Eric Bakker N.D.April 1, 2022

Hemorrhoids are swollen and inflamed veins in the rectum or anus, they are also known as piles. Many of the most common symptoms are around the anal area, causing discomfort, itching, and bleeding. Treatments include ointments, home remedies, and lifestyle changes are frequently used in treatment as well as prevention. 

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What Are Hemorrhoids?

Hemorrhoids are swollen veins which are situated around the anus and in the rectal area, they are most always situated in the very lowest portion of the colon. Hemorrhoids are also known as “piles” which comes from the Latin word meaning “ball”. I tell patients that hemorrhoids are actually varicose veins, but not in the legs. These pesky little protrusions of veins can enlarge and as the veins lose their elasticity they can result in sac-like protrusions which push into the anal canal. Don’t worry, hemorrhoids are definitely not tumours or cancers. But they can be most annoying and also embarrassing.

What Causes Hemorrhoids?

The most common cause of hemorrhoids is venous insufficiency (poor return of blood in the veins back up to the heart) and involves inadequate drainage of (venous) blood from any region of the body resulting in oedema (the pooling of fluid in the body) The most common region of the body which venous insufficiency affects is in the legs, especially lower, but it will also occur in the anus.

Any impairment of blood circulation (via the veins) towards the heart is often referred to as venous insufficiency. It is quite common to see people get these “small grapes” when they quit smoking, because this changes the micro-circulation to a small extent in the lower extremities. This in turn puts “back-pressure”on the liver, and piles are formed.

Sedentary Lifestyle

Think of piles as varicose veins of the anus, it is a slowing of blood flowing from the legs back to the heart. I have found that many patients come to see me with this problem, and in my opinion the best way to get rid of them permanently is to engage in a permanent exercise program, especially walking/running/swimming and/or gym work, and to never let yourself get constipated. Massage of the legs is especially good as it stimulates the circulation which is good, daily walking is the best. Studies have shown that constipation, a low fibre diet, a high Body Mass Index, and a sedentary lifestyle are often assumed to increase the risk of hemorrhoids. Check out the article about constipation. The big area to bear in mind is to keep the bowel going all the time, you must not get complacent about activity. A sedentary (couch or computer) lifestyle is the enemy of the sigmoid colon, the part of the bowel, just before the anus.

Pregnancy and Childbirth

Pregnancy and after childbirth and common factors with hemorrhoids, and I’m sure many women out there can relate to this. Some of the biggest reasons with pregnancy is that the growing foetus puts increasing pressure on the liver and circulation, and this is often accompanied by several hormonal changes.

Hemorrhoid Symptoms

Hemorrhoids can be really annoying, have you noticed? What is there to be happy about when your hemorrhoids can itch, burn, sting or create many different annoying sensations throughout your day. The most common symptoms are itching, burning, pain and discomfort, inflammation, swelling, seepage and bleeding.

Hemorrhoids can be caused as well as being aggravated by sitting or standing for long periods, violent coughing, lifting heavy objects (or even lifting light objects but improperly) and especially with straining when you have a bowel movement (especially when the bowels are hard to shift).

Bleeding

Bleeding hemorrhoids will usually produce bright red blood during bowel movements and these can be quite distressing for many. Several patients over the years have come to see me who were worried about having developed bowel cancer, which turned out to be nothing but those annoying hemorrhoids. Although it is an indication the something is not quite right “down there”, bleeding from the anus does create quite a scare.

Obesity

What other causes can be found with hemorrhoids, especially if they are recurrent? You may find the being overweight or obese can be a cause, but you may also find lack of exercise, liver damage, food allergies or intolerances and especially a lack of dietary fibre.

Types Of Hemorrhoids

Apparently half of people in the Western developed nations over the age of fifty develop hemorrhoids, and the incidence increases until the age of 65, by which time the incidence tends to reduce. There are many different types of hemorrhoids, but the most common three types are the ones listed below.

External Hemorrhoids

These are piles which have a tendency to develop just under the skin at the opening of the anal cavity. Sometimes they can form a hard lump and if a blood clot forms within them a hard lump may even form. These are the little bluish or purplish lumps which form because the skin becomes firm and tight. They can be very painful and affect younger people in general.

Internal Hemorrhoids

These are different from the external type, because they tend to form just inside the rectum. They are most always painless because the tissues inside the rectum lack sensitive nerve fibres. These internal piles do tend to bleed, and when they do bright red blood appears.

Prolapsed Hemorrhoids

These piles are prolapsed and are most always as a result from an internal hemorrhoid which has collapsed. These piles protrude and are accompanied by a mucous discharge and can have a tendency to heavy bleeding. Sometimes these prolapsed hemorrhoids have become thrombosed as clots can form within as they shrink and become withdrawn. As this occurs, they can become the most painful of all hemorrhoids in some cases.

Hemorrhoids Diet

After doing some research into hemorrhoids when writing this article, I was surprised to discover that humans are the only ones afflicted with hemorrhoids, no animals are know to suffer from hemorrhoids, only the humans. This can be easily explained because it is humans who have strayed the most away from nature with their unhealthy modes of diet and lifestyle. Animals tend to eat instinctively and not for emotional reasons or the “pleasure principle” like we humans can tend to do.  I like patients with this problem to change their diet for the better, and once they do they will often notice a big difference in a matter of weeks.

  • Eat foods high in dietary fibre like oat bran, plenty of fresh fruits and vegetables such as apples, broccoli, spinach, beans, avocados, pears, psyllium husk, guar gum, and whole grains in general.
  • Careful when eating beetroots, your stool may be red and this may cause you to think that you are bleeding when in fact it is the beetroot. The same goes for a reddish coloured urine which beetroot can cause as well. There is nothing wrong with this colour when eating beetroot so don’t stop eating them for this reason.
  • High fibre diet is the BIG one to commit to when you have hemorrhoids, forget junk foods please.
  • Psyllium is especially good if you have any bleeding hemorrhoids – and please be sure to have your blood tested for iron regularly if you have bleeding hemorrhoids, because you could well be iron depleted and develop anaemia.
  • Aloe vera is one of the best herbal medicines for the sigmoid colon, which is the lower part of the bowel leading to the anus. If you have constipation and suffer with hemorrhoids, especially if you have a long-standing case, then get a good quality aloe vera juice and take 20mls three times daily in water before meals.
  • Do you have bleeding hemorrhoids? Then ensure you take an iron supplement regularly and in addition eat foods high in Vitamin K. Best foods here are molasses, dark green leafy vegetables and alfalfa sprouts.
  • Cut back on animal proteins like red meats and proteins like pork, bacon, lamb, etc. These proteins are hard on the digestive system, instead eat more chicken and fish.
  • Cut back significantly on alcohol, spicy foods and coffee.
  • Take 1 – 2 Tablespoons of flaxseed oil daily, and have two capsule of a good Omega 3 daily like HokiMega3.

Local Treatment of Hemorrhoids

If you have hemorrhoids which are giving you a lot of grief, clean the area daily with warm water. A warm to hot bath each day for ten to fifteen minutes can be very helpful. Avoid bath oils or adding bubbles as this could be quite irritating to sensitive and inflamed areas of skin down there. I would recommend plenty of plain warm water and NO soap.

Sit on a soft cushion, and definitely not on a hard surface like a wooden chair or floor. Do avoid donut shaped cushions as these can actually put more pressure on the area. Just use a soft cushion. Another tip – avoid harsh toilet paper and buy that expensive soft stuff from your supermarket. Yes, it does make a difference and if your piles are pretty bad you may want to moisten the toilet paper a little too.

Careful When Lifting 

improper_liftingLearn to lift objects properly, I’ve given up counting how many people I’ve seen over the years who developed a back, knee or hemorrhoid problem after lifting an object far too heavy or improperly. Bend your knees and NOT your back! Do not hold your breath as you lift the object, this only puts a lot of strain and pressure on the blood vessels surrounding the hemorrhoid.
Instead, take a deep breath and slowly exhale when you start to and during the lift. Let your thigh muscles do the work and not your back. Good advice? Avoid heavy lifting as much as you possibly can, especially if you have hemorrhoids or a previous bad back.

How To Treat Hemorrhoids

  • Pine Bark Extract (take 400 – 600mg/day when it is an acute problem, you’ll be glad you did)
  • Don’t get constipated – stool bulking is best augmented with a powdered fibre supplement from stuff like from rice and oat bran, and apple fibre. Make sure you have 1-2 good motions/day. Eat an apple every day. Eat kiwifruit, etc. If you move your bowels well, you will have much less bother with piles. Don’t let yourself get constipated, you will make matters worse.
  • Drink water. Keep your digestive health in good condition, be sure to drink plenty of water throughout the day.
  • Vitamin C with Bioflavonoids daily – have 1-2 scoops of a top quality powder daily in water or juice. Vitamin C is  a good product for the treatment and prevention of hemorrhoids. This will make motions much easier and strengthen & tone blood vessels throughout the body.
  • Do you smoke? Smoking is bad for your circulation, consider quitting.
  • Witch Hazel Lotion can be applied directly to the piles, this is astringent (drying) and will tone them up. You can get this at a chemist (drug store if you read this and live in USA/Canada), get a low % dilution, tell them you want it to “tone your skin”, if you need to buy it over the counter and you don’t want to mention the word “hemorrhoid”.
  • Daily exercise. The trick is to get out there and improve your circulation. Just Do It.

By engaging in a daily walking program in addition to eating a high-fiber diet and taking a few quality supplements you will soon be on the road to getting rid of those annoying little things you’d rather not have.

References:

  • Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010 Feb;90(1):17-32, Table of Contents.
  • Nelson H, Cima RR. Anus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 51.

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