A ROYAL PAIN IN THE A**
Facts About Hemorrhoids and What You Can Do To Address Them
This is such a sensitive topic. It’s not easy to talk about and those “things that must not be named” are certainly not easy to live with. Well, I’m just gonna go there since I don’t want anyone to suffer because they’re too embarrassed to broach the subject. Don’t worry, you can read this article in private and no one will ever know that you sought advice. Make sure you stick around all the way to the end where I give the #1 best thing you can do for an angry bottom. You won’t believe it!
Remember, everything is formatted in sections for ease of reading and hyperlinks lead to additional resources!
FACTS
Hemorrhoids are known by several names including piles, hemmies, and assteroids. No matter what you refer to them as, I think we can all agree that they are a royal pain in the posterior. Despite carrying a certain stigma that keeps them out of polite conversation, they are actually very common. Here are some truths to offer context and consolation:
Everyone has hemorrhoids. They are actually veins (much like a varicose vein) and are a normal part of our anatomy. What we have come to call hemorrhoids are actually swollen veins.
It has been reported that 1 in every 20 persons around the world has inflamed hemorrhoids. I believe that number is even higher but, because most deal with the problem on their own and are too self-conscious to talk about it, that estimation is likely conservative.
There are four types of hemorrhoids:
Internal - are located inside the rectum and aren’t visible outside of the body. They are sometimes known by pressure, occasional appearances of blood following a bowel movement, and intermittent pain. These have the potential to become strangulated.
External - are found just outside the anus can sometimes bleed, are known to get itchy or have a sensation of warmth or burning, and can very uncomfortable.
Prolapsed - internal hemorrhoids that have come out of the body.
Thrombosed - this happens when a blood clot forms inside of a hemorrhoid. The hemorrhoid may have the appearance of a red or purple colored bulge resembling the size of a grape. This can happen with internal or external hemorrhoids and can be quite painful.
There are varying grades to internal hemorrhoids that determine the level of prolapse (means to drop or fall).
Grade 1: No prolapse.
Grade 2: Some prolapse but they retreat on their own.
Grade 3: Prolapse out of the anus but can be tucked back in manually.
Grade 4: Prolapse out of the anus and it is difficult or impossible to replace them.
Some hemorrhoids will produce mucous, especially if they are aggravated. Yes, it’s unpleasant but it usually resolves on its own once everything calms down and the root cause of the hemorrhoids is tackled.
The older you get, the more likely you are to develop them. Another perk of aging, I suppose.
Men are just as likely to have them as women but thankfully, they are highly unlikely in children.
Generally, hemorrhoids are manageable at home and a decent number of cases can even heal without formal medical intervention. For those that need a physician’s assistance, there are procedures and operations that can be performed such as banding, stapling, and removal. Just keep in mind, the fail rate can be quite high in as little as a few years post-op so make certain whatever method you decide is the best approach for you.
WHAT CAUSES OR CONTRIBUTES TO HEMORRHOIDS?
Aging
Anal activities that we won’t talk about here
Chronic constipation or diarrhea
Falling hard on one’s bottom (trauma)
Forcing a bowel movement by bearing down (often accompanies constipation)
Systemic inflammation
Lifting heavy objects
Obesity
Pregnancy and/or child birth
Pressure on the derrière (sitting too much)
Sitting on the toilet for prolonged periods
WHAT NEVER TO DO
Never, ever, ever, ever, ever:
Try to “pop” or “bleed” a hemorrhoid on your own (yes, people have tried).
Apply anything with astringent properties (witch hazel, apple cider vinegar, essential oils) to broken skin (good Lord, that will BURN and you can really do some nasty damage).
Implement a “cure” without first researching it and/or having first-hand, reliable, and tested accounts of its viability and ruling out ahead of time any adverse side effects (such as an allergy to an ingredient). People will put all sorts of things on the interwebs to get attention. Don’t be fooled.
Ignore bleeding or discharge (e.g., mucous, stool) that has an odor, off color, or does not resolve on its own.
PREVENTION & TREATMENT
Many of the same things recommended to manage and treat hemorrhoids also apply for preventing them. Please note that a number of these recommendations have hyperlinks that will take you to helpful articles and resources so be sure to follow them for even more valuable information.
Avoid constipation
Don’t go digging for gold. Gross, I know, but some people feel the need to be reeeeeaaallly clean. Surface cleaning is sufficient and perfection is not necessary. Don’t believe me? Watch this doctor who explains it very well.
Employ products with hydrocortisone with caution and only temporarily. Overuse can thin (and weaken) tissues and create a bigger problems.
Keep a healthy weight
Lubricate the “exit” with a bit of salve, coconut oil or olive oil before every bowel movement (BM)
Maintain proper hydration not hyper-hydration!
Perform gentle exercises (walking, swimming, tai chi, yoga) regularly
Quit eating the foods that upset your digestive tract (learn what they are here)
Reduce or eliminate the use of toilet paper by installing a bidet or buying a hand-held model and consider using a portable dryer or patting dry (not wiping)
Stop sitting on the throne for longer than it takes to do your business – “spray and spree” and “drop and go” come to mind. Remember, it’s not an internet café or library, it’s a bathroom.
Try oral supplements such as rutin, cayenne pepper capsules, whole black peppercorns, and cascara sagrada
Use a squatty potty and get a travel version for “on the go”
An important word about constipation. To avoid getting stopped up doesn’t mean loading up on fiber or fiber supplements, especially regularly. Doing so is a slippery slope and, if not done correctly, can cause a plethora of problems. You are better off getting to the source of your constipation rather than using a potentially dangerous, addictive Band-Aid or altering your food intake in an unbalanced way. Try working on your diet and lifestyle, addressing stress, fixing your digestion, enjoying a daily carrot salad, eating properly prepared mushrooms regularly, balancing your thyroid, and staying adequately hydrated.
WHAT TO DO IF THOSE BUGGERS ARE FLARING
No matter what you do, sometimes a flare can present and you have to triage the situation. In addition to following all of the suggestions above under Prevention & Treatment, try these tips for fast relief:
Apply over the counter medicated pads such as Tucks or Preparation H or, make your own using witch hazel or raw apple cider vinegar soaked on a soft, cotton pad. Keeping a stash in the fridge or freezer in a small container makes them especially soothing.
Put a dab of ice cold aloe vera gel (stored in the fridge) to take the sting out of a burning bum. There are spray forms available as well.
Rest with your feet elevated. Adding an ice-pack over the target or running a wet cube of ice (so it doesn’t stick to the tissues) on the bullseye for a few minutes can help with swelling, itching, and burning.
Soak your seat in a (warm or cold) sitz bath. Plain water works well but if you are inclined, including any one or a combination of the following can offer additional benefits: Epsom salts, baking soda, borax, witch hazel, chamomile or comfrey tea. If you opt to add other ingredients such as essential oils, make sure you test them first as some products may burn or cause irritation to delicate tissues. If a sitz bath isn’t available, a wet tea bag (any flavor) placed on the area may help.
Some find that gently pushing hemorrhoids back into place (usually with a little oil or in the shower with a wet finger) can help get them on the right track. This may provide temporary relief but, if underlying issues aren’t addressed, the effort will end up being futile.
Try a topical application of any one of these in a carrier oil:
Do additional research to find more options. Whatever you choose, always test first to avoid any unpleasant reactions and bear in mind, some products may stain and others will have a bit of zing (like peppermint) so be prepared for a refreshing boost to your caboose!
Use a commercial suppository or make your own by either dipping the tip of a clove of scored garlic (ok to trim it to a comfortable size) in olive or coconut oil or use the below recipe. Insert at bedtime (use a pad in underwear or use a disposable pair for any oil that may escape). Don’t worry, you won’t smell like garlic and it will be eliminated with the next bowel movement.
Directions for Homemade Hemorrhoid Suppositories
Finely mince garlic and mix with solidified coconut oil – about 1 clove per tablespoon of oil
Form into one inch pieces the shape of a pencil - you can also use suppository forms
If making by hand, place on a pan/plate lined with parchment or wax paper
Pop them in the freezer
Once frozen, remove and place in to an airtight container
Store in freezer until ready to use
Time is your ally. It may take a few days or even a couple of weeks but, eventually - with nurturing, symptoms should subside. If, however, you are still dealing with the discomfort after trying all the tools in your box, it is best to consult your trusted health care professional.
THE #1 BEST TREATMENT FOR HEMORRHOIDS
This is, by far, the number one best antidote to inflamed hemorrhoids and for keeping them at bay. Ready? It’s
But not just any honey. The best, most effective is manuka honey. It is naturally thick, and is sometimes a little grainy due to crystallization (this is a good thing). While some may advocate for a blend of ingredients such as honey and olive oil, honestly, just singular honey will do the trick.
Immediately following a BM, after gingerly cleaning - preferably with mostly water and oh-so-gently patting dry - dip a clean finger into honey and tenderly apply a good smear to cover the angry bastards. If you can, try to get a bit just inside the anal opening (not deep!). This can be done after every evacuation and throughout the day, as needed, as both a treatment and preventative. Due to the nature of the sweet goo, it is best to place a pantyliner in your undies (guys, too) to keep your “tidy-whities” clean. You can remove the liner after an hour or so. And yes, this gives a whole new take on being a sweet ass!
WHEN TO SEEK MEDICAL INTERVENTION
There are times when at home remedies and over the counter preparations are just not enough and you need to seek assistance - even though they can be distressing to talk about. This is especially true in cases of unrelenting bleeding, foul discharge, extreme pain, and/or fever. As well, other comorbitities such as anal fissures or an anorectal abscess might also be at play. Search for a compassionate professional with an excellent reputation to confide in then allow them to guide you. If it is an emergent situation, go to the nearest emergency department and don’t worry, they’ve seen it all there (and more) and their calling requires them to be discreet.
Additional Resources:
Hemorrhoid Help protocol - purchase products from Fullscript where I have outlined many quality options to aid in your healing journey. As a bonus, you can enjoy exclusive, generous discounts as a thank you for supporting my work!
Your Friendly Proctologist - helpful videos from a kind and knowledgable practitioner
Hemorrhoids and What to Do About Them
Treatment of Hemorrhoids: A coloproctologist’s view
Take care of that tush!
Marie Stumphauzer, FNTP
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