Hi Everyone,

I'm new to the forum, but I have been a hemorrhoid sufferer for a while. I have had five rubber-band ligation surgeries so far, and I'm due for a sixth. Since the roids keep coming back, I have a feeling that I'm treating the symptoms of some greater problem. I have always been a pretty good pooper, so no hard stools or straining on the toilet. But there is blood and pain. I am really interested to hear of other remedies and what has been successful for other people.

A week after the last banding surgery, I was at the gym. I had just gotten changed and my workout mates went out on the floor while I went to the toilet. I had a painful bowel movement, and then felt nauseous and light headed. I had to lay down on a bench for ten minutes to regain myself. I went out to tell the other guys that I wasn't feeling well and I was not going to work out and just change back into my clothes and wait for them. I got out the words "I'm not feeling well", and then I started sweating, saw stars and then I hit the ground. I regained conciousness after a second or two, but my face and lips were as white as a fish's belly. One of the guys drove me to the emergency room, but the tests showed that I was healthy. I have a feeling that the pain from the bowel movement sent me into shock.

I'm a relatively young guy (34), I eat loads of fresh fruit and raw vegetables and lots of leafy greens. I am not overweight, I don't smoke and drink alcohol infrequently. For me, the veins in my rectum REALLY get inflamed with caffiene. If I have a cup of coffee, I will have intense pain and bleeding within 15 minutes. I have completely eliminated coffee, caffienated teas, soft drinks, and more recently even chocolate after a gourmet hot cholocate drink made me start bleeding (real chocolate has naturally occurring caffiene).

My proctologist surgeon said that some people are really affected by tomatos, while a naturopath said to avoid oranges and orange juice.

I have tried the following things:
1. Warm baths with magnesium sulfate salts (really nice, but I can't spend my life sitting in a bath)
2. Preparation H cream (super painful to insert applicator, so I abandon this after one try...maybe it would work if I could use it)
3. Preparation H suppositories (seem to releive pain, but this is temporary solution)
4. White Oak Bark herbal supplements (supposed to help with collagen elastisity - ie blood vessel walls - I didn't really see an effect)
5. Avoid caffeine (works great to avoid hemorrhoids, but not great in getting rid of one's you already have)
6. Avoid "bouncy" exercises like jogging and jumping jacks (same as #5)
7. Tucks moist pads after bowel movement (works great in keeping area clean, they also have a slight astringent effect that is cooling)
8. Annusol suppositories (not as good a PrepH suppositories)
9. Prescription hydrocortisol suppositories (good for antiseptic qualities, reasonable pain relief, helps to stop bleeding, but temporary solution)

I'd like to get more suggestions of things to try. The suppositories are a temporary solution and I don't want to be on pain killers all my life. Has anyone had any great success with treating hemorrhoids? It is going to be at least three months before I can get my next rubber-band ligation surgery, and I can't be bleeding and in pain for that long.

It sounds like you've been through the mill. The rubber-band ligations will work for lower grade hemorrhoids, but will not prevent their recurrence. Researcher's still don't fully understand precisely what causes internal hemorrhoids to form in the first place. They understand what happens, they just don't understand what factors specifically trigger them, although they have some ideas.

Caffeine is a diuretic, removing water from the stool, causing stool to be less flexible and more rigid. This causes issues of constipation, which in turn, is thought to worsen existing internal hemorrhoids that are pushed out into the anal canal. Caffeine also increases blood flow thereby enlarging veins. For veins that are entangled within the "anal cushions" that make up the internal hemorrhoids this is also a negative impact. In the case of hardened stools, as they pass the already damaged "anal cushions" aka hemorrhoids, they tear at them, causing a release of fresh arterial blood which is supplied to them. These cushions are designed to inflate and deflate using this blood, so the supply is purposeful.

As you know, physiology varies between individuals, and in your case it appears these triggers are magnified with respect to caffeine. I cannot speak to the faintness, although a considerable loss of blood through rectal bleeding could cause anemia which has many symptoms in common with what you described.

The warm salted baths can help, but only marginally. They help by altering blood flow to the affected area thereby improving nutrient delivery and waste exchange to the damaged cells that make up the damaged tissues in the anal canal and surrounding areas. Cold measures have a similar effect. It's a tossup as to which works better. Some use a combination of both.

The over-the-counter medications such as Preparation-H are designed for symptom relief. This relief does give the inflamed tissue a break and promotes minimal healing, but it's rarely enough to overcome the damage. These compounds work by blocking pain signals (anesthetics/analgesics), constricting vascular tissue (vasoconstrictors), which in turn reduce swelling and thus pressure on pain-receptive nerves in the areas, and drying tissue for itch prevention among other reasons. Unfortunately, they are all temporary measures. Supositories tend to push higher up into the rectum, above where the damaged tissue resides and the result is that much of the compound is absorbed into the wrong tissue and becomes minimally effective. It's a hit and miss with them.

The difficulty you've encountered is a hallmark of chronic internal hemorrhoids. For some, the body readily reponds to various treatments, for others, it's a much more intractable problem. Since this condition has been around for ages, there have been many remedies, both surgical and home based develop. What works for one may not for another, but hopefully you'll find the right one. One good thing is that in the last decade, with biochemistry proven the efficacy of various natural compounds, many commercial products have been developed to specifically target this problem.

Good luck.

http://www.hemorrhoidtreatmentanswers.com/

An update,

I went to a practitioner of acupuncture. He told me to stay away from oranges and orange juice and to take grapefruit juice with two tablespoons of olive oil every night before bed. Oranges are acidic and may hurt the hemorrhoids, whereas the digestion of grapefruit leaves an alkaline "ash". I was sceptical, but coincidentally the day that I got that prescription we were served freshly squeezed orange juice at work and I had horribly painful hemorrhoids and bleeding afterwards. I have avoided oranges ever since. The grapefruit juice and olive oil is surprizingly tasty. I'm not sure how much it helps the problem.

What has really worked...
I thought I was getting plenty of fiber in my diet. I eat salads all the time, raw fruit and vegetables, brown rice...everything. But every hemorrhoid discussion on the web says fiber, fiber, fiber. So I started taking a tablespoon of psyllium husks in a big glass of water every morning, and one every evening. I follow each one with a big glass of water since psyllium husks form a gel that requires a lot of water to pass. It took only two or three days and I've been pain and blood free for two weeks now. It is fantastic! Oh yes...I'm also taking one of those little Danone probiotic yoghurts every morning as well. I thought my hemorrhoids might have been related to unhealthy gut flora, so I thought I would try repopulating my GI tract with the good bacteria.

Lessons learned:
1. If you think you are getting enough fiber in your diet, you are wrong. Take fiber supplements.
2. If you think you are drinking enough water, you are wrong. Increase your water intake.
3. Promote healthy friends in your gut by taking yoghurt.

I'm feeling great now. Bowel movements are easy. No bleeding. And psyllium husk fiber is the cheapest solution I've tried!