Thanks, Brad and Paul for having me on this episode of Talking with Docs. I love talking about vascular issues of all kinds. As you know I’m passionate about dietary supplements. I can’t wait to have you as guests on my channel.

Thrombosis was the worst pain of my life. Crying and no sleep for days even after taking many extra strength pain killers. Emergency department wouldn’t lance it for me. They only gave me Tylenol, told me to take Anusol OTC, and suggested fibre. It is hard to get empathy for this, even from doctors. Some people make jokes. I know hemorrhoids aren’t life threatening, but they could make you wish you were dead. If there is anyone else out there suffering this way, your feelings are valid!

I'm a bleeder (no pain) since my early 20's, getting tired of it and I'm having surgery in 2026, wish me luck!

1. What Are Hemorrhoids?

   Vascular structures (veins) in the anal canal that help with blood flow and act as "cushions" to keep the anus closed.

   Two types:

       Internal hemorrhoids: Above the dentate line (less sensitive, no pain).
       External hemorrhoids: Below the dentate line (painful due to nerve endings).

2. Symptoms

   Lump or swelling near the anus.
   Bright red blood on toilet paper, in the bowl, or on stool.
   Pain (especially with external or thrombosed hemorrhoids).
   Itching or discomfort.

3. Causes & Risk Factors

   Straining (due to constipation, low-fiber diet, or heavy lifting).
   Pregnancy (increased pressure on pelvic veins).
   Age (weakening of connective tissue over time).
   Prolonged sitting (e.g., on the toilet scrolling your phone!).

4. Diagnosis

   Digital rectal exam (DRE): A finger exam to check for lumps or bleeding.
   Anoscopy: A scope to view internal hemorrhoids.
   Rule out serious conditions (e.g., colorectal cancer) if bleeding persists.

5. Treatment Options
Non-Surgical:

   High-fiber diet (fruits, veggies, whole grains, or supplements like psyllium/Metamucil).
   Hydration (softens stool).
   Topical creams (e.g., Preparation H, witch hazel pads).
   Flavonoids (natural compounds in citrus rinds/supplements that support vein health).
   Sitz baths (warm water soaks for relief).
   Squatty Potty (positions hips for easier bowel movements).

Minimally Invasive:

   Banding: Rubber bands cut off blood flow to internal hemorrhoids.
   Thrombectomy: Draining clotted external hemorrhoids.

Surgical (Last Resort):

   Hemorrhoidectomy: Removal of severe hemorrhoids (painful recovery).

6. Prevention Tips

   Don’t strain during bowel movements.
   Limit toilet time (no reading/scrolling!).
   Exercise regularly (improves circulation).
   Avoid sitting on hard surfaces (increases rectal pressure).
   Use gentle wipes or a bidet (reduces irritation).

7. When to See a Doctor

   Persistent bleeding (to rule out cancer).
   Severe pain or prolapse (hemorrhoid won’t go back in).
   Symptoms worsening despite home care.

Final Takeaway

   Hemorrhoids are common—don’t be embarrassed!
   Early treatment = less pain.
   Lifestyle changes (fiber, hydration, movement) are key to prevention.

Quick-Fix Tips for Hemorrhoids

✅ For Immediate Relief:

   Ice packs (10 mins on/off) to reduce swelling.
   Witch hazel pads (Tucks) for soothing irritation.
   Over-the-counter creams (e.g., Preparation H) for temporary relief.

🚽 Toilet Habits:

   Don’t linger! >5 mins = increased pressure.
   Squatty Potty hack: Elevate feet (or use a stool) to straighten the rectum.
   Gentle wiping: Use wet wipes (alcohol-free) or a bidet.

Long-Term Prevention

🍏 Diet & Hydration:

   30g fiber/day (beans, oats, berries, chia seeds).
   Psyllium husk (Metamucil) if diet falls short.
   Hydrate aggressively (water > coffee/alcohol).

💪 Lifestyle Tweaks:

   Move more: Sitting worsens hemorrhoids; walk 5 mins hourly.
   Lift smart: Exhale when lifting (no breath-holding!).
   Sitz baths: 15 mins warm water 2–3x/day (use Epsom salts for extra relief).

When to Seek Help

⚠ Red flags:

   Blood in stool (dark/maroon = ER visit).
   Persistent pain (thrombosed hemorrhoids may need drainage).
   Prolapse (hemorrhoid won’t retract).

💡 Pro Advice:

   Flavonoid supplements (e.g., Diosmin/Hesperidin) strengthen veins.
   Banding > Surgery: If home remedies fail, internal hemorrhoids can often be banded painlessly.

Avoid:
❌ Straining, spicy foods, prolonged sitting, and ignoring symptoms!

(Note: Severe cases may need a colorectal surgeon—don’t suffer silently!)

TL;DR: Fiber + water + movement = prevention. Ice, witch hazel, and sitz baths = relief. See a doc if it’s bad! 🚑💨

The  most painful surgery ever I had was having haemorrhoids removed, that first bowel movement afterwards is well..I was clawing the walls !. Eat lots of roughage, dont dwell on the toilet, dont push for more than a few seconds ..oh and drink plenty of water throughout the day, dry stools cause issues.Thanks guys

I switched to a Whole Food Plant Based diet about 14 years ago. I enjoyed all sorts of important benefits like permanently losing more than 100 pounds, lower blood pressure and so on. But the biggest benefit was that I no longer had the ever present excruciating pain of hemorrhoids due to all the fiber I was eating. It was the bane of my existence for years. I'll skip over the details here but that was far and away the best part of switching over my diet! Great topic gentlemen!

My mom used to yell through the bathroom door, "Stop playing Gameboy on the toilet, that's how you get hemorrhoids!" and she was right... 😅

Both my parents have/had hemorrhoids and I do as well.  One thing I discovered a couple of decades ago is that bleached toilet paper and cheap rough toilet paper would trigger episodes of flare ups that could last days.  So not having a bidet I just started not wiping with paper at all and taking a shower immediately after, clearing any remaining fecal matter (always with my left hand) and using mild soap bars suds to clean and in a way massage the sphincter with my finger pads. If I'm not able to be home and need to have a bowel movement, I wipe but not extensively and finish with either medicated wipes or a damp warm hand towel that I keep in a ziplock just in case.  This has greatly reduced the frequency of these episodes along with a balanced diet and fiber.  I have also found that the 4 fish oil capsules that I consume a day to help lower my cholesterol also helps with making my stools softer therefore pass easier.  Warm to hot water has always helped from the rear but also from the front warming my abdomen the heat spreading and relaxing to the rear as well.

Worst experience of my life I had them comig out prolapsed stage 4 n I literally starved myself n prayed n asked God to reach down himself n push them back in ! He did man glory to God n never went to the doctors ! I was but he healed me so I didn’t need to never again will I be so depressed again after comig out of that

I'm not an asshole, I'm a hemorrhoid - I irritate assholes 😆

Love these doctors talk about prevention, the whole holistic cause and prevention. I got Hemorrhoids about 6 yrs ago when I turned 60, had never felt that before. Looking back at the time, I had been in a hot country, not eaten enough fibre and the big one was hadn't drunk enough water. Haven't had the problem since, but god was it uncomfortable.

I had occasional mild hemorrhoids years ago, but since we put bidet "washlet" seats in our bathrooms five years ago, no more issues!!! 100% recommend!!

Decades ago, I thought I was going to bleed to death because of hemorrhoids.  They were that bad.  One night I was lying in bed and listing to a talk show on the radio.  The guess was a doctor who had performed over 16,000 autopsies for research.  He believed most disease states started out as a deficiency. Vitamin, mineral, amino acid.   Long story short he mentioned that wheat blocked vitamin K1 uptake and that deficiency showed up as bleeding hemorrhoids.  At that time, I was eating lots of pasta, bread, donuts cookies.  Bought some k1 (super cheap) and took 3 capsule a day and stopped eating anything with wheat.   Saw nothing different until day 4.  The bleeding was much more reduced and that gut wretch feeling was gone too.  By day 7 all the bleeding was gone.  3 decades now without any flareups.  I now rarely eat anything with wheat.

Good info. Getting old is no fun. All kinds of embarrassing stuff can happen.

I had a young surgeon that was the head of the department fix my hemorrhoids several years ago and I have been very happy ever since. Don’t suffer in silence 🤐 get them fixed. All the stuff over the counter is just a temporary relief.

Thank you for this very informative program. This is the first time I've watched. I was very impressed with Dr. Chuback's answers, perspective, compassion, and professionalism. (As I was watching him speak, I found myself saying out loud, "You're a good doctor.")  We need more doctors like him.

The puns in this video were golden!

Fiber is your friend. When I travel, I try to take along a bag of ground flaxseed grain which I eat a spoonful of at least once a day. If I can remember to do this, it does help.

Thanks, Docs!

Literally watching this on the toilet... 😂

I had a hemorrhoidectomy. Horrid recovery process. So painful