An herbal sitz bath using witch hazel, Hamamelis virginiana, may shrink hemorrhoids and ease discomfort. A strong infusion should be prepared by adding a
gallon of boiling water to eight ounces of the dry herb, and then letting this mixture steep overnight. The infusion can be used several times as a 15-minute soak. Witch hazel can also be wiped directly over external hemorrhoids. In addition, an ointment formulated of plantain, Plantago spp. and yarrow, Achillea millefolium, will reportedly reduce pain and swelling.
Chinese herbal medicine may be formulated to treat Spleen Qi deficiency or heat in the lower burner. Hemp seeds are recommended for constipation. Daily helpings of foods that soften the stools and make them easier to pass are recommended by traditional Chinese medicine (TCM); examples of these include carrots, broccoli, dried persimmons and unripe figs. Acupuncture and acupressure are also recommended.
Homeopathy offers a gentle treatment solution for hemorrhoids. It is, therefore, especially appropriate for use during pregnancy. Suggested remedies include Aeschulus hippocastanum 30c, Hamamelis virginiana 6c, and Calcarea fluorica 6c. Homeopathic and herbal rectal suppositories are available.
Hemorrhoids can often be dealt with effectively by dietary and lifestyle changes. Avoiding constipation is important; therefore adding fiber to the diet is recommended. Bulk laxatives and fiber supplements such as Metamucil or Citrucel may be suggested. After each bowel movement, wiping with a moistened tissue or pad sold for that purpose helps lessen irritation. A warm sitz bath for about 10 or 15 minutes two to four times a day can ease hemorrhoid pain. A cool compress or ice pack to reduce swelling is also recommended. Many people find temporary relief using over-the-counter hemorrhoid creams and foams. These products, however, are not receommended during pregnancy.
When painful hemorrhoids do not respond to home-based remedies, professional medical treatment is necessary. Rubber band ligation is probably the most widely used of the many treatments for internal hemorrhoids. It is also the least costly for the patient. This procedure is performed on an outpatient basis. An applicator is used to place one or two small rubber bands around the base of the hemorrhoid, cutting off the blood supply. After 3 to 10 days in the bands, the hemorrhoid falls off, leaving a sore that heals in a week or two. Because internal hemorrhoids are located in a part of the anus that is not sensitive to pain, anesthesia is unnecessary and the procedure is painless in most cases. The procedure may need to be repeated a few weeks later. After five years, 15–20% of patients experience a recurrence of internal hemorrhoids, but in most cases all that is needed is another banding.
External hemorrhoids, and some prolapsed internal hemorrhoids, are removed by conventional surgery in a hospital. Depending on the circumstances, this procedure may require anesthesia. Full healing takes two to four weeks, but most people are able to resume normal activities at the end of a week. Hemorrhoids seldom return after surgery.
Patience Paradox, The Gale Group Inc., Gale, Detroit,