What are Hemorrhoids?
Hemorrhoids, also known as piles, are actually just enlarged (varicose) veins that occur in the anus or rectum. Because the veins in these areas are located in the lower part of the body, gravity causes the blood to pool in them instead of flowing back to the heart. This causes the veins to stretch and weaken. The blood can also sometimes flow backward, since these veins lack valves to prevent this.

When veins enlarge, two types of hemorrhoids can develop. Internal hemorrhoids form inside the rectum, about an inch above the anus. Though they can cause bleeding after a bowel movement, they are painless and cannot be seen or felt easily. However, internal hemorrhoids can painlessly pop out through the anus (prolapse). Patients quickly discover that prolapsing hemorrhoids can be reinserted with their finger. External hemorrhoids form around the anal opening. These hard, itchy, tender bumps are fragile, so they are likely to be tender and bleed easily after a bowel movement or when wiped with toilet tissue.

The only time hemorrhoids actually become painful is the fortunately uncommon event when a prolapsed hemorrhoid develops a blood clot (thrombosis) inside it; it can’t be reinserted and begins to lose its own blood supply (strangulation). This situation is quickly remedied with a surgical procedure. Doctors recommend that repeatedly prolapsing hemorrhoids undergo surgical removal to avoid this painful occurrence.

Hemorrhoids are a common problem, afflicting nearly three-quarters of all Americans at some point in their lives. Because they cause few symptoms, however, some people are not even aware that they have them. While hemorrhoids can be a nuisance, they are not a serious health risk.

Key Symptoms

Bright red blood on toilet tissue, in the stool, or in the toilet bowl after a bowel movement

Painful bowel movements

Itchy anal area

Painful, hard bump on or near the anus

Anal discharge of mucus

What Causes Hemorrhoids?

The main cause of hemorrhoids is straining during bowel movements, which exerts extra pressure on the anal and rectal veins. This straining is often the result of constipation caused by dehydration or inadequate fiber in the diet.

Other possible causes are:

Pregnancy, childbirth, or obesity, which all put excess pressure on the lower abdomen and weaken veins

Prolonged periods of sitting or standing

Loss of muscle tone due to old age or rectal surgery; some muscles help pump blood through veins

Heredity

Frequent diarrhea.

Treatment and Prevention

Mild cases of hemorrhoids are mainly treated by drinking plenty of fluids and increasing the fiber in your diet. A variety of over-the-counter hemorrhoid creams contain corticosteroids and local anesthetics to reduce pain and swelling.

Doctors frequently recommend patients have daily sitz baths. Surgical treatment of internal hemorrhoids includes rubber banding them (they eventually wither and fall off) or using cryosurgery. Prolapsing hemorrhoids require a hemorrhoidectomy, or surgical removal of the hemorrhoid.

A variety of supplements can help relieve hemorrhoids and prevent future flare-ups by strengthening the veins and minimizing irritation. They should be used in conjunction with exercise and a high-fiber diet, which together will help tone the muscles around the veins, promote regular bowel movements, and soften stools, making them easier to pass.

Just a reminder: If you have a serious medical condition or are taking medication, it’s always a good idea to talk to your doctor before you start a supplement program.

How Supplements Can Help

Taken together, vitamin C, flavonoids, and the herb butcher's broom will help tone and shrink enlarged veins.

Zinc will speed up the healing process. Add copper when taking zinc longer than one month as it interferes with copper absorption.

Psyllium or flaxseeds will add enough fiber to your diet to bulk up the stool and make its passage easier.

For painful hemorrhoids, apply an oil or ointment containing the herb St. John's wort, especially after bowel movements. It helps shrink swollen tissues.

Because hemmoroids are due to weakness of the valves within veins, using the herbal "vein tonic" horse chestnut will help increase the muscular tone of the vessels and keep the veins from bulging. (Be sure to use a commercial product and not parts of the tree in your back yard. Unprocessed horse chesnut may contain toxins.)

Self-Care Remedies

For external hemorrhoids, try ice compresses or warm-water sitz baths two or three times daily.

An over-the-counter cortisone cream (0.5 percent strength) will also provide relief.

If you have heart disease or diabetes, be sure to check product labels carefully. Some OTC products containing compounds that shrink hemorrhoidal tissue may carry warnings.

Don't strain excessively during bowel movements, and don’t stay on the toilet longer than necessary.

To ease defecation, apply zinc oxide paste or powder, or petroleum jelly, to the anal opening. Use a latex glove when doing so.

Apply a poultice made from elderberry to soothe swollen veins and relieve pain. Grind a small amount of the herb, mix with warm water until it becomes a paste, spread on gauze, and apply to anus for a couple of hours.

Witch hazel cream is another popular topical remedy in gel or glycerine tincture form; avoid alcohol–based products as they will be very irritating to rectal and anal tissues.

After a bowel movement, clean the anal area thoroughly but gently. Use soft toilet tissue moistened with warm water or witch hazel, or pre-moistened wipes. To dry the area, dab--don't scrub--it with a soft, clean disposable cloth. Another alternative for drying the area is to use a blow dryer. Do not be aggressive in your cleaning as this can inflame veins.

Eat a high-fiber diet with plenty of fruits (especially citrus fruits which also contain vein-strengthening flavonoids), vegetables, grains, and legumes.

To avoid constipation, drink at least eight glasses of water a day (more during hot, humid weather).

Stay away from foods that may aggravate hemorrhoids: nuts, red pepper, mustard, coffee (regular and decaffeinated), and alcohol.

Avoid laxatives. Diarrhea can be as aggravating to hemorrhoids as constipation.

When lifting weights or heavy objects (or during a bowel movement), breathe normally. Holding your breath increases abdominal pressure.

For comfort, wear cotton underwear and loose-fitting clothes.

When to Call a Doctor

The first time you notice blood-streaked toilet tissue, to make sure it's caused by hemorrhoids rather than something more serious

If blood is dark rather than bright red

If bleeding isn't due to a bowel movement, even if you know you have hemorrhoids

If you feel a throbbing pain in the anal area. (This could indicate a possible blood clot in the hemorrhoid.)

If you have hemorrhoids and daily bleeding is severe. (This could lead to iron deficiency anemia.)

Supplement Recommendation