Hemorrhoids are a common condition that can be caused or aggravated by diarrhea and constipation.  Hemorrhoids are varicose veins in the rectum, which can lead to rectal pain, bleeding, and itching.  They can also be relatively symptomless.  Occasionally, hemorrhoids can prevent the anus from closing fully, which can lead to the soiling of underwear.  The condition can also cause fissures in the skin around the anus.  External hemorrhoids are found outside of the anus and are often accompanied by pain unless they are prolapsed.  Prolapsing can close off the anus and can be extremely painful.  It’s important to note that bleeding from the rectum can also signal rectal cancer or polyps.  In the case of bleeding, you must have a medical diagnosis of the symptoms.  Surgery is necessary if a blood clot develops in a hemorrhoid.

Self Help

The mild pain, swelling and inflammation caused by hemorrhoids can often be treated at home.
• Sitz Bath: Dissolve 1/4 cup of Epsom salts into 4 inches of water in a bathtub.  Soak in this mixture for 10 minutes, 3 to 4 times a day for best results
• Add a comfrey or yarrow tea to the Sitz bath by first steeping 4 ounces of the dry herbs in 32 ounces of boiling water for 10 minutes
• Topical treatments.  Apply over-the-counter creams or suppositories containing hydrocortisone, or use pads containing witch hazel or a numbing agent
• Keep the anal area clean.  Baths are preferable to showers with this condition.  Cleanse the skin around the anus gently with warm water.  No soap is necessary and it may actually aggravate the problem.  Do not use alcohol based or perfumed wipes.  Gently dry the area with a hair dryer after bathing
• Don’t use dry toilet paper.  Use moist towelettes or wet toilet paper to clean the area after bowel movements
• Apply cold.  Apply ice packs or cold compresses to relieve swelling
• Take oral pain relievers.  Acetaminophen, aspirin or ibuprofen can temporarily help relieve discomfort.

Western Treatments

When Western medical treatment becomes necessary, there are a variety of options available.

• Medications.  When hemorrhoids produce only mild discomfort, your doctor may suggest creams, ointments, suppositories or pads.
• Rubber band ligation.  Your doctor places one or two tiny rubber bands at the base of each internal hemorrhoid.  With no circulation, the hemorrhoid withers and falls off within a week.
• Injection (sclerotherapy).  With this procedure, your doctor injects a chemical solution into the hemorrhoids tissue, which shrinks it.
• Coagulation (infrared, laser or bipolar).  These techniques use laser or infrared light or heat.  They cause small, bleeding, internal hemorrhoids to harden and shrivel.
• Surgical removal.  A hemorrhoidectomy is when a surgeon removes excessive tissue that causes bleeding.
• Hemorrhoidal stapling.  This technique blocks blood flow to hemorrhoidal tissue.  This procedure is generally less painful than a hemorrhoidectomy and allows an early return to regular activities.

A Case Study in TCM Treatment

A 32-year-old businesswoman complained of internal hemorrhoids, which caused burning, itching, and straining upon bowel movements.  She also experienced PMS, occasional vaginal yeast infections and she had a history of asthma.  Traditional Chinese diagnosis revealed that her pulse was superficial and wiry, and her tongue had red spots, was pale in the center and had a thin white coating.  She was advised to use over-the-counter remedies for hemorrhoids daily including ointment and witch hazel pads.  Initially, she was prescribed two herbal formulas.  The first contained Bupleurum root, Tang Kuei root, White Peony root, salvia root, poria sclerotium and White Atractylodes with a few other herbs in smaller quantities.  The second contained sanguisorba root, pulsatilla root, sophora flower, Rehmannia root (raw), Fraxinus cortex, phellodendron cortex and lonicera flower.  These two formulas helped bring the hemorrhoids and accompanying symptoms under control.  At this point, the second formula was discontinued and a third was added to treat the underlying condition, which was stress and anxiety.  This formula included biota seed, fu shen sclerotium, polygala root, zizyphus seed, ophiopogon tuber, codonopsis root, amber resin and a number of enzymes.