{ "slug": "magnesium-hemorrhoid", "question": "Does magnesium help hemorrhoids?", "shortTitle": "Magnesium for Hemorrhoids", "clinicalQuestion": "In adults with symptomatic internal or external hemorrhoids, does oral magnesium supplementation or topical magnesium sulfate (Epsom salt) soaking reduce symptom severity (pain, itching, bleeding) or speed healing compared with no treatment or usual care?", "pico": { "population": "Adults with symptomatic hemorrhoids (internal or external)", "intervention": "Oral magnesium supplementation or topical magnesium sulfate (Epsom salt) soaks/baths", "comparator": "No treatment, placebo, or usual care (e.g., fiber and sitz baths without magnesium)", "outcomes": [ "Hemorrhoid symptom score (pain, itching, swelling)", "Rectal bleeding frequency or amount", "Time to symptom resolution or lesion healing", "Stool straining or constipation measures", "Recurrence at follow-up (e.g., 3-12 months)", "Adverse effects (diarrhea, skin irritation)" ] }, "category": "anorectal", "relatedConditions": [ "hemorrhoids", "constipation", "anal-fissure" ], "relatedTreatments": [], "relatedEvidence": [], "bottomLine": { "verdict": "No study has isolated whether magnesium itself — taken by mouth or soaked on as Epsom salt — reduces hemorrhoid pain, swelling, or bleeding.", "detail": "In the six studies found, magnesium sulfate (or a related magnesium salt) always appears mixed with something else, so its own effect can't be separated out: it was one ingredient in a control ointment combined with another treatment in one study, part of the standard background care given to both treatment groups in another, and one ingredient in an uncontrolled multi-ingredient gel in a third. The remaining studies looked at magnesium content in herbs, camel urine, or a mineral compound without testing any treatment on hemorrhoid patients at all. Because none of these designs can tell magnesium's own contribution apart from the other treatment it was combined or compared with, this specific question remains unanswered by current evidence.", "studyIds": [ "pmid:41357914", "pmid:38239194", "pmid:38027399", "pmid:19452098", "pmid:19339231", "pmid:12368938" ] }, "strength": { "level": "very-low", "why": "The 3 human studies found measure a related question rather than this one, so they can only be read indirectly.", "override": null }, "direction": { "level": "not-studied", "why": "No study has measured this outcome in people with this condition.", "override": null }, "counts": { "recordsRetrieved": 18, "recordsScreened": 18, "included": 6, "rcts": 0, "systematicReviews": 0, "observational": 2, "participants": 387, "yearFrom": 2002, "yearTo": 2025, "registeredTrialsWithoutResults": 0 }, "excluded": [], "outcomes": [ { "name": "Hemorrhoid symptom score (pain, itching, swelling)", "status": "insufficient", "note": "One study compared a magnesium sulfate compress with a different herbal sitz-bath treatment and found the magnesium group had more swelling and lower comfort scores at 14 days — but this compares two treatments against each other, not magnesium versus no treatment. Another study used magnesium sulfate paste only as part of the standard care given to every patient, so its own contribution can't be seen.", "studyIds": [ "pmid:41357914", "pmid:12368938" ] }, { "name": "Rectal bleeding frequency or amount", "status": "not-studied", "note": "None of the studies found measured bleeding as an outcome.", "studyIds": [] }, { "name": "Time to symptom resolution or lesion healing", "status": "insufficient", "note": "A small case series of 30 post-surgery patients reported normal wound healing with a gel containing magnesium biphosphate alongside other active ingredients, but there was no comparison group, so healing can't be credited to the magnesium.", "studyIds": [ "pmid:19452098" ] }, { "name": "Stool straining or constipation measures", "status": "not-studied", "note": "No study isolated magnesium's effect on straining or constipation. The only mention of 'easier defecation' comes from a study where magnesium sulfate paste was combined with glycerin and other conventional treatments, so its individual contribution cannot be determined.", "studyIds": [ "pmid:12368938" ] }, { "name": "Recurrence at follow-up (e.g., 3-12 months)", "status": "not-studied", "note": "No study followed participants long enough to report whether hemorrhoids came back.", "studyIds": [] }, { "name": "Adverse effects (diarrhea, skin irritation)", "status": "insufficient", "note": "Two small studies reported no meaningful irritation or toxicity with magnesium-containing topical products, but magnesium was combined with other ingredients in both, so safety can't be credited to magnesium alone.", "studyIds": [ "pmid:41357914", "pmid:19452098" ] } ], "benefits": [], "limitations": [ { "text": "None of the 6 studies randomly assigned people to treatment. They include retrospective comparisons between groups (not random assignment), an uncontrolled case series, laboratory analyses of herbs and animal urine, and narrative reviews — all more prone to bias than a randomised trial.", "studyIds": [ "pmid:41357914", "pmid:38239194", "pmid:38027399", "pmid:19452098", "pmid:19339231", "pmid:12368938" ] }, { "text": "Wherever magnesium sulfate appears, it is combined with something else: in one study it was one part of a wet compress paired with a separate ointment in only one of the two groups; in another it was one ingredient in a multi-component gel with no comparison group at all; and in a third it was part of the standard background care given alongside the treatment being tested, not the treatment itself. In none of these studies can magnesium's own effect be separated from the other treatments around it.", "studyIds": [ "pmid:41357914", "pmid:19452098", "pmid:12368938" ] }, { "text": "Two of the six records are not clinical studies of people with hemorrhoids at all — one analyses mineral content of herbs, the other analyses camel urine composition — and neither reports a treatment outcome.", "studyIds": [ "pmid:38027399", "pmid:19339231" ] }, { "text": "One review mentions hemorrhoids only as one of many conditions mirabilite has historically been used for, without describing any specific trial, sample size, or outcome measure.", "studyIds": [ "pmid:38239194" ] }, { "text": "Sample sizes are small (30 to 268 people). The studies that reported a timeframe followed people for only 10 to 14 days, too short to know whether hemorrhoid symptoms returned afterward.", "studyIds": [ "pmid:41357914", "pmid:19452098", "pmid:12368938" ] } ], "risks": [ { "text": "Adverse reactions were measured in this study comparing a magnesium sulfate compress with a comparison herbal bath treatment, but the abstract does not report the actual results, so whether one caused more or fewer side effects is unclear.", "studyIds": [ "pmid:41357914" ], "severity": "minor" }, { "text": "A topical gel containing magnesium biphosphate, combined with other ingredients, caused no reported irritation or toxicity in a small group of post-surgery patients.", "studyIds": [ "pmid:19452098" ], "severity": "minor" } ], "whyPeopleTryIt": [ { "text": "Warm Epsom salt soaks (sitz baths) feel immediately soothing on irritated skin, even if they aren't treating the hemorrhoid itself." }, { "text": "Magnesium sulfate and similar mineral salts have a long history of use in folk and traditional medicine for swelling and skin complaints." }, { "text": "Epsom salt is cheap, available without a prescription, and easy to try at home." }, { "text": "Magnesium is sometimes promoted as an anti-inflammatory or muscle-relaxing mineral, which sounds like it should help a swollen, painful area." } ], "keyStudies": [ "pmid:41357914", "pmid:12368938", "pmid:19452098", "pmid:38239194", "pmid:19339231", "pmid:38027399" ], "studies": [ { "id": "pmid:41357914", "pmid": "41357914", "doi": "10.5498/wjp.v15.i12.111180", "nctId": null, "pmcid": "PMC12679078", "title": "Effects of Tongyangxiao lotion bidet therapy combined with Ziyu ointment on postpartum hemorrhoidal pain, oedema, anxiety, and depression", "firstAuthor": "Wang", "multipleAuthors": true, "journal": "World J Psychiatry", "year": 2025, "design": "retrospective", "n": 268, "nField": "reported", "population": "women with hemorrhoids after childbirth", "intervention": "magnesium sulfate wet compress combined with Ziyu ointment", "comparator": "Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment", "primaryOutcome": "hemorrhoid pain, swelling, comfort, and psychological state after treatment", "result": "Hemorrhoid diameter and edema were significantly smaller, and comfort scores higher, in the Tongyangxiao group than in the magnesium sulfate group at 14 days, with no significant difference in adverse reactions.", "resultDirection": "no-benefit", "quality": "low", "qualityWhy": "This is a retrospective, non-randomized study in a specific postpartum population where magnesium was only used as part of a comparator treatment, not tested alone.", "directness": "indirect", "limitations": "Retrospective design without randomization, magnesium sulfate used only as a comparator combined with another ointment, and population limited to postpartum women.", "followUp": "14 days", "plainFinding": "Less effective than alternative herbal treatment.", "retracted": false, "expressionOfConcern": false, "hasErratum": false, "url": "https://pubmed.ncbi.nlm.nih.gov/41357914/", "sourceText": "BACKGROUND: Postpartum hemorrhoids are common complications in women after childbirth, with an incidence rate of 37.9%. Progesterone levels increase during pregnancy, which can lead to constipation. Abdominal pressure surges sharply during delivery, which can block the venous return of the rectum and result in hemorrhoids, pain, and edema. Tongyangxiao lotion and Ziyu ointment, traditional Chinese medicinal preparations, have the efficacy of subduing swelling, relieving itching, and promoting healing; however, their combined application in treating postpartum hemorrhoids is less studied. AIM: To investigate effects of Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment on postpartum hemorrhoidal pain, edema, anxiety, and depression. METHODS: A retrospective analysis was conducted at Hebei Hospital of Traditional Chinese Medicine on 268 patients with hemorrhoids (September 2023 to February 2025). They were divided according to treatment method into control (wet compress with magnesium sulfate + Ziyu ointment) and observation (Tongyangxiao lotion sitz bath therapy + Ziyu ointment) groups (n = 134 in each group). Degree of pain, comfort level, compliance behavior with medical care, psychological state, therapeutic effect, hemorrhoid edema score, incidence of adverse reactions, and hemorrhoid diameter were compared. RESULTS: No statistically significant difference was observed in the diameter of the hemorrhoids or edema between the two groups before treatment. Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment. No statistically significant difference was observed in the scores of the General Comfort Questionnaire (GCQ) dimensions and participants' compliance before treatment. All GCQ dimension scores were significantly higher in the observation group than those in the control group 7 and 14 days post treatment. The compliance rate was significantly higher in the observation group than that of the control group. No statistically significant difference was observed in the incidence of adverse reactions between the two groups (P > 0.05). CONCLUSION: Tongyangxiao lotion combined with Ziyu ointment can improve patients' surface edema, postpartum hemorrhoid pain, treatment adherence, and comfort, reducing negative emotions. This is relatively safe and worthy of clinical promotion.", "provenance": [ { "field": "n", "quote": "n = 134 in each group" }, { "field": "population", "quote": "patients with hemorrhoids" }, { "field": "intervention", "quote": "control (wet compress with magnesium sulfate + Ziyu ointment)" }, { "field": "comparator", "quote": "observation (Tongyangxiao lotion sitz bath therapy + Ziyu ointment) groups" }, { "field": "primaryOutcome", "quote": "Degree of pain, comfort level, compliance behavior with medical care, psychological state, therapeutic effect, hemorrhoid edema score, incidence of adverse reactions, and hemorrhoid diameter were compared." }, { "field": "result", "quote": "Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment." } ] }, { "id": "pmid:38239194", "pmid": "38239194", "doi": "10.3389/fphar.2023.1293097", "nctId": null, "pmcid": "PMC10794775", "title": "The application of mirabilite in traditional Chinese medicine and its chemical constituents, processing methods, pharmacology, toxicology and clinical research", "firstAuthor": "Tao", "multipleAuthors": true, "journal": "Front Pharmacol", "year": 2023, "design": "narrative-review", "n": null, "nField": "not-reported", "population": "people with various conditions treated in traditional Chinese medicine, including hemorrhoids", "intervention": "mirabilite (a mineral mainly composed of sodium sulfate, with small amounts of magnesium sulfate and other salts)", "comparator": "", "primaryOutcome": "not a specific outcome; review of chemical composition, pharmacology, toxicology and clinical use of mirabilite", "result": "the abstract states mirabilite has been widely used in the clinical treatment of inflammation, edema, wound healing, digestive system diseases, infusion extravasation, hemorrhoids, skin diseases and other conditions, but no specific trial data or outcome measures for hemorrhoids are given", "resultDirection": "unclear", "quality": "very-low", "qualityWhy": "this is a narrative review summarizing traditional uses and pharmacology rather than reporting original clinical trial data on hemorrhoids outcomes", "directness": "indirect", "limitations": "abstract does not describe study design, sample size, or specific outcome data for hemorrhoids; mirabilite is mostly sodium sulfate, with magnesium sulfate only a minor component", "followUp": "", "plainFinding": "No specific evidence reported for hemorrhoids.", "retracted": false, "expressionOfConcern": false, "hasErratum": true, "url": "https://pubmed.ncbi.nlm.nih.gov/38239194/", "sourceText": "Purpose: This study reviews the use of mirabilite in traditional Chinese medicine and various preparations by describing its chemical composition, processing methods, pharmacology, toxicology, and clinical research progress. Methods: The applications and processing methods of mirabilite are searched in traditional and modern Chinese medical writings, and the articles on chemical composition, pharmacological effects, toxicology, and clinical studies of mirabilite and its combinations in PubMed and China Knowledge Network are reviewed, sorted, and analyzed. Results: The main chemical component of mirabilite is sodium sulfate decahydrate (Na2SO4·10H2O), followed by small amounts of sodium chloride, magnesium sulfate, calcium sulfate, and other inorganic salts. This study systematically organizes the history of the medicinal use of mirabilite in China for more than 2,000 years. This mineral has been used by nine Chinese ethnic groups (Han, Dai, Kazakh, Manchu, Mongolian, Tujia, Wei, Yi, and Tibetan) in a large number of prescription preparations. The Pharmacopoeia of the People's Republic of China (2020 edition) records stated that mirabilite can be used for abdominal distension, abdominal pain, constipation, intestinal carbuncle, external treatment of breast carbuncle, hemorrhoids, and other diseases. The traditional processing methods of mirabilite in China include refining, boiling, sautéing, filtration after hot water blistering, and firing. Since the Ming Dynasty, processing by radish has become the mainstream prepared method of mirabilite. Mirabilite can exhibit anti-inflammatory detumescence effects by inhibiting AMS, LPS, IL-6, IL-10, TNF-α, and NO levels and attenuating the upregulation of TNF-α and NF-κB genes. It can promote cell proliferation and wound healing by increasing the production of cytokines TGFβ1 and VEGF-A and gastrointestinal motility by increasing the release of vasoactive intestinal peptide, substance P, and motilin. It can increase the expression of low-density lipoprotein receptor and AKT phosphorylation in the liver by up-regulating bile acid synthesis genes; reduce TRB3 expression in the liver, FGF15 co-receptor KLB expression, and FGF15 production in the ileum, and JNK signal transduction; and increase the transcription of CYP7A1 to achieve a cholesterol-lowering effect. Mirabilite also has a variety of pharmacological effects, such as regulating intestinal flora, anti-muscle paralysis, anti-colon cancer, promoting water discharge, and analgesic. Only a few toxicological studies on mirabilite are available. External application of mirabilite can cause local skin to be flushed or itchy, and its oral administration is toxic to neuromuscular cells. The sulfur ions of its metabolites can also be toxic to the human body. At present, no pharmacokinetic study has been conducted on mirabilite as a single drug. This mineral has been widely used in the clinical treatment of inflammation, edema, wound healing, digestive system diseases, infusion extravasation, hemorrhoids, skin diseases, breast accumulation, muscle paralysis, intestinal preparation before microscopic examination, and other diseases and symptoms. Conclusion: Mirabilite has good application prospects in traditional Chinese medicine and ethnomedicine. In-depth research on its processing methods, active ingredients, quality control, pharmacokinetics, pharmacological and toxicological mechanisms, and standardized clinical application is needed. This paper provides a reference for the application and research of mirabilite in the future.", "provenance": [ { "field": "intervention", "quote": "The main chemical component of mirabilite is sodium sulfate decahydrate (Na2SO4·10H2O), followed by small amounts of sodium chloride, magnesium sulfate, calcium sulfate, and other inorganic salts." }, { "field": "population", "quote": "mirabilite can be used for abdominal distension, abdominal pain, constipation, intestinal carbuncle, external treatment of breast carbuncle, hemorrhoids, and other diseases" }, { "field": "result", "quote": "This mineral has been widely used in the clinical treatment of inflammation, edema, wound healing, digestive system diseases, infusion extravasation, hemorrhoids, skin diseases, breast accumulation, muscle paralysis, intestinal preparation before microscopic examination, and other diseases and symptoms." }, { "field": "primaryOutcome", "quote": "This study reviews the use of mirabilite in traditional Chinese medicine and various preparations by describing its chemical composition, processing methods, pharmacology, toxicology, and clinical research progress." } ] }, { "id": "pmid:38027399", "pmid": "38027399", "doi": "10.5455/OVJ.2023.v13.i10.1", "nctId": null, "pmcid": "PMC10658017", "title": "Is camel's urine friend or enemy? Review of its role in human health or diseases", "firstAuthor": "Tharwat", "multipleAuthors": true, "journal": "Open Vet J", "year": 2023, "design": "narrative-review", "n": null, "nField": "not-reported", "population": "people with various illnesses historically treated with animal urine, including camels", "intervention": "camel urine (which contains magnesium among other minerals)", "comparator": "bovine (cow) urine mineral content", "primaryOutcome": "mineral/chemical composition of camel urine and its reported health effects", "result": "camel urine had higher magnesium, sodium, potassium, iron, and zinc than bovine urine, but no actual treatment outcome for hemorrhoids was tested or reported", "resultDirection": "unclear", "quality": "very-low", "qualityWhy": "This is a general review of historical and anecdotal uses and mineral content of camel urine, not a study testing magnesium or camel urine as a treatment for hemorrhoids.", "directness": "indirect", "limitations": "No clinical study, no control group, no measured outcome for hemorrhoids; hemorrhoids only mentioned as one of many conditions historically treated with animal urine.", "followUp": "", "plainFinding": "No real evidence found for hemorrhoids.", "retracted": false, "expressionOfConcern": false, "hasErratum": false, "url": "https://pubmed.ncbi.nlm.nih.gov/38027399/", "sourceText": "Camels play an important role in the pastoral mode of life by fulfilling basic demands of livelihood. Various pathologies, such as tuberculosis, hemorrhoids, ascites, increased size of the abdomen, gas colic, anemia, and abdominal tumors, were treated with animal urine, including camels, horses, donkeys, sheep, goats, elephants, and buffalo. Thirty different compounds were analyzed in camel urine by gas chromatography and mass spectrometry. For inductively coupled plasma mass spectrometry analysis, 28 important elements were analyzed in the urine of both camel and bovine. It was found that the inorganic elements are almost similar, except sodium, potassium, iron, zinc, and magnesium are higher in levels in camel urine, while chromium is high in bovine urine. Camel urine also contains different nanoparticles, crystals, and nano-rods with varying shapes and sizes, which offer potent selective cytotoxic activity against several lines of cancer cells. It is believed that the camel's urine has a therapeutic effect for a wide range of diseases such as chill, fever, or even tumors; therefore, it has been consumed in the Arabian Peninsula for a long time. Usually, patients take it directly or by mixing a few drops with camel milk. Camel urine is also used for therapeutic purposes, most widely in Asia, Africa, the United States, the United Kingdom, and other European countries. The religious aspect of using camel urine in treatment comes from the fact that there has been convincing evidence that the Prophet Mohammad (PBUH) suggested the use of camel urine to treat his companions who were suffering from abdominal pains at that time. The camel's urine has anti-diabetic, anti-cancer, antibacterial, antiviral, and antifungal properties. It also has hepato-protective and cardiovascular effects.", "provenance": [ { "field": "population", "quote": "Various pathologies, such as tuberculosis, hemorrhoids, ascites, increased size of the abdomen, gas colic, anemia, and abdominal tumors, were treated with animal urine, including camels, horses, donkeys, sheep, goats, elephants, and buffalo." }, { "field": "intervention", "quote": "sodium, potassium, iron, zinc, and magnesium are higher in levels in camel urine" }, { "field": "comparator", "quote": "the inorganic elements are almost similar, except sodium, potassium, iron, zinc, and magnesium are higher in levels in camel urine, while chromium is high in bovine urine" }, { "field": "primaryOutcome", "quote": "28 important elements were analyzed in the urine of both camel and bovine" }, { "field": "result", "quote": "sodium, potassium, iron, zinc, and magnesium are higher in levels in camel urine, while chromium is high in bovine urine" } ] }, { "id": "pmid:19452098", "pmid": "19452098", "doi": null, "nctId": null, "pmcid": null, "title": "[Proctological surgery: use of a salsobromoiodic gel solution in the post-operative period]", "firstAuthor": "Gaj", "multipleAuthors": true, "journal": "Clin Ter", "year": 2009, "design": "case-series", "n": 30, "nField": "reported", "population": "patients after surgery for severe (grade III-IV) hemorrhoids or chronic anal fissure", "intervention": "a topical gel solution (salsobromoiodic gel) containing salicylic acid and magnesium biphosphate applied to the wound after surgery", "comparator": "none; all patients received the gel, no comparison group", "primaryOutcome": "prevention of infection and healing/re-epithelialization of the surgical wound", "result": "all treated patients showed prevention of infective complications and normal tissue healing, with no irritation or toxicity", "resultDirection": "unclear", "quality": "very-low", "qualityWhy": "This was a small, uncontrolled case series with no comparison group, so it cannot show whether the gel (or its magnesium component) actually caused the healing seen.", "directness": "indirect", "limitations": "No control group, small sample size, and the magnesium is only one of several active ingredients in a combination product, making it impossible to isolate its effect.", "followUp": "at least 10 days", "plainFinding": "Gel seemed to help wound healing.", "retracted": false, "expressionOfConcern": false, "hasErratum": false, "url": "https://pubmed.ncbi.nlm.nih.gov/19452098/", "sourceText": "BACKGROUND: This study was aimed to demonstrate the advantages and the efficacy of a salsobromoiodic gel solution sponge to use in coloproctology after surgery for the most frequent pathologies of anal canal and of perineal region. MATERIALS AND METHODS: The Authors have tested the salsobromoiodic gel solution (Fertomcidina U) in a consecutive series of patients referred to 5 coloproctological centers where they have been submitted to surgery for pathologies of anal canal and of perineal region. A total of 30 patients, 15 with clinico-instrumental diagnosis of III-IV degree haemorrhoids and 15 with diagnosis of chronic anal fissure entered in a clinical follow-up after an out-patient setting or surgery for the respective pathologies. The gel formulation is realized as a salsobromoiodic solution containing salicylic acid and magnesium biphosphate making a strong bactericide and fungicide action applicable on human skin for tissues reparation and their re-epithelization. The experimental treatment was performed on the duration of at least 10 days, with two topic applications. RESULT: In 100% of the treated patients, the used gel has determined the prevention of infective complications, favouring a normal re-epithelization of tissue submitted to surgery or affected by previous anal mucosal lesions. The use of gel has not caused irritation and skin damage. No symptom and sign of toxicity were observed. CONCLUSIONS: The use of salsobromoiodic gel solution has been useful to prevent infections and to contribute to the cicatrisation, healing and re-epithelization of anal mucosal lesions after surgery on a normal outpatients setting. The use of gel formulation resulted easy and satisfactory for the patients affected by the most frequent proctological pathologies which require a surgical treatment.", "provenance": [ { "field": "n", "quote": "A total of 30 patients, 15 with clinico-instrumental diagnosis of III-IV degree haemorrhoids and 15 with diagnosis of chronic anal fissure" }, { "field": "population", "quote": "15 with clinico-instrumental diagnosis of III-IV degree haemorrhoids and 15 with diagnosis of chronic anal fissure entered in a clinical follow-up after an out-patient setting or surgery for the respective pathologies" }, { "field": "intervention", "quote": "The gel formulation is realized as a salsobromoiodic solution containing salicylic acid and magnesium biphosphate making a strong bactericide and fungicide action applicable on human skin for tissues reparation and their re-epithelization." }, { "field": "comparator", "quote": "The Authors have tested the salsobromoiodic gel solution (Fertomcidina U) in a consecutive series of patients referred to 5 coloproctological centers" }, { "field": "primaryOutcome", "quote": "In 100% of the treated patients, the used gel has determined the prevention of infective complications, favouring a normal re-epithelization of tissue submitted to surgery or affected by previous anal mucosal lesions." }, { "field": "result", "quote": "In 100% of the treated patients, the used gel has determined the prevention of infective complications, favouring a normal re-epithelization of tissue submitted to surgery or affected by previous anal mucosal lesions. The use of gel has not caused irritation and skin damage. No symptom and sign of toxicity were observed." }, { "field": "followUp", "quote": "The experimental treatment was performed on the duration of at least 10 days, with two topic applications." } ] }, { "id": "pmid:19339231", "pmid": "19339231", "doi": null, "nctId": null, "pmcid": null, "title": "Investigation of vasoactive ion content of herbs used in hemorrhoid treatment in Turkey", "firstAuthor": "Gulec", "multipleAuthors": true, "journal": "Pak J Pharm Sci", "year": 2009, "design": "lab", "n": null, "nField": "not-reported", "population": "herbal remedies used in Turkey for hemorrhoid treatment (not human patients)", "intervention": "measuring ion content (including magnesium) of herbs used for hemorrhoids", "comparator": "systemically used herbs vs locally used herbs", "primaryOutcome": "concentration of vasoactive (vasoconstrictor vs vasodilator) ions in herb samples", "result": "Herbs contained more vasoconstrictor ions than vasodilator ions; magnesium levels were slightly higher in locally used herbs but differences were not statistically significant", "resultDirection": "unclear", "quality": "very-low", "qualityWhy": "This is a chemical analysis of herb samples in a lab, not a study of people with hemorrhoids, so it cannot show whether magnesium actually helps.", "directness": "indirect", "limitations": "No human subjects or clinical outcomes were studied; only ion concentrations in herb extracts were measured, and most differences were not statistically significant.", "followUp": "", "plainFinding": "No direct evidence magnesium helps.", "retracted": false, "expressionOfConcern": false, "hasErratum": false, "url": "https://pubmed.ncbi.nlm.nih.gov/19339231/", "sourceText": "OBJECTIVES: The aim of the present study is to determine anion and cation contents of the herbals used in Turkish folk remedy to explore the rationale of their use in hemorrhoid treatment in the context of the vasoactivity of these elements. DESIGN: Herbs used in the treatment of hemorrhoid were determined by the way of literature search. These herbs were obtained from certified herb sellers. Ground herb samples were placed in individual tubes containing methanol and incubated for 48 hours at 30 degrees C. At the end of the incubation, supernatants were analyzed for their ion concentrations by using ion chromatography. RESULTS: The difference between ion levels between systemic and locally used herbs, was not statistically significant (p>0.05). Anion concentrations (except nitrate) of locally used herbs were slightly higher than systemically used herbs (p>0.05). Cation levels (except magnesium) of systemically used herbs were slightly higher than locally used herbs (p>0.05). It was shown that the concentration of vasoconstrictor effective ions was higher than the concentration of vasodilator effective ions (p<0.001). While vasoconstrictor ion concentration of systemically used herbs was 88.06 +/- 147.42 mg, vasodilator ion concentration of locally used herbs was 90.15 +/- 136.94 mg. The difference between vasodilator concentrations of groups was more evident; 5.39 +/- 9.80 mg and 14.32 +/- 66.48 mg for locally and systemically used herbs respectively. CONCLUSIONS: This study showed that herbal remedies used for the treatment of hemorrhoid in Turkey contain vasoactive and especially vasoconstrictor ions. Vasoconstrictor agents could amplify each others' effects as it has been previously shown, therefore, it is probable that the vasoconstrictor ion contents could contribute to the curative effects of herbals in the treatment of hemorrhoids.", "provenance": [ { "field": "population", "quote": "Herbs used in the treatment of hemorrhoid were determined by the way of literature search." }, { "field": "intervention", "quote": "analyzed for their ion concentrations by using ion chromatography" }, { "field": "comparator", "quote": "The difference between ion levels between systemic and locally used herbs, was not statistically significant (p>0.05)." }, { "field": "primaryOutcome", "quote": "It was shown that the concentration of vasoconstrictor effective ions was higher than the concentration of vasodilator effective ions (p<0.001)." }, { "field": "result", "quote": "Cation levels (except magnesium) of systemically used herbs were slightly higher than locally used herbs (p>0.05)." } ] }, { "id": "pmid:12368938", "pmid": "12368938", "doi": null, "nctId": null, "pmcid": null, "title": "Use of enzyme and heparin paste in acute haemorrhoids", "firstAuthor": "Gupta", "multipleAuthors": false, "journal": "Rom J Gastroenterol", "year": 2002, "design": "retrospective", "n": 89, "nField": "reported", "population": "patients with acutely inflamed hemorrhoids (piles)", "intervention": "heparin-enzyme (trypsin and chymotrypsin) paste applied directly to the piles, in addition to standard conservative care", "comparator": "conventional conservative treatment alone (bed rest, stool softeners, antibiotics, anti-inflammatories, Sitz baths, and glycerin-magnesium sulphate paste)", "primaryOutcome": "reduction in pain, swelling, tenderness and pile size, and overall healing of inflamed hemorrhoids", "result": "the group given the added heparin-enzyme paste had significantly less pain, easier defecation, less itching, and significantly reduced pile size, swelling and tenderness compared with conventional treatment alone", "resultDirection": "benefit", "quality": "low", "qualityWhy": "this was a small, non-randomized comparison of two patient groups without blinding, so it can't reliably isolate the effect of magnesium itself.", "directness": "indirect", "limitations": "not randomized, no blinding described, and magnesium sulphate paste was only one component of the background conventional treatment used in both groups rather than the tested intervention", "followUp": "", "plainFinding": "Tested enzyme-heparin paste, not magnesium alone", "retracted": false, "expressionOfConcern": false, "hasErratum": false, "url": "https://pubmed.ncbi.nlm.nih.gov/12368938/", "sourceText": "BACKGROUND: While treating acutely inflammed piles, surgeons in general prefer to stick to the conservative method of treatment. This includes bed rest in a Trendelenburg's or jack-knife position, administration of liquid diet, stool softeners, antibiotics, and anti-inflammatory drugs along with warm Sitz baths and local application of glycerin and magnesium sulphate paste. We introduced an additional method in treating acutely inflammed piles. Ten tablets of trypsin and chymotrypsin (Chymoral forte, Elder Pharmaceuticals India) were powdered and were mixed with 30 grams of heparin (Thrombophobe, German Remedies Ltd, Germany) ointment. This paste was applied to the inflammed pile mass. In all, 67 received this in patient treatment with an average hospital stay of 2 days. The results were compared using chi2 test with similarly placed 22 patients who were treated with the conventional method only. RESULTS: In the patients receiving the application of the enzyme paste, local pain was reduced to a great extent, the defecation was comfortable, there was negligible local pruritus, and the routine body movements of the patient were painless. Local signs observed in the form of the size of the piles, perianal edema, and tenderness, were also found to be significantly reduced. CONCLUSION: The results of this study demonstrate that the additional use of a heparin-enzyme paste applied directly over the pile masses significantly improves the healing and resolution of acutely inflammed hemorrhoids. The effectiveness of the traditional conservative method of treatment could be gainfully supplemented by use of the pharmaceutical preparation suggested in this study.", "provenance": [ { "field": "n", "quote": "In all, 67 received this in patient treatment with an average hospital stay of 2 days." }, { "field": "n", "quote": "similarly placed 22 patients who were treated with the conventional method only" }, { "field": "population", "quote": "acutely inflammed piles" }, { "field": "intervention", "quote": "This paste was applied to the inflammed pile mass." }, { "field": "comparator", "quote": "local application of glycerin and magnesium sulphate paste" }, { "field": "primaryOutcome", "quote": "Local signs observed in the form of the size of the piles, perianal edema, and tenderness, were also found to be significantly reduced." }, { "field": "result", "quote": "local pain was reduced to a great extent, the defecation was comfortable, there was negligible local pruritus, and the routine body movements of the patient were painless" } ] } ], "faqs": [ { "q": "Should I stop soaking in Epsom salt baths for my hemorrhoids?", "a": "There's no evidence it treats the hemorrhoid itself, but the studies found didn't report serious harm from magnesium-containing soaks or gels either. If a warm soak feels soothing, there's nothing in the evidence saying to stop — just don't expect it to shrink or heal the hemorrhoid on its own." }, { "q": "Does taking magnesium supplements by mouth help hemorrhoids?", "a": "No study in this review tested oral magnesium supplements for hemorrhoids at all. All six studies looked at magnesium sulfate used topically, as a compress, paste, or gel, or as a trace component of other products." }, { "q": "Why do some articles mention magnesium for hemorrhoids if it isn't proven?", "a": "Magnesium sulfate (Epsom salt) has a long history in sitz baths and traditional remedies, and it often shows up as one ingredient in combination treatments. That's different from it being tested on its own and shown to work." }, { "q": "Is it safe to use a magnesium-containing product someone recommended to me?", "a": "The small studies found reported no significant irritation or toxicity from magnesium-containing topical products, but these products always contained other active ingredients too, so magnesium's own safety wasn't tested in isolation. If you have ongoing bleeding or severe pain, see a doctor rather than relying on a home remedy." }, { "q": "What should I do instead, if magnesium isn't proven to help?", "a": "This review only looked at magnesium, so it can't tell you what else works. If hemorrhoid symptoms are bothering you or you notice bleeding, it's worth getting checked by a doctor, who can confirm the diagnosis and recommend treatment suited to your situation." } ], "patientTakeaway": "No study has actually tested whether magnesium — by mouth or as an Epsom salt soak — treats hemorrhoids; the studies found only use it as a minor ingredient in other treatments or as background care given to everyone. It's unlikely to cause harm based on the limited safety data available, but don't count on it to shrink or heal a hemorrhoid. If you have ongoing pain or bleeding, see a doctor to confirm the diagnosis and discuss treatments that have actually been tested.", "methodology": { "databases": [ "PubMed", "ClinicalTrials.gov", "Crossref" ], "searchStrings": { "pubmed": "(\"Hemorrhoids\"[Mesh] OR hemorrhoid*[tiab] OR piles[tiab]) AND (\"Magnesium\"[Mesh] OR \"Magnesium Sulfate\"[Mesh] OR magnesium[tiab] OR \"epsom salt\"[tiab] OR \"epsom salts\"[tiab])" }, "pubmedQueryTranslation": "(\"Hemorrhoids\"[MeSH Terms] OR \"hemorrhoid*\"[Title/Abstract] OR \"piles\"[Title/Abstract]) AND (\"Magnesium\"[MeSH Terms] OR \"Magnesium Sulfate\"[MeSH Terms] OR \"Magnesium\"[Title/Abstract] OR \"epsom salt\"[Title/Abstract] OR \"epsom salts\"[Title/Abstract])", "searchedOn": "2026-10-05", "inclusion": [ "Human, animal or laboratory studies reporting an outcome relevant to the question" ], "exclusion": [ "Records about a different condition or intervention", "Records reporting no outcome", "Retracted publications, which are listed but excluded from every count" ], "extractionLevel": "abstract", "gradingNote": "Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.", "limits": [ "Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured." ] }, "seo": { "title": "Does Magnesium Help Hemorrhoids?", "description": "No study has directly tested if magnesium helps hemorrhoids; 6 low-quality studies only touch the question indirectly, not conclusively." }, "lastChecked": "2026-10-05", "lastChanged": "2026-10-05", "nextCheckDue": "2026-11-05", "history": [], "pipeline": { "screenModel": "claude-haiku-4-5", "extractModel": "claude-sonnet-5", "composeModel": "claude-sonnet-5", "promptVersion": "ev-1", "ranOn": "2026-10-05" }, "status": "published" }