Gill Stannard

Monday, August 11, 2008

Haemorrhoids – more than a pain in the rear end

What are haemorrhoids?

For a problem that at least 50% of people in the developed world experience by middle age, there’s not a lot talked about haemorrhoids. Also called “piles” (the things that popular culture and some parents said you’d get if you sat on cold concrete*), this is kind of a varicose vein in the anus or rectum.

Blood vessels have an elastic-like wall, which if the pressure is altered, can bulge. In haemorrhoids they can become swollen and inflamed, which may cause bleeding, itchiness, discomfort or in the case of prolapse actually hang outside of the anus like a small bunch of grapes.

What else can cause this kind of bleeding?

Not all red blood on the toilet paper is caused from piles, though it is the most common reason. Bright red blood may be from a fissure (or tear) in the area. Sometimes a red bowel motion is mistaken for blood after eating beetroot.

More serious forms of bleeding in the intestines can occur higher up but by the time it passes from the body, the blood will look black like tar, rather than red. If this occurs always see a doctor as soon as possible.

What causes piles?

The main causes involve a build up of pressure in the area – such as straining when trying to move your bowels or just sitting on the toilet too long (contrary to popular belief the bathroom is not a library or games room) which when the bottom is sealed within the toilet seat can create a vacuum.

Haemorrhoids are also common in pregnancy, obesity and aging. Anal sex cause haemorrhoids and fissures.

How do you treat haemorrhoids?

First it is important to change any behaviours that may have caused the problem. If constipation is the cause of straining then stool bulkers and softeners such as psyillium seeds, prunes, figs, oats and fibre generally should be increased. Hard motions can be caused by dehydration, so make sure to have at least 2 litres of water (excluding caffeine and alcohol).

Conventional treatment includes cold compresses, wipes and other topical medication for pain. However, haemorrhoids tend to resolve without treatment within 6 weeks, although a small percentage (10-20%)of chronic cases require surgery.

What natural remedies can help?

A naturopathic dietary overhaul can help with constipation. This may involves having a rest from refined foods like flour and sugar or dairy products for a couple of weeks, increasing the amounts of raw and cooked plant foods and pulling back on meat.

Psyllium seeds are a form of bulk fibre which can be useful if constipation is caused by small, difficult to pass motions. Take a heaped teaspoon of powdered psyillium on cereal or mixed in a glass of water 1 –2 x a day. Always drink lots of water when you have this as fluid is needed to help it swell up and do its job.

Supplements of horse chestnut, rutin and butchers broom may help astringe the veins.

Other herbs such as yellow dock can be useful for constipation but for more accurate prescribing it is best to see a herbalist.

Don’t forget to drink water!

A compress or ointment using astringent herbs such as witch hazel or calendula may help shrink an external haemorrhoid.

Work with gravity rather than against it. Squat toilets are better ergonomically than Western ones.

Don’t sit on the toilet for more than 10 minutes at a time.

Increasing core muscle strength can be useful. Pilates, pelvic floor exercises and even walking may help.

* Which in this case our parents got wrong!

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