Hemorrhoids
Hemorrhoids
In August of 1990, the Food and Drug Administration (FDA) ruled which ingredients in over-the-counter hemorrhoid products were permissible and which were banned. Hemorrhoid products constitute a $150 million industry, and those rulings had an immediate impact on the kinds of products available at your local drugstore.
Permissible products included local anesthetics and analgesics to deal with the pain of hemorrhoids; vasoconstrictors to tighten the distended veins that lead to hemorrhoids; lubricants to help relieve constipation, the underlying cause of hemorrhoids; astringents, which help tighten anal tissue distended by hemorrhoids; and keratolytics, which help remove excess hemorrhoidal tissue. Some of the permissible products were herbal or derived from plant sources: benzyl alcohol, an anesthetic; cocoa butter, a lubricant; witch hazel water, an astringent; and menthol, camphor and juniper tar, for relief of pain and itching. That's the good news.
The bad news is that the FDA also banned several herbal hemorrhoid treatments with long histories of use for this common affliction, among them goldenseal, used for centuries as an anal antiseptic; mullein, a soothing, itch-relieving herb; tannins, well-documented astringents; and menthol and camphor as counterirritants, substances that produce minor irritation and thus relieve other pain.
But even though the FDA approves some herbal remedies and not others, I'd advise you to keep an open mind. Personally, I don't give much credence to the FDA's opinions about herbal remedies. Both folklore and scientific research suggest that the variety of usable remedies is much larger than the government agency attests.
The All-American Condition
Estimates vary, but it looks like hemorrhoids affect one-third of Americans--some 75 million people. All four people in my family have experienced them, more often when we get away from the high-fiber diet that we eat at home.
Hemorrhoids are varicose veins of the anus. Anal veins drain blood away from the area. They expand (dilate) during defecation and shrink back to normal size afterward. However, repeated straining during defecation, which is a common result of constipation, can interfere with the normal functioning of these veins. They may become permanently swollen, causing pain and itching.
In addition, defecation can rupture the swollen blood vessels, causing bleeding. This is a particular problem among pregnant women, because during pregnancy, the developing fetus places pressure on all the veins of the lower abdomen.
The best way to deal with hemorrhoids is to prevent them, and the best way to do that is to prevent constipation. You'll find several herbs that are good for relieving chronic constipation mentioned in this chapter. (For additional details, see page 140.)
A Regular Kind of Person
Basically, staying regular boils down to eating a high-fiber diet, with lots of fruits and vegetables, and drinking plenty of nonalcoholic fluids. I daresay that anyone who regularly eats five fibrous fruits and five fibrous veggies a day will not suffer from constipation. In other words, a preventive ounce of carrots or apples--and of course, prunes--is worth a pound of buckthorn, an herbal laxative, taken later.
Another approach is to use an internal lubricant that allows stool to pass more easily. Mineral oil is the pharmaceutical approach, but you might try olive or linseed oil instead.
Finally, beyond preventing constipation, I'll offer a few more lifestyle suggestions. Never ignore "the urge" to go. When sitting on the toilet, don't bear down; try to relax. Straining leads to hemorrhoids. Don't sit on the toilet any longer than necessary. Adopt more of a squatting position and raise your feet on a small stool. This helps many people.
Green Pharmacy for Hemorrhoids
If you develop hemorrhoids, here are some herbs to try.
comfrey (Symphytum officinale). comfrey is rich in allantoin, a wound-healing chemical that is anti-inflammatory, stimulates the immune system and hastens the formation of new skin. You can moisten powdered comfrey with vegetable oil and apply the paste. Or you can pound the leaf to soften the fuzzy hairs it's covered with and apply the leaf itself, topically. You don't have to worry about washing it off, as the residue will come off the next time you shower.
What's in a Name? Just for the record, here's an herb you don't want to use but might be tempted to because of its name--pilewort (Ranunculus ficaria). Piles is an old-fashioned word for hemorrhoids, and you can pretty much guess that an herb with that name would be good for hemorrhoids. In fact, this herb has an interesting history. Early herbalists believed it was useful because they subscribed to the Doctrine of Signatures, the medieval idea that a plant's physical appearance hinted at its medicinal use. Pilewort tubers were thought to resemble hemorrhoids. The Doctrine of Signatures obviously has problems, but people would not have kept using pilewort for hemorrhoids for thousands of years if it didn't help, at least a little. Although there's some controversy about this herb, Rudolf Fritz Weiss, M.D., the dean of German medical herbalists and author of Herbal Medicine, concludes: "In my own trials and observations, pilewort has failed completely, both internally and as an ointment." But noted British herbalist David Hoffmann, author of The Herbal Handbook, whom I respect, is more positive, saying that it helps. Since many species of Ranunculus can cause blisters, and the benefits are elusive, you're probably well-advised to avoid it. |
Plantain (Plantago, various species). Plantain has a strong folk reputation as a hemorrhoid remedy. This herb contains allantoin, the same soothing compound found in comfrey. If I were caught in the bush with a hemorrhoid and without my Tucks, I'd create a poultice and apply it to the afflicted area.
Psyllium (Plantago ovata). In one study, 51 people with hemorrhoids received a psyllium preparation. More than three-quarters (84 percent) reported improvement--less pain, itching, bleeding and discomfort on defecation. Commission E, the German herbal advisory panel, recommends taking anywhere from four to ten teaspoons of psyllium seeds a day for constipation. It's easy to get that much by using a commercial product such as Metamucil, which is made with psyllium seeds. Simply follow the directions on the package.
Psyllium works by absorbing water in the gut and swelling considerably, which adds bulk to stool and triggers the muscle contractions we experience as "the urge." If you use psyllium, make sure you drink enough fluids. You should get at least eight (eight-ounce) glasses of water or juice a day. And watch how you react to this herb if you have allergies. If allergic symptoms develop after you take it once, don't use it again.
Witch hazel (Hamamelis virginiana). For a long time, I thought the H in Preparation H stood for Hamamelis. This is the Latin name for witch hazel, the active ingredient in the popular Preparation H Cleansing Pads. (I guess I should have guessed that that the H actually stands for hemorrhoids.) Witch hazel is also the active ingredient in Tucks, the commercial pharmaceutical product often recommended for hemorrhoids.
Witch hazel is a soothing, cooling astringent that can help relieve hemorrhoidal pain and itching. But you really don't have to spend extra for a brand name. Simply make a compress using witch hazel, which is available at pharmacies for a much lower price. Just tuck a fresh compress in place whenever you feel the need for a little soothing. Then forget it's there and go about your business.
Aloe (Aloe vera). Aloe gel is astringent and helps heal wounds. You might try applying it topically to the anal area. When ingested, aloe juice is laxative. India's Ayurvedic physicians suggest drinking a half-cup of aloe juice three times a day until hemorrhoid flare-ups have cleared. You can buy aloe juice at most health food stores. (Don't try to prepare your own. The inner part of the leaf itself is such a powerful laxative that juicing that could cause problems.)
German physicians echo the Ayurvedics. Commission E suggests aloe as a stool softener for those with hemorrhoids or anal fissures or after anal or rectal surgery. The suggested dose is 0.05 to 0.2 gram of powdered aloes, also known as dry extract. This really isn't very much powder--a pinch thrown into a cup of tea would do it. (This remedy may turn the urine red.)
I wouldn't hesitate to apply the yellow gel from a kitchen aloe leaf to a hemorrhoid. I also might add a little gel (a spoonful or two) to some prune juice.
Butcher's broom (Ruscus acu-leatus). This woody herb has a long history as a treatment for venous problems like hem-orrhoids and varicose veins. The plant contains chemicals called ruscogenins, which have anti-inflammatory and vasoconstricting properties. I'd try five rounded teaspoons of root in a cup of boiling water for internal consumption; you can sweeten the tea with honey. And for topical application, I'd use a tincture of the herb made with alcohol.
 Butcher's Broom You can get this herb in the form of powdered root or as a tincture. |
Horse chestnut (Aesculus hippocastanum). The bark of this tree contains several chemicals that help treat hemorrhoids. Aesculin and aescin strengthen blood vessel walls, reducing the risk of further hemorrhoids. Other chemicals in this herb have anti-inflammatory benefits.
Some experiments have shown that horse chestnut does help relieve hemorrhoid symptoms. About 5 to 10 percent of the active chemicals are absorbed if you take this herb orally. There's just one problem: The herb contains tannins that tend to contribute to constipation if you drink it. But you can use a tea made from the herb to apply to the hemorrhoids or make a poultice by moistening powdered bark or seeds and apply the resulting paste directly.
Assorted essential oils. Aromatherapists suggest adding one or two drops of any number of herbal essential oils to vegetable oil, then applying the ointment to the anal area. I'd suggest using an emollient oil such as almond as a base. For essential oils, I'd try cypress, juniper, lavender, lemon or rosemary. (Remember though, not to ingest essential oils, as even a small amount can be toxic.)
Assorted herbs. I'll also share two hemorrhoid treatments recommended by herbalists I trust, both authors of good books on herbal medicine.
Herbal pharmacologist Daniel Mowrey, Ph.D., author of The Scientific Validation of Herbal Medicine and Herbal Tonic Therapies, suggests making a tea for topical application using alumroot (astringent), goldenseal (vasoconstricting), mullein (soothing), slippery elm bark (soothing) and witch hazel (astringent). You can use any amount of these ingredients.
David Hoffmann, noted British herbalist and author of The Herbal Handbook, recommends using a topical salve made from calendula, camomile, yarrow, plantain and St.-John's-wort after every bowel movement. Try mixing one teaspoon of each herb in powdered form with enough emollient oil (almond) to form a paste, then apply.
