Hemorrhoids and Varicose Veins: A Review of Treatment Options

Alternative Medicine Review, April, 2001 by Douglas MacKay

Dietary and Hydrotherapy Approaches to Hemorrhoids and Varicose Veins

Dietary Recommendations

Diet therapy is a widely accepted modality in the management of hemorrhoids and varicose veins. Many physicians consider the first line of therapy to be a high fiber diet with commercial fiber supplements and enough oral fluids to produce soft, but well formed and regular bowel movements.[28] A low fiber diet can result in small hard stools that can cause patients to strain during bowel movements. This strain increases intra-abdominal pressure, subsequently increasing pressure on the veins of the lower legs and the hemorrhoidal cushions. Over time this can deteriorate vascular integrity. A high fiber diet is an important component to the prevention and treatment of both hemorrhoids and varicose veins.[28] This in addition to hydrotherapy, proper anal hygiene, and avoiding activities that require the patient to strain are the foundation of the approach of many family practitioners to these conditions.

Hydrotherapy

The warm sitz bath is the hydrotherapy indicated for conditions associated with increased pelvic congestion.[25,29,30] The warm sitz bath is an effective non-invasive therapy for uncomplicated hemorrhoids and varicose veins, but requires a high degree of patient compliance.

Specific Nutrients and Botanicals for the Prevention and Treatment of Varicose Veins and Hemorrhoids

A major component of a safe and effective therapy for both varicose veins and hemorrhoids, that is often overlooked, is the use of botanical and nutritional therapies. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and strengthen connective tissue of the perivascular amorphous substrate. The goals of botanical and nutritional support are consistent with the philosophy of treating the cause of a disease. Conversely, the bulk of standard treatments for varicose veins and hemorrhoids are geared toward removing the problem or palliating the disease. Additionally, the low compliance associated with treatments such as hydrotherapy, mechanical compression therapy, and diet and lifestyle changes renders oral dietary supplementation an attractive option. The use of nutritional and botanical agents for the treatment of hemorrhoids and varicose veins is possibly the missing link to an effective conservative approach to these diseases. Early intervention with conservative therapies may prevent time-consuming and expensive complications of varicose veins and hemorrhoids.

Centella Asiatica (Gotu Kola)

Centella asiatica is a tropical medicinal plant with a long history of therapeutic use. An important active constituent of Centella asiatica, asiaticoside, was isolated and purified in 1940 and the first systematic clinical studies were carried out in 1945.[31] Pharmaceutical Centella preparations are titrated for the pentacyclic triterpene derivatives asiatic acid, madecassic acid, and asiaticoside.[32] Most clinical studies of Centella asiatica used either undefined alcohol or aqueous extracts or one of the following extracts: TECA, TTFCA, or TTF. The extracts TECA (titrated extract of Centella asiatica) and TTFCA (total triterpenoid fraction of Centella asiatica) are combinations comprised of asiatic acid (30%), madecassic acid (30%), and asiaticoside (40%). The Centella extract TTF (total triterpenic fraction) is comprised of asiatic acid and madecassic acid (60%) in a ratio not clearly defined, in combination with asiaticoside (40%).[32]