Fiber supplementation helps to soften stool and reduce constipation, which can minimize irritation to the anal cushions and improve healing. A meta-analysis of controlled trials found that fiber supplementation, most often psyllium, reduced the risk of overall hemorrhoid symptoms by half and was particularly effective for reducing the risk of bleeding. However, it can take up to 6 weeks for these benefits to take effect. Once hemorrhoids have healed, fiber supplementation can be continued as a preventative measure.[1]
Bioflavonoid supplementation, particularly micronized purified flavonoid fraction (MPFF) containing 90% diosmin and 10% hesperidin, was assessed in two recent meta-analyses of controlled trials. One meta-analysis reported a reduction in bleeding, anal leakage, and overall symptoms, while the other only found an effect for reduced bleeding.[2][3] MPFF is thought to work by reducing vein inflammation and increasing vein tone (the tightness of the vein).[2] While these products are commonly used in other parts of the world, they are not currently approved by the U.S. Food and Drug Administration for hemorrhoid treatment.[4]