Very not fun: hemorrhoids. I hate them. I first got them in 1992, so I’ve been dealing with them for 25 years, and for the first years they were so incredibly awful before I learned many tricks and medications and preventative measures. There is no pain quite like them and a full flare-up can be insane agony and last for weeks of constant hurt. A flare-up is a code red personal emergency. Flare-ups used to happen maybe 6x a year, but now I've got that down to maybe 2x annually, although those terrible days can make me want to cry every time I have to take a shit.
So I know well what it’s like to be suffering from them so much that you’re trying to ignore the pain while desperately looking for any information online that may help you. Which is probably what led you here. Well, I’ve got some advice to pass along that will help you immediately and long-term.
I went to a specialist surgeon about a decade ago. I know the surgical options, which have a long, painful recovery time. I should have had them cut off (or lasered off) back when I had good health insurance, but I chickened out and didn’t have the recovery time to spare with a full-time job. Instead of surgery, the doctor told me I could just “baby” my poor hole and treat it right and keep it clean and eat lots of fiber and deal with infrequent flare-ups, which is what I do.
#1. Keep your asshole totally clean. Hemorrhoids are basically angry infections in tiny fissures in your anus and rectum that clot and swell and scar. The cleaner you are downtown, the less frequently you’ll get flare-ups. Get good, soft toilet paper. This is seriously not the place to skimp in life! The cheap stuff is like sandpaper and will totally rip you up and exacerbate or even cause hemorrhoids.
Even with the best brands, toilet paper alone can't keep you as clean as you need to be. Which is why I use disposable, flushable wet wipes every single time I take a dump. Basically, gently swipe once or twice with wads of soft toilet paper, and follow that up with the wet wipes. I clean up and down my crack with the wipes, making sure the exterior is totally spotless. Then I cover my finger with a doubled-over wipe and slide it in my anus, cleaning in the side fissures and folds and definitely underneath and around existing hemorrhoids until the wipes come back completely clean. This can hurt like the dickens during a flare-up, but it must be done. If there’s any feces left, hemorrhoids get infected, get blood clots, and swell up with incredibly painful pressure. Avoid that at any costs, so obsessive, gentle cleanliness is the first and best defense.
My favorite toilet paper and wipes:
#2. The second defense is Preparation H Cooling Gel. Not the regular, greasy Preparation H cream, which only ever made things worse for me. I use Prep H Cooling Gel after every shower and after every time I clean myself after going to the bathroom. It chills out the ‘roids and protects my ass. And it dries clear if it gets on your underwear. Again, I use the cooling gel constantly. It really helps with itching and dryness and chafing.
#3: Make sure no fabric from your underwear, especially synthetic fabric, rubs against your hole repeatedly all day, which can chafe and set off a swelling. Do not wear underwear with a seam up the crack! That rips you up, so only wear cotton underwear with no seam in the back. It is a mystery to me how anyone every wears a silk thong. It would be like dragging a diamond necklace across your hole. I like briefs because they stay tight across my crack and don’t give me any kind of wedgie. You want no clothing touching your hole if at all possible. Anything that rubs against it will cause irritation and possible flare-ups.
#4: Take Chinese herb pills, and others herbs, including painkillers. I take a herbal supplement called Fargelin daily, and a lot of it during a flare-up. They're a little yellow pill of flower extracts and ginseng and they work. Also, I sometimes take the herbs Butcher’s Broom, Horse Chestnut, and White Oak, which can help with vasoconstriction of blood vessels, stool softening, anti-inflammatory needs, and astringent benefits. Also: regular acetaminophen and Naproxen tablets help with relaxing the blood vessels, reducing swelling and pain, and improving blood flow. I take some combination of those every day, depending on what my stomach can handle. Take the painkillers carefully and with food so you don't burn your stomach lining or damage your liver! I take Fargelin daily as it seems to have no side-effects, only benefits.
#5: Chinese medicine says hemorrhoids are a problem of having too much “heat” in your body. They are a “hot” ailment. So you should eat mostly “cold” foods and avoid “hot” ones. There are lists you can find online, or in the terrific book, Chinese System of Food Cures, charting out the hot and cold foods according to Chinese medicine, although these lists don’t always agree. Sometimes tomatoes are hot and sometimes cold. Bananas are always cold. Eating bananas helps (and also give great fiber). Always eat more fiber. Eat as much fucking fiber as you possibly can. Take fiber supplements, like psyllium husk caps. Fiber gives you good, easy, soft but solid shits so you’re never straining on the bowl.
#6: The Squatty Potty. Discovering this stool was life changing! This easily-stored bathroom device forces you to adopt a more natural crouch instead of using the toilet in the usual Western sitting position. It adjusts the angle of your pelvis as you sit on the toilet so that your rectum and colon and intestines and all those other pipes up there are better situated for your poop to slide out more easily, putting less pressure on your poor hole. It's awesome and highly recommended for anyone suffering from hemorrhoids.
Note: If you ever feel any tearing in your anal lining or see any blood, clean it immediately and put on Preparation H Cooling. Immediately! Leaving even the tiniest rip in the anal wall to fester can lead to a terrible infection and flare-up. Although sometimes, if you're already undergoing a flare-up, some blood might mean that a clot has burst, and that actually relieves the swelling, so don’t freak out. It’s kind of like when a zit pops and feels better afterward.
Okay, but what can you do during a flare-up? Mostly, try to get comfortable and wait it out. Take more Fargelin and acetaminophen and/or Naproxen. Keep your hole clean and try not to cry while wiping your ass. Try to find comfortable sitting and sleeping positions that keep the pressure off your anus. Take it easy and don't stress about it and chill out and let yourself heal. Remember that Elizabeth Taylor suffered from bleeding hemorrhoids most of her adult life, as do about 75% of adults. Don’t drink alcohol. Go easy on coffee and spicy foods. Don’t panic. The swelling will subside. Eventually.
But never fast enough. When there is real pain, I give up on Preparation H Cooling Gel, and move to a cream called HemAway, which has Lidocaine. It’s too strong and expensive for daily use like the Preparation H Cooling (and HemAway stains underwear), but it seems to help with the shooting burning pains and horrible itching of a flare-up. A hemorrhoid is an infected blood clot thrombosis in your asshole and man, it’s the throbbing worst.
If the HemAway gives you no noticable relief after a day or so, and it’s getting insanely bad, like no sleep and want to die bad, I switch to a Chinese cream called Ma Ying Long. That is so soothing and good and eases the pain and really helps the hemorrhoids relax and calm down until they heal and shrink and go back to sleep. But Ma Ying Long smells like graveyard death. At first, I’m like, aw, it’s not so bad, but it lingers and becomes pervasively everywhere and gets progressively more horrible. You can’t wear it in public. You can barely wash the smell off your hands. It smells so bad that although it works, I only use it in the worst of emergencies when I know I’m not leaving my home. That said, I have like 6 boxes of it under my sink because when a ‘roid really gets so bad that it takes over your whole life with pain, Ma Ying Long is the only thing that works.
Over the years, I’ve had some luck with suppositories, although they can be hard to jam up there if the pain and swelling are really awful. Still, they’re useful and can sooth the pain over a more extended period of time.
Sometimes a hot bath helps to relax everything downtown, too – but beware of heat in general. Like I said, hemorrhoids are a “hot” ailment. Sitting in a Jacuzzi has set off my worst flare-ups, for example.
So I also have a frozen device in my freezer, just a little plastic wedge called an Anuice, that I use to cool my hole when things get really bad. Whatever you can do to bring down the swelling. You know, like with any swelling, sometimes heat brings it down, sometimes cold. You’ve got to go with your instincts there. Or try everything in desperation.
Does exercise help? Probably. Anything that improves blood flow . . . but nothing that puts strain on your hole, like lifting weights.
I think that’s all my personal advice, from years of trial and error and studying every possible thing written on the subject.
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