Haemorrhoids are normal vascular structures present in the anal canal¹. They become pathological, i.e piles when they are swollen or inflamed. It is in other words defined as the symptomatic enlargement and distal displacement of anal cushions. There are two types of haemorrhoids namely, internal and external. The various reasons cited are chronic diarrhoea or constipation²,straining in the toilet, lack of exercise, frequent masturbation³,anal intercourse⁴, aging, pregnancy .Bleeding piles is due to the susceptibility of the anal vein to rupture due to increased intra abdominal pressure.

The faeces is usually of normal colour with blood over it. The blood is generally bright red in colour and is seen on toilet paper and in the toilet bowl.⁵Severe bleeding to the point of anaemia is rare though possible. Rectal bleeding may not always be the due to piles as is the general assumption. They could also be due to much serious problems like colon cancer⁶.

General modifications of diet and lifestyle can produce relief from the problem. Other general measures include wearing cotton underwear, using pads, using a sitz bath⁷, avoiding scratching, not sitting for a long time, etc. Conventional treatment proposed is surgery. Home remedies given in the early stages help prevent surgical treatment.

It is preferred by patients because of ease of access of day to day herbs, privacy, non invasiveness and also the inexpensiveness. The herbs that are focused on are Blueberry, Witch hazel, Butcher's broom, Sesame seeds and oil, Horse chestnut, Jambul fruit, Apple cider vinegar, Cow's urine, Neem oil, Aloe Vera etc.

BLUEBERRY⁸

The scientific name is Vaccinium myrtillus. It is a perennial shrub found in the northern U.S and Europe. It is a blue coloured, bell-shaped fruit with the pulp also of a similar colour. They are rich in bioflavonoids (anthocyanidins) and anti-oxidants. They are used in bleeding piles. The flavonoids are responsible for collagen stabilization and therefore help strengthen blood vessels. This helps reduce bleeding piles on consumption.

WITCH HAZEL^4,9

The scientific name is Hamamelis virginiana. They grow in partial shade or in sunny areas. The leaves and bark extracts are used. It has astringent, anti inflammatory and local haemostatic effects¹¹.application topically around the rectum can reduce the inflammation and haemorrhage. It helps reduce the discomfort caused due to piles. It helps contract and shrink the blood vessels.

BUTCHER'S BROOM¹⁰

The scientific name is Ruscus aculeatus. Its name comes from its use by butchers to clean the meat stalls to keep flies away¹².It is found in the Mediterranean Europe and Africa. The root is used in treatment. It has an initial sweet taste which later turns acidic. The herb has steroids like ruscogenins. Anti-elastase, astringent and anti inflammatory actions present. It reduces the bleeding and soreness. Small amounts of the extract help strengthen blood vessels.

SESAME SEEDS AND OIL:

The scientific name is Sesamum indicum. They are found in the west, Middle East and Far East. They can be of pale or black varieties. The plant grows best in tropical climates. Sesame grows best in sandy, well drained soil with hot climate and moderate rainfall. They are useful in bleeding piles when ground to a paste and given with butter.60g should be eaten chewing it well. Applying sesame oil to the external haemorrhoids provides relief.¹⁴

HORSE CHESTNUT¹²

the scientific name is Aesculus hippocastanum. The seeds contain a complex mixture of triterpene saponins collectively referred to as aescins. It also contains flavonoids and tannins. The seeds when administered reduce bleeding significantly.

JAMBUL FRUIT:

The scientific name is Syzygium cumini. Jambolan is a large evergreen tree with a greyish brown thick bark, that exfoliates woody scales. The fruit is oval in shape with the colour of the pulp a deep purple. It tends to stain the lip and tongue when eaten. They have a sweet-sour flavour. The fruit should be taken with salt for 2-3 months in its season. Taking the fruit this way every season can prevent bleeding piles. Taking the fruit fresh with honey is also helpful¹³.

APPLE CIDER VINEGAR¹⁴

Consumption or application of apple cider vinegar on the affected area can help relieve bleeding piles; it reduces the size of the haemorrhoids due to its astringent.1 tablespoon of apple cider vinegar is taken with a cup of water or herbal tea.

COW URINE¹⁵

According to a research, it has been proven that consuming cow's urine prevents complications and therefore expensive, painful treatment of grade I and grade II haemorrhoids.cow urine helps in passing out stools easily without straining.

NEEM OIL¹⁶

It is the oil obtained from neem seeds. Applying this oil on the affected area twice a day reduces pain and itching thereby reducing the probability of worsening the problem and simultaneously providing relief.

ALOE VERA¹⁷

It is used in both internal and external haemorrhoids. It can be applied directly to the anus or a juice of aloe Vera (1 cup thrice a day.)can also be taken. It helps accelerate healing, reduce itching and inflammation. It also helps in stopping bleeding.

REFERENCES:

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2. Lohsiriwat V. Approach To Haemorrhoids. Curr Gastroenterol Rep.2013 jul.15(7),332

3. Mohammad Zarenezhad,Amin Hosein Zadeh, Seyed Hosseini And Saeed Gholamzadeh. Could Frequent And Lengthy Masturbation Sessions Dispose To Haemorrhoids?. Thrita Journal of Medical Sciences.2012 Jul.1(3).106-108.

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6. Ceci F, Picchio M, Palimento D, Et Al. Long Term Outcome Of Stapled Haemorrhoidopexy For Grade III And Grade IV Haemorrhoids. Dis Colon Rectum. July 2008.51(7).1107-1112

7. Dodi G Et Al. Hot Or Cold In Anal Pain? A Study Of The Changes In Internal Anal Sphincter Pressure Profiles.

8. www.ssrsi.org/onsite/blueberries.htm

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10. Douglas Mckay. Hemorrhoids And Varicose Veins: A review Of Treatment Options. Alternate Medicine Review.2001.vol6.number 2.126-140.

11. Bouskela, Eliete, Cyrino Z. G.A, Marcelon, Gilbert. Effect Of Ruscus Extract On The Internal Diameter of Aterioles And Venules Of The Hamster Cheek Pouch Circulation. Journal Of Cardiovascular Pharmacology. Aug 1993.Vol 22.issue 2.

12. Kathy Abscal. Eric Yarnell. Botanical Treatments For Haemorrhoids. Alternative and Complementary Therapies. Dec 2005.

13. www.besthomeremedies.com/herbal medicine/fruits/jambul-fruit-htm.

14. www.ehow.com/way_5312234_home-remedy-bleeding-haemorrhoids.html

15. Dr. Omaprakash W. Talokar, Dr. Archana R. Belge, Dr.Raman S. Belge. Clinical Evaluation of Cow-Urine Extract special reference to Arsha (Hemmorrhoids). International Journal of Pharmaceutical Science Invention. 2013; 2 (3).

16. http://recyclepointsbh.webs.com/health%20downloads/Neem%20for%20human%20medicinal%20uses.pdf

17. http://makehemorrhoidsgoaway.com/aloe-vera-for-hemorrhoids

Received on 02.08.2013 Modified on 15.10.2013

Research J. Pharm. and Tech. 7(2): Feb. 2014; Page 253-254