Systematic review catalogs 181 medicinal plants used for hemorrhoids across 18 ethnic groups in Thailand

Hemorrhoids is one of the most prevalent diseases affecting people’s health both in Thailand and worldwide. The therapeutic use of medicinal plants for hemorrhoidal treatments is widespread across many countries, supported by evidence demonstrating the efficacy of their pharmacological activity. This study aims to (1) conduct an in-depth literature review on plants used in Thailand for hemorrhoid treatment and (2) identify the most promising species in traditional Thai medicine to effectively treat hemorrhoids. A total of 53 references were methodically reviewed. The important medicinal plants were determined using ethnobotanical indices including use-value (UV) and choice value of species (CVs), and the important species were selected for an in-depth review of their pharmacological activities. Our literature review found that there were 181 species belonging to 147 genera and 78 families used to treat hemorrhoids among 18 ethnic groups. The most cited species were Cissus quadrangularis, Biancaea sappan, Croton persimilis, Mimosa pudica, Aegle marmelos, Leea indica, Plumbago indica, Rotheca serrata, and Tectona grandis. Prevalent pharmacological activities such as anti-inflammatory, anti-oxidative, anti-microbial, anti-hemorrhoid, analgesic, and vasorelaxant activities are found in key species used for hemorrhoid treatment. This study identifies the most important species for ethnopharmacological explorations in hemorrhoid treatments, which is expected to inspire the selection of medicinal plants for development into pharmaceutical products.