About half of Americans over the age of fifty have hemorrhoids. They are not life-threatening or dangerous, but can be painful or might bleed. They occur when blood vessels in and around the anus get swollen and stretch under pressure, similar to varicose veins in the legs.

They are found either inside the anus (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Internal hemorrhoids may become so swollen that they push through the anus. When they become irritated, inflamed, and painful, they are called protruding hemorrhoids.

Straining during bowel movements is a common cause of hemorrhoids. The most common symptom is bright red blood with a bowel movement. Hemorrhoids are also common but temporary during pregnancy. Hormonal changes cause the blood vessels to expand. During childbirth, extreme pressure is put on the anus.

Hemorrhoids also occur in people with chronic constipation or diarrhea. Sitting for long periods, heavy lifting, and genetics are other influential factors. In most cases, hemorrhoids go away in a few days. If you have bleeding that lasts longer, have your doctor examine you to rule out a more serious problem.

A high-fiber diet with plenty of fluids—water, fruit juices, and herbal teas—helps prevent hemorrhoids because fiber and fluids soften stool so they pass through easily. No straining with bowel movements means less pressure on the blood vessels near your anus.

So, increase your intake of fruits, whole grains, legumes, and vegetables, especially those containing the most fiber: asparagus, brussels sprouts, cabbage, carrots, cauliflower, corn, peas, kale, and parsnips. Eating a high-fiber breakfast cereal significantly increases your fiber intake.

Hemorrhoids generally don’t itch. If your anus itches mainly at night, you might have pinworms. The best time to check for them is at night while you itch. Place a piece of tape around your finger, sticky side out. Put the tape on your anus, pull it off and check for worms, which look like moving white threads.

If you are checking one of your children, you can use the tape method or just look. Another cause of rectal itching is called pruritus ani, which can be caused by food sensitivities, contact with irritating substances (laundry detergent or toilet paper), fungi, bacterial infection, parasites, antibiotics, poor hygiene, or tight clothing. If you have hemorrhoids, you might find relief from the following suggestions.

Prevention

• Improve your diet. A high-fiber diet usually prevents hemorrhoids and allows them to heal. Increase your intake of fruits, vegetables, whole grains and legumes, and drink plenty of fluids, including water, fruit juices, and herbal teas.

• Use psyllium seed husks. Psyllium seeds add bulk and water to stool, which allows for easy passage. They regulate bowel function and can be beneficial for both diarrhea and constipation. Because they are not a laxative, they do not cause harmful dependency.

Gradually build up to 1 teaspoon of psyllium with each meal to avoid gas and cramping from the sudden introduction of fiber. As your dietary fiber increases, you will probably find you no longer need to take psyllium seeds.

• Try wheat or corn bran. Wheat and corn bran can be used in the same way as psyllium seeds to add bulk and moisture to stool, allowing them to pass more easily. Take 1 teaspoon with meals or eat a high-fiber breakfast cereal. Be sure to add fiber to your diet slowly to prevent any gas or discomfort.

• Take probiotics. Poor bowel flora causes the digestive system to move sluggishly. Use of antibiotics, hormones, or steroid drugs; high-stress levels; and poor diet can cause an imbalance of intestinal flora.

Take acidophilus and bifidobacteria two to three times daily to help regulate peristalsis. If you are able to digest yogurt, it also has a normalizing effect on the bowel and can be helpful for either constipation or diarrhea.

• Address magnesium deficiency. Americans have widespread magnesium deficiency that contributes to constipation. According to recent studies, we lose 75 percent of magnesium during food processing, and 40 percent of Americans fail to meet the RDA levels for daily magnesium intake.

One of the many functions of magnesium is the proper relaxation of muscles, and peristalsis is a rhythmic muscle relaxation and contraction. When magnesium deficiency or a calcium-magnesium imbalance is present, poor bowel tone can occur. On the other hand, too much magnesium can cause diarrhea. Take 400 to 500 milligrams daily.

• Explore possible lactose intolerance. People with lactose intolerance can become constipated from dairy products.

• Examine hormone changes. Women often notice that their bowel habits change at various times in their menstrual cycle. Pregnancy is a common but temporary cause of constipation and hemorrhoids. An underactive thyroid can also cause constipation.

• Take vitamin C. Vitamin C can be used to help soften stool. The amount needed depends on your individual needs. Use a vitamin C flush to determine your daily need for vitamin C.

Healing Options

• Change your bathroom habits. In many countries, people squat to relieve themselves. A squatting position on the toilet takes pressure off the rectum and can help during a flare-up of hemorrhoids. (You may feel a little silly, but who’s watching!) Also, wipe gently with soft toilet paper. It may help to wash your anal area with warm water after each bowel movement, or if you have a bidet, now is the time to use it.

• Use salves. Salves can soothe inflamed tissues. Spread vitamin E oil, comfrey, calendula ointment, or goldenseal salve gently on the anus with your fingers. Witch hazel is also soothing to hemorrhoidal tissue. Put some on a cotton ball and press gently. Repeat treatments several times daily.

• Take sitz baths. Sitz baths are an old-fashioned remedy for hemorrhoids that are still in favor with the medical profession. Place three to four inches of warm water in the bathtub, and sit in it for ten minutes several times daily. You can improve the results by adding ¼ cup Epsom salts or healing herbs.

Chamomile, chickweed, comfrey, mullein, plantain, witch hazel, and yarrow are all healing and soothing to mucous membranes. Most of these are weeds and may even be growing in your yard. (Comfrey is a very easy herb to grow; just put it in a place where it can spread.

It helps with wound healing of any sort and is also soothing for colds and lung problems.) Bring a large pot of water to a boil. Steep 1 to 2 cups of fresh herbs or 1½ cups of dried herbs until cool; strain and add to bathwater.

• Use horse chestnuts. Horse chestnuts, also called buckeye, help tone blood vessels, improve their elasticity, and reduce inflammation. They can also be used in a sitz bath. Chop up two cups of horse chestnuts, add to boiled water, strain, and add infusion to bathwater.

Sit in bath twice daily for ten to fifteen minutes. You can also take 500 milligrams of the bark orally three times daily. Horse chestnut salves are also available.

• Use butcher’s broom. Butcher’s broom helps strengthen blood vessels and improves circulation. Take 100 milligrams extract three times daily.

• Take vitamin E. Vitamin E helps bring oxygen to the tissues and promotes healing. You can use it topically or take it internally. Take 400 to 800 IU of d-alpha tocopherol and mixed tocopherols daily.

• Take vitamin C and bioflavonoids. Vitamin C and bioflavonoids increase capillary and blood vessel strength so that they don’t rupture easily. Bioflavonoids are also essential to collagen formation and elasticity of blood vessels.

Berries of all types and cherries have high amounts of protective bioflavonoids. Take 500 to 2,000 milligrams vitamin C daily plus 100 to 1,000 milligrams bioflavonoids, which can usually be purchased in a single supplement.

• Use dimethylsulfoxide (DMSO). In the literature, there is one anecdotal study in which a physician used DMSO topically for hemorrhoids. By his report, a 70 percent solution of DMSO will dissolve blood-engorged hemorrhoids almost overnight. It may be worth trying.