Conditions

Hemorrhoids

Hemorrhoids (also known as piles) are swollen veins that form around the anus and in the rectum that may protrude from the anus. Hemorrhoids are very much like varicose veins; they enlarge and lose their elasticity, resulting in saclike protrusions into the canal. They can be caused, and aggravated, by sitting or standing for prolonged periods, violent coughing, lifting heavy objects (or even light objects ­ if lifted improperly), and straining during bowel movements.

Other factors that can cause or contribute to the formation of hemorrhoids include obesity, lack of exercise, liver damage, food allergies, and insufficient consumption of dietary fiber. Hemorrhoids are common during pregnancy and after childbirth.

There are different types of hemorrhoids, depending on their location, severity and amount of pain, discomfort, or aggravation they cause.

Signs and Symptoms:

• Itching
• Burning
• Pain
• Inflammation
• Swelling
• Irritation
• Seepage
• Bleeding

Diagnosis:

Your doctor will perform a physical exam. Sigmoidoscopy or colonoscopy may be performed when there is bleeding or if carcinoma is suspected as a cause of the hemorrhoids. In cases of significant or repeated bleeding, a barium enema may be administered.

Treatment Options:

The goal is to alleviate symptoms and promote healing. Surgery may be needed in severe cases, but most cases respond well to other measures.

Traditional Treatments:

• Conservative treatment for hemorrhoids includes measures to minimize constipation and straining. This is usually accomplished with increased fluid intake, stool softeners, and/or supplementary fiber.
• Though typical creams do not seem to offer great relief, suppositories that shrink and anesthetize, such as Anusol may offer relief in the case of larger, protruding hemorrhoids, once they have been manually worked back into place.
• Warm sitz baths can help relieve pain and itching.
• If conservative measures are ineffective, injection sclerotherapy may be tried. This technique involves injecting the hemorrhoid with a chemical that shrinks and scars the inside of the mass. This can be effective in stopping bleeding.
• If sclerotherapy fails, your doctor may recommend banding, or ligation, in which a tiny rubber band is placed around the base of the hemorrhoid, "strangling" it. The hemorrhoid then dies and is sloughed off.
• Very large, painful hemorrhoids may require surgical opening and removal of some of the stretched tissue.
  Note: If too much tissue is removed or infection sets in, the rectum or anus may become narrowed.

Complementary and Alternative Therapies:

Nutritional support, topical preparations, and sitz baths may be effective in reducing hemorrhoids.

Nutritional Supplementation:

• Fiber supplements are natural bulking agents that can significantly reduce constipation and straining during bowel movements. They are less irritating to the bowel than whole wheat or cellulose products. Follow the label directions.
• Rutin, a bioflavonoid, is a component of vitamin C that acts to combat fragile capillaries. Bioflavonoids are very beneficial for any venous condition where weakness is involved. They help to strengthen the integrity of vein walls and increase the muscular tone of the veins. Take 500 to 1,000 mg per day.
• Grape seed or pine bark extract works to calm inflammation while fortifying blood vessel strength. Follow label directions.
• Bromelain is an enzyme that helps to prevent the formation of fibrin, a substance that surrounds varicose veins in the rectum or anus.
• Bromelain reduces the discomfort of acute inflammations. Follow label directions.
• Vitamin E promotes tissue healing and helps control bleeding. Take 600 IU per day.
  Warning: If you are taking a blood thinner, consult your doctor before taking supplemental vitamin E.
• Vitamin A with beta-carotene helps facilitate the healing of mucous membranes and damaged tissue. Take 10,000 IU of vitamin A and 25,000 IU of beta-carotene.
  Warning: If you are pregnant, intend to get pregnant, or have liver disease, contact your doctor before taking supplemental vitamin A.
• Calcium and magnesium are essential for blood clotting. Use calcium chelate or asporotate form. Take 1,500 mg daily of calcium and 750 mg daily of magnesium.
• Use a good probiotic supplement containing acidophilus or bifidobacteria. Follow the label directions.

Alternative Therapies:

• Horse chestnut seeds work as a natural astringent to shrink swollen membranes. Take 300 to 500 mg three times daily.
• Bilberry boosts the strength of blood vessels and may even help to prevent/treat hemorrhoids associated with pregnancy. Follow label directions. Use a standardized product with guaranteed anthocyanoside content.
• Butcher's broom constricts the hemorrhoids and has anti-inflammatory properties. Take 100 to 200 mg three times daily.
• Carthamus and persica is an herbal combination that has been used in China for over 2,000 years to help hemorrhoids heal quickly. Take 500 mg three times daily.
• Fargelin is an ancient herbal formula that helps shrink swollen tissue and reduces inflammation quickly.
• Witch hazel leaves, brewed as a tea, can be applied topically. This helps reduce local inflammation and helps shrink swollen tissue.
• Aloe vera gel, applied directly on the anus, can relieve pain and soothe the burning sensation. The fresh pulp is best.
• Bayberry, goldenseal root, myrrh, and white oak, used in salve form, work like conventional hemorrhoid preparations.
• A paste made from powdered comfrey root can be used in a poultice to heal bleeding hemorrhoids.
  Warning: Comfrey is recommended for external use only.
• Lady's mantle (yarrow), prepared in a strong warm tea, can be applied to with a cotton pad to shrink the swollen veins.
• Other beneficial herbs include blackthorn bark, collinsonia root, parsley, red grapevine leaves, and stone root.
• The homeopathic remedy, Aesculus hippocastanum, is the remedy for acute hemorrhoid pain and discomfort. Calcareea fluorica, Collinsonia, Hamamelis verginica, Nux vomica, and Sulfur remedies may all help. Consult a homeopathic practitioner for more information.

General Recommendations:

• Eat foods that are high in dietary fiber, such as wheat bran, fresh fruits, and nearly all vegetables. A high-fiber diet is probably the most important consideration in the treatment and prevention of hemorrhoids.
• To help bleeding hemorrhoids eat foods which are high in vitamin K, such as ­ alfalfa or blackstrap molasses.
• Drink plenty of liquids.
• Taking 1 or 2 tablespoons of flaxseed oil daily can help soften stools.
• You can use raw potato suppositories to help heal hemorrhoids and relieve pain. Peel a potato and cut it into small cone-shaped pieces.
• A hot bath for fifteen minutes a day is quite helpful.
• Learn proper lifting techniques.
• Sit on a soft cushion, not on hard surfaces. Note: The old-fashioned inflated doughnut cushion actually increases pressure upon the hemorrhoidal blood vessels. Choose a normal cushion.
• Get regular moderate exercise.
• Avoid using rough toilet paper. Use moistened toilet paper or baby wipes instead.
• If you are overweight, adopt a sensible weight-loss program that includes exercise.

Warnings:

• Comfrey is recommended for external use only.
• If you are taking a blood thinner, consult your doctor before taking supplemental vitamin E.
• If you are pregnant, intend to get pregnant, or have liver disease, contact your doctor before taking supplemental vitamin A.