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Hemorrhoids: A Total Pain in the Butt

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Perhaps not the most fun thing to talk about but let’s face it, most adults will suffer from hemorrhoids at some point in their life.  Ignoring them doesn’t make them go away.  This condition is full of hope and answers from the holistic nutrition realm.  

What are hemorrhoids?

Hemorrhoids, sometimes referred to as piles, are cushions of tissue in the anal canal.  They are present in healthy people and they’re primarily to help maintain continence.  However, when most people refer to hemorrhoids, they are speaking of the abnormal issue of when they become swollen and inflamed.  In some people (about 40% of those who suffer), they’re not even aware of them and have no symptoms at all.2  In others, symptoms can include pain, bleeding, anal itching, mucus, prolapse and fecal seepage.3  This inflamed tissue can be internal or external.  When they are internal, they are less likely to cause pain.  External hemorrhoids protrude with a slight bulge of purplish tissue and tend to be more painful.

What causes them and what are the imbalances involved?

There is not a ton of research on this condition despite it being one of the main gastrointestinal complaints in medical facilities across the nation.  There are lots of factors associated with this issue that may or may not be actual causes.

Possible causes and associations may include:

  • Constipation (and straining) often due to a low fiber diet.
  • Poor posture while eliminating.  Sitting instead of squatting seems to be associated with a greater number of people with hemorrhoids.3  Squatting is a more physiologically natural position to be in while eliminating.  
  • Increased abdominal pressure from obesity, overweight or pregnancy.4
  • Diarrhea and the conditions that go along with it (malabsorption, colitis, IBD, etc.).3
  • Certain disease conditions such as liver disease.2 

Besides contributing to hemorrhoids, the nutritional implications of a low fiber diet include reduced immunity, skin issues, digestive issues, blood sugar imbalances, deficiencies in several nutrients, constipation, weight gain and a lack of energy, to name a few.

A food plan that can help:

You guessed it!  A whole food plant-based diet can be profoundly helpful for this condition in a couple of ways:

  1. Increasing fiber!  Fiber is a magical nutrient.  When you increase your fiber, by its very nature you are improving your microbiome which helps support your immune system, digestion, energy and so much more.  Increasing fiber can reduce the pain and bleeding of hemorrhoids by 50%!5
  2. Weight loss. A balanced whole food plant-based diet is a great to support healthy weight loss which can prove helpful for reducing hemorrhoids.6

A few specific foods that are great include:

  • High fiber foods:  Although nearly all fruits and vegetables, whole grains, beans and other plant foods are good sources of fiber, some especially great options are oatmeal, lentils, berries, soaked chia seeds, ground flaxseeds and dark leafy greens. These foods can soothe the gut and help waste move through the colon with more ease.
  • Fermented foods: raw sauerkraut or kimchi are extra helpful for adding healthy/friendly bacteria to the gut microbiome!
  • Juicy foods with high water content: watermelon, cucumbers, oranges, tomatoes, pineapple… these foods increase both fiber and hydration!

Two supplements that can be great to help with hemorrhoids:

Perhaps the most common supplement for this condition is a fiber supplement.  I rarely recommend that because there are SO many inexpensive and delicious ways to increase fiber in the diet.  However, there is a special way I like to use this (fiber) and one other supplement in addition to a whole food plant-based diet:

  1. Pre-meal water loading with 1-2 tsp of psyllium or freshly ground flaxseed.  All you have to do is add the psyllium or ground flax to 16oz of water about 30 minutes before each meal.  This can help by increasing fiber and water as well as having a weight loss effect, all of which are helpful for hemorrhoids.7
  2. Resveratrol (from PRL), 100mg twice/day. This supplement is rich is flavonoids which is a plant compound that has found to be helpful for hemorrhoids.8

One additional tip:

Remember that although food/nutrition is important, there are also great benefits from becoming more active, drinking more water, not waiting when you feel like you have to eliminate, using a squatty potty and sitting less (try a standing desk).  

And finally, if you have pain, bleeding, or any issues when you have a bowel movement, don’t wait to get help.  You are worth taking good care of and your health is your greatest possession on earth!  If you can’t resolve these (or any health issues) within a couple of weeks, get help!  

Resource list:

1. Djurin D. Hemorrhoids pic. Pixabay. https://pixabay.com/photos/hemorrhoids-proctalgia-fugax-2790200/. Accessed May 17, 2021.

2. Sun Z, Migaly J. Review of Hemorrhoid Disease: Presentation and Management. Clin Colon Rectal Surg. 2016. doi:10.1055/s-0035-1568144

3. Sandler RS, Peery AF. Rethinking What We Know About Hemorrhoids. Clin Gastroenterol Hepatol. 2019. doi:10.1016/j.cgh.2018.03.020

4. Margetis N. Pathophysiology of internal hemorrhoids. Ann Gastroenterol. 2019. doi:10.20524/aog.2019.0355

5. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World J Gastroenterol. 2015. doi:10.3748/wjg.v21.i31.9245

6. Turner-McGrievy G, Mandes T, Crimarco A. A plant-based diet for overweight and obesity prevention and treatment. J Geriatr Cardiol. 2017. doi:10.11909/j.issn.1671-5411.2017.05.002

7. Pre-meal water consumption for weight loss. Aust Fam Physician. 2013.

8. Changazi SH, Bhatti S, Choudary A, RAJPUT MNA, Iqbal Z, Ahmed QA. Calcium Dobesilate Versus Flavonoids for the Treatment of Early Hemorrhoidal Disease: A Randomized Controlled Trial. Cureus. 2020. doi:10.7759/cureus.9845

Nothing said or implied in this post is intended to treat, cure, diagnose or prevent any disease.  It does not take the place of a health care practitioner.  It is for educational purposes only.