82% of aescin-treated subjects versus 32% with placebo. Reviews confirm clinical efficacy comparable to synthetic flavonoid therapies for reducing perianal edema and venous congestion.

Alexandrian senna (Cassia acutifolia) is the pharmaceutical botanical source of sennosides, explicitly advocated by European Society of Coloproctology guidelines among natural therapies for hemorrhoid symptoms and bleeding. Its laxative sennosides reduce defecatory straining, addressing the principal mechanical cause of hemorrhoid exacerbation.

A placebo-controlled, double-blind trial in 80 patients with first- and second-degree hemorrhoids evaluated a topical combination preparation containing allantoin (with standardized leech extract and polidocanol). Both subjective and objective symptoms improved significantly faster under the active preparation versus placebo over one week, with histologically confirmed reduced inflammation.

Aloe Vera is widely used topically in gels, creams, and suppositories for hemorrhoids. A 2025 PMC comprehensive review reports that aloe preparations improve pain scores and healing time in combination with standard hemorrhoidal therapies, and lists aloe vera among botanical agents demonstrating anti-inflammatory, venotonic, and astringent effects addressing hemorrhoid symptoms.

Anthocyanosides are flavonoid pigments from bilberries and related berries with capillary-strengthening and venoprotective properties relevant to hemorrhoids. EBSCO Research Starters identifies bilberry anthocyanosides as a principal proposed natural treatment for hemorrhoids. A 2021 PMC retrospective study incorporating Vaccinium myrtillus extract (anthocyanosides) achieved 89.8% hemorrhoid grade reduction in grade II–III disease.

Asiaticoside is the principal triterpene glycoside of Centella asiatica used in hemorrhoid management. It promotes collagen synthesis, strengthens venous walls, and reduces capillary permeability. It is the key active component in Centella asiatica preparations evaluated in clinical trials showing 89.8% grade reduction in grade II–III hemorrhoidal disease.

Bioflavonoids as a class (principally diosmin, hesperidin, rutin, troxerutin, and quercetin) are among the most evidence-supported natural treatments for hemorrhoids. A 2006 British Journal of Surgery meta-analysis confirmed bioflavonoid phlebotonics significantly reduce hemorrhoidal bleeding, pain, and itching. The American Society of Colon and Rectal Surgeons includes flavonoids in its Clinical Practice Guidelines for hemorrhoid management.

Butcher's broom (Ruscus aculeatus) is recognized by the EMA as a traditional herbal medicinal product for symptomatic relief of hemorrhoid itching and burning. Clinical studies show reduction in edema, bleeding, and analgesic requirement with ruscogenin-based formulations. It activates alpha-adrenergic receptors to enhance vascular resistance and lymphatic drainage.

Centella triterpenes (asiaticoside, asiatic acid, madecassoside from Centella asiatica) have been evaluated in clinical trials for hemorrhoidal disease. A 2020 PMC RCT compared a Centella triterpene complex against flavonoids for hemorrhoid management, and a 2021 PMC retrospective study incorporating Centella asiatica extract achieved 89.8% hemorrhoid grade reduction in grade II–III patients (p<0.001).

Cissus quadrangularis is listed in the Thai National List of Herbal Products for the oral treatment of hemorrhoids and has been evaluated in a PMC clinical pilot study (n=105) and a comparative RCT versus MPFF. It exhibits analgesic, anti-inflammatory, and venotonic effects with a superior safety profile versus hydrocortisone/cinchocaine suppositories.

Diosmin is a flavonoid glycoside with the strongest clinical evidence base for hemorrhoid management, endorsed by multiple RCTs, meta-analyses, and professional guidelines including the American Society of Colon and Rectal Surgeons. A 2006 British Journal of Surgery meta-analysis confirmed phlebotonics including diosmin significantly reduce hemorrhoid bleeding (RR 0.33), pain (RR 0.35), and itching (RR 0.65).

Escin (variant spelling of aescin) is the principal saponin of horse chestnut used for hemorrhoids. A double-blind, placebo-controlled RCT in 72 patients showed 82% improvement with escin versus 32% with placebo. Reviews confirm venotonic and anti-inflammatory efficacy comparable to synthetic flavonoid therapies for hemorrhoidal disease.

Gotu Kola (Centella asiatica) contains triterpenes (asiaticoside, asiatic acid, madecassoside) that promote connective tissue repair and venous tone. A 2020 PMC RCT compared Centella asiatica extract versus flavonoids for hemorrhoidal disease, and a 2021 PMC retrospective study incorporating 300 mg Centella asiatica extract achieved 89.8% hemorrhoid grade reduction in 49 patients (p<0.001).

Hesperidin is a flavanone glycoside that is the key co-component of MPFF (micronized purified flavonoid fraction) with diosmin, supported by meta-analyses and multiple RCTs for hemorrhoidal disease. A 2021 PMC retrospective study using a hesperidin-containing compound achieved 89.8% grade reduction in hemorrhoid severity (p<0.001) in 49 patients.

Horse chestnut seed extract (standardized to aescin/escin) is one of the best-studied natural treatments for hemorrhoids, with a double-blind RCT showing 82% improvement versus 32% placebo and reviews confirming efficacy comparable to synthetic flavonoid therapies. The 2025 PMC Cureus comprehensive review lists it among botanicals with demonstrated beneficial effects on hemorrhoid pain, bleeding, and swelling.

Clinical studies including RCTs have documented Pycnogenol's efficacy in reducing acute hemorrhoidal episodes and postpartum hemorrhoid symptoms. The mechanism relates to venous tone improvement, anti-inflammatory action, and strengthening of capillary walls. Studies by Belcaro et al. are cited as primary evidence.

Psyllium husk (Plantago ovata) is clinically documented to reduce hemorrhoid-related symptoms by softening stool, reducing straining, and increasing anal resting pressure. It is listed by multiple reviews and the PMC 2024 publication among conditions where psyllium provides measurable clinical benefit.

Psyllium (Plantago ovata husk) has documented clinical benefits for hemorrhoids, listed alongside constipation, IBS, and diarrhea in a 2024 PMC systematic review of clinical evidence. By softening stools and reducing straining, psyllium fiber directly reduces hemorrhoidal irritation and recurrence. Traditional use of P. major for hemorrhoids is also documented.

Psyllium is the most well-studied fiber supplement for hemorrhoids and is endorsed by European Society of Coloproctology guidelines. A 2006 systematic review and meta-analysis in the American Journal of Gastroenterology showed fiber supplementation (psyllium being the most studied form) reduced risk of persistent hemorrhoid symptoms by approximately 47% and hemorrhoidal bleeding by approximately 50%.

Quercetin is a flavonol included in evidence-based multi-flavonoid combinations for hemorrhoidal disease. A 2018 double-blind multicenter RCT (n=154) using a flavonoid mixture including quercetin showed safe and effective reduction in hemorrhoidal bleeding. A 2021 PMC retrospective study incorporating quercetin 140 mg/day achieved 89.8% hemorrhoid grade reduction in grade II–III disease.

Ruscogenins are the active steroidal saponins from Ruscus aculeatus (butcher's broom), with a long history of use specifically for hemorrhoids and varicose veins recognized by the EMA. They reduce capillary permeability via anti-elastase activity and exert vasoconstrictive effects through alpha-adrenergic mechanisms, supported by in vitro, animal, and clinical studies.

Rutin, a bioflavonoid glycoside with antioxidant and capillary-strengthening properties, has been studied in multiple clinical trials for hemorrhoidal disease. A 2018 double-blind multicenter RCT (n=154) confirmed that a flavonoid mixture including rutin, diosmin, troxerutin, hesperidin, and quercetin safely and effectively reduced grades I–III hemorrhoidal bleeding.

Senna is a stimulant laxative endorsed by the European Society of Coloproctology guidelines as a natural therapy for hemorrhoid symptoms and bleeding. By softening stools and reducing defecatory straining—a principal mechanical cause of hemorrhoids—senna addresses key pathophysiological triggers. It is included in the 2024 Molecules PMC review of natural products for hemorrhoid management.

Sophora japonica is one of the most historically documented remedies for hemorrhoids in TCM, listed in both the Chinese Pharmacopoeia and European Pharmacopoeia for this use. Its rutin content strengthens capillary walls and reduces venous inflammation. Hydroxyethylrutosides—semisynthetic derivatives of rutin originally sourced from S. japonica—have demonstrated clinical benefit in venous disorders including hemorrhoids.

Troxerutin (hydroxyethylrutoside) is listed among hemorrhoid medications with established clinical evidence of effectiveness in a 2024 Molecules PMC review, and appeared in the 2006 British Journal of Surgery meta-analysis of phlebotonics for hemorrhoidal disease. A PubMed-listed clinical study on troxerutin specifically for hemorrhoids and post-hemorrhoidectomy RCTs further support its use.

Witch hazel (Hamamelis virginiana) is listed in the FDA OTC anorectal drug products monograph as a recognized active ingredient for hemorrhoidal symptom relief. Its astringent tannins constrict blood vessels, reduce local inflammation, and alleviate minor bleeding and irritation. It is also recognized by the EMA and EBSCO among evidence-supported natural treatments for hemorrhoids.

Agrimony is traditionally used as an external compress to relieve haemorrhoids, with cooled agrimony infusions applied via cloth to reduce swelling and improve local circulation. This use appears in European herbal traditions and is described in folk medicine references. No clinical trial data exist.

Hemorrhoids ('piles') are explicitly listed as a traditional indication of ajwain in Ayurvedic and Unani medicine. Its carminative, antispasmodic, and anti-inflammatory properties are invoked. No clinical evidence exists; the relationship is documented in traditional ethnopharmacological sources.

Barberry has traditional use for hemorrhoids, attributed to its effects on hepatic portal vein congestion and its vascular-toning properties. European and Persian herbal medicine traditions connect barberry's liver and vascular effects to relief of hemorrhoidal conditions.

External application of a bayberry decoction or tincture is a documented traditional remedy for hemorrhoids. The astringent tannins are proposed to reduce swelling and inflammation of hemorrhoidal tissue. This use is recorded in multiple herbal references and folk medicine texts.

Belleric myrobalan fruit pulp is documented in Ayurvedic texts and ethnobotanical records as a traditional remedy for piles (hemorrhoids). The astringent action of tannins is thought to reduce venous engorgement and inflammation of hemorrhoidal tissue. References appear consistently across Ayurveda, Unani, and traditional medicine sources from South Asia.

Bilberry (Vaccinium myrtillus) has a long history of traditional use in European herbal medicine for vascular conditions including hemorrhoids. Rich in anthocyanins, it is listed by EBSCO Research Starters as a principal proposed natural treatment for hemorrhoids. It was incorporated in a 2021 PMC retrospective study compound that achieved 89.8% grade reduction in hemorrhoid severity.

Walnut leaves (Juglans regia, pharmacopoeially related) are officially recognized by ESCOP for hemorrhoidal symptomatology due to their astringent tannins. Black walnut hull shares this tannin-rich profile and is used similarly in traditional herbalism for hemorrhoids and venous insufficiency.

Blackberry root and leaves have been applied topically as astringent washes for hemorrhoid discomfort in Cherokee and European folk medicine traditions. The tannin content is considered to reduce local inflammation and swelling. A Modern Herbal (Gerard) specifically notes blackberry leaves as 'a most useful application for piles.'

Ayurvedic texts list Boswellia (Shallaki) as indicated for Arsha (hemorrhoids). The anti-inflammatory and astringent properties of the resin support this traditional use, but no human clinical trials have evaluated Boswellia specifically for hemorrhoids.

Buckthorn bark has a long documented traditional use for hemorrhoids, primarily by softening stool and reducing straining. The German Commission E and ESCOP monographs identify constipation associated with hemorrhoids as an indication for buckthorn. The mechanism is indirect: by promoting softer, easier-to-pass stools, pressure on the anorectal venous plexus is reduced. No controlled clinical trials specifically targeting hemorrhoid outcomes have been conducted.

In TCM, B. falcatum's 'lifting action' (raising Spleen Qi) is traditionally used in formulas for hemorrhoids and prolapse, specifically in the formula Bu Zhong Yi Qi Tang. This is well-documented traditional use; no clinical scientific evidence for hemorrhoid treatment with B. falcatum has been identified.

Calendula (Calendula officinalis) is used topically for hemorrhoids based on its anti-inflammatory, wound-healing, and astringent properties. A 2025 PMC review lists it among botanical agents with demonstrated effects on hemorrhoid symptoms, and a PMC observational study confirmed improved QoL with a rectal product containing calendula, witch hazel, and chamomile.

Capsicum has a traditional history of use for hemorrhoids, attributed to its circulatory stimulant properties and local counterirritant effects. Capsaicin is listed among traditional applications in the ethnobotanical and medical literature, though controlled clinical trial evidence specifically for hemorrhoids is lacking.

Cascara sagrada has been used traditionally to relieve the constipation and straining that precipitate and worsen hemorrhoids. By softening stool and accelerating transit, it reduces the anorectal pressure associated with hemorrhoidal flare-ups. A 19th-century physician's case series (published in the British Medical Journal, 1884) described its use specifically for hemorrhoid management. No modern RCTs evaluate cascara directly for hemorrhoid outcomes.

Cat's claw is listed in traditional and ethnobotanical sources as a remedy for hemorrhoids, attributed to its anti-inflammatory properties. RxList and other referenced sources include hemorrhoids among the digestive conditions for which cat's claw is traditionally used. No clinical trials for this indication exist.

Chaff flower is documented in Ayurveda, Siddha, and other traditional systems for the management of hemorrhoids (piles). The astringent and anti-inflammatory properties of the plant are traditionally cited as the basis. No controlled clinical data exist.

Chamomile (Matricaria chamomilla) is used as warm sitz baths, compresses, and in topical hemorrhoid products for its anti-inflammatory, antioxidant, and soothing properties. A 2025 PMC comprehensive review reports evidence of reduced inflammation and faster resolution of itching and irritation. A PMC observational study confirmed improved QoL with a rectal product containing chamomile.

Collinsonia (stone root, Collinsonia canadensis) is listed by EBSCO Research Starters as a proposed natural treatment for hemorrhoids. It has been used in 19th-century North American eclectic medicine specifically for hemorrhoids and rectal venous congestion. No controlled clinical trials have been identified; use is entirely traditional.

Geranium has a documented traditional use for hemorrhoids (piles) across multiple herbal medicine traditions. Its hemostatic, astringent, and anti-inflammatory properties provide mechanistic support. No human clinical trials for this indication have been identified.

Goldenrod is listed in traditional herbal medicine texts for hemorrhoids, including the Commission E monographs and A.D.A.M. health database. Astringent tannins and anti-inflammatory flavonoids, especially rutin (which supports venous endothelial integrity), provide pharmacological rationale. No clinical trials on goldenrod for hemorrhoids have been published.

Goldenseal is traditionally used topically and internally for hemorrhoids, attributed to its astringent and anti-inflammatory properties. The USPTO patent review of goldenseal traditional uses specifically cites hemorrhoids, and the herb has been used to treat a variety of hemorrhagic disorders in herbal tradition.

In Ayurveda, guggul-based formulations — particularly Triphala Guggulu — are among the primary treatments for hemorrhoids (Arsha). The anti-inflammatory, astringent, and venotonic properties of guggul are invoked for this indication. No standalone clinical trials for guggul in hemorrhoids have been published.

Gymnema sylvestre is documented in classical Ayurvedic texts as a traditional treatment for hemorrhoids (piles), with multiple authoritative reviews corroborating this traditional indication. No human clinical or preclinical experimental data specifically for hemorrhoids exist.

Classical Ayurvedic texts, including those attributed to Vagabhatta, identify kutaj as a primary herb for bleeding piles (hemorrhoids). The bark and seeds are described as arshoghna (destroys hemorrhoids) and anti-hemorrhagic. Preclinical studies cite anti-haemorrhoidal activity among documented pharmacological properties.

Traditional medicine practitioners in Indonesia, China, Pakistan, and Cameroon use leaves, seeds, flowers, and roots of Impatiens balsamina to treat hemorrhoids. This is recorded in multiple ethnobotanical reviews but has not been evaluated in clinical trials.

Acacia nilotica has traditional use for hemorrhoids documented in multiple ethnobotanical surveys. Tannins with anti-hemorrhagic and astringent properties provide a pharmacological rationale. The Biochemistry review of A. nilotica lists hemorrhoids among treated conditions.

Adhatoda vasica is documented in Ayurveda and Unani for bleeding hemorrhoids, a use repeated consistently across multiple ethnopharmacological reviews. The hemostatic and anti-inflammatory properties of the plant provide mechanistic support.

Mango bark and skin are used in Ayurvedic medicine for hemorrhoids, attributed to their strong astringent (Kashaya) properties, which tone and tighten vascular tissues. Bark decoctions are documented as being used traditionally in India for hemorrhoids and other conditions involving tissue laxity.

Momordica charantia is documented in traditional African and Asian folk medicine as a remedy for hemorrhoids (piles). Multiple ethnopharmacological databases include hemorrhoids among its traditional uses. No human clinical evidence exists.

Traditional herbal literature records mullein leaf poultices as a topical remedy for hemorrhoids, attributed to astringent tannins and anti-inflammatory mucilage. This use is documented across Turkish, Spanish, and early American folk medicine. No clinical studies exist.

TC is specifically cited in Ayurvedic Materia Medica as useful for hemorrhoids (piles), including bleeding piles, based on its astringent properties that reduce mucosal hemorrhage and tissue inflammation. Folk medicine use across South Asia is consistently documented.

Nattokinase is listed among traditional uses of natto for circulatory conditions including hemorrhoids, based on the rationale that hemorrhoids involve local venous congestion and fibrin deposition akin to thrombotic conditions. No controlled human clinical trials specifically targeting hemorrhoids have been identified in the peer-reviewed literature. The association rests on documented traditional and folk use of natto in Japan and the theoretical fibrinolytic mechanism.

The Indian Journal of Dermatology review documents hemorrhoids among the traditional indications for neem in South Asian folk medicine. The anti-inflammatory and astringent properties of neem bark tannins provide mechanistic plausibility. Human clinical studies for this indication are absent.

Nopal flowers have documented traditional use as an oral anti-hemorrhoid medication in sub-Saharan traditional medicine. No human clinical trial evidence for nopal in hemorrhoid treatment has been identified. The anti-inflammatory and fiber-normalizing properties of nopal provide biological plausibility.

Oligomeric proanthocyanidins (OPCs) from grape seed and pine bark are listed by EBSCO Research Starters as proposed natural treatments for hemorrhoids. A 2021 PMC retrospective study incorporating Vitis vinifera extract (OPCs) in a multi-ingredient phlebotonic achieved 89.8% hemorrhoid grade reduction in grade II–III patients. Mechanistic evidence supports capillary-stabilizing and anti-inflammatory effects relevant to hemorrhoidal disease.

Oriental arborvitae is documented in NLM/WebMD databases as a traditional treatment for hemorrhoids. Its hemostatic properties—recognized in the Chinese Pharmacopoeia—provide the primary rationale, as hemorrhoidal bleeding is one of the bleeding conditions the plant is traditionally used to address.

P. foetida has been used in folk medicine for piles (hemorrhoids) across South and Southeast Asia, including Bangladesh, India, and in Chinese traditional medicine. Roots and barks are specifically cited for this use. The plant's anti-inflammatory and astringent properties provide mechanistic rationale.

Pineapple/bromelain is included in traditional formulas for hemorrhoids due to its fibrinolytic, anti-edematous, and phlebotonic properties. It has been used as a venous and lymphatic decongestant. Formal clinical trials dedicated to hemorrhoids are lacking.

Traditional use of prickly pear flowers as an oral anti-hemorrhoid medication is specifically documented in sub-Saharan African pharmacopeia. The plant's anti-inflammatory and mucosal-protective properties are mechanistically relevant. No clinical trial evidence has been published.

Proanthocyanidins (oligomeric proanthocyanidins, OPCs) from grape seed and pine bark are proposed natural treatments for hemorrhoids based on their capillary-stabilizing and anti-inflammatory properties. EBSCO Research Starters lists oligomeric proanthocyanidins among proposed natural treatments for hemorrhoids. Evidence is primarily mechanistic and indirect via chronic venous insufficiency studies.

Constipation is a primary driver of hemorrhoid development; prunes' well-documented laxative action (softening stool, reducing straining) makes them a traditional and logically supported remedy for hemorrhoid prevention and management. No clinical trials have directly studied prunes specifically for hemorrhoid outcomes, but the constipation link is scientifically established.

Radish has been used in Ayurvedic and folk medicine traditions for hemorrhoids, attributed to its bile-stimulating and gentle laxative properties that reduce straining at stool. TCM similarly uses radish for intestinal Qi stagnation associated with hemorrhoidal conditions. No clinical evidence supports this use.

Rhubarb root is traditionally used for hemorrhoids in both TCM and Western herbalism, primarily by softening stool to reduce straining and by topical astringent action. It is listed for this use by major reference sources including RxList, though specific RCTs targeting hemorrhoids are lacking.

Topical use of figwort/Scrophularia root for hemorrhoids is one of the plant's best-attested European folk applications, so prominent that the common name 'figwort' derives from an old term for hemorrhoids. Medieval and Renaissance herbalists applied poultices of the root directly to hemorrhoids. No modern clinical trials have assessed this use.

Herbalists have traditionally recommended sheep's sorrel for hemorrhoids, likely due to its astringent properties which may help tone inflamed venous tissue. This is documented in folk herbal practice but unsupported by any clinical evidence.

Shepherd's purse is traditionally used both internally and topically for hemorrhoids, exploiting its astringent, hemostatic, and venous-toning properties. Historical sources including the King's American Dispensatory document its use for 'bleeding piles.' Its capacity to support venous integrity and reduce local bleeding underpins this application.

Slippery elm is listed across multiple traditional and herbal pharmacopoeial references as a remedy for hemorrhoids, used both orally and topically. Its mucilage is thought to soothe anorectal mucosa and soften stool, reducing straining. No clinical trials specifically evaluate this use.

Slippery elm bark is listed in multiple traditional medicine references for hemorrhoid relief, both orally and topically. The mucilage softens stool to reduce straining, and topical preparations may soothe inflamed anorectal tissue. No clinical trials specific to hemorrhoids have been conducted.

Hemorrhoids represent one of the oldest and most geographically widespread traditional indications for smartweed, documented across Asian and European folk medicine. The plant's astringent, styptic, and rutin-mediated capillary-strengthening properties provide a plausible mechanistic basis.

European folk medicine records the use of snapdragon poultices and infusions to treat hemorrhoids, attributed to the plant's mild astringent and anti-inflammatory effects. The traditional use is documented in multiple herbalism and pharmacological review sources. The 2018 in vivo wound-healing study specifically cited hemorrhoids as part of the traditional context motivating the research.

Solomon's seal is documented for topical and internal use in hemorrhoids by European herbalists from Gerard onward, and in eclectic medical texts. Drugs.com confirms topical application for hemorrhoids. The astringent, anti-inflammatory, and demulcent properties of the rhizome underpin this traditional use.

Hemorrhoids are among the conditions listed in Ayurvedic texts for S. indicus (Gorakhmundi). Traditional use is well-documented though no clinical evidence exists.

Squawvine is listed in folk medicine references as a remedy for hemorrhoids, consistent with its documented astringent and anti-inflammatory properties from tannin-rich constituents. Traditional herbal practice also combined it with witch hazel for bleeding piles. No clinical evidence exists.

SJW oil has been used topically for hemorrhoids in European and Turkish folk medicine to ease itching, burning, and discomfort. Its anti-inflammatory and antimicrobial properties provide pharmacological plausibility. No controlled clinical trials for this specific indication have been conducted.

Stillingia's root has been documented in traditional medicine texts and Eclectic pharmacopeias as a remedy for hemorrhoids. It appears alongside bronchitis and constipation in MSKCC's herb monograph. No human clinical evidence supports this use.

Charaka Samhita classifies Vacha as arsoghna (anti-hemorrhoidal), making this among the most formally documented traditional indications in Ayurvedic pharmacopoeia. Its use for hemorrhoids appears in Ayurvedic texts spanning millennia. No clinical trial data exist.

T. chebula (haritaki) is one of the most consistently cited Ayurvedic remedies for hemorrhoids ('arsha'). Traditional texts and the Ayurvedic Pharmacopoeia of India document its use for bleeding piles. Its astringent tannins are considered to reduce bleeding and shrink hemorrhoidal tissue. No dedicated clinical RCTs were identified.

Triphala is a classical Ayurvedic polyherbal formula (Terminalia chebula, Terminalia bellirica, Phyllanthus emblica) used for at least 2,000 years in Indian medicine for hemorrhoids. A 2025 PMC comprehensive review (Cureus) confirms Triphala demonstrates beneficial effects on hemorrhoid pain, bleeding, and swelling, and Triphala Guggulu is a recognized Ayurvedic hemorrhoid formulation.

White oak bark has well-documented traditional use for hemorrhoids, used topically as a sitz bath, compress, or enema to tighten engorged venous tissue and reduce bleeding. Germany's Commission E approves this topical indication. Limited exploratory studies suggest reduced pain and inflammation, but no rigorous clinical trials have been completed.

Yarrow is used traditionally for hemorrhoids in West Azerbaijani, Persian, and European folk medicine. Its astringent, anti-inflammatory, and hemostatic properties provide a pharmacological rationale, and it appears alongside hemorrhoids in traditional indication lists in the published literature.