Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Citrus spp., particularly extracts from the peels and fruits of species like Citrus sinensis (sweet orange), have a longstanding traditional use in the management of hemorrhoids, especially in the form of flavonoid-rich preparations. In traditional and folk medicine, citrus-derived bioflavonoids—mainly diosmin and hesperidin—are used to improve venous tone, reduce capillary permeability, and decrease inflammation, all of which are thought to be beneficial in hemorrhoidal disease. Preparations such as micronized purified flavonoid fraction (MPFF), containing diosmin and hesperidin often sourced from citrus, are widely used in Europe and other regions as venoactive drugs for hemorrhoids and chronic venous insufficiency. Traditional texts support their use for symptoms like bleeding, swelling, and pain associated with hemorrhoids.

While there are some clinical studies and meta-analyses suggesting benefit from flavonoid mixtures in reducing hemorrhoidal symptoms and recurrence, the direct use of whole Citrus spp. (as opposed to isolated flavonoids) is less well-studied. The bulk of scientific evidence focuses on specific purified flavonoids rather than the fruit or plant itself. Thus, the rating of evidence is moderate (2/5), reflecting a blend of tradition and some scientific support, but not strong, consistent clinical trial evidence for the use of whole Citrus spp. in hemorrhoid treatment.

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