Haemorrhoids/piles

Overview

Haemorrhoids, commonly called piles, are swollen and inflamed blood vessels in the rectum and anus that cause discomfort, bleeding, and sometimes pain. These vascular structures are actually normal parts of anal anatomy that help with continence, but become problematic when enlarged, inflamed, or prolapsed due to increased pressure or straining. Internal haemorrhoids develop inside the rectum and typically don't cause pain but may bleed, while external haemorrhoids form under the skin around the anus and can be painful, especially if a blood clot develops (thrombosed haemorrhoid).

This extremely common condition affects approximately half of adults by age 50, though many cases go unreported due to embarrassment. While often dismissed as merely inconvenient, haemorrhoids can significantly impact quality of life, causing chronic discomfort, bleeding with bowel movements, itching, difficulty sitting, and anxiety about symptoms. They commonly result from chronic constipation, straining during bowel movements, pregnancy, prolonged sitting, obesity, and low-fibre diets characteristic of modern lifestyles.

Traditional, Complementary, and Integrative Health (TCIH) modalities offer valuable approaches for managing haemorrhoids by addressing root causes like digestive dysfunction and constipation, reducing inflammation, strengthening vascular tissues, promoting healing, and preventing recurrence through dietary optimisation and holistic constitutional care.

Common Causes and Contributing Factors

• Chronic constipation and straining - Repeated straining during bowel movements increases pressure on rectal veins, the primary cause of haemorrhoid development
• Low-fibre diet - Insufficient dietary fibre leads to hard stools and constipation, creating conditions for haemorrhoid formation
• Prolonged sitting - Extended sitting, particularly on toilets or during work, increases pressure on anal and rectal veins
• Pregnancy and childbirth - Increased abdominal pressure from the growing uterus and straining during delivery commonly trigger haemorrhoids in women
• Obesity - Excess body weight increases abdominal and pelvic pressure on the rectal veins
• Heavy lifting - Repeated heavy lifting or activities increasing abdominal pressure can contribute to haemorrhoid development
• Chronic diarrhoea - Frequent loose stools and extended time on the toilet create irritation and pressure on the rectal tissues
• Ageing - Weakening of supportive tissues in the rectum and anus occurs naturally with age, increasing susceptibility
• Portal hypertension - Liver disease causing increased pressure in the portal venous system can lead to rectal varices similar to haemorrhoids
• Genetic factors - Family history suggests hereditary weakness in vascular tissues, predisposing to haemorrhoid development

Signs and Symptoms

• Rectal bleeding - Bright red blood on toilet paper, in the toilet bowl, or coating stool, typically painless and occurring with bowel movements
• Pain and discomfort - Varying from mild irritation to severe pain, especially with external haemorrhoids or thrombosis
• Itching and irritation - Persistent anal itching (pruritus ani) from mucus discharge or difficulty cleaning the area thoroughly
• Swelling around the anus - Visible or palpable lumps or bumps around the anal opening, particularly with external haemorrhoids
• Prolapsed tissue - Internal haemorrhoids that protrude through the anus, feeling like bulging tissue, sometimes requiring manual repositioning
• Mucus discharge - Clear or slightly bloody mucus leaking from the anus, causing irritation and cleanliness concerns
• Feeling of incomplete evacuation - Sensation that the bowel hasn't emptied completely, even after a bowel movement
• Pain during bowel movements - Discomfort or sharp pain when passing stool, particularly with external haemorrhoids
• Thrombosed haemorrhoid - Sudden severe pain and a firm, tender lump indicating blood clot formation within the external haemorrhoid
• Difficulty sitting - Pain or discomfort when sitting for extended periods, affecting work and daily activities

Holistic and TCIH Approaches

Holistic and Traditional, Complementary and Integrative Healthcare (TCIH) care addresses haemorrhoids by treating underlying digestive dysfunction, reducing inflammation, supporting vascular health, and preventing recurrence through constitutional approaches.

• Naturopathy offers comprehensive treatment addressing root causes through high-fiber dietary protocols to ensure soft, regular bowel movements, herbal medicines including horse chestnut, butcher's broom, and witch hazel for vascular support and inflammation reduction, topical natural preparations for symptom relief, nutritional supplementation with bioflavonoids and vitamin C for vein integrity, hydrotherapy applications including sitz baths for local relief³, and lifestyle counseling addressing constipation, straining, and digestive health optimization^{[1,2,3,5,8,9,10]}.
• Ayurveda understands haemorrhoids (arsha) as resulting from digestive fire (agni) impairment and dosha imbalances, providing treatment through dietary modifications emphasizing easy-to-digest foods and adequate fiber, specific herbs like triphala for gentle bowel regulation, haritaki for vein strengthening, and neem for inflammation, specialized procedures including medicated enemas and topical applications, lifestyle recommendations preventing constipation and promoting digestive health, and constitutional treatment addressing underlying metabolic and digestive imbalances predisposing to haemorrhoid development^[4].
• Traditional Chinese Medicine (TCM) views haemorrhoids as heat and dampness accumulation, often with qi deficiency affecting holding capacity, offering treatment through acupuncture points that clear heat, reduce swelling, strengthen qi, and stop bleeding, Chinese herbal formulas tailored to individual pattern differentiation (heat, dampness, deficiency), dietary therapy based on TCM food energetics avoiding heat-producing and damp-forming foods, lifestyle recommendations supporting healthy bowel function, and constitutional treatment addressing spleen qi deficiency or other root imbalances^[6].
• Acupuncture addresses haemorrhoids through traditional point prescriptions that reduce inflammation and pain, strengthen vein wall integrity, improve local circulation and tissue healing, stop bleeding through specific hemostatic points, address underlying digestive dysfunction and constipation, regulate bowel movements, and provide constitutional support for prevention, often combined with moxibustion or herbal applications for enhanced therapeutic effect^[6].
• Herbal Medicine provides botanical support through vascular-strengthening herbs like horse chestnut and butcher's broom containing compounds that improve vein tone, anti-inflammatory herbs including calendula, plantain, and chamomile for local application, astringent herbs like witch hazel and oak bark that tone tissues and reduce bleeding, demulcent and vulnerary herbs supporting tissue healing, and gentle laxative herbs like psyllium or flax ensuring soft bowel movements, formulated into topical ointments, suppositories, sitz bath preparations, or internal teas and tinctures^[2,5,10].
• Nutrition forms the foundation of haemorrhoid management through high-fiber diet (25-35g daily) from vegetables, fruits, whole grains, and legumes ensuring soft, bulky stools, adequate hydration to prevent hard stools, foods rich in bioflavonoids (citrus, berries, dark leafy greens) strengthening blood vessels, anti-inflammatory foods reducing vascular inflammation, avoidance of constipating foods and excessive spicy foods or alcohol that may aggravate symptoms, and emphasis on regular meal patterns supporting consistent bowel function^[1,8,9].

Self-Care and Lifestyle Practices

• Increase dietary fibre - Consume 25-35g daily from whole grains, vegetables, fruits, and legumes to ensure soft, easy-to-pass stools
• Stay well hydrated - Drink 8-10 glasses of water daily to prevent hard stools and support healthy bowel function
• Don't delay bowel movements - Respond promptly to the urge to defecate; delaying leads to harder stools and increased straining
• Avoid prolonged sitting - Take breaks during long sitting periods and avoid spending extended time on the toilet, reading, or using devices
• Use sitz baths - Soak the anal area in warm water for 10-15 minutes several times daily, especially after bowel movements, to reduce inflammation
• Apply cold compresses - Use ice packs wrapped in cloth for acute pain and swelling relief, particularly with external haemorrhoids
• Practice good hygiene - Keep the anal area clean and dry, using gentle cleansing with water rather than harsh wiping; pat dry carefully
• Avoid straining - Never force bowel movements; if constipated, increase fibre and water rather than straining
• Exercise regularly - Engage in regular physical activity to support healthy bowel function and prevent constipation
• Use natural topical relief - Apply witch hazel, aloe vera, or coconut oil to reduce discomfort and support healing

When to Seek Professional Support

Conventional medical practitioners should be consulted for proper diagnosis ruling out more serious conditions like colorectal cancer, evaluation of persistent or heavy bleeding, assessment of severe pain particularly if thrombosed haemorrhoid requiring possible intervention, examination of prolapsed haemorrhoids that don't reduce manually, consideration of minimally invasive procedures (rubber band ligation, sclerotherapy) or surgery for severe cases unresponsive to conservative treatment, and screening for contributing conditions like inflammatory bowel disease. Medical attention is important when experiencing significant rectal bleeding, a change in bowel habits, severe or worsening pain, signs of infection, or symptoms persisting despite self-care and conservative management. Immediate care is needed for severe continuous bleeding causing anaemia or dizziness, or extreme pain suggesting complications.

A verified SoulAdvisor practitioner can work collaboratively with medical providers to address the underlying digestive issues that contribute to haemorrhoids. This integrative approach recognises that effective management involves more than treating local symptoms. It requires understanding root causes such as chronic constipation, digestive dysfunction, inadequate fibre intake, and lifestyle patterns that strain the vascular system.

By combining appropriate conventional treatment with evidence-informed complementary approaches that support vascular health, improve digestion, and encourage sustainable dietary and lifestyle changes, individuals can achieve lasting relief. This comprehensive pathway empowers clients to prevent recurrence and restore comfort through balanced, long-term wellbeing practices.