What are Hemorrhoids?
Hemorrhoids also known as haemorrhoids or piles are swellings and inflammation of veins in the rectum and anus. The anatomical term “hemorrhoids” technically refers to “‘Cushions of tissue filled with blood vessels at the junction of the rectum and the anus”.
What types of Hemorrhoids are there?
- External hemorrhoids are those that occur outside the anus. They are sometimes painful, and can be accompanied by swelling and irritation. Itching, although often thought to be a symptom of external hemorrhoids, is more commonly due to skin irritation.
- Internal hemorrhoids are those that occur inside the rectum. As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated. Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids:
- Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside the anus.
- Hemorrhoids trapped outside the anal opening, when the supply of blood is cut off, become strangulated hemorrhoids.
What causes Hemorrhoids?
Sitting for long periods of time can start the hemorrhoidic process.
Increased straining during bowel movements caused by constipation or diarrhea may lead to hemorrhoids. It is thus a common condition due to constipation caused by water retention in women experiencing premenstrual syndrome or menstruation.
Hypertension, also referred to as high blood pressure, is also a contributing factor.
Obesity as well as poor muscle tone or poor posture all of which can contribute to additional pressure on the rectal veins.
Pregnancy which may lead to hypertension and increased strain during bowel movement can be a contributing factor.
Cigarette smoking during bowel movements may worsen hemorrhoid and lead to severe internal bleeding of veins (bleeding hemorrhoids) inside rectum area. Both can cause diarrhea.
What are the Symptoms?
- Itchiness around your anus,
- Discomfort around your anus, such as feeling sore or it being visibly red,
- Excessive straining when passing a stool,
- Bleeding after you have passed a stool,
- Discharge of mucus present after passing a stool,
- Pain while passing a stool, and
- Feeling like your bowels are still full and need emptying.
Hemorrhoids are usually not dangerous or life threatening and in most cases, symptoms will go away within a few days.
Can the Food we eat, affect Hemorrhoids?
- Insufficient liquid can cause a hard stool, or even chronic constipation, which can lead to hemorrhoidal radiation.
- Too many dairy products such as yoghurt, cause excessive lactic acid in the stool can contribute to hemorrhoids.
- Eating spicy food does NOT cause hemorrhoids, though spicy foods may aggravate the condition
How can we Prevent Hemorrhoids?
- Drinking more fluids
- Eating more dietary fiber (such as fruits, vegetables and cereals high in fiber)
- Exercising
- Better posture
- Reducing bowel movement strain
- Avoid wearing tight clothing and underwear around that region.
- Women who notice painful stools around the time of menstruation should begin taking extra dietary fiber and fluids a couple days prior.
Washing the anus with cool water and soap may reduce the swelling and increase blood supply for quicker healing and remove irritating fluid.
Increase your dietary fiber. A small change in the daily diet can help enormously in both prevention and treatment of hemorrhoids.
What is involved in an Examination?
- Visual examination of anus and surrounding areas for external or prolapsed hemorrhoids
- Using an anoscope, basically a hollow tube with a light attached at one end, allows the doctor to see internal hemorrhoids.
- If required, a complete colonoscopy allows an examination of the entire large bowel (Colon)
What are the Treatments for Hemorrhoids?
For many people, hemorrhoids are mild and temporary conditions that heal spontaneously or by the same measures recommended for prevention.
There is no medicine that will cure hemorrhoids but local treatments such as:
- Warm sitz baths,
- Cold compress, or
- Topical analgesic can provide temporary relief.
Warm baths, causing the vessels around the rectal region to be relaxed, are especially beneficial for providing relief with external hemorrhoids.
Keep the area clean and dry. Hemorrhoidal creams or lubricants, including ointments or suppositories such as Proctosedyl can also relieve the symptoms.
Surgical and non-medicinal treatments
For people with severe or chronic hemorrhoids, surgical and medical treatments may be required and these can include:
- Rubber band ligation
- Hemorrhoidolysis/Galvanic Electrotherapy
- Sclerotherapy (injection therapy)
- Stapled Hemorrhoidectomy
- Enema
- Doppler Guided Hemorrhoidal Artery Ligation
Natural treatments for Hemorrhoids
There are many natural treatments, including herbal and “natural” remedies, that can be successfully applied to treat hemorrhoids, however, make sure you discuss these with your doctor to avoid possible drug interactions.
In a nutshell what we want to achieve is:
- Relieve itching and swelling of hemorrhoids
- Create a softer stool that is easier to pass
- Increase circulation and help to restore flexibility back to the vessel walls
Treatments to achieve this include:
- Topical application of natural astringents and soothing agents, such as Witch hazel (astringent), Cranesbill, Aloe Vera, and honey. Witch hazel is made from the leaves and bark of a plant called Hamamelis virginiana. It is applied topically to the anal area in the form of witch hazel distilled liquid, ointment, or medicated pads.
- Eating fiber-rich bulking agents such as plantain and Psyllium seed husks to help create a softer stool that is easier to pass, to lessen the irritation of existing hemorrhoids. A typical amount of psyllium is one teaspoon of the husks in water followed by another glass of water. Another option is ground flaxseeds. Whatever the source of fiber, it’s important to drink sufficient water or constipation may worsen.
- Sleeping overnight with raised legs helps reduce or completely eliminate, especially external hemorrhoids. Combine that with a dietary supplement like hem-eez, which has shown to increase circulation and help to restore flexibility back to the vessel walls.
- Placing an ice pack to an external hemorrhoid should relieve itching and swelling. Leave the ice pack on the hemorrhoid for 15 to 20 minutes.
The combination of internal and external remedies is particularly recommended, e.g., Witch-hazel suppositories combined with frequent cups of strong chamomile tea.
Dietary supplements can help treat and prevent many complications of hemorrhoids, and natural botanicals such as Butchers Broom, Horse-chestnut, Hem-eez and bioflavonoids can be an effective addition to hemorrhoid treatment.
Butcher’s Broom extract, or Ruscus aculeatus, contains ruscogenins that have anti-inflammatory and vasoconstrictor effects that help tighten and strengthen veins. Butcher’s Broom gets its name because it was once used by butchers in Europe to clean their chopping blocks, has traditionally been used to treat venous problems including hemorrhoids and varicose veins
Butcher’s broom is usually recommended in capsule or tea form. The tea has a slightly bitter taste, so a bit of honey can be used to sweeten it. The tea can be made by steeping one teaspoon of the herb in a cup of hot water for 10 to 15 minutes. Butchers broom has also been shown to be effective when applied topically as an ointment or compress.
Butcher’s broom should not be used by people with high blood pressure, benign prostatic hyperplasia (BPH), by pregnant or nursing women, or by people taking alpha blocker or MAO inhibitor drugs unless otherwise recommended by their doctor.
Horse-chestnut extract, or Aesculus hippocastanum, contains an active compound known as aescin, which has anti-inflammatory, anti-edema, and venotonic actions. Aescin improves tone in vein walls, thereby strengthening the support structure of the vein. Horse-chestnut helps relieve the pain and swelling associated with chronic venous insufficiency.
Horse chestnut can either be taken as a tea or in capsule form or be applied externally as a compress. People with an allergy to the horse chestnut family, bleeding disorders, or people taking blood thinners should not take horse chestnut. Only products made from the seeds or bark of the young branches should be used. Other parts of the plant are poisonous. Although uncommon, side effects have included kidney damage, severe bleeding, bruising, and liver damage.
Bilberry extract, or Vaccinium myrtillus, is an anthocyanoside bioflavonoid. Supplementation with this potent flavonoid protects and maintains venous strength and function.
Bioflavonoids have been found to reduce anal discomfort, pain, and anal discharge during an acute hemorrhoid attack. Side effects of bioflavonoids appear to be mild and rare, making them a promising treatment for hemorrhoids in pregnancy (the flavonoid tangeretin however, shouldn’t be used by people taking tamoxifen for breast cancer). The major flavonoids found in citrus fruits, diosmin, herperidin, and oxerutins, appear to be beneficial.
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