Hemorrhoids

Hemorrhoids

Surveys suggest that, in westernized countries, as much as half the population over 40 years of age may suffer from hemorrhoids.

The common explanation for their absence in the developing world is "a high fiber diet." An Internet search on "incidence of hemorrhoids" turns up many instances of the following statement, carefully worded to suggest a causal connection: "Populations in which fiber intake is high have a very low incidence of hemorrhoids."

The medical establishment accepted the fiber theory without proof because they had no other explanation for the dramatically lower incidence of hemorrhoids in the developing world. They ignored the fact that these populations follow a wide variety of diets. The Masai cattle-herders of central Africa are almost exclusively carnivorous. The Hindus of India are vegetarian. Other groups subsist on fish, or even on insects.

Researchers have also been unaware of another, more relevant factor which would explain the data: the use of squat toilets. This factor has three advantages over the fiber theory:

• It is consistent throughout the developing world.
• It pertains directly to the anatomy of hemorrhoids.
• It has been validated by published clinical research.

The research was conducted by Dr. Berko Sikirov, an Israeli physician, who studied the effect on hemorrhoid patients of squatting for elimination. The results were published in 1987 in the Israel Journal of Medical Sciences. In 1996, the study was the subject of an article in the Townsend Letter for Doctors and Patients.

Twenty male and female patients who had hemorrhoids of varying degrees of severity participated in the study. They had all used conventional treatments with little or no success. Two of the patients had been treated with ligation (tying off the hemorrhoid at its base with a rubber band.)

The patients underwent a proctoscopy at the beginning of the trial. Then they were told to change their toilet habits in two ways: to wait until the urge to evacuate was strong (to avoid straining) and to use the natural squatting position for elimination. The proctoscopy was repeated after one year.

Of the 20 patients, 18 reported within a few days to a few months a significant reduction or complete absence of symptoms. Lack of improvement in the two other patients, who had previously had ligation for hemorrhoids, "may be ascribed to fibrous tissue development in the submucosa as a consequence of the ligation."

Follow-up examinations, 12 and 30 months later, on the 18 other patients (90% of the subjects in the study), revealed no recurrence of the symptoms. This chart shows the results obtained by all 20 patients. A detailed account of Dr. Sikirov's research can be found in his U.S. Patent #4,819,277.

Dr. Sikirov's conclusion is that hemorrhoids result from continual aggravation and injury due to excessive straining in the sitting position. Straining is necessary to overcome the constriction in the rectum designed to maintain continence. When this ongoing insult to the body is removed by returning to the squatting position, the natural healing process can occur without hindrance.

The importance of squatting is not unknown to gastroenterologists. Dr. Michael I. Freilich, a retired colorectal surgeon from Marina del Rey, California, recently commented,

Twenty-five years ago, when former President Carter had a hemorrhoid problem, Time Magazine called and asked me to explain the cause of hemorrhoids. In the magazine, I was quoted as saying, "Man was not meant to sit on a toilet, but to squat in a field."

Even the standard textbook, Bockus Gastroenterology, contains the statement, "The ideal posture for [voiding] is the squatting position, with the thighs flexed upon the abdomen. In this way the capacity of the abdominal cavity is greatly diminished and intra-abdominal pressure is increased, thus encouraging expulsion ..."

Unfortunately, most gastroenterologists pretend to be unaware of the therapeutic value of squatting. Surgery and ligation are lucrative procedures. Not wanting their income to suffer, they cause their patients to suffer instead.