Your shoppers are health seekers—they wouldn't come to you if they weren't. But even the healthiest people aren't immune to some of life's little annoyances, or the big ones either. Hemorrhoids and varicose veins can fall into either category, depending on the severity of the condition. And though they're not pretty to think, read or talk about, they're a fact of life.
A March 1999 issue of Primary Care estimated that hemorrhoids occur in 80 percent to 90 percent of the U.S. population, and according to an April 2001 issue of Alternative Medicine Review, the "prevalence of varicose veins is 58 percent for men and 48 percent for women. More than three-quarters of individuals in the United States have hemorrhoids at some point in their lives, and about half of the population over age 50 requires treatment." Thankfully, the naturals industry offers several avenues to help these conditions, so the next time one of your customers comes to you with that familiar cringe of embarrassment, you'll be able to quickly point him or her in the right direction.
Varicose veins and hemorrhoids are of the same family, hemorrhoids being "considered varicose veins in an unfortunate place," according to Brigitte Mars, a Boulder, Colo.-based herbalist with Pharmaca Integrative Pharmacy. This means that their causes and cures can be similar as well.
Both conditions are caused when stress or pressure is placed on veins, and the valves within them cease to function properly. "Veins keep blood flow going in one direction. When they get weak and are not well-toned, the blood can flow backwards and get stuck, causing the area to bulge," says Rosemari Roast, a Connecticut-based herbalist.
The April 2001 issue of Alternative Medicine Review defines a varicose vein as "a vein [that] has permanently lost its valvular efficiency and, as a result of continuous dilation under pressure, in the course of time becomes elongated, tortuous, pouched and thickened," and so the condition of varicose veins is often referred to as venous insufficiency.
According to Mark Blumenthal, an Austin, Texas-based herbalist and executive director of the American Botanical Council, "A hemorrhoid is basically a varicosity or weakness in the venous wall, which allows it to balloon, either slightly or significantly. The therapy for hemorrhoids is thus similar or equal to the therapies for varicose veins or venous insufficiency."
Hemorrhoids are also swollen veins, occurring specifically in the anal area. According to the American Gastroenterology Association, "One set of veins is inside the rectum (internal), and another is under the skin around the anus (external). When the veins stretch, they may even fall down (prolapse) through the anus to outside the body (protruding hemorrhoids). When this happens, the vein may become irritated and painful."
Americans are placing pressure on their veins every day without realizing it. Simply standing for long periods of time puts stress on the venous valves in the lower half of the body and can, over time, cause venous insufficiency. Other causes include inactivity, sitting cross-legged, being overweight and, in the case of hemorrhoids, straining during a bowel movement, not eating enough fiber and being pregnant. The symptoms of varicose veins and hemorrhoids can range from being simply irritating and embarrassing to being downright painful and debilitating. Furthermore, venous insufficiency can often indicate a more serious problem. In the case of hemorrhoids, that could mean colon or rectal cancer. "If you have one of these conditions, it's good to look at it as an early warning sign that you might want to change some of your lifelong habits. Pay attention to how you're eating, sitting and eliminating because if you don't, the body is going to speak louder to get your attention, in the form of more serious conditions like diverticulitis or colon polyps," says Mars.
Besides certain preventive measures, which, according to Mars include elevating the legs when possible, wiggling your toes when standing, eating more fiber and staying active to increase circulation to all areas of the body, there are several supplements on the market that can help with venous insufficiency.
According to an October 1999 study published in Clinical Drug Investigation, the herb butcher's broom (Ruscus aculeatus), an evergreen shrub native to Mediterranean Europe and Africa, can be used to improve symptoms of venous insufficiency such as itching, ankle swelling and tension in the leg.
Besides masking symptoms of venous insufficiency, however, astringent herbs like horse chestnut seed extract (Aesculus hippocastanum), yarrow (Achillea millefolium) and stoneroot (Collinsonia canadensis) are effective in treating the condition because they assist in strengthening and tightening the veins. According to Blumenthal, "Europeans have used horse chestnut seed extract for chronic venous insufficiency, lower varicosis and symptoms associated with varicose veins such as swollen legs (edema), pain and heaviness in the legs, and calf pain since the late 16th century."
Roast agrees that horse chestnut seed extract is effective in toning the blood vessels and recommends taking it in tincture form at a dosage of 20 to 30 drops with water at mealtimes, three times daily.
Roast also suggests taking yarrow, a perennial herb native to Europe, in a tincture combined with prickly ash bark (Xanthoxylum Americanum). "The astringent qualities of the yarrow will increase circulation and help veins get stronger, while the prickly ash bark is a gentle stimulant that will help the nervous system encourage the astringent herbs to flow to lower parts of the body and the extremities, so they can go directly to where you need them most," says Roast.
Flavonoids, which aid in strengthening capillaries, are another important ingredient for sturdy, healthy veins. Mars suggests eating foods high in flavonoids, like dark-green leafy vegetables, cabbage, garlic, onions, blueberries and cherries. Collinsonia (stoneroot) is high in flavonoids and contains astringent properties that strengthen the veins. "It can be taken internally or applied topically with wipe pads that also contain soothing herbs and witch hazel extract," says Mars. She warns against heavily massaging areas with weak veins, however, since this could make the problem worse. Instead she recommends "gently wiping the solution onto an area when topically applying a remedy." Mars also suggests drinking three cups of nettle tea (Urtica dioica) daily, since nettles are "known to improve circulation, build blood and facilitate the elimination of toxins."
Now that you know the ins and outs of venous insufficiency and its relatives, it's time to help your shoppers rid themselves of these conditions. Because discussing things like hemorrhoids and varicose veins can be awkward for some customers, it's important to make asking about treatment options as painless as possible. "Try to read your customers to get a sense of what would help them relax. Sometimes humor is effective in lightening the mood, and other times being straightforward and talking about things in a clinical, medical way is best," says Roast. She recommends that staff take a physiology class because "understanding medical terms will make using them easier when you're put on the spot in the supplements aisle."
It's likely that customers will be asking you about vein-related problems. Mars contends that she fields such inquiries several times a week. And Roast says it is important to "let your customers know they're not alone. Whatever problem they're facing is not unique to them." In the case of hemorrhoids and varicose veins, she's right?they're a fact of life, a fact that will lead shoppers directly into your supplements aisle.
Christine Spehar is a freelance writer in Boulder, Colo.
Natural Foods Merchandiser volume XXVII/number 3/p. 122-123