Chinese Medicine's Approach to Hemorrhoid Treatment

From the very earliest texts in the Chinese medical canon, we see evidence of continual research into and treatment of hemorrhoids. The Yellow Emperor’s Inner Canon (99-26  BCE), for instance, details certain pulse properties on the radial pulse that might suggest the presence of hemorrhoids and posits that the ailment might stem from derangements of the kidney and urinary bladder channels.

By the early Jin dynasty (256 CE), the Systematic Canon already shows evidence of differentiated acupuncture treatment strategies for different hemorrhoid presentations with point choices showing marked continuity with the Inner Canon.

The Origins and Indicators of Disease (610 CE) distinguishes five different kinds of hemorrhoids, each with its own treatment strategy and also clearly indicates that hemorrhoids result from constipation, fatigue and parasites. Interestingly, this Sui Dynasty tome also provides various Daoyin exercises that sufferers can use to heal hemorrhoids themselves. For instance, one exercise instructs the patient to start in a standing position, then hug one knee to the chest and hold in this balanced position for several breaths and then alternate to the other leg. One can easily see how such an exercise would strengthen the peri-anal muscles and prevent or improve anal prolapse.

Daoyin exercises

By the Tang Dynasty, a very mature understanding of the pathomechanisms of hemorrhoids emerges in the Prescriptions Worth a Thousand Gold and over 20 herbal formulas, internal and topical are listed to tackle this menacing ailment. These formulas reflect that ancient physicians believed the primary causes of hemorrhoids were fatigue, “dampness” which we can take to mean poor lymph drainage, constipation, parasites, “heat” or inflammation, and poor blood circulation, which could also then lead to bleeding. The fungus Laccocephalum mylittae  (雷丸 literally “thunder ball”) which grows in bamboo forests was used to treat parasites and has been identified by modern science as a powerful anthelmintic.

Laccocephalum mylittae

Interestingly, these same pathomechanisms are clearly reflected in the design of the two hemorrhoid formulas available on this site. Sophora Combo, for instance, uses rhubarb to target constipation, peony root and rhubard to improve peri-anal microcirculation, sophora and garden burnet to stop bleeding and scutellaria and goldthread to combat inflammation. Together, this combination heals the hemorrhoidal tissue and improves local circulation and lymph drainage to resolve the ailment at the root. Hemorrhoid Support also includes herbs to help local lymph and blood circulation like notoginseng root and amber, herbs to treat inflammation and abscess like coptis chinensis and tetraarsenic tetrasulfide, but it additionally includes puckering and astringent herbs like pomegranate bark and chebula fruit which help in retraction of rectal prolapse. Thus, Sophora Combo would be more helpful in early stage hemorrhoids, while Hemorrhoid Support would be more helpful in later stage hemorrhoids with prolapse and abscess.

Modern studies have found that hemorrhoid formula preparations with herbs similar to those listed above are markedly effective at treating hemorrhoids. A 2007 study of 100 patients found the herbal formula Zhi Tong Ru Shen Tang had a 96% success rate in treating hemorrhoids, particularly internal hemorrhoids,  while a 2001 study of 324 patients found a 90.4% success rate in the treatment of internal, external and mixed hemorrhoids. 

Interestingly, combining acupuncture with herbal treatments might produce even better results than just using medicine alone. A 2019 study from the Shanghai Journal of Acumoxa found that acupuncture-herbal combination therapy outperformed single acupuncture or herbal therapy by a significant margin, reducing swelling severity and hemorrhoid size more effectively than either modality in isolation.

Given the utter lack of effective treatment options for hemorrhoids provided by western medicine, Chinese medicine provides a highly effective and cheap alternative. Importantly, early treatment of hemorrhoids with Chinese herbs and acupuncture can help patients avoid costly surgery and painful and difficult post-surgical recovery.

 References:

 朱瑞刚, 韩劲松.止痛如神丸治疗痔病的临床观察(附100例报告) ,《光明中医》, 2007,22(7)

 叶玲; 郑鸣霄. 采用乙字汤治疗痔疮324例. 《福建中医学院学报》, 2001,11(3)

 李斌,张狄,宋双临,石焱,洪媚,黄振. 针药并用治疗炎性外痔临床观察. Shanghai J Acu-mox, Feb 2019, Vol 38, No 2