The Hidden Pain

Hemorrhoids can be uncomfortable and embarrassing, but you can find relief.

by Michele Wojciechowski

January/February 2017

Hemorrhoids, also called piles, are literally pains in the butt—as anyone who has ever suffered from the anal discomfort and itching they cause can tell you. And because of the location, people who have them are sometimes embarrassed.
Don’t be. The Mayo Clinic states that by age 50 half of all adults have had hemorrhoids.

All in Veins

The anus and surrounding tissues have a lot of blood vessels. As a result, “repeated trauma or irritation can cause the blood vessels to swell or bleed,” explains David Belk, MD, of Alameda, California. “Internal hemorrhoids occur when the vascular tissue above the anus either bleeds or swells to the point where the tissue prolapses (bulges past the anal sphincter). External hemorrhoids occur when blood vessels bleed into tissue that are below the anus and then form small clots, which are extremely painful.”

The most common signs of hemorrhoids are bright red blood on toilet paper or blood in the toilet, says Belk. “People will also have the feeling of something sticking out of the anus, after a bowel movement, which can either be pushed back in or goes back in by itself.”

Even just one teaspoon of blood in the toilet can look frightening, notes Patricia Pimentel Selassie, ND, CNS, of the New Flower Center for Naturopathic Medicine in Brooklyn. “Anytime you have bleeding from the anus, you should go to the doctor to make sure it isn’t a bleed from another part of the intestine,” she says. Hemorrhoids can also cause itching as well as pain—from mild discomfort to stabbing pain.

Belk explains that pregnant women are predisposed to hemorrhoids “because of both the increased vascularity and increased pressure in the pelvic region from pregnancy. Other predisposing factors are chronic constipation or diarrhea, obesity or jobs that require a person to either stand or sit for most of the day without breaks.” Selassie adds that people who have irritable bowel syndrome, marked by either loose or difficult bowel movements, are susceptible to hemorrhoids.

While hemorrhoids are generally caused by physical issues, Selassie says on occasion they can be caused by emotional ones as well. “Sometimes hemorrhoids can be associated with the inability to let go,” she says. “I find that when people get rid of these emotional issues, they get rid of the hemorrhoids.”

Easing the Painful Itch

There are natural ways to ease hemorrhoids. “While they do not usually completely go away, it is possible for the symptoms of hemorrhoids to improve,” says Amelia Roberts, BSN, RN, CPN, of Rockville, Indiana.

It helps to avoid having frequent, hard bowel movements. Belk suggests a high-fiber diet but adds, “Be careful not to overdo it because diarrhea can be just as traumatic or even worse.” (Roberts suggests talking with your practitioner before making any major dietary changes.) Avoiding standing or sitting for extended periods of time; exercise and weight loss can also help.

Selassie suggests drinking more water, on the order of half your body weight in ounces of water a day. For example, a 150-pound person should drink 75 ounces. She also recommends getting fiber from vegetables and taking magnesium citrate (magnesium is the most common mineral deficiency).

Witch hazel-soaked pads and cornstarch suppositories are a common treatment. Witch hazel is an astringent, explains Selassie, and can tighten up the hemorrhoid and dampen inflammation, reducing the pain. “Make sure there is no underlying parasite or candida that is also contributing to the itch and inflammation,” she says.

Selassie also recommends using suppositories, salves and ointments made from herbs such as marshmallow, plantain, slippery elm and calendula. “Homeopathic creams and oral tablets specially formulated for hemorrhoids are helpful,” she adds. “Taking the herb horse chestnut, 250 milligrams standardized to 20% triterpenoids orally, has been demonstrated to help strengthen the intima media (the middle wall of the hemorrhoidal vein) to tighten up the hemorrhoid and help it heal.”

Sitz baths are beneficial for hemorrhoids. You can use a type that fits on your toilet seat or take a sitz bath in the bathtub. To do so, run two or three inches of warm (not hot) water into the bathtub without any soap or other bath products, and sit in the water for between 10 to 15 minutes. Soak for up to three times a day or more depending on your practitioner’s recommendations.

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