Hemorrhoids in Armageddon

As I research various medical topics, it’s always interesting to see which references address the various issues.  With today’s topic, one of my favorites—Armageddon Medicine—didn’t cover hemorrhoids at all.  This again underscores the need to have more than two medical books on hand when you don’t have anyone else to consult. 

Maybe it didn’t cover hemorrhoids because the condition is a fairly common one and usually resolves without medical intervention.  However, some become a little more complicated and a lot more painful.  It’s a good idea to be prepared to deal with them.

First off, let’s start with the information contained in The Ship’s Medicine Chest and Medical Aid at Sea:

Hemorrhoids (Piles)

Hemorrhoids are enlarged veins surrounding the last inch or so of the rectum and its outlet, the anus.  Not all hemorrhoids bleed, but bleeding occurs sooner or later in most untreated cases.

The enlarged veins may occur internally above the anal sphincter muscle or externally below the muscle.  Although external hemorrhoids can be seen, internal hemorrhoids cannot be seen unless they are forced through the anus by straining. 

Hemorrhoids may be painful or painless, and may be as large as an almond or even larger.  Bleeding hemorrhoids may produce a few drops or a tablespoonful of blood.  Internal protruding hemorrhoids may pose a very serious medical problem when they become engorged and inflamed.  They may not be able to be pushed back easily into the rectum. 

Common causes of hemorrhoids include constipation, straining at the stool, excessive use of cathartics [substance that accelerates defecation], and heredity.

Treatment

A patient with hemorrhoids should be advised to consult a physician to make sure that other conditions are not present as an abscess, fissure, or possibly cancer.

To relieve pain in acute cases, warm compresses made by wringing out cloths with warm saline solution (one teaspoonful of sodium chloride in 1,000 ml of water) may be applied.  The patient should sit in a tub of warm water for 20 to 30 minutes, every two to three hours for relief of pain and itching.  After the baths he should return to bed rest.  Hemorrhoidal suppositories may be inserted rectally, as directed on the package, to supply relief.  Medical advice by radio should be obtained on whether local application of hydrocortisone ointment 1% may be prescribed.

To keep the stools soft, milk of magnesia should be administered once or twice daily.

 

That’s the info from The Ship’s Medicine Chest.  Further information from other references may help in an austere situation.

Symptoms

• Anal itching
• Bleeding, usually on the toilet paper, but sometimes a drop or two will appear in the toilet
• Painful bowel movements
• Anal pain that is worse when sitting
• Painful bumps near the anal opening

Risk factors for hemorrhoids

• Low fiber diet
• Pregnancy
• Standing for several hours each day

Prevention

• Eat a high fiber diet that includes whole grains, fruits, and vegetables[2]
• Exercise
  

Most hemorrhoids are easily diagnosed by simple observation—the hemorrhoid is a bluish bump at the edge of the anus.  In the case of an internal hemorrhoid, a rectal exam to palpate the hemorrhoid will be necessary.  Interestingly, most hemorrhoids are asymptomatic.  Only hemorrhoids that cause pain or bleeding need to be treated.  If the hemorrhoid develops a clot, it becomes inflamed and may cause constant discomfort or pain that can make everyday activity nearly impossible. 

Additional treatments not mentioned above include:

• Witch hazel used in a compress or dabbed on the hemorrhoid directly.[1]
• Stool softeners
• Corticosteroid creams like Anusol-HC or Preparation H
• Wipes such as Tucks pads

Herbs that may be employed to treat hemorrhoids include:

• Blackberry root bark decoction, compress applied externally
• Calendula lotion, cream, or ointment
• Catnip essential oil, applied topically
• Cattail dried root powder and pollen
• Cayenne
• Eggplant
• Elder, dried flower wash
• German chamomile salve
• Isatis
• Japanese honeysuckle
• Jimsonweed seed salve
• Juniper
• Lamb's quarter
• Mullein, leaf and flower poultice
• Oak, bark tea
• Passionflower
• Peach bark, flowers, fruit, leaves, roots
• Plantain infusion, poultice, salve, seeds
• Purslane
• Snapdragon poultice
• Yarrow, infusion taken internally, or poultice, or tincture in a bath
• Chocolate
• Coconut oil, 2 drops lavender essential oil diluted in 1 teaspoon coconut oil and applied to affected area

If the hemorrhoid is bleeding, the bleeding may be controlled by direct pressure. [3]  If 30 minutes of direct pressure fails to stop the bleeding, a physician should be sought out if possible.  If this is not possible, the bleeding may be controlled by removing the clot that is inside the hemorrhoid. 

The procedure a physician may use is as follows:

• Apply local anesthesia if you have it[4] (tattoo numbing cream, cold spray, etc.).
• Cleanse the area thoroughly with povidone iodine.[5]
• Use a scalpel to incise just enough to remove the clot.[6]
• Use gauze to absorb blood and apply pressure to stop the bleeding.[7]
• Be prepared to suture the incision if the bleeding is heavy.[8]

DO NOT try to cut out the hemorrhoid itself as this could result in the patient bleeding to death.[9] 

Links to related posts:

TEOTWAWKI Local Anesthesia Options for Everyone 

Betadine for Preparedness 

All About Sutures

The Ship’s Medicine Chest Book Review

For further information on the herbs, use the search bar at right. 

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[1] David Werner, Where There Is No Doctor, 1992, 175.

[2] David Werner, Where There Is No Doctor, 1992, 175.

[3] David Werner, Where There Is No Doctor, 1992, 175.

[4] Joseph Alton, The Survival Medicine Handbook, 2013, 442.

[5] David Werner, Where There Is No Doctor, 1992, 175.

[6] David Werner, Where There Is No Doctor, 1992, 175.

[7] David Werner, Where There Is No Doctor, 1992, 175.

[8] David Werner, Where There Is No Doctor, 1992, 175.

[9] David Werner, Where There Is No Doctor, 1992, 175.

 5 january 2022