Chapter 6. Hemorrhoidal Disease
“Fiber enlarges stools. Large stools require straining to evacuate. Straining enlarges hemorrhoids and constricts the anal canal. The narrow anal canal requires even more straining and results in fissures, bleeding, and pain”
National Institutes of Health[1]
What Nature Giveth, Newton’s Law Taketh
From what we already know concerning the impact lifestyle, nutrition, and medicine have on stools, it isn’t hard to comprehend the forces behind the pandemic of hemorrhoidal disease, which actually starts with a little “defect” in human anatomy. Here’s what I mean by this:
Besides pain, discomfort, and embarrassment, the most unpleasant thing about hemorrhoidal disease is its negative impact on the aperture of the anal canal, which maxes out in healthy adults at 3.5 cm (1.37”) or about this much:
As you can see, it’s not that wide. So when the anus is stretched out this much, you’ll certainly feel discomfort, or even pain, just as with any other body orifice when it’s expanded to the max. Just try to swallow a small apple whole. Sure, you can shoehorn it in, but oh, will it hurt.
The anal canal, too, can pass large stools through. It doesn’t have a choice, does it? But it wasn’t intended to do so regularly, in the same way your teeth weren’t intended to open beer bottles, even though they can. Not surprisingly, when the anal canal is overstretched by large stools, the forces needed to pass them—pressure from the inside, straining from the outside—cause hemorrhoids to enlarge, and this brief passage to the sewer gradually becomes one long tortuous journey.
How torturous? Based on the U.S. Census 2000, “half of the population” by age fifty translates into 38 million victims of hemorrhoidal disease. Once you factor in people under fifty and the undiagnosed, the actual number is much greater.
Fiber-related constipation and straining (a telltale sign of latent constipation and dysbacteriosis) are the two principal causes of hemorrhoidal disease. The number of affected individuals illustrates just how widespread those two problems are.
What giveth? Newton’s third law, of course: for every action there is an equal and opposite reaction. Here’s what I mean:
- As hemorrhoids get larger, the anal canal aperture gets smaller, and the stools become harder to pass;
- As the difficulty of passing stools intensifies, the need to strain grows more pronounced, and the hemorrhoidal pathologies grow worse;
- As the first two problems evolve, people keep increasing the amount of dietary and/or supplemental fiber to counteract defecation difficulties;
- As people increase the amount of fiber in their diet, their stool keep getting larger, causing further enlargement of hemorrhoids, while the anal aperture becomes smaller and smaller;
- As the anal aperture becomes smaller and the stools larger, people experience more constipation, strain harder, feel more pain, and begin experiencing other complications described elsewhere in this book.
If not interrupted by luck, education, or God’s will, this vicious cycle continues unabated until patients may need surgery to fix rectal prolapse, anal fissures, fistulas, abscesses, fecal incontinence, or other related ailments.
Because most surgeries leave scars, damage nerves, and affect surrounding tissues, recovery is rarely one hundred percent. The muscle damage alone may place you in diapers for the rest of your life because of fecal incontinence. The residual pain may cause incomplete or delayed stools—the culprits behind chronic fecal impaction with its own compliment of nasty ills, such as diverticular disease, irritable bowel syndrome, ulcerative colitis, precancerous polyps, and, to top it off, colorectal cancer itself.
No, I’m not making all this up. Here is what proctologists—the physicians who specialize in mending hemorrhoids—have to say about the unfolding of hemorrhoidal disease:
Hemorrhoid.net: Unfortunately, a hemorrhoidal condition only tends to get worse over the years, NEVER better [original emphasis—ed.].[2]
That is certainly true if you continue treating constipation and hemorrhoidal disease with evermore fiber, water, and exercise. Otherwise, never say never!
A case of mistaken identity
It may surprise you to learn that every individual on planet Earth possesses hemorrhoids since birth. It’s true, because hemorrhoids aren’t what you think they are. What you think they are, is, in fact, hemorrhoidal disease, not hemorrhoids. What’s the difference?