Ruscogenins are steroidal saponins found primarily in the roots of Ruscus aculeatus (butcher’s broom), a plant traditionally used for vascular health. Their use in treating hemorrhoids is supported by both traditional and scientific evidence, though the scientific validation is moderate rather than robust.

The rationale for using ruscogenins in hemorrhoid support stems from their pharmacological effects on the vascular system. In vitro and animal studies have shown that ruscogenins possess anti-inflammatory and vasoconstrictive properties, which can reduce vascular permeability and edema. These actions are believed to help alleviate symptoms such as swelling, discomfort, and bleeding associated with hemorrhoids, which involve inflamed and dilated anal veins.

Human clinical data are limited but promising. Several small-scale randomized controlled trials and observational studies have found that extracts of butcher’s broom (standardized to ruscogenin content) can reduce symptoms of chronic venous insufficiency and hemorrhoids, especially when used as part of combination therapies with hesperidin and vitamin C. These studies report improvements in pain, itching, and bleeding compared to placebo, with a favorable safety profile.

However, the quality and quantity of evidence are not strong enough for unequivocal endorsement by major clinical guidelines. Larger, high-quality trials are needed to confirm efficacy. Nonetheless, the use of ruscogenins for hemorrhoids is supported by plausible mechanisms and moderate clinical evidence.