By Dr. Mercola
Hemorrhoids aren’t a pleasant subject and can be embarrassing to discuss -- even with your healthcare specialist. But they are quite a common problem in both men and women. In fact, according to the National Institute of Diabetes and Digestive and Kidney Diseases (a branch of the National Institutes of Health), it’s estimated about half the people in the U.S. will have hemorrhoids by age 50.
This isn’t surprising given the typical Western diet coupled with lifestyles which often include too much stress and too little physical exercise. Hemorrhoids aren’t exclusively a condition of the modern Western world; however they are rarely seen in more primitive, less industrialized cultures.
What Is a Hemorrhoid, Exactly?
Hemorrhoids are veins in the wall in your rectum and anus that have become twisted, swollen, and inflamed. They can form either internally or externally, and the resulting lumps can cause pain and bleeding.
If you have a hemorrhoid inside your anus, above the junction of your rectum and anus, you have an internal hemorrhoid. If your hemorrhoids are below this junction and under the skin around the anus, they are considered to be external. Both types of hemorrhoids may remain in your anus or protrude outside it.
How Hemorrhoids Form
Hemorrhoids are most often created by an increase in pressure, usually from straining to have a bowel movement. Hemorrhoids are common in people with chronic digestive disturbances – especially constipation. They are also seen in the elderly, and during pregnancy. If you’re pregnant, the additional pressure your growing baby places on your uterus can result in hemorrhoids. Childbirth can increase the problem, but fortunately, most hemorrhoids caused by pregnancy resolve after delivery.
Another common cause of hemorrhoids is obesity, because when you are overweight, your body simply does not have enough of the forces to generate proper elimination through your intestine.
How Do You Know if You Have a Hemorrhoid?
If you have hemorrhoids you may or may not experience symptoms, and with proper care, most symptoms disappear within a few days.
The most common sign of an internal hemorrhoid is the presence of bright red blood, usually noticeable on toilet paper or in the toilet bowl. It’s possible for an internal hemorrhoid to protrude through your anus, however, in which case you’ll probably experience some irritation and pain.
If your hemorrhoids are external, your symptoms can include swelling or a lump (blood clot) around your anus. These are referred to as thrombosed external hemorrhoids, and can be quite painful.
Depending on your toilet habits, you can aggravate your problem, causing additional irritation, bleeding, and itching. (Drainage from hemorrhoids can also cause itching.) If you suffer from hemorrhoids, it’s important not to strain to have a bowel movement. Excessive rubbing or cleaning of the area can also exacerbate your problem.
Other conditions with symptoms which can mimic those of hemorrhoids are anal abscesses, anal fissures and fistulas, and non-specific itching or irritation (commonly termed pruritus ani).
A Word of Caution About Rectal Bleeding
If you have bleeding you suspect is hemorrhoid-related, I recommend you consult your doctor or other medical specialist – especially if it’s a new symptom for you. Bleeding from the rectum can be a sign of other, more serious conditions, including colorectal cancer, especially if you’re elderly.
As mentioned above, bright red blood is most often a sign of hemorrhoids, but any new or sudden signs of bleeding should be investigated, regardless of your age.
Interestingly, vitamin D is one of the best ways to reduce your risk of colon cancer. Optimizing your vitamin D levels may reduce your risk by as much as 80 percent!
So make sure you get your vitamin D levels checked, and strive to maintain your levels around 60 ng/ml throughout the year as a powerful preventive measure.
Preventing Hemorrhoids in the First Place Is the Goal
Hemorrhoids are most often the result of straining due to constipation.
Constipation is frequently caused by improper diet, lack of exercise, inadequate intake of water, and stress. Other contributors include laxative abuse, irritable bowel syndrome, and hypothyroidism.
These simple steps can help prevent constipation:
Eat fiber-rich foods. Vegetables are great sources of fiber. Ideally you’ll want to eat those recommended for your individual nutritional type. Consuming a wide variety of vegetable fiber will provide the bulk needed for your stool to pass comfortably through your intestines. If you need extra fiber, I suggest whole organic flaxseeds. Grind them in a coffee grinder and add one or two tablespoons to your food. You can also try organic psyllium, which helps alleviate both constipation and diarrhea. I recommend avoiding any type of non-organic psyllium, such as Metamucil. Proceed slowly if you’re not used to getting much fiber in your diet, as you may experience some bloating and gas as your digestive system gets accustomed to the added fiber.
Consider eating fresh oranges for the flavonoids they contain. Flavonoids are powerful phytochemicals which promote the health of your veins. You might also consider adding coconut oil to your diet. South Pacific tropical islanders are known to consume at least half the fat in their diets from coconuts, with the result that many typical Western illnesses and conditions -- including hemorrhoids -- are uncommon. My personal recommendation is pure virgin coconut oil.
Drink plenty of pure water -- either clean spring water or water filtered by reverse osmosis. Use your thirst and the color of your urine as guides for whether you’re adequately hydrated. Your urine should be a light yellow color. If it is dark yellow, you’re likely not drinking enough water. (A bright yellow color is usually the result of vitamin B2, found in most multi-vitamins.) Adequate fiber and water create softer stools. A softer stool moves more easily through your colon and lessens the need for straining.
Exercise regularly to keep your digestive tract stimulated.
Take a high-quality probiotic. Balancing your gut bacteria will not only help your constipation, but your overall health as well.
Get control of your emotional stress. I highly recommend tools such as Emotional Freedom Technique (EFT) to help alleviate emotional stressors which contribute to constipation. It can also help you reduce and eliminate painful symptoms of hemorrhoid flare-ups.
Another option few people are aware of is using a squat toilet. I went to India last year and, interestingly, many places do not have regular toilets but just a hole in the floor. When you use a toilet like that, your body will be in the position it was designed to be in when you’re having a bowel movement.
When you sit on a regular toilet, you lose a lot of the force that helps with elimination. Now, I’m not suggesting you cut a hole in your bathroom floor; there are other devices you can put around your toilet that will somewhat simulate that squatting position, to help you eliminate with greater ease.
Practice Good Toilet Habits
Allow your body to work naturally by using the toilet whenever you feel the urge to have a bowel movement. Go as soon as you feel the need – delaying can cause or aggravate constipation.
Don’t sit on the toilet for prolonged periods. This increases pressure on your rectum, which is exactly what you don’t want do. Limit time on the toilet to three to five minutes per sitting. If necessary, get up, walk around or otherwise distract yourself, and wait for the urge to return before returning to the toilet. You can also use a small footstool while seated on the toilet to elevate your legs and relieve pressure on swollen tissue.
Don’t strain excessively to have a bowel movement. Exert gentle pressure only, for no more than 30 seconds per attempt, focus on using your abdominal and pelvic muscles.
Use a squatting position. Hemorrhoids are rarely seen in countries where people squat for bodily functions. Results of a study published in the late 1980’s showed 18 out of 20 hemorrhoid patients had complete and sustained relief from pain and bleeding with use of a squat toilet.
Use Proper Cleaning and Wiping Practice
Don’t aggressively rub the area with toilet paper or other types of wipes, as this will further irritate and inflame your skin.
If possible, clean the area in a bath or shower without using soap – soap is an irritant. Make sure to rinse the area well, and gently pat dry with a soft towel.
In situations where bathing isn’t possible, use a disposable moistened wipe in a slow and gentle motion.
At-Home Hemorrhoid Symptom Relief
Butcher’s broom is an herbal extract you can use if you’re struggling with hemorrhoids. It has powerful anti-inflammatory and vasoconstrictor effects, and can help tighten and strengthen those veins. It’s used specifically to treat problems with veins; it helps strengthen the vein’s walls so they don’t dilate and expand when pressure is applied during a bowel movement.
Other beneficial supplements include horse chestnut, bromelain, Japanese pagoda tree extract, and aloe vera extract.
Try a sitz bath. A sitz bath involves immersing your hips and buttocks in warm water. The moist heat of the bath provides relief from symptoms and helps to heal inflamed tissue. Use warm, not hot water, and don’t add anything to it. Sit for 10 to 15 minutes at a time, as often as you like, to help relieve symptoms.
Apply cold compresses or ice packs to your anal area on and off for 10 to 15 minutes at a time, up to five times per day.
Keep your anal area dry, as moisture promotes irritation, itching, and infection of your skin.
Apply a coating of petroleum jelly to your anal area to soothe irritated tissue. You can also apply aloe vera gel to relieve burning, or a topical astringent like witch hazel.
After bowel movements, wipe with toilet paper, compresses, or cotton moistened with witch hazel (available in the pharmacy section of most stores).
In severe cases, it is sometimes necessary for hemorrhoids to be treated surgically or endoscopically. However, this should be done only as a last resort.
There are a number of techniques for medical hemorrhoid treatment, including:
Rubber band ligation, in which a rubberized band is placed around the base of the hemorrhoid. The band cuts off blood flow to the hemorrhoid, causing it to die off and wither away within a few days.
Sclerotherapy, which involves the injection of a chemical solution to shrink the hemorrhoid.
Infrared coagulation (burning of the hemorrhoidal tissue).
Hemorrhoidectomy -- surgical removal of hemorrhoids.
Always strive to prevent a condition like hemorrhoids -- so treatment isn’t necessary. Like most painful or irritating health conditions, hemorrhoids are a signal from your body to pay more attention to your diet, water consumption, physical exercise, emotional stress, or other lifestyle issues.