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An answer to your burning question.

"I'm desperate," Ellen wrote me.

"This is the fourth summer I'm in trouble, and I don't want surgery. The technician who did my colonoscopy last summer said I have internal and external hemorrhoids. I'm not bleeding, just in constant pain. There must be an answer, and there must be others out there like me. So ... S.O.S. for all of us."

Ellen is right. She's not alone. Hemorrhoids affect about 50 percent of people over the age of 50 in this country. That translates into a lot of people with burning pain and discomfort. Hemorrhoids are not a condition that just occurs with aging. In fact, they often begin in people in their 20s and 30s.

Hemorrhoids are actually varicose veins in the anus and rectum. They occur when blood vessels that are either inside the anus or around it become swollen. The more swollen they become, the more painful they are. Hemorrhoids may cause bleeding, and their constant irritation could lead to itching. However, most often itching is a sign of pinworms or an overgrowth of Candida albicans.

The following can cause hemorrhoids: constipation, chronic diarrhea, straining when you go to the bathroom, and any pressure that contributes to congestion in veins in that area (like coughing, sneezing, or sitting or standing for long periods of time). But let's face it, if you have strong blood vessels, sneezing and sitting won't give you hemorrhoids.

Traditional treatment

The first step in most doctors' approach to treating hemorrhoids is to suggest a high-fiber diet and bulking agents, such as Metamucil. Next, they typically suggest taking laxatives for constipation. The problem is that some of the herbs used in laxative formulas, such as senna leaf, are harsh and irritating. Instead, eat a higher fiber diet and take ground flaxseed if your intestines need a little help.

Daily sitz baths can reduce inflammation. Get a large plastic basin and put it in your bathtub. Put two to three inches of hot water (110-120 degrees) in the basin and sit in it for about 20 minutes. If possible, add some hotter water in the tub so your feet are warmer than your bottom. Bring a cold washcloth with you so you don't get too warm. Afterward, take a cool shower or splash the area with cool water and gently dry well.

Topical anti-inflammatory suppositories (such as Anusol and Preparation H) may give temporary relief. But they don't address the problem like some herbal formulas.

Ligation is a more drastic therapy where your doctor ties a small rubber band tightly at the base of an external hemorrhoid. This cuts off circulation and the hemorrhoid falls off. Sometimes, it's necessary to repeat this treatment. Ouch!

Finally, surgery may be an option if your hemorrhoids are particularly large or painful, or if bleeding won't stop. If you and your doctor think you have time to try other therapies, I have some safe suggestions.

An integrative approach to healing hemorrhoids

Improve your sitz baths by adding a cup of strong anti-inflammatory chamomile or comfrey tea to the water. If you have spasms, try adding a dropperful of valerian root tincture.

Two citrus bioflavonoids, diosmin and hesperidin, accelerated healing and reduced pain in a French study of 120 people with hemorrhoids. A high amount of hesperidin is in the Hot Flash Formula I helped create (800-728-2288). If you have both hot flashes and hemorrhoids, this formula would be ideal. It won't hurt you if you don't have hot flashes. Or take 1,000 mg of mixed bioflavonoids along with 500 mg or more of vitamin C.

Horse chestnut (Aesculus hippocastanum) is an herb I've talked about before. It, and all other herbs suggested for hemorrhoids, are approved by the American Botanical Council's Expanded Commission E Monographs for safety and efficacy. The ABC suggests a standardized extract containing 20 mg escin, its active ingredient. Horse chestnut is often combined with other herbs that improve circulation, such as bilberry and gingko. Dose: Use according to label instructions.

Butcher's broom (Ruseus aculeatus) is used for fragile veins and varicose veins, as well as acute attacks of hemorrhoids. It can both reduce pain and treat the source of the problem. Butcher's broom is approved for the itching and burning from hemorrhoids. Dose: 7-11 mg of ruscogenin a day.

Witch hazel leaf (Hamamelis virginiana): This astringent herb has been approved both for inflammation and for hemorrhoids. You can use witch hazel both internally or topically. Drink an herb tea made from its bark and leaves two or three times a day between meals. Or apply an ointment or salve that contains witch hazel.

Probiotics: A doctor friend of mine said recently, "You can't have too many friendly bacteria." I agree. Any time you have any intestinal problem, reach for the probiotics.

Topical treatments include applying a little witch hazel with a cotton ball. Most health food stores sell soothing salves or ointments that contain witch hazel, calendula, comfrey, or golden seal. If you have vitamin E capsules, puncture one and apply its contents to the area.

See your doctor

Make sure your hemorrhoids are just that.... uncomfortable bulging veins.... and not covering up something more serious like rectal or colon cancer. Hemorrhoids don't cause cancer, but since both conditions can cause bleeding, you want to know what you have.

Blumenthal, Mark. Herbal Medicine: Expanded Commission E Monographs, American Botanical Council, 2000.

Lipski, Elizabeth, MS, CCN. Digestive Wellness, Keats Publishing, 1996.

MoonDragon Birthing Services, "MoonDragon's Health Therapy (sitz bath therapy),"

Murray, Michael, ND and Joseph Pizzorno, ND. Encyclopedia of Natural Medicine, Prima Publishing, 1998.
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Title Annotation:hemorrhoids
Publication:Women's Health Letter
Geographic Code:1USA
Date:Sep 1, 2004
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