Hemorrhoids ? You're Not Alone ! Hemorrhoidal pain, bleeding, and itching has afflicted mankind since the days of the Babylonians, a misery so intense it has led to the designation of a separate patron saint for hemorrhoid sufferers. [MacKay]. And if you suffer from hemorrhoids, you are indeed not alone! Hemorrhoids appear in about half of all adults by age 50, according to the National Institutes of Health. In the United States alone, that statistic translates into roughly 10 million hemorrhoid sufferers, with about 1 million new cases diagnosed each year. About one-third of hemorrhoid sufferers seek medical help from a physician each year, prompting more than 3 million office visits and 1.5 million prescriptions each year. Although hemorrhoids afflict both men and women, many women first begin to develop hemorrhoids during pregnancy, thanks to hormonal changes as well as the increased downward pressure of pregnancy.     INFOBOX | Hemorrhoid Signs & Symptoms (And When To See Your Doctor!) Typical hemorrhoid symptoms include : • a swollen, tender lump near the anus; • pain, especially while sitting; • bright red blood with a bowel movement; and/or • itching. In most cases, the most painful symptoms of a hemorrhoid flare-up ("crisis") will subside after a few days with simple home care. But if symptoms worsen or fail to improve on their own in a few days, call your doctor. Occasionally, pooled blood inside the hemorrhoid may clot, requiring surgical removal. Prolonged loss of blood can result in anemia. Severe bleeding or dizziness from a loss of blood can represent a real medical emergency. Call 9-1-1 or seek other emergency medical aid.     What Causes Hemorrhoids ? Hemorrhoids (sometimes called piles) are actually varicose veins located near the rectum or anus. Sometimes the distended veinous tissue protrudes beyond the anal opening; other times the swollen vein remains concealed within the rectum, making its presence known only when symptoms such as pain or bleeding develop. A wide variety of factors can cause or aggravate hemorrhoids. Like development of varicose veins elsewhere in the body, hemorrhoids are fundamentally linked to a loss of vascular integrity [MacKay]. Other contributing factors include constipation; a low-fiber diet; pregnancy; and a sedentary occupation or lifestyle. Certain medical conditions, such as cirrhosis of the liver and anal infections, also may increase the risk of developing hemorrhoids. How Hemorrhoids are Commonly Treated In centuries gone by, hemorrhoids might be treated with the not-so-tender mercies of a red hot poker. [MacKay]. Mercifully for today's patients, "poker therapy" is off the list of preferred medical options. Physical examinations typically begin with a simple digital rectal exam. To ensure an accurate diagnosis, your doctor will also want to rule out conditions that can produce similar symptoms, including fissures, abscesses, and colorectal cancer. Further diagnostic steps may including screening a stool sample to test for blood, and an internal exam using a lighted, flexible "scope" (known variously as an anoscope, proctoscope, sigmoidoscope, or conoloscope, depending on the tool's design and the region to be viewed). Hemorrhoidectomy, as the surgical removal of hemorrhoids is known, is often both painful and costly. With the evolution of other less-invasive procedures, this surgery is now reserved only for the most severe and intractable cases. A more common procedure is rubber band ligation, in which a tiny rubber band is applied around the hemorrhoid to cut off circulation to the protruding tissue. Other techniques include chemical cauterization (sclerotherapy) and infrared coagulation, which use scar tissue or heat to seal off the hemorrhoid tissue. Multiple treatments may be necessary if hemorrhoid problems are extensive. These techniques are generally not recommended during pregnancy. [MacKay]. For less serious cases, suppositories, topical anaesthetics and anti-itch medicines, and pain relievers can be prescribed to help reduce bothersome symptoms. However, these do nothing to alleviate the underlying problem or to prevent recurrences.     Diosmin and Hemorrhoids : Diosmin is thought to help reduce inflammation and to increase vein tonicity, two important factors that contribute to hemorrhoids. And taken at larger-than-usual "crisis dose" levels, diosmin also appears to significantly shorten the duration of hemorrhoid bleeding. One dramatic 2000 Italian study of 66 hemorrhoid patients reported that diosmin decreased pain by 79% and bleeding by 67% during the first week of treatment, followed by an astonishing 98% and 86% reduction in these symptoms by the second week. [Diana]. Other clinical studies involving hemorrhoid patients have shown: • After hemorrhoid surgery, flavonoids were found to relieve pain, bleeding and other symptoms more rapidly than standard antibiotic/anti-inflammatory treatment alone, with especially significant symptom relief during the first three days after surgery [LaTorre]. • In a 12-week study of 50 pregnant women suffering acute hemorrhoids, micronized diosmin/hesperidin therapy was reported to be a "safe, acceptable, and effective" treatment. Of the patients sampled, 66% obtained relief from acute hemorrhoid symptoms within four days, and significantly fewer patients experienced a relapse of symptoms during the post-birth period. [Buckshee]. • Bleeding time was significantly reduced in patients treated with flavonoids plus a fiber supplement in a study of 162 patients with nonprolapsed hemorrhoids; bleeding subsided in an average of just 3.9 days among the dual-treatment group, versus 10.6 days with fiber alone and 5.6 days for rubber band ligation plus fiber [Ho]. A similar study of 100 patients reported that acute bleeding had subsided by the third day of treatment for 80% of patients receiving micronized flavonoids, two days sooner than in patients receiving a placebo. [Misra]. • In a study involving laboratory rats, hesperidin and diosmin have been shown to help reduce colonic inflammation and oxidative damage. Hesperidin was also found to improve fluid absorption in the colon, a factor that may reduce colitis. [Crespo].     . . . . AND MORE? While the data remains preliminary, several scientific studies suggest that diosmin and hesperidin may have surprising beneficial effects in other arenas as well: Anti-carcinogenic effects : A pair of intriguing Japanese studies suggest that the dietary use of diosmin and hesperidin may provide a protective effect against certain types of cancer in rats. These 1997 studies reported that diosmin and hesperidin (both alone and in combination) appear to inhibit the development of colonic and oral neoplasms (tumors), and significantly decrease certain cell proliferation biomarkers. [Tanaka]. Other studies have also reported that hesperidin tends to inhibit tumors in mouse skin. [Berkarda]. The potentially protective mechanisms of dietary flavonoids are under investigation by the National Institutes of Health. [Yeh]. Cholesterol-lowering effects : One 1995 Italian study reported that treatment with hesperidin significantly increased HDL ("good") cholesterol and decreased LDL ("bad") cholesterol in rats. [Monforte].