Medicinal Plants for Hemorrhoid Therapy: Mechanistic Insights, Bioactive Compounds, and Preclinical-to-Clinical Evidence

Hemorrhoid is a multifactorial condition involving inflammation, venous stasis, degeneration of supporting tissue, and vascular fragility. It requires safer adjunctive therapy options for long-term use. This narrative review seeks to comprehensively examine potential anti-hemorrhoidal medicinal plants by linking bioactive compounds, pharmacological targets, and evidence from in vitro , in vivo , and clinical trials. Literature searches were conducted using PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar, focusing on original research articles that documented anti-inflammatory, antioxidant, venoprotective-venotonic, hemostatic-astringent, analgesic, and wound healing activities. The articles were further synthesized qualitatively according to the pathophysiology of hemorrhoids. A total of 90 articles met the inclusion criteria and were classified based on the predominant mechanism, namely anti-inflammatory–antioxidant agents (14 plants; 41 articles), vasoprotective–venotonic agents (6 plants; 10 articles), astringent–hemostatic agents (6 plants; 14 articles), and analgesic and wound healing acceleration (7 plants; 25 articles). The findings showed that medicinal plants operate through a multitarget manner by suppressing inflammatory mediators, increasing endogenous antioxidant defenses, improving venous tone and microvascular stability, supporting local hemostasis, and accelerating mucosal regeneration. Nonetheless, the evidence remains predominantly derived from preclinical studies, with variations in extraction methods, formulations, routes of administration, and dosages. Overall, medicinal plants have potential as adjuvant therapy for hemorrhoids; nevertheless, standardization of extracts and controlled clinical trials are necessary to ensure efficacy and safety.