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Follow this advice for putting hemorrhoids behind you—naturally.

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OK, so maybe you don’t want to bring it up over dinner with friends—or even tell your doctor about it—but chances are, you or someone you know has suffered from hemorrhoids at some point in life. Estimates show that 2 million Americans seek treatment for this painful condition annually. So if you do have hemorrhoids, know that you are definitely not alone. The good news is that there are natural remedies that can bring fast relief, as well as long-term solutions to reduce the likelihood of future problems.

When it comes to hemorrhoids, there are two main types: external and internal. The first kind tend to protrude in grape-like clusters from the anus and feel swollen and tender, especially after periods of prolonged sitting. These types of hemorrhoids and are easy to remove with minor surgery, offering rapid and permanent relief in most cases. Internal hemorrhoids, on the other hand, may or may not protrude from the anus; they are often uncomfortable and bleed with bowel movements. Internal hemorrhoids are trickier to remove surgically.

The best topical treatments are apple cider vinegar, coconut oil, and witch hazel (the main ingredient in Tucks and Preparation H). Apply with a cotton ball as needed. For quick relief, a small ice cube can also be placed over the affected area to slightly numb the hemorrhoid and soothe inflammation.

Supplements of stone root, horse chestnut, butcher’s broom, gotu kola, ginkgo, and citrus bioflavonoids can also help reduce hemorrhoids. Take as single remedies or in a combination formula (see “Good Buys” below for suggestions). Ideally, you want about 250 mg per herb.

Constipation and straining are the most common causes of hemorrhoids, which become more common with age. These “pains in the rear end” are also prevalent during pregnancy because of increased blood volume and added pressure on the body’s venous system. Consuming plenty of filtered water and fiber-rich foods (20–30 gm daily), along with regular exercise, helps to facilitate bowel movements and prevent hemorrhoids.

Blueberries may also help shrink veins related to hemorrhoids: eat about ½ cup of blueberries daily. Frozen blueberries are even better because the process of freezing ruptures the cell walls of the berries and renders the vein-shrinking pigments more bioavailable.

If you can’t pinpoint the cause of your hemorrhoids, it’s time to check your liver function. Here’s why: After delivering oxygen to tissues, venous blood passes through the liver before reaching the heart. Any kind of liver congestion will slow the blood’s journey back “uphill” to the heart. This can then create a backlog in the process, causing veins to balloon under the extra pressure. To restore liver health, avoid all drugs, alcohol, and coffee. Additional liver-cleansing strategies to employ include castor oil packs (applied nightly over the liver area); liver-friendly supplements (e.g., milk thistle, yarrow, turmeric, dandelion, Siberian ginseng, alpha lipoic acid, and NAC); and liver-friendly foods (e.g., beets and artichokes).

Emily Kane, ND, LAc, is a naturopathic physician and acupuncturist specializing in gynecology, counseling, herbal medicine, and naturopathic manipulation (body work) based in Juneau, Alaska. She is the author of Managing Menopause Naturally. Visit her online at dremilykane.com.

FUTUREBIOTICS VeinFactors is one of the most comprehensive blends for vein health; and it includes citrus bioflavonoids and butcher’s broom. Use for both varicose veins and hemorrhoids.

HIMALAYA HERBAL HEALTHCARE LiverCare, which has developed quite a cult-like following for its liver-cleansing abilities, boasts a mix of Ayurvedic herbs such as yarrow.

RENEW LIFE Organic Triple Fiber, one of the bestselling fiber products on the market, features a trio of soluble and insoluble fiber from flaxseeds, oat bran, and acacia gum.