Hemorrhoids

Description

Hemorrhoidal disease resembles varicose veins (although there are no valves) in the rectal area. Blood vessels may become enlarged and painful, with bleeding into the stools, or toilet tissue.

They may occur within the anal canal (internal hemorrhoids) or at the periphery (external hemorrhoids), or a combination of the two. Internal hemorrhoids may enlarge and prolapse beyond the anal sphincter. Large lesions are treated with surgical ablation, nowadays provided by laser instrumentation.

Causes

This seems to be another of the “Western diseases”, brought on by a low fiber diet and sedentary lifestyle. As many as a third of the US population suffers from hemorrhoids, more than half after age 50.

Straining during defecation may activate the underlying condition. Excessive venous pressure is the key, although there may be a genetic predisposition.

Isolated cases may be brought on following trauma to the sacrococcygeal joint.

Signs & Symptoms

Itching is rarely due to hemorrhoids. The lack of sensory nerves above the anorectal line excludes pain from internal hemorrhoids. The major sign is bleeding, which can become chronic causing anemia.

External hemorrhoids can be painful, especially if there is acute inflammation, or strangulation of a prolapsed hemorrhoid by the anal sphincter.

Straining during bowel movements should be avoided, which may require dietary changes. Straining increases abdominal pressure, retarding venous return, increasing pelvic congestion and weakening veins.

In the elderly, low fiber and dehydration may contribute to fecal impaction which can be fatal.

Nutritional Supplements

Structure & Function: Intestinal Health

---------------------------------
General Supplements
---------------------------------

B-complex	30-100 mg
Bioflavonoids	200-1000 mg
Fiber*
Vitamin A	10,000 i.u.
Vitamin C	500-1000 mg
Vitamin E	200-600 i.u.
Zinc	15-25 mg

* Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

A high fiber diet is key: fruits, vegetables and whole grains. Various cellulose fiber products are available commercially as a supplement. Many form a gelatinous mass when added to fruit juice. They contribute bulk (and zero calories) providing a mild laxative action, thereby removing the necessity of straining and reducing the symptoms of hemorrhoids.

High fiber also requires additional liquids. a contributing factor itself.

Fruits, containing flavonoids are recommended to build up the venous structures. These include blackberries, blueberries and cherries or a supplement like pycnogenol (usually derived from pine bark and/or grape seeds).

Patients should be advised to avoid caffeine, or other dietary items, that seem to exacerbate symptoms.

The usual array of antioxidant nutrients are convenient, when fruits are out of season. These include: vitamins A, C, E and zinc.

Vitamin B complex is also recommended.

Homeopathic Remedy

Description	Remedy
Bleeding, protruding, itching	Calcarea fluorica tinct.
Dark blood	Hamamelis virginica
Itching	Nux vomica
Prolapsed rectum	Ruta graveolens tinct
Protruding with stitching pains	Ignatia amara
Sensitive	Hypericum tinct.

Treatment Schedule

Over-the-counter homeopathic remedies may be single strength (of fairly weak potency e.g. 6X ) or a blend of several weaker strengths (6X, 8X, 10X).

This may comprise a single remedy, or several remedies.

Doses are administered on a 3 times daily (tid), between meals,schedule and continued for 3 days.

Liquid preparations usually use 8-10 drops per dose.

Solid preparations are usually 2 or 3 pellets per dose.

Children use 1/2 dose i.e. 1 pellet.

If there is aggravation of the symptoms, stop taking the remedy and consult a homeopath.

References

Murphy, R. : Homeopathic Medical Repertory. Hahneman Academy, Pagosa Springs, Colorado. 1993.

Murphy, R. : Lotus Materia Medica. Hahneman Academy, Pagosa Springs, Colorado. 1995.

Pert, J.C.: Homeopathy for the Family. The Homoeopathic Development Foundation, London. 1985 edition.

Tissue Salts

Calc. Fluor.	primary remedy, relaxed sphincter muscles, bleeding, itching piles;
Ferr. Phos.	soreness and inflammation, also bright-red bloody discharge;
Kali Mur.	thick, dark blood, white-coated tongue;
Mag. Phos.	sharp pain, stinging, spasmodic attacks;
Nat. Mur.	hard, dry, crumbly stools, fissuring;
Nat. Sulf.	piles and biliousness.

Herbal Approaches

----------
Herbs
-----------

Butcher's broom (Ruscus aculeatus)
Horse chestnut
Psyllium
Witch hazel

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Butcher's broom (Ruscus aculeatus) acts as a vasoconstrictor. It may also be applied as a cold compress.

Horse chestnut ("Conkers") is a topical astringent.

Psyllium is a laxative, to overcome any constipation associated with this condition.

Witch hazel is another topical astringent.

Aromatherapy - Essential Oils

Cypress Essence,	Frankincense Essence,
Myrtle Essence,	Patchouli Essence,

Related Health Conditions

        Anemia
        Constipation
        Varicose veins

Abstracts

References

Buckshee K et al., Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet, 1997 May, 57:2, 145-51.

Dennison AR et al., New thoughts on the aetiology of haemorrhoids and the development of non-operative methods for their management. Minerva Chir, 1996 Apr, 51:4, 209-16.

Gray-DS.: The clinical uses of dietary fiber. Am-Fam-Physician. 1995 Feb 1; 51(2): 419-26

Johanson JF: Association of hemorrhoidal disease with diarrheal disorders: potential pathogenic relationship? Dis Colon Rectum, 1997 Feb, 40:2, 215-9; discussion 219-21.

MacRae HM & McLeod RS: Comparison of hemorrhoidal treatments: a meta-analysis.
Can J Surg, 1997 Feb, 40:1, 14-7.

Metcalf-A.: Anorectal disorders. Five common causes of pain, itching, and bleeding. Postgrad-Med. 1995 Nov; 98(5): 81-4, 87-9, 92-4.

Moesgaard, F. et al: High fiber diet reduces bleeding and pain in patients with hemorrhoids. Dis. Colon Rectum, 1982, 25: 454 - 456.

Polglase AL: Haemorrhoids: a clinical update. Med J Aust, 1997 Jul 21, 167:2, 85-8.

Read-NW. et al: Constipation and incontinence in the elderly. J-Clin-Gastroenterol. 1995 Jan; 20(1): 61-70.

Sinclair-A.: Remedies for common family ailments: 9. Haemorrhoids. Prof-Care-Mother-Child. 1995; 5(6): 161-2.

Webster, D.J. et al: The use of bulk evacuation in patients with hemorrhoids. Br. J. Surg. 1978, 65: 291 - 292.