Hemorrhoidal disease is one of the most common proctological diseases in the population, covering, according to a number of authors, from 4 to 86% of the population over the age of 40 years. In addition, the problem of metabolic syndrome and accompanying obesity have become a real disease of the century in developed countries. This condition predisposes to a large number of diseases, including hemorrhoidal disease. From these positions, it is advisable to highlight the possibilities of treating not only hemorrhoids themselves, but also combating metabolic syndrome in this category of patients. The article describes modern data on the therapeutic effect of bioflavonoids, in particular hesperidin, and the mechanisms of their therapeutic action in acute and chronic hemorrhoids. The possibilities of using topical therapy for hemorrhoids are also highlighted, attention is paid to suppositories based on sodium alginate, thanks to which the drug has a hemostatic, anti-inflammatory and reparative effect, alleviating local symptoms of hemorrhoids and anal fissure. Data are provided on the therapeutic effect of the combination of hesperidin + diosmin in relation to the symptoms of hemorrhoids in patients with excess body weight and to metabolic syndrome are presented, as well as the experience of clinical observation in the hospital of the Faculty of Surgery No. 2 L/F of the N.I. Russian National Research Medical University is presented. Pirogov in the treatment of 1 300 comorbid patients with acute hemorrhoids and exacerbation of chronic hemorrhoids, followed by surgical treatment. The potential benefits of drugs with a standardized content of hesperidin (Venarus®) in relation to the treatment of hemorrhoids in patients with excess body weight and metabolic syndrome, comparison with other drugs from the group of bioflavonoids, are described.