Additional risks include obesity, pregnancy and birthing, regular heavy lifting, straining on the toilet, and having to be on one’s feet for long periods of time. Of these, the latter is the most hazardous. Standing exerts enormous strain on the veins, up to ten times that of other postures. The upright position encourages the flow of blood downward while simultaneously forcing the body to work against gravity to return the blood up to the heart. To ease the tremendous effort it would take for the heart to handle this task by itself, the legs contain a series of muscle driven pumps and one-way valves, a system called the "second heart."

When leg health is not maintained, the second heart weakens. The ensuing vein problems range from being unsightly but purely cosmetic aggravations to being downright dangerous. The degree depends on which veins are affected. Two distinct networks of veins exist in the legs. One is close to the surface of the skin. This superficial system connects to the second deeper system. Small varicose veins, or spider veins, affect the superficial system and pose little threat to health. Larger varicose veins involving defects in the deeper valves are serious, requiring medical attention and sometimes surgery.

 When valves are defective, they either do not close completely or don’t close at all.* Although there is certainly nothing normal about it, this condition is called normal inadequate leg circulation or NIC. NIC can result in feelings of heaviness, a sensation of tension (chiefly located in the calves), restless legs, and edema (swelling). The ropy, swollen knots known as varicose veins occur when the incompetent valves cause blood to pool in the larger leg veins, forcing them to bulge against the skin surface. This slowing of the blood transit time triggers the clotting response. Usually a healthy physiological response, clotting can become life threatening in this situation. Pockets can form, trapping blood and resulting in minor clots and inflammation, leading to a condition called phlebitis.

According to Julian Whitaker, MD, all of these conditions may be associated with a lack of the enzyme which breaks down fibrin. Fibrin is an insoluble protein network that forms the basis of a blood clot. Also, a combination of fibrin and fat causes the hard lumpiness surrounding some varicose veins. Supporting the body to dissolve fibrin is part of the natural approach to improving circulation presented in this issue.

*Until recently, there has been no way to restore these veins to competency. However, some innovative physicians are addressing this problem with new surgical techniques.

Nearly one in every three Americans is estimated to suffer from hemorrhoids. Worse, every other person over 50 has the affliction. Sources referred to for this issue agreed that the major causative factor in the development of hemorrhoids is straining while on the toilet. This is also the major connection between hemorrhoids and varicose veins. Straining during bowel movements blocks the flow of blood back up through the veins in the legs. Other situations which cause rectal venous pressure are pregnancy and birthing, coughing, sneezing, vomiting, physical exertion, and increased blood pressure in the portal vein (the main vein into the liver) due to cirrhosis.

These interruptions in the normal blood return system cause pressure to build up in the veins, weakening the vein walls and, eventually, dilating the veins. This makes it impossible for the valves to close properly because they no longer fit the vein circumference. Hemorrhoids result from blood congesting in the rectum during straining. No valves exist in this venous system so there is no way for the pressure to be relieved.

That explains the causative mechanism, but not the real bottom line (so to speak). Most cases of hemorrhoids, and the varicose veins associated with them, are the result of unhealthy dietary patterns. Simply put, there is not enough fiber and water in the diet. When the stool is hard and/or small in diameter, it becomes difficult to evacuate. Straining is the result. Both hemorrhoids and varicose veins are more common in affluent populations, particularly in the US and Great Britain. People in these countries are more likely to eat refined carbohydrates and high protein animal foods, and to lead a sedentary lifestyle. Hemorrhoids are a rare occurrence in countries where the people eat large amounts of fiber.

A comparative study completed by British investigators many years ago continues to illustrate the point. British schoolboys on the usual refined diet passed an average daily stool of 108 grams, and the average transit time was 77 hours. In comparison, the stool of African villagers weighed 400 grams and was passed within 35 hours. Unfortunately, as nations increase their economic base, people change their eating habits. This is followed by a corresponding increase in the occurrence of hemorrhoids.

A diet rich in fruits, vegetables, legumes, and grains promotes peristalsis (bowel movement). Many fibers attract water, forming a gelatinous mass. This keeps the stools soft, bulky, and easy to pass. The current recommendation from the American Dietetic Association is 20-35 grams per day. The infamous average American eats only about half that amount. Fiber can easily be increased not just by eating more fresh whole foods, but by adding wheat bran and psyllium seed.

     Unprocessed wheat bran is an insoluble fiber while psyllium is a soluble fiber. Both are useful and inexpensive additions to our daily food intake. Wheat bran is an old time health food store staple. It remains as useful as ever in combating constipation and its chronic effects: hemorrhoids and diverticulitis. Long called the broom of the intestines, work up to 2 teaspoons before each meal mixed with water or sprinkled directly on food. (Overdoing fiber foods can cause bloating and flatulence so start with 1/2 teaspoon 3 times per day. Incidentally, bran is almost tasteless.)

     Psyllium can be bought in bulk at the health food store. It is described as "blond psyllium husk," "ground psyllium seed," or a similar permutation. Psyllium is the basic ingredient of MetamucilÔ, and is much less expensive. Soluble fiber has several benefits not directly connected with its benefits to elimination. It forms a gel in the intestines which slows down the absorption of food and helps control postprandial elevation of blood sugar levels. In addition, it lowers cholesterol levels by binding with cholesterol-containing acids and carrying them out of the system with the rest of the solid waste. Psyllium has yet another benefit which isn’t discussed in polite company. Ingesting it regularly results in a very clean stool. This can be accomplished with as little as 1/4 teaspoon upon arising and before going to bed. Up to one tablespoon twice a day can be taken for constipation.

     Be sure to drink enough water: 8-10 eight ounce glasses minimum. Otherwise, the additional fiber will create just what you don’t want – a blockage in your intestines. One rule of thumb is to add one cup of water (to what you usually drink) for each two teaspoons of isolated fiber added to your diet. 

There are four herbs specifically recognized for support to the venous system. These are bilberry, gotu kola, horse chestnut seed extract, and butcher’s broom. These herbs can be found alone and in various combinations for proper circulation, the elimination of hemorrhoidal aggravation, and healthy veins in the legs. Gotu kola and bilberry are widely known and have demonstrated a number of additional health benefits. Horse chestnut and butcher’s broom are used solely for their effectiveness in the treatment of vascular problems.