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  • Writer's pictureCarly Gossard

Hemorrhoids; may be easier to treat than to spell!

Pelvic health is one of those fields where we get to talk about all the fun stuff you don’t normally bring up at dinner parties. This month’s blogs topic may top the list of things people don’t want to share, but should because of how common and how much help is out there - hemorrhoids! We are going to talk about what they are and what to do about them, with some insight from the pelvic therapists that Dr. Google may not be sharing with you.

Hemorrhoids are distended veins that can form externally around the anus or internally in the lower rectum. You can think of them similarly to varicose veins in the legs, only in the pelvic region. Typically, if you are seeing them externally, you have some internal involvement as well. Hemorrhoids are a very common issue, with some sources citing 50% of people will deal with them by the time they turn 50. While they can be common in the pregnancy and postpartum phase of life, there is a misnomer that its only during this time. The reality is people of all ages can deal with hemorrhoids.

Symptoms related to hemorrhoids can vary between non-painful annoyances to extreme pain during distention, as in the case of bowel movements. They are typically made worse from increased pressure. Examples of increased pressure include straining during bowel movements, increased laxity in the body during pregnancy, pushing during childbirth, and general conscious or unconscious clenching and butt gripping. A tight pelvic floor will increase pelvic pressures and increase the chances of hemorrhoids forming.

Treatment of hemorrhoids range from topical creams to hemorrhoidectomy and everything in between. In this blog, we are going to focus on the pelvic health solutions you may not be aware of or told when you are seeing your GI or proctologist.

  1. Manual therapy - yes, you can touch it. Better yet, you can put light pressure on the hemorrhoid and “encourage” it to move farther inward. The lighter pressure, the better. You want to feel what is happening under your finger, which is often a throbbing or pulsing. You can hold that pressure for a few minutes or until you feel that therapeutic pulse lessen.

  2. While also under the topic of manual therapy, it’s also incredibly important to apply manual therapy to the surrounding tissue. Remember above when we said a tight pelvic floor is typically at play? We need to focus on reducing the tone in the muscles, which are constricting the vasculature. Pelvic wands like the ones at can be very helpful in reducing that tone. A pelvic floor therapist can be extremely helpful in this area.

  3. Breath work and biofeedback: Understanding how our bodies hold tension is SO important. Are you aware of your pelvic floor’s ability to contract and relax? Are you able to take a deep breath and feel the pelvic floor expand? If not, this is a great way to bring what is typically unconscious patterning (our posture and how we hold tension in our body) into conscious awareness.

  4. Stretching: poses like child’s pose, happy baby, and mulasana squats are great to help lengthen the pelvic floor and decrease constriction on the blood vessels.

  5. All the toileting tricks!! Get your squatty potty. Drink half your body weight in water everyday. Avoid straining when having a bowel movement (breathe that baby out). Avoid hanging out on the toilet. A big way to manage pressures in the pelvis is to keep your gut healthy. No system works in isolation.

These are some, although not all, things you will be learning and working on if you see a pelvic floor therapist for hemorrhoid issues. Keep in mind, that while conventional treatments like cauterizations and hemmorhoidectomies can be effective in some cases, the underlying issue - uncontrolled tone - will not go away with procedures like this, so there is always a chance of recurrence. It’s an example of treating the symptom instead of the cause. We hope this is helpful and are here for all your hemorrhoid questions!!

Happy & Healthy bowel movement for all,

Team EPH


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