Horse Chestnuts and Hemorrhoids Treatment

Horse chestnut (Aesculus hippocastanum) 'conker' and leaves, Ross-shire, Scotland
Iain Sarjeant / Getty Images

While hemorrhoids may be an embarrassing topic of conversation for many, the fact is, they are a normal anatomic structure found in everyone. Hemorrhoids are the veins found in the lower rectum near the anal region. According to the American College of Gastroenterology, over half of Americans will have experienced problematic hemorrhoids, also known as piles, by the age of 50. In addition, over 5 percent of the population have already sought help for this common problem – statistics that do not even include those who opt to self-treat without seeing a physician.

Hemorrhoids can be useful because they work like a shock absorber or cushion when using the restroom, but when they become swollen or filled with blood, they can cause symptoms. 

Types of Hemorrhoids

There are two types of hemorrhoids: internal and external. Internal hemorrhoids are located high enough in the rectum that they are not visible and usually do not cause any pain. When they cause symptoms, the most common may be bleeding that appears as bright red blood staining the toilet or found on toilet paper. Other symptoms may include itching and difficulty completing a bowel movement or cleaning yourself afterward. Occasionally, internal hemorrhoids may prolapse, or come out of the rectum. When this happens, they may be seen and can be painful.

External hemorrhoids are outside of the rectum and may appear as small, pink bumps that can become enlarged with blood. Sometimes external hemorrhoids are present but do not cause symptoms, but often they are symptomatic with the most common complaints including pain, pressure, bleeding, and itching.

It is not uncommon to have both internal and external hemorrhoids at the same time. 

Hemorrhoids are caused by: 

  • Constipation

  • Straining

  • Spending too much time sitting on the toilet

  • Heavy lifting

  • Pregnancy

  • Obesity

  • Inadequate fiber intake

Available Hemorrhoid Treatments

When symptoms suggesting possible hemorrhoids, such as rectal pain or bleeding, occur it is important to see your physician to confirm the diagnosis.

Currently, there are a variety of conservative strategies as well as non-invasive treatment options for problematic hemorrhoids, and typically most patients and physicians alike prefer to begin with the most conservative route. This may include simple steps such as increasing dietary fiber and water intake to help promote softer bowel movements that are easier to pass, which will decrease any constipation or straining that could be contributing to the hemorrhoids. 

Although there are many conservative treatment options available for problematic hemorrhoids, one often overlooked remedy is horse chestnut. This herbal supplement comes from a tree whose seed, bark, flowers, and leaves have been used for centuries for medicinal purposes. In fact, European doctors began using an extract formed from the seeds and leaves of horse chestnut as early as the 1800s to treat hemorrhoids as well as other disorders involving sluggish circulation.

Today, modern medicine has performed extensive research studies further supporting the use of horse chestnut as an effective treatment for chronic venous insufficiency, a condition where the veins are unable to effectively circulate blood flow. Some common types of venous insufficiency include varicose veins or problematic hemorrhoids.

Horse Chestnut and Relief

Horse chestnut is considered a triterpenoid saponin whose active ingredient is a substance called aescin. This substance works as a natural anti-inflammatory to support blood vessel tone by blocking the release of enzymes that contribute to venous insufficiency. Specifically, horse chestnut helps to seal up microscopic holes in these tiny vessels which lessen fluid retention, promotes elasticity and strengthens venous walls. In turn, this results in improved blood circulation which decreases the swelling and inflammation associated with problematic hemorrhoids.

Horse chestnut can be taken by mouth as well as used topically as a gel or cream to help relieve the swelling and inflammation of painful hemorrhoids.

For oral treatment, it is recommended to take horse chestnut products standardized to 50-75 mg of aescin per dose, with a recommended dose of 250 mg twice daily. Alternatively, topical gels or creams containing 2 percent aescin can be applied three to four times per day to the affected hemorrhoid.​

Dudek-Makuch M, Studzinska-Sroka E. Review Article: Horse chestnut & efficacy and safety in chronic venous insufficiency: an overview. Revista Brasileira de Farmacognosia, Volume 25, Issue 5, September-October 2015, pages 533-541. Accessed via Science Direct.