Hemorrhoids are a condition in which veins in the rectal or anal area become
swollen and painful and may bleed. Hemorrhoids may occur inside the entrance to
the anus (interior hemorrhoids) or outside the entrance to the anus (exterior
hemorrhoids). A blot clot (thrombosis) may form in the vein, making the
hemorrhoid more painful and sometimes requiring surgical treatment.
|Signs and Symptoms|
Symptoms of hemorrhoids include:
- Anal itching
- Anal ache or pain, especially while sitting
- Bright red blood on toilet tissue, stool, or in the toilet bowl
- Pain during bowel movements
- One or more hard tender lumps near the anus
Hemorrhoids are a type of varicose vein that simply occur with age. Being
constipated or passing large, hard stools may contribute to the formation of
hemorrhoids. In many cases, however, there is no obvious cause. In addition to
age and constipation, other contributing factors include the
- Certain medical conditions (like cirrhosis -
end stage liver disease)
- Sitting for prolonged periods of time
- Diet low in fiber or fluids
Your provider will do an examination; this is usually enough to make the
diagnosis of hemorrhoids. If you have had significant bleeding or other
symptoms, your health care provider may perform a procedure called
sigmoidoscopy, or colonoscopy. In this procedure a small instrument is inserted
into the rectum in order to view the inside of your colon. The intention of
these endoscopic exams is, in part, to look for another cause of bleeding or
Avoid straining during bowel movements. You can also help prevent hemorrhoids
by preventing constipation. Drink plenty of fluids (at least eight glasses per
day). Eat a high-fiber diet (fruits, vegetables, whole grains). You may want to
Medications can ease pain and
discomfort during the time it takes for the hemorrhoids to heal. In addition to
lifestyle measures can help you feel
better and even prevent the recurrence of hemorrhoids.
Try the following approaches to reduce the pain and itching from your
- Apply witch hazel with a cotton swab
- Avoid pressure on the area (for example, sit on an inflatable ring).
- Wear cotton undergarments
- Avoid toilet tissue with perfumes or colors
- Try not to scratch the area
- Sit in a warm bath (or use a Sitz bath - ask
your doctor) for 10 to 15 minutes 1 to 2 times per day.
- Avoid straining during bowel movements.
- Limit the amount of time you sit on the toilet.
There are also dietary and other lifestyle steps you can take to prevent or
treat constipation which will help you avoid hemorrhoids. See article entitled
Constipation for more information.
- Over-the-counter corticosteroid creams can help reduce the pain and
swelling. Hemorrhoid creams with lidocaine (also available over-the-counter) can
- Stool softeners help reduce straining and prevent hard stools.
- Bulk laxatives help prevent hard stools and constipation.
|Surgery and Other Procedures|
For cases that don't respond to home treatments, a doctor may recommend
surgery, like rubber band ligation or surgical hemorrhoidectomy. These
procedures are generally used for patients with severe pain or bleeding who have
not responded to other therapy.
|Nutrition and Dietary Supplements|
Soluble fiber, such as psyllium, may be recommended by a physician to
help soften stool and reduce the pain associated with hemorrhoids.
This group of antioxidants, found primarily in dark berries, can help
maintain or regain vascular integrity. Loss of vascular integrity due to age or
other causes can contribute to the development of hemorrhoids.
The use of herbs is a time-honored approach to strengthening the body and
treating symptoms. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care and only under the supervision of
a practitioner knowledgeable in the field of herbal medicine. Some remedies that
such a practitioner might consider based on clinical experience
- Goldenrod (Solidago virgaurea) - used
topically in traditional herbal medicine to reduce inflammation of hemorrhoids.
- Gotu kola (Centella asiatica) - used
for venous insufficiency, pooling of blood in different locations such as the
- Grape seed (Vitis vinifera) - used by
European folk healers to stop bleeding, inflammation, and pain, such as the kind
brought on by hemorrhoids.
- Roman Chamomile (Chamaemelum nobile) - This herb may reduce
inflammation associated with hemorrhoids.
- St. John's Wort (Hypericum perforatum)
- applied topically, may prove to be beneficial for
reducing pain and inflammation from hemorrhoids.
- Yarrow (Achillea millefolium) -- popular in European folk
medicine, this herb has traditionally been used to treat wounds and bleeding
Although very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider the following
remedies for the treatment of hemorrhoids based on their knowledge and
experience. Before prescribing a remedy, homeopaths take into account a person's
constitutional type. A constitutional type is defined as a person's physical,
emotional, and psychological makeup. An experienced homeopath assesses all of
these factors when determining the most appropriate treatment for each
individual. The following are examples of remedies from which a homeopath might
select to treat someone with hemorrhoids.
- Aesculus for burning hemorrhoids with a sensation of a lump in
anus that feels worse when walking
- Aloe for a sensation of pulsation in the rectum with large,
- Collinsonia for chronic, itchy hemorrhoids with constipation
- Hamamelis for large bleeding hemorrhoids with a raw feeling
|Prognosis and Complications|
Most treatments for hemorrhoids are very effective. Talk with your provider
if the hemorrhoids are still a problem after one to two weeks. To prevent the
hemorrhoids from coming back, you will need to maintain a high-fiber diet and
drink plenty of fluids.This is especially important if you get hemorrhoids
The blood in the enlarged veins may form clots, and the tissue surrounding
the hemorrhoids can die. Hemorrhoids with clots generally require surgical
Severe bleeding may also occur. Iron deficiency anemia can result from
prolonged loss of blood. Significant bleeding from hemorrhoids is unusual,
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|Review Date: April 2004|
|Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine Shiva Barton, ND, Wellspace, Cambridge,
Copyright © 2004 A.D.A.M., Inc
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