Help! Hemorrhoids

peacewillcome...and also for you wavewolf...this is just a thought but if the problem is affecting effective evacuation then any straining to evacuate will escalate the problem further. The best way forward is not to put any pressure on the veins outside and internally.
I can suggest some more natural options for you but it may be worth considering talking with your doctor about using an oral stool softener so that you can evacuate with ease otherwise the problem will not resolve.
I appreciate that this may be a double edged sword especially if evacuating relies on having a firmer stool but if this is the case then you may need to use a mild laxitive also.

So here are some options for you to consider 
For the external hemorrhoids (original forum source)
Apple Cider Vinegar
Apple cider vinegar will help sooth and heal hemorrhoids – the panacea of natural remedies.
Soak a cotton wool ball and dab it to the anal area.

Witch Hazel – The Oldest Remedy
Use witch hazel, Hamamelis virginiana, topically, in the form of a cream, liquid or as a compress. It will help to reduce bleeding and relieve pain, itchiness and swelling.
You can buy pads pre-soaked with witch hazel. Or just apply pure witch hazel and use direct to the area using a cotton ball.
Aloe vera can be added to cool the area, it has a natural antiseptic also. 

Also clean up after a bowel movement using baby wipes as its important this will help prevent infection of your hemorrhoids are bleeding. Sudocrem what is traditionally used for nappy rash is a good option to put on any external bleeding hemorrhoids and it has an antiseptic in its ingredients but the natural options will have also.


To help treat and relieve the internal and external hemorrhoids internally and externally
Drinking plenty of water, eating a good amount of fibre and fruit is always a general advice

Butcher's Broom
The plant butcher's broom (Ruscus aculeatus), which is also known as knee holly, box holly, and sweet broom, gets its name because it was once used by butchers in Europe to clean their chopping blocks. Butcher's broom has a long history of traditional use for hemorrhoids and varicose veins. It is often used when there is underlying poor circulation in the veins.

Butcher's broom has been shown to cause constriction of the veins by activating alpha-adrenergic receptors on smooth muscle cells of the walls of the veins. There is a lack of evidence on the effectiveness of butcher's broom for hemorrhoids. The limited studies, which include a review of 124 cases of patients with hemorrhoids, found that 75% of reporting physicians rated butcher's broom extract as having good or excellent effectiveness in reducing hemorrhoids. Further research is needed.

Butcher's broom is usually recommended in capsule or tea form. The tea, which has a slightly bitter taste, can be made by steeping one teaspoon of the herb in a cup of hot water for 10 to 15 minutes. A natural sweetener such as stevia can be used to sweeten it.
Here is a link which gives advice on this natural remedy and possible interactions so please read but as with all advice please clarify with your doctor before taking: Butchers Broom

additional source

Thank you both for your advice. 

witch hazel caused blistering which was disastorous
my stool is not hard
on the bristol scale it seems perfect
i have zinc ointment with a few other additives and it helps with comfort but no reduction of the swelling
i believe it got started when i was using more manual expression of bowel than suppositories
i use baby wipes for cleaning
and often have to use a suppository or digi stim to get urine flow.
sometimes i can avoid cathing if enough of the bowel moves it can trigger the bladder to empty.
is a suppository better than digi stim?
can hemarroids lead to other problems other than obvious infection?
can these cause bowel fistulas?
Thanks again everyone
nice to know i am not alone

Why do they call it an asteroid when it's outside the hemisphere, but call it a hemorrhoid when it's in your butt?

peacewillcome, since the witch hazel blistered you, maybe the apple cider vinegar would be worth a try? It is also astringent, and inhibits bacterial growth. My PCP was not too worried about infection, even though I have relatively minor but regular bleeding. I don't really get that, and would like to see bleeding stop. I don't feel pain because I don't feel anything there... I asked about fistulas, and she said that would be an unlikely and extreme result. Large and obstructive hemorrhoids can be tied off (not considered a surgery), and then they die and fall off. Ugh, seems I might just feel that!!!! Baby wipes are good for normal cleaning, but the saline seems to be soothing after. The astringent seems to be helping reduce size of hemorrhoids.

This is a common problem for people with SCI and everyone who has the good fortune to age.  I don't suffer from the internal ones, but the external one can bleed like a slasher movie.  During Sandy we had to be evacuated and I was forced out of my familiar bathroom element.  The bleeding was so bad, I scheduled a consult with a colo-rectal surgeon.  My opening statement was hers.  By the time I saw her things had settled down and bleeding had diminished.  She thought it was normal for someone in his 60's, 40 yrs. post SCI.

Here is my two cents worth.  If you have a neurogenic bowel, you will have to strain and the hemorrhoid tissue will become thin, will tear and bleed.  OTOH, you may have extended cramping and you can't stop.  This, too, will cause the tissue to become thin; it will tear and then bleed.  What I found is that daily Activia or other probiotic can ease the entire process.  The probiotic should be supplemented by the minimal dietary fiber you can tolerate. 

This method is only for those with some sensation and have some abdominal muscle to aid in the process.  Plan on extended time in the bathroom, but the straining is minimized.  The cramping will tell you that you aren't finished yet, so you use what muscles you have to gently force the stool to come out.  Once the cramping ends, you are finished.  However, when you transfer back in to your w/c, be prepared for the cramping to resume due to the physical stress on the abdomen caused by the transfer.  If it does resume, transfer back to the john and finish the job.  Usually once is enough, but getting up and down two or three times can occur.

Once the job is done, you will not need to have another bowel movement for two or three days.  This will allow time for the tissue to heal and the hemorrhoid should get smaller.  You can also apply an OTC ointment or whatever works for you.  Check out your seating and positioning with pressure mapping to see where your pressure points are.  Extra gel in your cushion may help to protect the hemorrhoid.  Perhaps this is TMI for most, but if it prevents an unnecessary surgery, it is worth it.

hobo, there's no such thing as TMI when it comes to B&B issues among SCIs!!!! Thanks for details and suggestions, info.