Hemorrhoids

Hemorrhoids

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Definition Causes Signs and symptoms Differentiation Prevention When to call a health professional Treatment Western Herbal Treatment Western Biomedical Treatments Acupuncture Treatments Chinese Herbal Medicine Treatments Dietary Recommendations

 

Definition of Hemorrhoids:

Hemorrhoids are swollen veins and tissue located in the wall of the rectum and anus. These veins may become inflamed, develop blood clots and bleed.  The actual hemorrhoid tissue may become enlarged and protrude outside of the anus. The inflammed veins and tissue if found inside the body is called "internal hemorrhoids".  Hemorrhoids which  protrude outside the anus are called "external hemorrhoids".  Usually external hemorrhoids are regarded as more serious than internal but both can cause extreme discomfort and lead to other problems such as infection.  

 

3 Main stages of Hemorrhoids

1st Stage:

small hemorrhoids which do not go protrude to the exterior, fresh bleeding upon defecation.

2nd Stage:

protrusion of hemorrhoids from the anus with bleeding, although the tissue retracts into the sphincter within a short period of time.

3rd Stage:

bleeding tissue with large protruding hemorrhoids.  They require physically pushing back into the interior of the anus.

They may exit the body with coughing, sneezing. laughing, when fatigued, or when standing for a long period of time.

 

 

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Causes:

Hemorrhoids can develop from repeated straining during bowel movements (which may be caused by hard stools and constipation), being overweight or pregnant, too many births, chronic diarrhea, prolonged sitting or standing, and liver disease (which increases the blood pressure in the portal vein). Also, over indulgence of rich greasy and spicy food can cause the Qi of the mid Jiao to sink, thus losing its control over muscles resulting in hemorrhoids.

While considering diet, it is also believed that a protein deficiency can lead to hemorrhoids.

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Signs and symptoms:

Bright red streaks of blood on stools (typically after a bowel movement) or spurting from the anus. This commonly leaves blood-streaked toilet paper or may turn the water in the toilet red. Generally the amount of blood is small so this rarely leads to severe blood loss or anemia. External hemorrhoids may give a feeling that there is something in the anus.

There may also be leakage of mucus from the anus (which creates a feeling of not being finished bowel movements), and quite often there is irritation and itching around the area (due to difficulty of keeping the area clean).

Sometimes an internal hemorrhoid will actually stick out of the anus, it should be gently pushed back into place with a finger. Although pain is not usually a symptom, a hemorrhoid may swell and become painful if it has been irritated or a blood clot has formed.

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Differentiation:

Differentiation between anal fissures and hemorrhoids should be taken into consideration. An anal fissure is simply a physical tear in the anal sphincter that causes pain during bowel movements (like stool contains sharp objects) and leave blood-streaked toilet paper.

These are generally caused by constipation, straining, and large stools. Anal fissures are stubborn long sores that re-open and get irritated every time one has a bowel movement. With inspection, a qualified healthcare professional can easily determine whether it is an anal fissure, hemorrhoid, or other problem such as a tumor.

 

Consult your healthcare professional if you suspect that you may have any of the above problems.

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Prevention of Hemorrhoids:

- Keep stool soft. Include plenty of water, fresh fruits and veggies, whole grains, and fiber in you daily diet.

- regular exercise promotes smooth bowel movements.

- try to breath through your bowel movements (do not hold your breath),

 

DO NOT STRAIN. Take your time, relax and enjoy!

- try to not sit or stand for prolonged durations too often. Take short walks, stretch, and wiggle your mid-section to get the blood flowing through that area.

- keep the anal area clean, although one should be gentle with cleansing. Try to use chemical free soaps such as pure oil soaps, or baby wipes.

- squat during defecation, the toilet seat may make it more difficult to pass the feces by compacting the anal canal. Try put platforms on either side of the toilet to raise yourself.

- anal exercises, tighten and hold sphincter/anal muscles while contracting the abdomen, do not hold breath, hold and repeat as often as possible.

- keep emotions smooth flowing, do not let them run your life! Anger in particular can aggravate hemorrhoids.

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When to call a health professional:

- if rectal bleeding occurs for no apparent reason and is not associated with trying to pass stools.

- if rectal bleeding continues for more than 1 week or occurs more than once.

- if stools become more than usual or have distinct grooves within them.

- if home treatment does not produce pain relief after 1 week.

- if a lump ever grows around the anal area (especially if one develops a fever).

- if bloody stool appears together with a fever.

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Treatment:

Natural Things to treat Hemorrhoids

-take warm baths. They are soothing and cleansing, especially after you have a bowel movement. Although sometimes too much bathing may worsen anal itching (pruritis ani).

- wear cotton underwear and loose fitting clothes to decrease moisture in the area.

- apply a cold compress to the area for 10 minutes, 4 times per day.

- applying vitamin E oilor virgin oil may help with the pain of passage of the stools.

- apply an herbal compress of Danelion (Pu Gong Ying), or Jiu Hua Gao, or Wu Bei Zi San to the area for 10 minutes, 4 times per day.

- external wash or steam with salty water or Fu Feng Jing Xi Ji, Ku Shen, Pu Gong Ying, Huang Bai. - Enema; inject 250ml of Da Huang, Dang Gui, or Mu Dan Pi decoction into rectum (be sure and be near a toilet, soon after the liquid is inserted into the rectum, the urge to defecate is guaranteed).

- add blond psyllium husks to the diet daily to promote bowel movements (the husk of the seed Che Qian Zi)

- do the same as above but use wheat bran.

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Western Herbal Treatment:

- Bovine Cartilage- taken via rectal route to soften stools, 2.2 grams in the form of a 2% suppository administered at least 3 times daily.

- Butchers broom- make a decoction and apply topically (wash or compress) to relieve itching and burning

- Camphor- a solution of 0.1-3% Camphor can be applied topically (wash or compress) 3-4 times daily.

- Diosmin- (citrus bioflavinoid) 1350mg plus Hesperidin 150mg twice daily for 4 days followed by Diosmin 900mg and Hesperidin 100mg twice daily for 3 days. Also for prevention of relapse, take Diosmin 450mg plus Hesperidin 50mg twice daily for 3 months.

- Hesperidin- (citrus bioflavinoid) used together with Diosmin (above).

- Peru Balsam- preparations of 5-20% can be used for daily application. If being used over large areas of the body it is advised to keep the solution under 10%.

- Poplar- 5 grams of the dried buds per day made into a topical application daily.

- Sweet clover- wrap a handful of flowers in linen, thouroughly soak in hot water, and place on the affected area 3-4 times per day.

- Witch hazel- apply compress to the affected area 3-4 times per day. Liquid preparations are available at any drug store.

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Western Biomedical Treatments:

Sclerotherapy- an injection of a substance that causes the veins to become obliterated with scar tissue.

Rubber band ligation- if the problem is not responsive to sclerotherapy, the hemorrhoid is tied off with rubber bands. This causes the hemorrhoid to wither and drop off painlessly.

This procedure is applied to one hemorrhoid at a time with an interval of 2 weeks or more. In serious cases, 3-6 treatments may be required.

Laser destruction, infrared photocoagulation, or an electric current (electrocoagulation) may also be used.

Surgery- may be implemented after all else has failed. This surgery usually involves the removal of the external sphincter ring.

This causes great difficulty with the control of the defecation response afterwards. Local anesthetic ointments, Zinc oxide, petroleum jelly, and Hydrocortisone creams are also given.

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Acupuncture Treatments for Hemorrhoids:

Acupuncture can be a very effective treatment in this condition but applying dietary and possible herbal therapy increases success.  Finding an acupuncturist who is specializing in digestive disorders will likely provide the best results. 

Acupuncture points used usually will be some local points around the anal region combined with other body parts.  

 

 

Chinese Herbal Medicine Treatments:


Intestinal Wind Type of Hemorrhoids

fresh blood before or after defecation, may be on stool or toilet paper. No pain, itch, distension, or swelling. This pattern responds quite well to Chinese medicine treatments. Tongue: not significant, Pulse: not significant

Herbal Treatment:

Zhong Guo Zhi Gen Duan or Yu Nan Bai Yao

 

Dry Intestine Type of Hemorrhoids

Chronic constipation with dry stools and repeated straining to defecate. Bleeding that may be before or after defecation. If before it may be copious and literally squirted out of the anus. The hemorrhoid may protrude to the 2nd stage but can be pushed back easily. There may be pain and fullness. Accompanied by thirst and dry skin.

Herbal Treatment:

 

Ma Zi Ren Wan

Zeng Ye Cheng Qi Tang

Run Chang Wan

 

 

 

Damp Heat Type Hemorrhoids

inflamed internal hemorrhoids. Fresh red or plum coloured blood that comes either before or after defecation. It may also coat the stool. The bleeding is usually quite copious. There may be swelling and pain and may correspond to either 2nd or 3rd stage of protrusion, although it can almost always be pushed back or recede on its own. There may be itch, discomfort, burning, and pain at the anus. The feeling of always needing to defecate may be present (tenesmus). Thirst, dark scanty urine, constipation or hard to pass loose stools usually accompany.

Herbal Treatment:

Huai Hua San

 

Huang Lian Jie Du Wan 

diet with this type of hemorrhoids is extremely important. 

 

Spleen deficiency Type Hemorrhoids

hemorrhoids are quite painful and protruding (2nd or 3rd stage), bleeding may be heavy or scanty, pale face, easily fatigued, poor appetite, weak (lack muscle tone and vigor), bloating after meals, loose stools light headed, shortness of breath, poor memory, insomnia, palpitations, anxiety, panic attacks, may show heavy menses, easily bruised, spontaneous sweating, elderly, may see other organ prolapse. Tongue: pale, swollen or thin with teeth-marks, Pulse: thready, weak, moderate, or hollow.

Herbal Treatment:

Bu Zhong Yi Qi Tang

Fu Zi Li Zhong Wan

 

Blood Stasis Type Hemorrhoids:

chronic hemorrhoids that have continuous or severe pain. This is usually the late stage of one of the other above mentioned patterns. It may also be closely associated with chronic Liver Qi stagnation caused by excessive emotions (especially anger). Western etiology may connect this to Liver portal circulation disruption. The hemorrhoids are quite large and are dark. Bleeding can be fresh red or dark coloured. may see spider veins around the inner ankles and knees. Pain in the lower abdomen and rib area on palpation, dry mouth with no desire for drink, dry skin, dull complexion, dark circles around the eyes, dark purple lips.

Herbal Treatment:

 

Tao He Cheng Qi Tang

Xue Fu Zhu Yu Tang

 

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Dietary Recommendations to Treat Hemorrhoids:

- consume more high fiber foods to aid in treating constipation, i.e. green leafy veggies, and whole grains.

- if you have the desire to eat a lot of vegetable and fruit, strongly consider lightly cooking or steaming them instead of always eating them raw. Too much raw food can damage ones digestion,…keep a balance.

- avoid consuming too much rich, greasy, spicy foods as the reek havoc on our digestive system.

- try frying 250 grams of clams in some peanut oil, add 10grams of fresh sliced ginger and some water then cook until the clams are very soft, then add some salt. Eat this on an empty stomach, once every other day, 7 times as one treatment.

 

- try eating 1-2 figs on an empty stomach first thing in the morning, or boil fig leaves in water and use the liquid to wash the affected area, or simply add it to you sitz bath.

- Steam 60grams of dried figs in an adequate amount of water with 100 grams of lean pork, season to taste. Eat at will for 1 month.

- try 10 fresh or dried figs in 1 liter of water and simmer for 30 minutes until there is about ¾ of the water left. Eat 5 of these figs per day and use the water to wash the affected area.

- get creative with lettuce seeds as they may help with hemorrhoids

- spinach helps promote great bowel movements and alleviates constipation

- try to increase your consumption of sour foods (not too much, this flavour is powerful); lemons, limes, hawthorne berries, pickles, rosehips, sauerkraut, crab apples, sour plums, vinegar, aduki beans, blackberries, cheese, grapes, s, raspberries, sourdough bread, tangerines, tomatoes, yogurt.

- use the seaweed agar-agar, it also is said to carry toxic and radioactive substances out of the body.

- drink the juice or eat the leaves of fresh Wheat grass.

- eggplant can stop bleeding. Pregnant woman should not eat eggplant.

 

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