GI Care (HMR)™

TCM herbal formula for internal and external hemorrhoids with or without swelling, inflammation, or rectal bleeding — anti-inflammatory; hemostatic; mild laxative; clears damp-heat and toxic-heat from the Intestines; stops bleeding; regulates bowel movements

⚠️ Contraindicated during pregnancy. Contains Dang Gui (Radix Angelicae Sinensis) — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all. Individuals with bleeding hemorrhoids should NOT take aspirin, Motrin/Advil (ibuprofen), or Aleve (naproxen) — these drugs may cause more bleeding.

CLINICAL APPLICATIONS

* Hemorrhoids: internal or external, with or without swelling, inflammation, or bleeding

Background: Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus. They are usually asymptomatic but may cause pain while sitting, itching, and bleeding. Causes include straining during bowel movements, constipation, sitting for long periods of time, and certain diseases such as liver cirrhosis. In Western medicine, hemorrhoids are generally treated only with OTC stool softeners and soothing agents (temporary symptomatic relief), or in severe cases, invasive treatments such as injection sclerotherapy, rubber-band ligation, laser destruction, infrared photocoagulation, and surgical hemorrhoidectomy.

TCM differentiation: Hemorrhoids are characterized by damp-heat and toxic-heat attacking the Intestines, leading to enlarged and protruding tissues in the rectum, constipation, and rectal bleeding. GI Care (HMR) clears damp-heat and toxic-heat, stops bleeding, tonifies blood, and regulates bowel movements simultaneously.

Key herb-level clinical data:

— Huang Qin (Radix Scutellariae / Scutellaria Baicalensis): significant and potent anti-inflammatory — inhibits nitric oxide, COX-2, prostaglandin E2, and proinflammatory cytokines (MAP kinase signaling); clears damp-heat and toxic-heat from Intestines; clinical study — 400 patients with hemorrhoids treated with herbal decoction containing Huai Hua + Dang Gui + Huang Qin + others: 61% significant improvement, 31% moderate improvement, 8% no improvement

— Di Yu / Di Yu Tan (Radix Sanguisorbae / Radix Sanguisorbae Carbonisatum / Sanguisorba / Burnet Root): anti-inflammatory — significantly suppresses production of nitric oxide and prostaglandin from LPS-activated cells and peritoneal macrophages in a dose-dependent manner (NF-κB and AP-1 signaling suppression); hemostatic — reduces bleeding time by 31.9–45.5% when ingested orally; treats GI bleeding and hematochezia; clinical study — Wu Bei Zi + Di Yu formula: 84.3% effectiveness for hemorrhoids

— Huai Hua Tan (Flos Sophorae Carbonisatum / Sophora Flower Charcoal): hemostatic — reduces bleeding time by 31.9–45.5% when ingested orally; stops rectal bleeding; cools blood; 400-patient hemorrhoid study ingredient

— He Zi (Fructus Chebulae / Terminalia Chebula / Chebulic Myrobalan): potent COX and 5-lipoxygenase dual inhibitor (chebulagic acid) — key enzymes in inflammation and carcinogenesis; astringent — reduces inflammation of swollen hemorrhoid tissues

— Wu Bei Zi (Galla Chinensis / Chinese Gall / Gallnut): astringent — reduces inflammation of swollen hemorrhoid tissues; hemostatic; clinical study — Wu Bei Zi + Di Yu formula: 84.3% effectiveness for hemorrhoids

— Lian Qiao (Fructus Forsythiae / Forsythia): anti-inflammatory; analgesic; antipruritic — inhibits substance P-induced itch-scratch response; relieves itching associated with hemorrhoids

— Dang Gui (Radix Angelicae Sinensis / Angelica Sinensis / Dong Quai): anti-inflammatory — approximately 1.1× stronger than acetylsalicylic acid; analgesic — approximately 1.7× stronger than acetylsalicylic acid; mild to moderate laxative — increases intestinal peristalsis and promotes bowel movement; tonifies blood; replenishes blood lost through rectal bleeding; moves blood to treat blood clots around the anus; caution with anticoagulants

— Jin Yin Hua (Flos Lonicerae Japonicae / Honeysuckle Flower): anti-inflammatory — decreases permeability of blood vessels, reduces swelling and inflammation; clears toxic-heat from Intestines

— Xian He Cao (Herba Agrimoniae / Agrimony): hemostatic — stops rectal bleeding; treats GI bleeding and hematochezia; cools blood

— Chun Pi (Cortex Ailanthi / Ailanthus Bark / Tree of Heaven): hemostatic — stops rectal bleeding; treats hematochezia; astringent; clears heat; cools blood

— Pu Gong Ying (Herba Taraxaci / Dandelion): clears damp-heat and toxic-heat from Intestines; anti-inflammatory

— Yu Li Ren (Semen Pruni / Bush Cherry Seed / Prune Seed): mild to moderate laxative — moistens Intestines; increases intestinal peristalsis; promotes bowel movement; relieves constipation

WESTERN THERAPEUTIC ACTIONS

* Anti-inflammatory — Huang Qin (NO↓, COX-2↓, PGE2↓, MAP kinase); Di Yu (NO↓, PGE2↓, NF-κB↓, AP-1↓, dose-dependent); He Zi (COX + 5-LOX dual inhibitor, chebulagic acid); Jin Yin Hua (blood vessel permeability↓); Lian Qiao; Dang Gui (1.1× aspirin)

* Hemostatic — Huai Hua Tan + Di Yu Tan (bleeding time↓ 31.9–45.5%); Chun Pi; Xian He Cao; Wu Bei Zi (84.3% / Wu Bei Zi + Di Yu formula); clinical study: 400 patients, 61% significant improvement (Huai Hua + Dang Gui + Huang Qin formula)

* Analgesic / antipruritic — Dang Gui (1.7× aspirin); Lian Qiao (substance P itch-scratch response↓)

* Mild laxative — Yu Li Ren (intestinal peristalsis↑); Dang Gui (intestinal peristalsis↑)

CHINESE THERAPEUTIC ACTIONS

* Clears damp-heat and toxic-heat from Intestines (Huang Qin, Jin Yin Hua, Lian Qiao, Pu Gong Ying)

* Cools blood; stops rectal bleeding (Huai Hua Tan, Di Yu Tan, Chun Pi, Xian He Cao)

* Astringent — reduces swollen hemorrhoid tissues; repairs intestinal walls (He Zi, Wu Bei Zi)

* Tonifies blood; replenishes blood lost through bleeding; moves blood to treat anal blood clots (Dang Gui)

* Moistens Intestines; relieves constipation; regulates bowel movements (Yu Li Ren, Dang Gui)

DOSAGE

Standard: 4 capsules three times daily on an empty stomach with warm water.

Supplementary formulas: Mild to moderate constipation — combine with Gentle Lax (Deficient). Moderate to severe constipation — combine with Gentle Lax (Excess). Severe and profuse bleeding — combine with Notoginseng 9. Hemorrhoids with extreme weakness and deficiency — use with Imperial Tonic. Blood deficiency — add Schisandra ZZZ. Ulcerative colitis — add GI Care (UC). Irritable bowel syndrome — add GI Harmony. Severe inflammation — combine with Astringent Complex.

Nutrition: Eat foods high in fiber to ensure regular bowel movements — wheat bran, fresh fruits, and nearly all vegetables. A high-fiber diet is one of the most important factors for prevention and treatment of hemorrhoids. Ensure adequate vitamins and minerals for blood clotting and coagulation — especially vitamin B complex, vitamin C, vitamin K, and calcium. Increase water intake. Folk remedy: eat one fresh unpeeled cucumber (ends removed) each morning and evening. Folk remedy: eat 2–3 pieces of ripe banana with wild honey daily for 30–50 days. Avoid fats, animal products, coffee, alcohol, pepper, mustard, and spicy or pungent foods — harder to digest and more likely to irritate the digestive system; alcohol may worsen pain and cause further bleeding. Avoid warm and hot-natured foods that damage qi and yin: heat-producing fruits (mango, durian); stimulants (coffee, alcohol, energy drinks); spicy/pungent/aromatic vegetables (pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, wasabi). Avoid artificial coloring. Minimize meat; avoid processed meats (lunch meats, hot dogs, sausages contain nitrites associated with inflammation).

Tao of Nutrition — Hemorrhoids (Dr. Maoshing Ni and Cathy McNease): Eat sea cucumber, black fungus, water chestnut, buckwheat, tangerines, figs, plums, fish, prunes, guavas, bamboo shoots, mung beans, winter melon, black sesame seeds, persimmons, bananas, squash, cucumbers, taro, tofu, and cooling foods. Avoid stimulating foods, spicy foods, alcohol, smoking, constipation, stress, lack of exercise, and standing or sitting too long.

Lifestyle: Maintain normal and soft bowel movements — straining worsens hemorrhoids. Empty bowels as soon as the urge occurs; bowel movements should take no more than 3–5 minutes; refrain from reading on the toilet. Avoid excessive wiping; use soft and moist toilet paper or baby wipes. Regular walking stimulates peristalsis and promotes normal bowel movements. Soak in a sitz bath with hot water for 20 minutes each night to focus blood circulation in the anal area — helps clear ballooned veins and disperse blood clots. Avoid prolonged sitting or standing — rest face down on a bed during flare-ups. Sit on soft cushions; avoid hard surfaces; when sitting for long periods, leave the seat for 5 minutes each hour or shift buttocks side to side to relieve rectal pressure. Exhale and do not hold breath when straining or lifting heavy objects.

CASE STUDIES

— B.R., 38-year-old female: Acute hemorrhoid after constipation; itching and constant discomfort; first hemorrhoid occurred after childbirth 2 years prior; damp-heat. GI Care (HMR) 3 grams 2x daily. Result after 1 dose: hemorrhoid receded completely, all discomfort, itching, and swelling resolved. Took one more dose 12 hours later to solidify effect. Hemorrhoid did not return.

— A.R., 53-year-old male: Constipation and hemorrhoids; slippery wiry pulse, scalloped tongue with dry center; prolonged sitting after shoulder surgery; Spleen qi deficiency with dampness and slight heat. GI Care (HMR) for 1 week. Result: normal bowel movement restored, no longer suffered from hemorrhoids.

— 65-year-old female: 7–8 year history of constipation and occasional rectal bleeding; last 10 days: increasingly difficult stool passage with severe pain, straining, and bright red rectal bleeding; yellow greasy tongue coat, wiry fine pulse; damp-heat and toxic-heat in Intestines with qi and blood stagnation. GI Care (HMR) for 7 days. Result: complete recovery — normal bowel movement, absence of bleeding, resolution of hemorrhoids.

— A.R., 50-year-old male: Hemorrhoids from sedentary lifestyle; Spleen qi deficiency with poor dietary habits; bowel movements only 2–3x per week; thin wiry pulse, thick sticky yellow tongue coating; Spleen qi deficiency with damp-heat obstruction in lower jiao. GI Care (HMR) for 2 weeks. Result: hemorrhoid greatly reduced in size, discomfort, and itching; minimal effect on bowel movements noted.

— B.K., 85-year-old female: Hemorrhoids with itching and distending pain; irregular pulse, thick turbid tongue coating; Kidney qi deficiency with damp-heat accumulation in lower jiao. GI Care (HMR) + acupuncture + dietary recommendations. Result at 2 days: distending pain relieved, itching reduced.

Related Reading

Also see: GI Care – for acid reflux, gastric ulcer, and H. pylori | GI Care II – for traveler's diarrhea and GI infection | GI Care (UC) – for ulcerative colitis and Crohn's disease | GI Harmony – for irritable bowel syndrome | Notoginseng 9 – for severe and profuse bleeding | Gentle Lax (Excess) – for moderate to severe constipation | Gentle Lax (Deficient) – for mild to moderate constipation | Astringent Complex – for severe inflammation | Digestive Health & GI Support Collection.