Did you know that Preparation H has been reported to be the second most frequently stolen item from pharmacies? Yes, 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.
Stage 1. The primal diet of plant eaters contains large amounts of unprocessed starch staples; there are few examples of subsequently mentioned diseases.
Stage 2. With the commencement of the westernization of diet, obesity and diabetes commonly appear in privileged groups.
Stage 3. With moderate westernization of the diet, constipation, hemorrhoids, varicose veins, and appendicitis become common clinical entities.
Stage 4. Finally, with full westernization of the diet, ischemic heart disease, diverticular disease, hiatal hernia, and cancer become prominent.
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. If external hemorrhoids are present, there is a good probability that you have internal hemorrhoids also. The hemorrhoidal plexuses drain through veins without valves, so factors that increase the pressure inside these veins can lead to hemorrhoids.
These factors 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.
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.
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.
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. 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.
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.
Treatment
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.
Among natural preparations that can help, the most effective, 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 3000-6000mg 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 like 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.
Signs, symptoms & indicators of Hemorrhoids
(Significant/frequent) blood in stools
Conditions that suggest Hemorrhoids
Pruritus Ani
Sometimes hemorrhoids will cause anal itching. Skin tags, rectal fistulas, rectal fissures or anorectal cancer (rarely) can do so also.
Risk factors for Hemorrhoids
Copper Deficiency
A copper deficiency has been associated with weakening of connective tissue that can be a contributing factor for the development of hemorrhoids.
Hemorrhoids suggests the following may be present
Hemorrhoids can lead to
Pruritus Ani
Sometimes hemorrhoids will cause anal itching. Skin tags, rectal fistulas, rectal fissures or anorectal cancer (rarely) can do so also.
Recommendations for Hemorrhoids
Conventional Drugs / Information
In acute hemorrhoidal attacks, DAFLON 500mg is highly effective, right from the second day of treatment, in improving all signs and symptoms, such as bleeding, pain, discharge, tenesmus, and proctitis, thereby reducing the consumption of oral analgesics.
The efficacy of DAFLON 500 mg associated with fiber supplement has been superior to fiber supplement alone and equivalent to rubber-band ligation plus fiber supplement in stopping anal bleeding due to hemorrhoids.
DAFLON 500 mg combined with hemorrhoidectomy significantly reduces the risk of postoperative bleeding.
In long-term treatment for chronic hemorrhoidal disease, DAFLON 500mg has been proven to significantly reduce recurrence, duration, number, and severity of hemorrhoidal attacks. [Dis Col Rectum.2000;43: pp.66-69, Phlebology. 1992;7(suppl 2): pp.61-63]
Ozone / Oxidative Therapy
Capsules filled with ozonated oil and used as suppositories, or rectal insufflation of ozone gas have proven useful in treating inflamed hemorrhoids. Ozone can kill bacteria which may slow tissue healing. Some companies offer ozonated oil which can be used as a suppository. You may need to fill your own capsules if frozen ozontaed olive oil in one ounce jars is all that is available.
20 female patients suffering from hemorrhoid were treated with ozonized oil in the anal zone. This therapy made pain stop in a short time, and stopped the itching and the feeling of anal tension. [G.Morris, S.Menèndez y Clinical M.Gomez Central ” Cira Garcia ” Centro Nacional De Investigaciones Cientificas]
Hydrotherapy
A sitz bath is recommended 3 times a day and after each bowel movement for at least 15 minutes. Just sitting in a few inches of warm water in a tub can lessen the swelling and the pain. Dry the area carefully, yet thoroughly, afterwards.
Surgery
Any of the following may require surgery.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
Glossary
Hemorrhoids
Varicose disorder causing painful swellings at the anus; piles.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Constipation
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Varicose Veins
Twisted, widened veins with incompetent valves.
Ischemia
Localized tissue anemia due to obstruction of the inflow of arterial blood.
Diverticular Disease
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.
Hiatal Hernia
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.
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
Usually Chronic illness: Illness extending over a long period of time.
Diarrhea
Excessive discharge of contents of bowel.
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.
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.
Hypertrophy
Increase in the size of an organ due to enlargement of its cells; frequently with a corresponding increase in functional capacity.
Pruritus
Severe itching, often of undamaged skin.
Colorectal Cancer
A cancerous tumor of the large intestine. It is marked by dark, sticky stools containing blood and a change in bowel habits.
Naturopathy
Medical practice using herbs and other various methods to produce a healthy body state by stimulating innate defenses without the use of drugs.
Herbs
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.
Milligram
(mg): 1/1,000 of a gram by weight.
TID
Three times a day.
Vitamin C
Also known as ascorbic acid, Vitamin C is 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.
Gram
(gm): A metric unit of weight, there being approximately 28 grams in one ounce.
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.
Flax
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 (especially Omega-3 oil), 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.
Topical
Most commonly 'topical application': Administration to the skin.
Vitamin K
Helps the blood clot when the body is injured.
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.