Help for Hemorrhoids Includes Fiber, Fluids and Fitness

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Q. I have hemorrhoids. What dietary changes can I make to ease the pain?

A. You're not alone. About 50% of people over age 50 have hemorrhoids, swollen blood vessels in and around the rectal area. The 3 F's in the headline hold the key for how to prevent and treat hemorrhoids.

Causes and Symptoms. Common triggers for developing hemorrhoids include inactivity--especially long periods of standing or sitting--heavy lifting, obesity and straining during bowel movements because of too little fiber and fluids. The itching, burning, pain and swelling you hear about in commercials are usually from external hemorrhoids. Bright red blood in stool, on toilet paper or in the toilet bowl are telltale signs of internal hemorrhoids.

Treatment. The first line of defense against hemorrhoids is to lessen pressure in the rectal area from straining. Increase dietary fiber and fluids to soften stools and make them bulkier. Strive daily for at least 25 grams of fiber (increase gradually) and a minimum of eight glasses of fluids. A bowl of wheat bran cereal can provide 8 to 12 grams of fiber right off the bat. Make it a habit on most mornings. Follow up with fluids like juice and tea, to get things moving.

Over-the-counter creams, ointments and suppositories can relieve discomfort temporarily. But you might get more relief sitting in a warm tub or on an ice pack. For more troublesome hemorrhoids, see a doctor.

Several herbs may be worth trying. An extract of prickly ash bark (Zanthoxylum clavaherculis L. or Zanthoxylum americanum) taken orally was recently found to reduce the size of hemorrhoids as well as relieve annoying symptoms. Researchers believe prickly ash bark strengthens veins so they can sustain increased blood flow.

In Europe, some hemorrhoidal ointments contain an extract of horse chestnut (Aesculus hippocastanum). Other herbs, like witch hazel and slippery elm bark, might also ease pain topically.

Prevention. The best way to prevent hemorrhoids is to avoid constipation--with the 3 F's. Combine a high-fiber diet with plenty of fluids and get fit with regular physical activity. Occasional laxative use may be helpful, but don't become dependent on laxatives or it may be difficult to restore a healthy bowel tone. If dietary fiber isn't enough to promote regularity, try a bulking agent with psyllium (e.g. Metamucil) or methylcellulose (e.g. Citrucel). For exercise, try walking more.

EN's Bottom Line. Hemorrhoids are not life-threatening. But keep in mind they can cause symptoms similar to rectal cancer. See your doctor for a proper diagnosis before self-treating.

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