Haemorrhoids, otherwise known as piles, are varicose veins of the peri-anal area. Piles begin as superficial veins in the vascular tissues which enlarge and become twisted. They can form internally or externally, and while some remain blind, others eventually hang like grapes.

Piles result from genetics, lack of tissue integrity, liver problems, and increased pressure, usually due to chronic constipation and regular straining at stool, which damages the tissues. A low-fibre diet, dehydration, a high consumption of spicy food, and sedentary habits are also risk factors.

Piles also accompany pregnancy due to increased abdominal pressure, increased vascular volume, and impeded vascular return. Constipation, straining during delivery, or large birth-weight babies add to the risk.¹

Symptoms include irritation, soreness after stool, and bleeding. These should be differentiated from ulcers or anal fissures.

Haemorrhoids are treated by rubber-band ligation, sclerotherapy, cauterisation, infrared coagulation, and surgical excision.

Treatment

General

The general approach is to soften the stool, while improving tissue strength. Go to the toilet without unnecessary delay. Maintain a healthy body weight and do plenty of exercise (not the king of straining found in weight lifting).

Liver function needs to be improved to reduce pressure in the portal circulation, and venous tissue integrity supported.

Ointments give relief from symptoms. A cold sitz bath may also be affective: the patient sits in a tub of cool water for ten minutes (15-20°C), with the feet in hotter water (40°C). A tepid hip bath made with the liquid of infused green cyprus leaves is astringent, taken morning and night.

Diet

The general approach is to avoid constipation by eating plenty of fibre of the kind found in nutrient-dense wholefoods. Drink plenty of fresh water and avoid carbonated drinks or juices sweetened with high-fructose corn syrup. Avoid ultra-processed foods, which contain refined oils and artificial fats.

Vitamin C can be supplemented, along with bioflavonoids (quercetin, rutin, hesperidin), but these compounds are found in abundance in vegetables, leafy greens, fruits, and berries. Nuts, seeds, and wholegrains provide plenty of fibre and nutrients. Berries and cherries improve microcirculation.

Figs, prunes, psyllium, and slippery elm can treat constipation without the regular use of laxatives. Decrease caffeine and alcohol consumption.

Herbs

Butcher’s broom, horse chestnut, witch hazel, comfrey, and plantain support tissue integrity. A cream can be made of butcher’s broom, witch hazel, plantain, or horse chestnut tincture added to a cream base, or to heated olive oil with 10% beeswax. Shepherd’s purse or yarrow can be used to stop bleeding. Gotu cola will help normalise blood flow and improve connective tissue.

Artichoke, milk thistle, dandelion, yellow dock, and chelidonium will support the liver and portal circulation. Burdock root is used to cleanse the blood.

Tissue Salts

Calc-fluor is to build tissue integrity. Silicea is indicated for a patient who strains ineffectually, has itching, and needs tissue support. Silicea is also for treating fissures.

Homeopathy

Aesculus-h—blind piles that are purple, burn, itch; piles with headache; severe lower backache; rectum feels full of sticks.

Aloe-s—piles in blue bunches, tender, burning; Intense itching; better cold applications; chronic loose stool, incontinence.

Ars-a—piles burn like fire, better heat; also ulcers.

Calc-fluor—swollen, bleeding piles, bright blood; chronic constipation; itching; prolapse of rectum.

Causticum—itching, stitching, or burning pain; very sensitive to touch; walking or sitting aggravate; piles impede stool; prolapse on coughing.

Collinsonia—piles with congested pelvis and portal system, constipation; worse night, pregnancy.

Hamamelis—profusely bleeding piles, tar-like blood; sore and raw; weakness; varicose veins on abdomen.

Hypericum—painful, bleeding piles.

Muriatic-a—piles in pregnancy, bunches; very sore, stitching pain; better heat; enlarged liver.

Nit-ac—painful piles which bleed easily; constipation; pain after stool even when soft, or while walking; itching, oozing; fissures.

Nux-v—blind piles with sticking, burning pain; piles with constipation, ineffectual urge to stool; sedentary, irritable; craves stimulants.

Paeonia—piles large and ulcerated, crusty; pain lasts long after stool, must rise and walk about to relieve; oozing; fissures, fistula.

Ratanhina—constriction, sharp splinter pains; prolonged burning after stool; dry itching.

Sepia—protruding piles, prolapse; intense itching, congested; hormonal issues; worse walking, touch, pregnancy; obstinate constipation; weary.

Sulphur—bleeding bunches or blind piles; tender, itching, burning, urging; worse night, heat of bed, washing; resists urge to stool from pain; hungry and weak 11 am.

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for diagnosis, treatment advice, or a prescription that is given in a consultation with a qualified physician.

References:

1.         Wall LL. Pelvis, posture and protrusion: evolution and haemorrhoids. BJOG Int J Obstet Gynaecol 2014;121:1672.