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 treatment.

• Constipation
• Straining while defecating
• Discomfort, itching, pain
• Tender swollen lumps in rectum
• Bleeding
• Sensation of fullness
• Mucus in stool

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 most cases, however, there is no obvious cause. In addition to age and constipation, other contributing factors include the following.

• Family history of hemorrhoids
• Certain medical conditions
• Pregnancy
• Sitting for prolonged periods of time
• Diet low in fiber or fluids

Your provider will do an examination. If you have had significant bleeding or other symptoms, your provider may perform a procedure called sigmoidoscopy, or colonoscopy. In this procedure a small instrument is inserted into the rectum for inspection of tissues to check for other diseases.

Medications can ease the pain and discomfort during the time it takes for the hemorrhoids to heal. In addition to medications, you can help prevent or heal hemorrhoids by doing the following.

• Prevent pressure on the area (for example, sit on an inflatable ring).
• Avoid straining during bowel movements.
• Limit the amount of time sitting on the toilet.
• Sit in warm baths with soapy water or Epsom salts 2 to 3 times daily for 15 to 20 minutes.

• Stool softeners help reduce straining and prevent hard stools.
• Bulk laxatives help prevent hard stools and constipation.
• Rectal preparations relieve itching and discomfort.
• Topical anesthetics and systemic analgesics relieve pain.

• Eat in a relaxed atmosphere, breathing and chewing food thoroughly.
• Eat smaller, more frequent meals and avoid overeating at one sitting.
• Eliminate refined foods, sugars, caffeine, alcohol, and dairy products.
• Decrease saturated fats (animal products) and increase polyunsaturated fats (cold-water fish, nuts, and seeds).
• Increase fresh vegetables and whole grains, as well as water intake.
• Stewed or soaked prunes, one to three/day have a slightly laxative effect and may help soften stools.
• Flaxmeal, 1 heaping tsp. in 8 oz. of apple juice, provides fiber and essential fatty acids to help relieve constipation. Follow with an additional 8 oz. of water.
• Vitamin C (1,000 mg two to three times per day) supports the integrity of connective tissue.
• Vitamin E (400 to 800 IU per day) promotes healing.

Flavonoids, a constituent found in dark berries and some plants, help restore the integrity of the vasculature. The following are flavonoids that may be taken in dried extract form as noted.

• Catechin (150 mg two to three times per day), quercetin (250 mg three to four times per day), hesperidin (250 mg three to four times per day), and rutin (250 mg three to four times per day).
• Rose hips (Rosa canina) and green tea (Camellia sinensis) are also high in flavonoids and either one may be used as a tea. Drink three to four cups/day.
• Stone root (Collinsonia canadensis) and horse chestnut (Aesculus hippocastanum) can be used to strengthen blood vessel walls (60 drops tincture twice a day).

Topical applications may relieve itching and burning, as well as promote healing. Apply one of the following two to four times a day.

• Witch hazel (Hamamelis virginiana) is an astringent that may reduce swelling (commercially available as Tuck's pads).
• A salve containing comfrey (Symphytum officinale) and/or marigold (Calendula officinalis) soothes and promotes healing.
• A poultice made from grated potato is astringent and soothing.

Some of the most common remedies used for hemorrhoids are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours.

• 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, external hemorrhoids
• Collinsonia for chronic, itchy hemorrhoids with constipation
• Hamamelis for large bleeding hemorrhoids with a raw feeling

Fill one basin with hot water, one with cold water. Sit in hot water for three minutes, then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets per day three to four days per week.

Acupuncture may be effective in resolving stagnant, congestive conditions.

Talk with your provider if the hemorrhoids are still a problem after one to two weeks. If you frequently have hemorrhoids, talk with your provider about diet and lifestyle changes to help prevent them in the future.

Balch JF. Prescription for Nutritional Healing. 2nd ed. Garden City Park, NY: Avery Publishing, 1997.

Barker LR, Burton JR, Zieve PD, eds. Principles of Ambulatory Medicine. 4th ed. Baltimore, Md: Williams & Wilkins; 1995:1347-1361.

Duke JA. The Green Pharmacy. Emmaus, Pa: Rodale Press; 1997.

Gruenwald J, Brendler T, Jaenicke C, et al., eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co; 1998.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:181-183.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998.

Olshevsky M, Noy S, Zwang M. Manual of Natural Therapy: A Succinct Catalog of Complementary Treatments. New York, NY: Facts on File; 1989.

Stein JH, ed. Internal Medicine. 4th ed. St. Louis, Mo: Mosby-Year Book; 1994:486-492.

United States Pharmacopeial Convention, Inc. Advice for the Patient. 15th ed. USPDI; 1995:2.