Many people are suffering from the side effects of having chronic constipation and sitting while defecating, hemorrhoids might be the worst. I remember when I had an external hemorrhoid years ago. Severe pain when I sat, and itching so bad I felt like a bear who rubs their butt on trees to get relief. The only thing that brought me relief for my hemorrhoids was scalding Epsom salt baths. So, what are hemorrhoids and what can we do about them to bring some relief?

All About Hemorrhoids

Hemorrhoids are vascular structures in the anal canal that sometimes swell and become inflamed. These structures help with stool control and act as a cushion composed of arteriovenous channels and connective tissue. Though the true causes of hemorrhoids are unknown, constipation is believed to be the main cause. Other causes and risk factors include prolonged straining or sitting, chronic coughing, and obesity.^{1 2}

Diagnoses of hemorrhoids are usually made by visual examination or a rectal exam using an anoscopy (tube device with a light on the end inserted into the rectum). There are two different types of hemorrhoids: internal and external.^{3 4}

Internal

Internal hemorrhoids usually present with painless, bright red rectal bleeding during or after defecation. The blood usually covers the stool (hematochezia) or is visible on toilet paper after wiping. The stool itself should be of normal color. Other symptoms include mucous discharge from the anus, itchiness, and fecal incontinence. Internal hemorrhoids only are painful if they have become thrombosed or necrotic which should be treated by a doctor. The degree of prolapse classifies internal hemorrhoids. Grade III and IV hemorrhoids usually warrant a visit to your doctor.^{5 6}

• Grade I: No prolapse. Just prominent blood vessels.
• Grade II: Prolapse upon bearing down but prolapse is reduced after ceasing defecation.
• Grade III: Prolapse upon bearing down and requires manual reduction by the person them self.
• Grade IV: Prolapsed and cannot be manually reduced.

External

An external hemorrhoid is outside of the anal canal. If the external hemorrhoid is not prolapsed, then it may go unnoticed. If the hemorrhoid becomes thrombosed, then it may become extremely painful. The pain will usually resolve within a few days. Itching and irritation may occur with an external hemorrhoid. Try to sit on a cushion if possible and try to reduce the pressure on the hemorrhoid.^{7 8}

Procedures and Surgery for Hemorrhoids

If my protocols do not reduce your hemorrhoid, then surgery might even be a need for relief. While most procedures for hemorrhoids are safe, sepsis and infections are possible. Surgery also poses elevated risks like uncontrolled bleeding, infection, anal strictures, fecal incontinence, and damage to nerves in the bladder causing urinary retention.^{9 10 11}

Rubber Band Ligation

Rubber band ligation is usually the primary treatment for those suffering from any hemorrhoidal diseases unless they have progressed to grade IV. In this procedure, an elastic band is tied around the hemorrhoid to cut off its blood supply. Within five to seven days, the hemorrhoid typically falls off. However, if the rubber band is too close to the dentate line, it will cause intense pain after it falls off. This method has a success rate of eighty-seven percent and a complication rate of about only three percent.¹²

Sclerotherapy

When a sclerotherapy is performed, an agent is injected into the hemorrhoid to shrink the blood vessel. Usually, phenol is used for this procedure, which causes the hemorrhoid to shrivel up and disappear. The success rate for this procedure is around seventy percent.¹³

Cauterization

Cauterization is usually used only for hemorrhoids that are classified as either grade I or II. When a hemorrhoid is cauterized, a laser usually burns it so that it the blood flow is blocked, and it eventually falls off.

Excisional Hemorrhoidectomy

Excisional hemorrhoidectomy is a surgical excision of the hemorrhoid and is only performed in the most severe cases. It comes along with significant post-surgical pain that lasts for up to a month. However, if the hemorrhoid is thrombosed and has started to turn necrotic, this may be the most effective treatment. Application of glyceryl trinitrate ointment post procedure improves general healing and reduces pain.

Doppler-Guided Transanal Hemorrhoidal Dearterialization

Doppler-Guided Transanal Hemorrhoidal Dearterialization is a minimally invasive treatment that uses an ultrasound Doppler to locate arterial blood flow to the hemorrhoid. The arteries are then tied off, and the prolapsed hemorrhoid sutured to its original position. There is a slightly higher recurrence rate, but less complication and pain than having a hemorrhoidectomy.

Stapled Hemorrhoidectomy

Stapled hemorrhoidectomy involves the removal of the enlarged hemorrhoidal tissue following the remaining hemorrhoidal tissue and stapling it back into position. It is usually less painful and associated with faster healing than complete removal of hemorrhoid. This procedure has a greater recurrence rate than the above surgeries and is usually used only on grade II and III hemorrhoids.

Hemorrhoid Prevention Protocol

• Use a Squatty Potty when defecating.
• Follow a fruit and vegetable rich diet like the Perfect Health Diet.
• Make sure you are properly hydrated.
• Magnesium malate – take 400 mg daily, with meals.
• Maintain a healthy body mass if possible.
• Have good posture when sitting; try to sit on the most comfortable furniture available if you have to sit for long periods.
• Ingest spicy foods when possible, if you are not sensitive to them. Capsaicin helps increase circulation at the anal sphincter, preventing hemorrhoids.

Hemorrhoid Protocol

• Use a Squatty Potty when defecating.
• Make sure you are properly hydrated.
• Magnesium malate – take 600 mg daily, with meals.
• Aescin (horse chestnut) – follow general supplement bottle recommendations.
• Uni-Fiber – consume one tablespoon mixed in a glass of water, three times daily.
• Follow a fruit and vegetable rich diet like the Perfect Health Diet.
• Use witch hazel wipes after defecation.
• If the hemorrhoid is painful, take a warm Epsom salt bath for twenty minutes.
• Follow the cayenne pepper protocol.Cayenne Pepper Protocol:Boil cold distilled water.

  Put your designated or acclimated amount of organic cayenne pepper powder in a small glass. Start with 1/8 of a teaspoon and work up to ½ of a teaspoon.

  Pour the very warm water over the organic cayenne pepper powder. Squeeze half a lemon into the glass.

  Let it steep for a minute, and then mix thoroughly.

  Drink it as fast as you can and love the burn!

• Rutin – take one capsule with breakfast and one with dinner.
• Consider Anax cream if you are having severe hemorrhoid symptoms.

The magnesium malate, Perfect Health Diet, and Uni-Fiber keep bowels loose and regulated.¹⁴

Using a Squatty Potty prevents straining and constipation.

Cayenne pepper heals hemorrhoids with anti-inflammatory factors and increases blood flow to the hemorrhoid.¹⁵

Witch hazel as an astringent shrinks hemorrhoids.¹⁶

Warm water in the bath increases blood flow to the hemorrhoids.¹⁷

Oral rutin was found in a pregnancy study to reduce hemorrhoids.¹⁸

Hemorrhoid Surgery Protocol

• Use a squatty potty when defecating.
• Make sure you are properly hydrated.
• Magnesium malate – take 600 mg, daily with meals.
• Uni-Fiber – consume one tablespoon mixed in a glass of water, three times daily.
• L-glutamine – one the first day take 10,000 mg, in divided doses mixed in filtered water with meals. The second day take 20,000 mg of glutamine. The third day take 30,000 mg of glutamine for three more days then reduce by 5,000 mg each day until you are at 0 mg, then discontinue (use with caution if you have a sensitivity to glutamic acid, deficiency in GABA, or severe leaky gut and brain).

L-glutamine protocols have been shown in studies to improve surgery outcomes.¹⁹