【Traditional Chinese Medicine Beyond the Line】Treatment of hemorrhoids by regulating daily life, taking Chinese medicine internally and externally

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Text: Qiu Yufeng (TCM physician), “Ming Pao”

(Hong Kong News) Hemorrhoids are venous masses formed by enlargement and varicose veins under the mucosa of the rectum and under the skin of the anal canal. They are divided into external hemorrhoids, internal hemorrhoids and mixed hemorrhoids according to their location. The understanding of hemorrhoids in traditional Chinese medicine dates back to the time when the Huangdi Nei Jing was written. There is a record that “as a result of a full meal, the tendons and veins are untied, and the intestines become hemorrhoids.” “Danxi Heart Method” believes that “hemorrhoids are caused by internal deficiency of the internal organs, external trauma and rheumatism, and internal heat and poison… Therefore, the qi and blood fall, gather in the anus, and remain stagnant, and the conflict is hemorrhoids.”

Sitting for long periods of time and lifting heavy objects often increases the risk of constipation

Wind-heat, dry-heat, blood stasis, and qi deficiency are all common clinical symptoms of hemorrhoids. In terms of symptoms, the main symptoms of internal hemorrhoids are blood in the stool and hemorrhoid prolapse; the main symptoms of external hemorrhoids are pain and foreign body sensation in the anus. Sitting for long periods of time, frequently lifting heavy objects, long-term constipation, improper diet, bad toilet habits, pregnancy and childbirth, old age, etc. can all induce hemorrhoids.

Chinese medicine treats hemorrhoids, regardless of the specific location of the disease.

Syndrome differentiation is always based on clinical manifestations, and treatment and medication are formulated based on the patient’s main symptoms.

Blood in the stool is the most common symptom among patients with hemorrhoids.

Traditional Chinese medicine determines based on bleeding color, texture, bleeding volume, etc.

As well as the patient’s systemic manifestations, tongue condition, and pulse condition, a comprehensive analysis and syndrome differentiation is made.

Bright red blood in the stool is mostly due to wind-heat and blood-heat

Those with bright red stools are mostly caused by wind-heat or blood-heat. The fiery heat forces the blood to flow away from the meridians, causing bleeding. The stronger the heat, the more severe the bleeding will be. Other symptoms of those with wind-heat or blood-heat syndrome include body heat, dry mouth, constipation, short red urine, red tongue, etc.

Treatment requires dispelling wind, clearing away heat, and cooling blood to reduce bleeding. Commonly used Chinese medicines include rehmannia glutinosa, sophora japonica, and Sanguisorba burnis.

Blood in the stool and mucus require clearing away heat and removing dampness

If the blood in the stool is dirty and mixed with mucus, the stool is shapeless, or the anus is often moist and itchy, accompanied by yellow and red urine and yellow and greasy tongue coating, it is called damp heat. Treatment requires clearing away heat and removing dampness, and commonly used traditional Chinese medicines such as Artemisia wormwood, coix seed, and coix seed are commonly used.

For example, patients often have bloody stools due to internal hemorrhoids. Excessive consumption can lead to anemia, dizziness, and pale complexion. At this time, the treatment should take into account the strengthening of the body and tonifying the deficiency. It can start from the aspects of replenishing qi and blood to promote blood production. Commonly used medicines include astragalus, angelica, and jujube.

It is worth mentioning that Chinese medicine theory believes that a small number of hemorrhoid patients repeatedly have bloody stools because blood stasis accumulates in the body, preventing new blood from returning to menstruation. At this time, TCM treatment needs to use the counter-treatment method of “treating the cause and removing the blood stasis” to remove the accumulated blood stasis in the body, so that the new blood can smoothly return to menstruation and stop bleeding.

Stir-fried charcoal with Diyu and Puhuang to remove blood stasis and stop bleeding

Diyu and Puhuang suffer from “fried charcoal to stop bleeding” syndrome. Traditional Chinese medicine has a saying that “when blood turns black, it will stop.” By processing medicinal materials with the effects of clearing away heat, cooling blood, and hemostasis, and frying them into black medicinal charcoal, the hemostatic effect can be enhanced.

Common examples of “frying charcoal to stop bleeding” include frying the traditional Chinese medicine Diyu Sangui, which has the effects of cooling blood and stopping bleeding, detoxifying and astringing sores, to make “Diyu Charcoal”, or frying Puhuang, which has the effects of removing blood stasis, stopping bleeding and diuresis, to make “Puhuang Charcoal”. “. This kind of Chinese medicine that has been processed and carbonized can be clinically considered to be used in prescriptions for treating hemorrhoids and bloody stools, and can have an astringent and hemostatic effect.

Enhance muscle strength and improve anal swelling

In addition to blood in the stool, patients who experience anal swelling, pain, and foreign body sensation due to external hemorrhoids are believed to be related to qi stagnation and blood stasis according to traditional Chinese medicine. Due to the obstruction of blood circulation, pain occurs due to blockage. Treatment can be combined with traditional Chinese medicine methods of promoting blood circulation, promoting qi, and removing blood stasis. Commonly used drugs include angelica tail, peach kernel, and hematoxylin.

According to traditional Chinese medicine, hemorrhoidal prolapse is understood as insufficient Qi, inability to lift and lift, which is a deficiency of Qi. Treatment requires replenishing Qi and strengthening muscle strength to improve problems such as organ prolapse. Traditional Chinese medicines such as astragalus, Codonopsis pilosula, and Cimicifuga are commonly used. People with intestinal dryness syndrome often have constipation of dry and hard stools. Hemorrhoids can easily be induced or aggravated by excessive force when going to the toilet, or when excrement rubs against the intestinal wall. In terms of treatment, hemorrhoids can be appropriately laxative and soothing the intestines. Traditional Chinese medicines such as hemp seeds are commonly used. , Bai Ziren, etc.

Don’t blindly warm up and don’t sit or squat for long periods of time

To improve or prevent hemorrhoids, you should reduce spicy, fried, stir-fried and other warm and stimulating foods in your diet, and do not blindly warm tonic to avoid getting angry.

It is also not advisable to eat too much food that is too sweet or too greasy to prevent accumulation of dampness and heat in the body. Eating more fruits and vegetables rich in fiber and adding enough water can help stimulate intestinal peristalsis and adjust intestinal microecology, thus improving constipation.

In terms of daily life, it is recommended not to sit or squat for long periods of time, and to reduce frequent lifting of heavy objects to avoid hemorrhoids caused by long-term excessive abdominal pressure. In terms of toilet habits, do not frequently hold back your bowels, do not use excessive force to relieve yourself, and it is recommended that the toilet time should not exceed 10 minutes. Do not develop the habit of reading books, newspapers, or scrolling on mobile phones while using the toilet, so as not to make the toilet time too long. , hindering blood circulation near the rectum and causing hemorrhoids.

Diet therapy to clear away heat, cool blood and moisturize intestines

To relieve the discomfort of hemorrhoids, dietary therapy can focus on clearing heat, cooling blood, activating blood circulation, and moisturizing the intestines to improve blood circulation around the anus and rectum and relieve constipation. etc.

In addition to taking Chinese medicine internally, there is also a method of fumigating and washing the affected area with Chinese medicine liquid externally. The prescription is such as “Sophora Sophora Decoction” recorded in “Experiences of the Department of Ulcers”.

Apply topical medicine to remove blood stasis and reduce swelling

In order to improve the efficacy, it is recommended to “smoke first and then wash” when using external medicines. That is, when the decoction has just been cooked, the patient should first sit in a squatting position and let the liquid vapor fumigate the anus for 5 minutes, and then soak it with warm liquid or wash it with a towel. Wet compress the affected area for 10 to 15 minutes, which has the effects of removing blood stasis and reducing swelling, activating blood circulation and relieving pain, clearing away heat and detoxifying, dispelling wind and dampness, astringing and relieving itching.

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