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Hemorrhoids are swollen hemorrhoidal plexuses in and around the anus and lower rectum that stretch under pressure, similar to varicose veins in the legs. Internal hemorrhoids are found just above the anal canal, while external hemorrhoids are usually visible under the skin around the anus. The presence of external hemorrhoids suggests a good probability of internal hemorrhoids also.
Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are incorrectly referred to as hemorrhoids. Although many people have hemorrhoids, not all experience symptoms. In many cases, hemorrhoidal symptoms will go away within a few days, but recurrences are common unless predisposing conditions are improved.
Incidence; Causes & Development; Risk Factors
Hemorrhoids are very common, and in both men and women. About half of the population have hemorrhoids by age 50.
Hemorrhoids appear to be due to the much loved 'Western Diet'. Health problems following its introduction into cultures have been described as coming in stages. - The primal diet of plant eaters contains large amounts of unprocessed starch staples; there are few examples of subsequently mentioned diseases.
- With the commencement of the westernization of diet, obesity and diabetes commonly appear in privileged groups.
- With moderate westernization of the diet, constipation, hemorrhoids, varicose veins, and appendicitis become common clinical entities.
- Finally, with full westernization of the diet, ischemic heart disease, diverticular disease, hiatal hernia, and cancer become prominent.
In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms.
Risk factors for hemorrhoids include: heredity, pregnancy, sedentary lifestyle, straining during bowel movements (chronic constipation), chronic diarrhea, standing for long periods of time, sitting on hard, cold surfaces, liver stagnancy or disease (cirrhosis), benign prostatic hypertrophy and anal intercourse. For most women, however, those hemorrhoids caused by pregnancy are only a temporary problem.
Signs & Symptoms
The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude or prolapse through the anus outside the body, becoming irritated and painful. This may require manual reduction or replacement back inside. Mucus discharge may be associated with itching.
Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid. External hemorrhoids tend to regress when internal hemorrhoids are treated.
Treatment & Prevention
The best way to prevent hemorrhoids is to 1) keep stools soft so they pass easily, thus decreasing pressure and straining, 2) to empty bowels as soon as possible after the urge occurs and 3) keep your veins strong. Exercise, including walking, and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass. Good sources of fiber are fruits, vegetables, and whole grains. Veins are strengthened by bioflavonoids.
Conventional medicine often will use either rubber band ligation (a rubber band is placed around the base of the hemorrhoid which cuts off circulation and withers the tissue away within a few days) or Sclerotherapy (a chemical solution is injected around the blood vessel to shrink the hemorrhoid). Severe thrombosed external hemorrhoids may require surgical incision and clot removal. Internal hemorrhoids may be treated with stool softeners, sitz baths, and cold applications.
Alternative medicine also offers some effective treatments like galvanic (Keesey treatment) and infrared cauterization. Both are non-surgical outpatient procedures with high success rates and few complications. Some naturopaths are doing these procedures. In addition, make sure you are drinking enough water to stay fully hydrated.
The most effective agents, though harder to find are aortic GAGs (glycosaminoglycans) from highly purified bovine sources. These contain dermatan sulfate, heparan sulfate, hyaluronic acid, chondroitin sulfate and other GAGs. Two double-blind studies have compared aortic GAGs to bilberry and HER (a flavonoid preparation like rutin and citrus bioflavonoids). The aortic extract produced far better results in both hemorrhoids and varicose veins.
Flavonoids strengthen connective tissue, especially capillaries. They help keep tissues from falling apart. Varicose veins, hemorrhoids, bleeding between periods, and lymphedema can be aided by flavonoids. Anthocyanosides from bilberry (European bilberry) act more effectively than the common flavonoids rutin and hesperidin. The herb horse chestnut and witch hazel (topically) have a long historical use.
Dosages- HER 1,000 - 3,000mg per day (better than rutin and citrus bioflavonoids).
- Bilberry (Vaccinium myrtillus) (25% anthocyanosides) 80-160mg tid.
- Butcher's broom (Ruscus aculeatus) (9-11% ruscogenin) 100mg tid.
- Horse chestnut (aesculus hippocastanum) extract for 50mg of escin per day.
- Grape seed extract 100mg bid-tid.
- Vitamin C 500-1,000gm tid with Bioflavonoids 3,000-6,000mg per day.
Some doctors are using different forms of iodine (SSKI or Lugol's) to help shrink and relieve the pain of hemorrhoids. A drop, placed on a finger and massaged into the affected area, can be very effective, though it may sting temporarily. Consider mixing 20 drops with an ounce of flax oil and storing it in the refrigerator. Apply twice per day; rapid relief should be on the way.
Miscellaneous- Shark liver oil is the active ingredient in topical ointments such as Preparation H.
- Ozonated Olive Oil has been used successfully in hemorrhoids, as well as many other conditions.
- A goldenseal salve can be helpful for irritations of an itchy nature as found in hemorrhoids.
- Vitamin K can help stop bleeding hemorrhoids. Good dietary sources are: alfalfa, blackstrap molasses, and dark green leafy vegetables. Vitamin K can be taken as a supplement also.
Seek medical attention if
A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool lasts more than a couple of days. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.
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Signs, symptoms & indicators of Hemorrhoids:
Conditions that suggest Hemorrhoids:
Risk factors for Hemorrhoids: | | | | | Diet |  Inadequate Fiber Intake |
Digestion |
Constipation | The hemorrhoidal plexuses drain through veins without valves, so factors that increase the pressure inside these veins - such as straining while on the toilet - can lead to hemorrhoids. |
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Nutrients |
Copper Deficiency| | A copper deficiency has been associated with weakening of connective tissue that can be a contributing factor for the development of hemorrhoids. |
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Hemorrhoids suggests the following may be present: | | | | | Digestion |  Constipation| | The hemorrhoidal plexuses drain through veins without valves, so factors that increase the pressure inside these veins - such as straining while on the toilet - can lead to hemorrhoids. |
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Recommendations and treatments for Hemorrhoids:
KEY | | Weak or unproven link | | | Strong or generally accepted link |  | | Proven definite or direct link |  | | May do some good |  | | Highly recommended |
GLOSSARY
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Benign Prostatic Hypertrophy (Benign Prostatic Hyperplasia, BPH)
The benign buildup in the prostate of "warts" or epithelial neoplasias that can block or interrupt urination, and which are usually concurrent with moderate prostate enlargement. They cause a dull ache on urination, ejaculation, and/or defecation. The diagnosis is medical, since the same subjective conditions can result fromcancer of the prostate. BPH is common in men over fifty and can be the result either of diminished production of complete testosterone or poor pelvic circulation. Alcohol, coffee, speed, and antihistamines can all aggravate the problem.
Bioflavonoid (Bioflavonoids, Flavonoid, Flavonoids)
Vitamin P. Any of a group of colored flavones (crystalline compounds) found next to the peel in many fruits. Essential for the stability and absorption of ascorbic acid.
Boil (Abscess, Abscesses, Boils, Carbuncle, Carbuncles, Cystic Acne, Furuncle, Furuncles, Hidradenitis Suppurativa, Pilonidal Cyst, Pilonidal Cysts)
A localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with white cells that the body sends to fight the infection (pus). Finally, the pus forms a "head" and drains out through the skin. A furuncle or carbuncle is an abscess in the skin caused by the bacteria Staphylococcus aureus. It can have one or more openings onto the skin and may be associated with a fever or chills. Cystic acne is a type of abscess formed when oil ducts become clogged and infected. Cystic acne is most common in the teenage years. Hidradenitis suppurativa is an illness in which there are multiple abscesses that form under the arm pits and in the groin area. These areas are a result of local inflammation of the sweat glands. A pilonidal cyst is a special kind of abscess that occurs in the crease of the buttocks. These frequently form after long trips that involve sitting.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Colorectal Cancer
A cancerous tumor of the large intestine. It is marked by dark, sticky stools containing blood and a change in bowel habits.
Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
Diarrhea
Excessive discharge of contents of bowel.
Dietary Fiber (Insoluble Fiber, Insoluble Fibers, Soluble Fiber, Soluble Fibers)
There are two types of dietary fiber - soluble and insoluble. Insoluble fiber acts like a sponge; it absorbs water and moves solid waste out of the intestines. It is found mainly in whole grains and on the outside of seeds, fruits, and legumes. Soluble fiber is found in fruits, vegetables, seeds, brown rice, barley, oats and oat bran. It forms a gel when mixed with liquid producing a softer stool. It also prevents and reduces the absorption of certain substances from the intestines into the bloodstream.
Discharge (Discharges)
A secretion, of pus for example, from a wound or bodily orifice.
Diverticular Disease (Diverticulitis, Diverticulosis)
Some people develop small pouches (diverticula) that bulge outward through weak spots in the colon. Diverticulosis is the condition of having these pouches; diverticulitis is an inflammation or infection in these pouches. The conditions diverticulosis and diverticulitis are both referred to as diverticular disease. Diverticulosis may not cause any symptoms but could include mild cramps, bloating and constipation - all of which are common to other conditions such as IBS or ulcers. The most common symptoms of diverticulitis are abdominal pain and tenderness around the left side of the lower abdomen. When infection is the cause, fever, nausea, vomiting, chills, cramping and constipation may also occur.
Flax (Flax Oil, Flax Seed)
Flax Seed or Flax Oil. Flax oil is nutty-flavored oil that is pressed out of flax seeds and is one of the richest sources of Essential Fatty Acids (EFAs), a vital element for good health. The oil making process removes many of the seed's phytoestrogens which offer several health-related benefits including reducing the risk of cancer and alleviating menopausal symptoms. Many choose to use the whole seed because of its fiber and lignan content. Flaxseed oil is light- and temperature-sensitive and must be stored in the refrigerator.
Hemorrhoids
Varicose disorder causing painful swellings at the anus; piles.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hesperidin
A bioflavonoid derived from citrus fruit.
Hiatal Hernia (Hiatal Hernias)
Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Iodine
A essential mineral that is an integral part of the thyroid hormones, thyroxin and triiodothyronine which have important metabolic roles and govern basal metabolism. The best known iodine deficiency symptom is goiter. Other iodine deficiency problems are reduced vitality, hypothyroidism, inability to think clearly, low resistance to infection, loss of control of the muscles of the mouth resulting in mouth contortion and drooling, defective teeth, tendency to obesity and cretinism which is a congenital abnormal condition marked by physical stunting and mental deficiency.
Ischemia (Ischemic)
Localized tissue anemia due to obstruction of the inflow of arterial blood. A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Mucus (Mucous)
The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Naturopathy (Naturopath, Naturopathic, Naturopaths)
Medical practice using herbs and other various methods to produce a healthy body state by stimulating innate defenses without the use of drugs.
Ounce (Ounces, oz)
Approximately 28 grams.
Pruritus
Severe itching, often of undamaged skin.
Rutin
A bioflavonoid obtained from buckwheat leaves.
TID
Three times a day.
Topical
Most commonly 'topical application': Administration to the skin.
Varicose Veins
Twisted, widened veins with incompetent valves.
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Vitamin K
Helps the blood clot when the body is injured.
Last updated: Dec 30, 2008
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