BACKGROUND:Butcher's broom is the common name for a small evergreen shrub called Ruscus aculeatus. The name developed because in the Mediterranean areas where the plant is native, butchers used its branches to scrub their chopping blocks clean. The shrub is unrelated to other plants with similar names such as Scotch broom and Spanish broom.
Butcher’s broom is an interesting plant in that it does not have leaves. Instead, it produces small, flattened green branches that look like leaves. The many bright, red berries that it carries throughout the autumn make it an attractive ornamental plant.
Interest has been growing in butcher’s broom as a remedy for haemorrhoids. The pain and discomfort of haemorrhoids are recorded in the ancient medical writings of all cultures, and they remain a common source of irritation. Many factors are involved in their development, leading to the lining of the anus and rectum becoming engorged with blood and protruding into the cavity.
Treatments have ranged from praying to St Fiachra – an Irish seventh-century monk who is said to have been miraculously healed of his haemorrhoids – to injecting half a pint of cold spring water into the rectum. Much remains unknown about their cause and how best to treat them.
EVIDENCE FROM STUDIES
Interest in using butcher’s broom for haemorrhoids developed from its reputation for affecting blood vessels. Extracts of the roots and rhizomes contain a number of plant steroids, which were shown to constrict blood vessels in laboratory experiments. Other components were shown to have anti-inflammatory effects. Case studies reported that butcher’s broom helped people with varicose veins, where underlying problems with faulty veins are also believed to be involved in haemorrhoids.
While a few clinical trials are available to show that butcher’s broom can help improve blood flow in the legs, only one study was found that examined its direct effect on haemorrhoids. The participating physicians reported that 75 per cent of the patients who used butcher’s broom showed good or excellent improvement. However, since this study did not use a control group, its results must be interpreted with caution. A randomised, controlled trial would be needed to provide clear evidence of benefit.
PROBLEMATIC ASPECTS
When butcher’s broom was used in clinical studies, no adverse effects were reported. Reports of allergic reactions have been made, and a small percentage of people experience nausea after taking it. The compounds in butcher’s broom are alpha-adrenergic agonists. A number of other drugs work via this same system, suggesting that butcher’s broom might interfere with their activity. These drugs include alpha-agonists such as Sudafed and alpha-blockers such as doxazosin, used for those with high blood pressure or enlarged prostate glands. Anyone taking such medications should talk with a doctor or pharmacist before using butcher’s broom.
RECOMMENDATIONS
Butcher’s broom has become popular for the treatment of haemorrhoids (and varicose veins) primarily on the basis of research conducted in animals and laboratory settings. While it contains compounds that appear to have beneficial effects on veins, very little research has examined its effectiveness in patients.
Products are available for oral consumption and for use as ointments. Many of them contain several herbs with reputations for treating haemorrhoids, but little is known about their effectiveness. Because of this, it is difficult to be confident about their benefit. Diet, stress and other lifestyle factors may contribute to haemorrhoids, and these areas should also be considered in striving for relief.
Dónal O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University
