Healthy people, healthy planet

Varicose Veins and Hemorrhoids: Prevention and Treatment

Veins are superbly designed tubes with a series of one-way valves which are structured to prevent the contents, blood, from flowing any other way than forwards towards the heart when they are in good health.


When, for any of a number of reasons, a valve becomes incompetent, and allows a back-flow of blood, the vein becomes distended, its walls stretch and, like tired elastic, sag, allowing the vein to swell in that region into a miniature balloon.


This is a varicosity.


When this happens in the legs, the commonest site, it is called a varicosity, and when this occurs in the rectum it is known as haemorrhoids, or piles.


How Do Veins ‘Move’ the Blood?

There are a number of driving forces which are involved in the return of blood to the heart for oxygenation, along the veins.
These include the contracting and relaxing effect of muscles in which many veins lie.


As muscles work they automatically apply a pumping action to any vein with which they are in touch,and this, because of the vein’s one-way valve system, causes a forward motion of the blood.


Many veins run alongside arteries (which carry fresh oxygenated to the body tissues) and the pulsating action of these arteries (due to the heart’s beating) also produces a pump-like effect on the veins.


Another key pumping action occurs as we breathe, with the rise and fall of the diaphragm, which creates an alternating positive and negative pressure in the chest cavity.


Much of the blood returning to the heart has to overcome the force of gravity, for example as it passes from the feet upwards into the pelvic area and then onto the chest cavity and its destination, the heart.


While muscle pump action can be said to have most to do with the movement of blood up the legs themselves into the pelvic cavity, the passage onto the heart from the pelvis is largely the result of this alternating positive and negative pressure created by breathing.


So we have three pump mechanisms apart from the heart itself: active muscles, the pulsation of the arteries and diaphragmatic movement.


Finally we should consider the actual structure of the veins, comprising as they do layers of elastic and connective tissue fibres.


Those veins which lie deeper than the more superficial ones are usually enclosed in a sheath of connective tissue in which the arteries are resting, and the health and integrity of the connective tissue can influence the efficiency of the vein.


What Goes Wrong?

The structure of the veins themselves, the healthy constituency of the connective and elastic tissues, is directly related to nutritional factors (as is the integrity of the nervous system which controls the muscles in which many veins lie).


Nutrition: for example the levels of certain important nutrients in the diet most notably dietary fibre, vitamins C and E, and substances called bioflavonoids (which influence the elasticity of the tissues) can have a profound effect on the prevention or development of varicosities.


If much of the movement of blood along veins is dependent on muscles regularly contracting and relaxing, as well as on the diaphragm’s movement, it is pretty clear that exercise, or lack of it, and breathing function as well as mechanical stress factors (see below), are bound to be massively influential in deciding on the overall efficiency of venous return.


When any of the various pumping mechanisms are inefficient, or when the structure of the supporting tissues of the veins is inadequate, there is a strong chance of veins becoming incompetent, allowing back-pressure to build up and causing a varicosity.


The good news is that a great deal can be done to prevent this from ever happening, and to improve things once they have, as long as the causes of the problem can be dealt with.


Factors which make varicose veins more likely include:



  • excessive weight (more than 20% above normal bodyweight)


  • excessive weight bearing (weight training, carrying etc)


  • inadequate exercise (sedentary occupations)


  • excessive standing (waiter, hairdresser, soldier)


  • increased intra-pelvic pressure (chronic constipation,
    straining at stool, tight restricting girdles, poor posture,
    pregnancy etc)


  • poor nutritional status


  • use of the contraceptive pill


Who Gets Varicose Veins and Are There Dangers?

Very few people in non-industrialized societies ever develop varicose veins but one person in five in the UK has or will have them, and most will relate to their legs.


When not in the legs the commonest sites are the scrotum (varicocele) and the rectal region (haemorrhoids).


In themselves the bunched clusters of tortuous worm-like superficial varicose veins are not dangerous.


The dangers that can develop relate to the relative slow moving nature of blood in varicose veins.


Because it cannot easily move along, due to valve incompetence, the blood becomes increasingly static, or may actually flow backwards.


The symptoms most commonly associated with this sort of picture include heaviness and aching in the area, discolouration of the tissues and commonly itching of the skin over the veins, as well as a generalized tendency to swelling in the limb, mainly affecting the ankles and feet but often the entire calf or at times the whole leg.


When the left leg only is affected it can be suspected that the cause lies in intra-abdominal pressure due to chronic constipation. When overweight or mechanical lifting stress is involved it will affect both legs.


Varicose eczema may develop and in time the skin and overlying tissue may break down leading to varicose ulcers and even to haemorrhage of the vein.


For many people, especially in the early stages, there is nothing more obvious that a tendency for the legs to feel tired more easily than previously.


When haemorrhoids or varicoceles develop symptoms are similar (heaviness, aching, irritation) with the underlying causes being much the same.


Phlebitis and DVT

A possibly serious consequence of varicose veins can be the development of inflammation of the vein (phlebitis).


Some researchers believe that varicose veins do not show themselves until there has been an incident of what is called deep vein thrombosis (DVT), the presence of a blood clot caused by the sluggish movement of the blood or because the blood had a more viscous (sticky) nature than usual.


Another reason for a thrombosis can be the development of a constriction or narrowing in the vessel causing the blood passing through it to swirl and to possibly produce a clot.


The result of any of these causes of a thrombosis would be an inflammation of the vein and consequent damage to it, resulting in varicosity.


It is seldom possible in any given case to say whether the venous damage comes before the thrombosis or the other way around, the same features and factors apply in both sequences.


Signs

If there is a DVT or phlebitis the signs will be local warmth , tenderness and swelling, but these signs can also relate to a muscle injury or cellulitis (inflammation of the connective tissues), therefore if in any doubt at all get expert advice.


The treatment of DVT calls for rest with the leg elevated, pressure (elasticated stockings or bandaging) and possible medication to dissolve the clot and reduce inflammation.


Medical Approaches to Varicose Veins

Surgery is often used to remove the unsightly damaged veins, either by ‘stripping’ them out, or by tying or blocking them off, and thus allowing secondary channels of circulation to take over the load.


This has an obvious cosmetic effect, but the truism ‘out of sight out of mind’ is often evidenced by a return of new varicosities within a short time, because the causes are not dealt with by such methods.


Surgery, or the palliative use of support stockings, as much as these ease the aching in the legs, do nothing for the causes and therefore are not a long-term answer, and more than surgical treatment of haemorrhoids undoes the reasons for their presence.


There are of course a variety of balms and creams to help ease the skin or rectal irritation or eczema symptoms, and some excellent treatments which help to heal ulcers.


But none of these methods has anything at all to do with the causes of these problems.


Complementary and Self-Help Approaches


  1. Nutritional Approaches:



    • Vitamin C and Bioflavonoids: This helps to maintain the health of the connective tissue. To do this effectively it needs bioflavonoids (see below) such as rutin and hesperidin. Many Vitamin C supplements state that they contain bioflavonoids, or these can be taken separately (in the form of buckwheat tea or tablets for rutin)

      Take between 1 and 5 grams daily of C with bioflavonoids.


    • Vitamin E: This powerful antioxidant is reported by Canadian researchers Drs Evan and Wilfred Shute to improve varicose veins status when supplemented in doses of 500 to 800iu daily.

      They believe it assists in the development of collateral channels of circulation, relieving the veins under pressure.

      Direct applications of vitamin E to ulcers is helpful.


    • Selenium acts symbiotically with Vitamin E and a dose of 50mcg daily should be taken of this.

      Ulcers seldom appear if E is supplemented adequately, and its use is a powerful aid when phlebitis is present, reducing pain and preventing clot formation.


    • Essential fatty acids: Evening primrose oil (500mgs daily) and EPA (4 to 6 capsules daily) are both useful in reducing chances of inflammation and the adhesiveness of the blood.


    • Fibre: It is absolutely essential to keep bowel function working smoothly, with no straining at all. Adequate fibre intake means also reducing to nil if possible any refined carbohydrates (white flour products, any colour of sugar, white rice). At the very least these should be cut severely, and as much complex carbohydrate (which is rich in fibre) eaten. This includes wholemeal bread and pasta, brown rice, vegetables and fruit, seeds and nuts, pulses (all the bean family).

      A supplemental intake of two or more dessertspoonsful of linseed (the Linusit brand is excellent is recommended daily to ensure bowel function.

      A general reforming of the diet is desirable to include minimal animal fat (cut down meat drastically, only use low or no-fat dairy produce, increase poultry, fish or vegetarian meals) as is the abundant use of unprocessed foods.


  2. Self-Help Measures:


    • a/ Deal with weight and constipation problems (use dietary methods above)


    • b/ Introduce regular exercise, such as walking, dancing, skipping, yoga. DO regular exercises in which you contract the muscles of the leg rhythmically, or move the ankles in circles or up and down firmly, or do upside down cycling exercises… anything which keeps muscles pumping.


    • c/ Learn to breathe more effectively. See a physiotherapist or a registered osteopath for advice and treatment, if necessary, as you may need some work done on the structures which are tight before you can breathe better.


    • d/ Stop use of the contraceptive pill, and get advice on what nutrients you need to make up for the damage this has done (consult a naturopath or nutrition consultant)


    • e/ Stop use of any tight clothing, especially if it constricts the waist area, and avoid use of high heels which stops normal muscle contraction in the lower leg, affecting circulation.


    • f/ Use elasticated support hose if your job entails excessive standing, or when pregnant, or if you are overweight. This should support not just the calf but the entire thigh, and should be put on before getting out of bed.


    • g/ Raise the foot of the bed by up to six inches (place blocks or books under the feet). This is not uncomfortable and helps gravity to ease back-pressure on the veins at night.


    • h/ Avoid standing still for lengthy periods. Rock from one leg to the other or pace gently up and down, to keep muscles moving.


    • i/ When sitting don’t cross legs as this restricts circulation. Try to have a footstool which allows the feet to be at least level with the hips and ideally slightly higher.


    • j/ Avoid hot baths, warm ones are fine, but finish with a cold splash or shower application to the legs.


    • k/ Regular use of alternating hot and cold sitz baths (up to umbilicus in water) is useful for causing a circulatory stimulus.

      Always finish with cold. If this cannot be organised use hand shower or bidet to at least apply cold water to rectal area in cases of haemorrhoids (after a bath, after every bowel movement and at least morning and evening as well).


    • l/ Use vitamin E cream on skin irritations.


    • m/ Herbal teas such as Mullein and Buckwheat are useful.

      Garlic is a powerful aid in reducing levels of viscosity of the blood and is highly recommended, raw or as a capsule (two or there daily)


    • n/ Spinal manipulation and postural reeducation (osteopathy and Alexander Technique) can together dramatically influence normalisation of poor body mechanics which is a contributor to the problem due to negative effects on breathing as well as forward tilt of the pelvis which causes abdominal/pelvic contents to become crowded.



A combination of nutrition, hydrotherapy, exercise and common sense can transform and improve early varicose veins and haemorrhoids. Once varicosity of any sort is advanced however the best that can be achieved is relief and a stopping of the progression towards a worse state, ulcers etc.


Surgery is sometimes advisable, but only if the sort of long-term approaches recommend above are also used.


Recommended reading: Varicose Veins (Thorsons New Self-Help Series) by Leon Chaitow ISBN 0-7225-1304-6


Leon Chaitow can be contacted at The Hale Clinic, London (071-631-0156)

Avatar Written by Leon Chaitow ND DO MRO