Dear Pharmacist,
What are the best treatments for hemorrhoids, both the internal sort and the external? I ask because my wife and I suffer with these. Lucky us.
–S. D., Gainesville, Florida
Answer: In the United States, approximately half of all people will suffer from hemorrhoids at some point in life, usually between the ages of 20 and 50. It’s not necessarily a problem of the elderly or constipated, it can happen to anyone, even people who are healthy, but happen to sit for very long periods of time. Hemorrhoids -whether internal or external- happen due to weak veins that swell because of pressure. If these weak veins occur on the legs, we refer to them as “varicose” veins. The blood pools, and causes veins to swell and engorge; this can be caused by many situations, among them obesity, pregnancy, lifting heavy objects or boxes, straining on the toilet, coughing, sneezing, standing or sitting for long periods of time. People who eat a high fiber diet and stay well hydrated are less likely to suffer with hemorrhoids, whereas people who eat processed foods will eventually feel it in the end. Before I offer suggestions, I will first describe internal and external. The primary difference is pain. With internal hemorrhoids, there is no pain because the swollen veins are higher up in the rectum where there are no nerves. There maybe no symptoms at all, or you may have bleeding after a bowel movement. For some bleeding may be the first, and only sign of internal hemorrhoids. For others, you may have a thin stool, and the urge that you are not finished yet. External hemorrhoids hurt like crazy and if untreated it can thrombose, meaning it can turn purplish-blue and bleed. They can itch, burn and irritate the anus, and you can feel them easily. No matter the type, don’t sit excessively, or let your butt fall asleep on hard chairs! Here are some ideas to help yourself:
Witch hazel- A natural astringent that helps with the swelling and pain.
Hydrocortisone or calendula cream- Apply externally to ease pain.
Preparation H suppositories- Perfect for internal hemorrhoids.
An ice cube or ice pack- Apply this to your little monster, but wrap it in a paper towel first, don’t put it on bare skin.
Ibuprofen- An anti-inflammatory can do a lot towards reducing inflammation and pain.
Quercetin- A dietary supplement related to vitamin C that may help improve vein strength.
Take 300 – 1000 mg three times daily.
Warm sitz baths- 10 – 20 minutes
Two herbs have a long history with regards to hemorrhoids. Butcher’s Broom contains ruscogenin which helps tighten the blood vessels. This herb was studied at Memorial Sloan-Kettering Center. Horse Chestnut contains aescin, which tones vein walls and is commonly used in Europe.
Aloe vera juice may help constipation.
Please see a specialist who can make sure that pencil thin stools, bleeding or other symptoms are in fact related to hemorrhoids, rather than something more serious. Physicians offer numerous helpful treatments.
