Digestive System Herbal Protocol

Hemorrhoids

Also called

Piles

Illness/ Disease Definition

From Merck Manual:

Hemorrhoids are swollen tissues that contain veins and that are located in the wall of the rectum and anus.

From David Hoffman’s Medical Herbalism book (taken from the Merriam-Webster Medical dictionary):

A mass of dilated veins in swollen tissue at the margin of the anus or nearby within the rectum; also called piles.

Etymology (terms)

External hemorrhoids – hemorrhoids that protrude outside the anus

Internal hemorrhoids – hemorrhoids that remain in the anus

Thrombus – blood clot

Etiology (causes)

From Merck Manual:

Hemorrhoids may develop from repeated straining during bowel movements, and constipation may make straining worse.  Liver disease increases the blood pressure in the portal vein, sometimes leading to the formation of hemorrhoids.

From David Hoffman’s Medical Herbalism book:

Hemorrhoids are caused by increased pressure in the veins of the anus.  The most common cause is straining during bowel movements. Constipation, prolonged sitting during bowel movements, and anal infection are contributing factors.

Incidence

Most people will deal with hemorrhoids at some point in their life.

Allopathic Treatments

• Take stool softeners or psyllium
• Injection sclerotherapy – injection of a substance that causes the veins to become obliterated with scar tissue
• Rubber band litigation- where hemorrhoid is tied off with rubber bands and causes hemorrhoid to wither and drop off painlessly
• Laser destruction – destroys hemorrhoid with lasers
• Infrared photocoagulation- destroys hemorrhoid with infrared light
• Electrocoagulation  – destroys hemorrhoid with electrical current
• Warm sitz baths
• Local anesthetic ointments
• Witch hazel compresses

Signs & Symptoms/ Body Systems Affected

Body system affected	Signs and Symptoms
Digestive system	Anal bleeding Bloody stools Mucous discharge
Cardiovascular system	Swollen veins

Actions needed: Vascular tonics, astringents, bitters, aperients/laxatives, vulneraries, emollients, and anti-inflammatories

HERB	ACTIONS
GINGKO Gingko biloba	Anti-inflammatory, Antioxidant, Antispasmodic, Astringent, Bitter, Neuroprotective, Nutritive, Relaxant, Stimulant (Circulatory), Stimulant (Uterine), Tonic (Vascular), Vasodilator
HORSE CHESTNUT Aesculus hippocastanum	Anti-inflammatory, Antioxidant, Antispasmodic, Astringent, Bitter, Diuretic, Expectorant, Febrifuge, Tonic (Vascular)
DANDELION ROOT Taraxacum officinale	Alterative, Aperient, Bitter, Cholagogue, Diuretic, Laxative (Mild), Stimulant (Liver), Stomachic, Tonic
PILEWORT Ranunculus ficaria	Analgesic, Antispasmodic, Astringent
GOLDENSEAL ROOT Hydrastis Canadensis	Alterative, Antibacterial, Anticatarrhal, Anti-emetic, Anti-inflammatory, Antimicrobial, Antiseptic, Aperient, Astringent, Bitter, Cholagogue, Detoxifier, Diuretic, Emmenagogue, Febrifuge, Hepatic, Immuno-stimulant, Laxative, Oxytocic, Tonic (Respiratory)
WILD GERANIUM Geranium maculatum	Anti-hemorrhagic, Anti-inflammatory, Astringent, Styptic, Tonic, Vulnerary
WITCH HAZEL Hamamelis virginiana	Anti-inflammatory, Astringent, Hemostatic, Sedative, Tonic
MARIGOLD Calendula officinalis                  SALVE	Antibacterial, Antifungal, Anti-inflammatory, Antimicrobial, Antiseptic, Antispasmodic, Antiviral, Astringent, Aperient, Cholagogue, Demulcent, Diaphoretic, Emmenagogue, Emollient, Immuno-stimulant, Lymphatic, Vulnerary
ST. JOHN’S WORT Hypericum perforatum   SALVE	Anti-depressant, Anti-inflammatory, Antimicrobial, Antispasmodic, Astringent, Expectorant, Nervine Relaxant, Tonic (Nervine), Vulnerary
GERMAN CHAMOMILE Matricaria recutita SALVE	Analgesic, Anodyne, Anti-emetic, Anti-inflammatory, Antimicrobial, Antiseptic, Antispasmodic, Bitter, Calmative, Carminative, Diaphoretic, Nervine, Sedative (Mild), Tonic, Vulnerary
PLANTAIN, COMMON Plantago major   SALVE	Alterative, Antacid, Antibacterial, Anticatarrhal, Antihistamine, Anti-inflammatory, Antimicrobial, Antiseptic, Antitussive, Astringent, Demulcent, Deobstruant, Diuretic, Emollient, Expectorant, Hemostatic, Laxative, Refrigerant, Tonic (Connective Tissues), Vulnerary
YARROW Achillea millefolium SALVE	Anti-hemorrhagic, Anti-inflammatory, Antimicrobial, Antipyretic, Antiseptic, Antispasmodic, Astringent, Bitter, Carminative, Cholertic, Diaphoretic, Diuretic, Emmenagogue, Hemostatic, Hepatic, Hypotensive, Peripheral Vasodilator, Styptic, Tonic (Vascular), Vulnerary

FORMULAS:

• Herbal Salve:  Marigold, St. John’s Wort, German Chamomile, Common Plantain, Yarrow, Pilewort
• Tincture:  Equal parts Gingko, Horse Chestnut, Dandelion Root, Goldenseal Root, Wild Geranium/Cranesbill, & Pilewort
• Herbal Witch Hazel: 1 part Horse Chestnut tincture & 8 parts distilled Witch Hazel  OR 1 part Pilewort tincture & 8 parts distilled Witch Hazel

CONTRA-INDICATIONS:

• Dandelion Root- Do not use if pregnant or breast-feeding.  Do not use while taking diuretics, or drugs that lower blood pressure or blood sugar.
• German Chamomile- Do not use in early pregnancy.
• Gingko-  Do not use if pregnant.  Use caution if taking blood thinners.
• Goldenseal- Interacts with CNS depressants, cardiac medications and anticoagulants.
• Horse Chestnut- Do not use if pregnant or breast-feeding.  Use caution if taking blood thinners.  Do not use if you have a bleeding disorder.  May turn urine red.
• Marigold- Do not use if pregnant or breast-feeding. 
• Plantain, Common- Do not use if pregnant or breast-feeding. 
• St. John’s Wort- May reduce the half life of some medications.  Please check all drug interactions. Do not use if pregnant or breast-feeding. 
• Wild Geranium (or Cranesbill)- Use caution in people with spastic, dry constipation or people taking anticholinergic medication. Do not use if pregnant or breast-feeding.
• Witch Hazel- Do not use if pregnant or breast-feeding.  Do not use internally.
• Yarrow- Do not use if pregnant or breast-feeding.   Long term use can lead to photosensitivity and rashes.  Use with caution if you’re drinking alcohol, taking CNS depressants, Antabuse, blood thinners,  or drugs that lower blood pressure.

Recommendations for Diet and Lifestyle

Diet:

• Increase fiber intake (esp. fruits, vegetables , grains, nuts, seeds, beans & legumes)
• Drink more water

Supplements:

• OTC Fiber supplements

Lifestyle Recommendations:

• Exercise regularly
• Maintain a healthy weight
• Don’t strain during bowel movements
• Do not wait to go… use the toilet as soon as you have the urge

References & Resources:

Adaptogens Herbs for Strength, Stamina, and Stress Relief, David Winston, RH (AHG).

Foundations of Medicinal Herbalism, Teresa Boardwine RH.

Medical Herbalism, David Hoffman, FNIMH

The Complete Guide to Herbal Medicines, Charles W. Fetrow, Pharm.D. & Juan R. Avila, Pharm.D.

The Merck Manual of Medical Information: Home Edition, Robert Berkow, M.D. & Mark H. Beers, M.D. & Andrew J. Fletcher, M.B., B.Chir. , 1997.

The Scientific Validation of Herbal Medicine, Daniel B, Mowrey, Ph.D.

The Naturopathic Herbalist.  http://www.thenaturopathicherbalist.com/.

WebMD. https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-basics.