Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Aescin (also spelled escin) is the main active compound in horse chestnut seed extract (Aesculus hippocastanum). Its use for hemorrhoids is supported by both traditional use in Europe and a growing body of scientific evidence. Aescin is known for its anti-inflammatory, vasoprotective, and venotonic properties. Several randomized controlled trials and systematic reviews have investigated the effects of aescin on chronic venous insufficiency (CVI), a condition with pathophysiological similarities to hemorrhoids, and found benefits in reducing edema, pain, and vascular permeability.

Regarding hemorrhoids specifically, aescin has demonstrated efficacy in reducing symptoms such as pain, swelling, and bleeding in several small clinical studies and open-label trials. These effects are likely due to its ability to strengthen capillary walls, reduce inflammation, and improve venous tone. A 2010 Cochrane review on horse chestnut seed extract concluded that it appeared to be efficacious and safe for short-term treatment of CVI, and some included studies mentioned hemorrhoids as an indication. However, the overall number of high-quality studies directly focusing on hemorrhoids is limited, and most evidence is extrapolated from its use in related venous disorders.

In summary, aescin’s use for hemorrhoids is justified by moderate scientific evidence, primarily from its established benefits in venous insufficiency and supportive but less robust data specifically on hemorrhoids. More large-scale, high-quality trials are needed to confirm its efficacy for this indication.

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