Q: Can horse chestnut extract help treat hemorrhoids?
A: It might be worth trying, especially since over-the-counter (OTC) drug treatments are of limited use. Horse chestnut (Aesculus hippocastanum) has long been used in Europe to treat various vein disorders of the legs. In Germany, the standardized extract is approved—and popular—for the treatment of varicose veins and hemorrhoids, which are basically a form of varicose veins that occurs in the rectum. The extract is taken orally or applied topically.
In the U.S., many herbal hemorrhoid remedies, such as Varicare, contain horse chestnut. The herb’s key ingredient appears to be aescin, which may reduce inflammation and the swelling of blood vessels. The antioxidants in the herb, it’s claimed, also play a beneficial role.
Despite its long history of use and the mostly positive studies focusing on other vein disorders, we could find only one well-designed study on the herb’s use for hemorrhoids—a 1976 Belgian study that found that it can reduce swelling and other symptoms.
One problem with herbal hemorrhoid remedies like this is that they often also contain other herbs and compounds, most of unknown usefulness. And as with all dietary supplements, you can’t be sure that the bottle or tube contains what’s listed on the label.
The extract appears to be safe, except for occasional minor reactions such as itching or stomach upset. People with kidney, liver or gastrointestinal problems should avoid it. Those taking anti-clotting medication should check with their doctors first. Don’t consume raw or unprocessed horse chestnut seeds, leaves, bark or flowers (or tea made from them), since they can be toxic.