(416) 929 0707
Hemorrhoids, also known as piles are very common - up to 86% of people will report they have had hemorrhoids at some time in their life, though people often use this as a catch-all label for any ano-rectal problem including simply itching.
What are Hemorrhoids?
Hemorrhoids are swollen tissues rectal / anal veins. They are located in the wall of the rectum and anus and may cause minor bleeding or develop small blood clots. Hemorrhoids occur when the tissues enlarge, weaken, and come free of their supporting structure. This results in a sac-like bulge that extends into the anal area.
Although they can be embarrassing to talk about, anyone can get hemorrhoids, even healthy young people in good shape. They can be painful and annoying but aren't usually serious. Hemorrhoids differ depending on their location and the amount of pain, discomfort, or aggravation they cause.
Internal hemorrhoids are located up inside the rectum. They rarely cause any pain, as this tissue doesn't have any sensory nerves.
External hemorrhoids develop under the skin just inside the opening of the anus. The hemorrhoids may swell and the area around it may become firm and sore, turning blue or purple in colour when they get thrombosed. External hemorrhoids may itch and can be extremely painful, especially during a bowel movement.
Symptoms of Hemorrhoids
Depending on whether they are internal or external, these inflamed veins can cause itching, rectal bleeding, and pain that can sometimes be severe. The classic symptom of internal hemorrhoids is rectal bleeding. Most often it is usually noticed as bright red streaks on toilet paper, but blood can also be found on the stool, underwear or in the toilet bowl. Internal hemorrhoids can sometimes bulge outside of the anus, rarely leading to the formation of a blood clot.
External hemorrhoids are more frequently associated with pain, and if irritated from straining or excessive rubbing or cleaning, may also itch and bleed. Blood clots – also known as thrombosed hemorrhoids – are more commonly formed in external hemorrhoids. They can often feel like a hard, painful grapelike lump on the anus, and sometimes need to be removed surgically.
What Causes Hemorrhoids?
Hemorrhoids are caused by repeated or constant pressure on the rectal or anal veins. The most common cause of pressure usually results from straining or prolonged sitting during a bowel movement and chronic constipation.
Other factors that increase the risk for getting hemorrhoids include:
- Lifting heavy objects
- Poor posture
- Prolonged sitting
- Eating a diet low in fibre
- Anal intercourse
- Being overweight
- Liver damage
- Some food sensitivities
- Lack of fitness/ not getting regular exercise
What are the Treatments?
Dietary and lifestyle tips:
- Don't delay bowel movements, because the stool can harden.
- Avoid straining to have a bowel movement, and don't stay sitting on the toilet for long periods.
- Drink at least 8 glasses of water a day.
- Eat foods that are high in fibre and bulk, such as whole grain foods, fresh vegetables, and fruit - especially prunes.
- Get plenty of exercise and don't sit for prolonged periods of time.
- Try to go for walks.
- Lose excess weight as this will also put a lot of pressure on the pelvic floor.
- Food sensitivity testing
Supplements & Remedies:
Treatment with natural interventions is really always on an individual case basis because there can be drug interactions etc. Many laxatives including botanical ones are habituating and therefore not recommended beyond a week. For most people magnesium glycinate at bedtime is a safe and effective treatment for constipation to use while you’re working on finding out the root cause. Most of the time Dr. Smith finds there is a root cause - usually related to diet and or undiagnosed food sensitivities. Often if patients simply remove gluten and or dairy from their diet, this is all it takes to solve a stubborn and long-standing constipation problem. Sometimes chronic constipation can be SIBO (LINK).
Veinous support is also recommended as there are various herbs such as horse chestnut and bilberry that will strengthen and tone the walls of the veins, however these must always be prescribed and an ND or herbalist. Drug herb interactions must be assessed for.