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Latest Edit: Hector 2014-05-15 (EDT)

Hemorrhoids are included under peripheral vascular conditions because they involve the vascular network of the anorectal area. They are essentially varicose veins resulting from many factors such as constipation, straining at stool or long periods of standing. This is common in individuals over 50 years of age. [1] They can cause significant discomfort and anxiety.[2]


Causes Dietary Factors, Lack of movement, Stress, Constipation, Infections
See Also Cardiovascular Conditions, Constipation, Anemia
Books Books on Cardiovascular Conditions
Articles Articles on Cardiovascular Conditions

Naturopathic Assessment

The root causes of hemorrhoids are similar to those of varicose veins.

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With hemorrhoids, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to hemorrhoids.


  • Long periods of sitting or standing are associated with increased risk of hemorrhoids.[3]
  • Heavy lifting can trigger a hemorrhoid attack.[3]


  • Higher levels of stress are associated with increased risk of hemorrhoids.[5]
  • Relationships
  • Practice of anoreceptive sex can lead to hemorrhoids.[4]


  • Household Products
  • Excessive use of harsh toilet paper can aggravate or trigger hemorrhoids.[3]
  • Use of dry toilet paper followed by wet cleaning methods increases the risk.[6]


  • Constipation, large bowel movements and straining for a bowel movement eventual compromise the tissues and mucosa leading to the formation of hemorrhoids.[1]
  • Diarrhea is also are associated with hemorrhoids.[1]
  • Increased intraabdominal pressure can be secondary to straining on stool, pregnancy, cough, sneezing, vomiting, exerting oneself and portal hypertension.[3]


  • The tendency to hemorrhoids seems to run in families. Assessment of genetic weakness of veins involves knowing family history of this condition or other varicosities as well as evaluation of the presence of straining during defecation.[3]

Common Questions

Common history questions for hemorrhoids[3]

  • Diet diary assessment and how much fiber is in the diet?
  • Family history of hemorrhoids?
  • Quality of stools?
  • Amount of straining?
  • Constipation or diarrhea?
  • Bleeding?
  • Pain?
  • Itching?
  • Mass or pressure?
  • Fecal soiling or incontinence?

Diagnostic Testing

  • The presence of hemorrhoids is typically based on symptoms, yet if hemorrhoids persist other diagnostic testing may be valuable to rule in/out other causes of rectal problems including.[2]
  • Fecal occult blood test
  • Fecal immunochemical test
  • Flexible sigmoidoscopy/colonoscopy
  • Stool for ova and parasites
  • Digital rectal exam
  • Anoscopy
  • Cultures for infectious organisms
  • Microscopic examination of stool

Related Symptoms and Conditions

Conditions that are associated with hemorrhoids or that may mimic hemorrhoids include:[3]


The following are the common characteristics of hemorrhoids..[1], [3]

  • There are two classifications but common to both is recurrent bleeding, rupture and incidental findings on physical exam.
  • External (below the anorectal line)– may present with bluish swellings if thrombosed.
  • Internal (above the anorectal line)– often bleed and may prolapse on bearing down.
  • Mixed hemorrhoids can also occur; without prolapsed (bleeding but no pain), Prolapsed (pain and bleeding), and strangulated (has prolapsed and usually becomes thrombosed and very painful).
  • Skin tags are usually evidence of previous hemorrhoids leaving connective tissue behind. Typically when resolving thrombosed hemorrhoids this tissue may be replaced by connective tissue resulting in skin tags.

Common Symptoms

  • A typical clinical presentation of hemorrhoids involves pain, constipation, incomplete defecation, rectal itching, bleeding and a prolapsed mass. The amount of bleeding from a ruptured hemorrhoid seems dramatic but is usually harmless.[1]
  • Bright red blood on the toilet paper or frank blood in the toilet water may be present with dull aching or itching with chronic prolapse.[2]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Treatment of hemorrhoids needs to be rooted in prevention and includes reducing lifestyle factors that may be responsible for pelvic congestion.[3]

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Schedule time for regular bowel movements and avoid straining at stool.[3]


Lifestyle recommendations include:

Water. Ensure you drink adequate water.

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for hemorrhoids include:

  • Differentials to consider include general conditions such as; damp heat, blood stagnation, blood deficiency. Organ pathologies may include; intestinal wind, sinking spleen qi or spleen qi deficiency.[13].
  • Acupuncture points to consider include; UB30, GV1, UB57, UB50/36, UB54/40, UB56, UB58, SI5, GV3, UB32, Erbai, SP6, SI3, UB62, Ear-shenmen, brain, spleen, rectum and large intestine.[13]
  • Sitz baths are very beneficial for uncomplicated cases by alternating hot with cold.[3][14]
  • Constitutional hydrotherapy.[15]


Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Goroll A, Mulley A, editors.(2009) Primary Care Medicine – Office evaluation and management of the adult patient. Boston: Lippincott Williams and Wilkins;66.pg525-526
  2. 2.0 2.1 2.2 2.3 Dains J, Baumann L, Schibel P (2007) Advanced Health Assessment and Clinical Diagnosis in Primary Care, ed 3. Mosby Elsevier;16:pg220-232
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 Murray Michael, Pizzorno Joseph (1997) Encyclopedia of Natural Medicine Three Rivers Press, New York:pg507-511
  4. 4.0 4.1 4.2 Wronski K (2012)Etiology of thrombosed external hemorrhoids. Postepy Hig Med Dosw (Online).;66(0):41-4. PMID:22371404
  5. Metcalfe C, Davey Smith G, Macleod J, Heslop P, Hart C(2003)Self-reported stress and subsequent hospital admissions as a result of hypertension, varicose veins and haemorrhoids.J Public Health Med.;25(1):62-8. PMID:12669921
  6. Gebbensleben O, Hilger Y, Rohde H (Oct 2009)Aetiology of thrombosed external haemorrhoids: a questionnaire study. BMC Res Notes;23(2):216. PMID:19852813.
  7. 7.0 7.1 7.2 Murray Michael (1996) Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing
  8. Lu Henry (1986) Chinese System of Food Cures, prevention and remedies Sterling Publishing Co. New York.
  9. Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser (2010) Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto
  10. Boon Heather, Smith Michael (2004) The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Robert Rose, Toronto
  11. Hershoff Asa (2000) Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  12. Ullman Robert, Reichenberg-Ullman Judyth (1997) Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing
  13. 13.0 13.1 Kuoch David(2011) Acupuncture Desk Reference. 2nd ed. Acumedwest Inc.:pg290-307
  14. Boyle W, Saine A (1988)Lectures in Naturopathic Hydrotherapy. Eclectic Medical Publications:pg89
  15. Boyle W, Saine A (1988). Lectures in Naturopathic Hydrotherapy. Eclectic Medical Publications:pg144