Q. Is there an effective natural remedy for hemorrhoids?

A. Hemorrhoids are swollen veins around the anus that can become inflamed, causing itching, rectal bleeding and pain that can sometimes be severe. According to the National Institutes of Health, about 50 percent of the U.S. population above the age of 50 have hemorrhoids. The most common causes are prolonged sitting, constipation and irritants in the diet, including strong spices such as red pepper and mustard, and drinks such as coffee, decaffeinated coffee and alcohol. Stress can cause hemorrhoids, as can pregnancy (due to pressure of the fetus in the abdomen, as well as hormonal changes that cause blood vessels to enlarge; these hemorrhoids usually disappear after delivery).

To prevent hemorrhoids as well as treat them, you should increase the amount of fiber in your diet to relieve constipation (and consequent straining, which increases pressure in the veins surrounding the anus). You can do this by eating plenty of fruits, vegetables and whole grains. If that's not possible, take psyllium seed husks, in any of the forms available in drugstores and health-food stores. Triphala, an herbal mixture from the ayurvedic tradition, is another excellent bowel regulator. You can buy it in capsules in health-food stores. Follow the dosage on the label. Drink lots of water, more than you think you need, and be sure to get regular exercise.

Yet another healthy option is freshly ground flaxseed, a great source of both soluble and insoluble fiber in addition to its omega-3 fatty acids and lignans. Flax helps promote bowel motility as well as softening stool. Try 1 to 2 tablespoons daily with food. If absolutely necessary, you can lessen pressure and straining with bowel movements by taking an over-the-counter stool softener such as docusate sodium (Colace).

A natural, soothing treatment for inflamed hemorrhoids is application of warm compresses several times a day for 10 minutes at a time. Local heat increases blood flow to the area, promoting healing. Use moist cleansing wipes after bowel movements instead of dry toilet paper and also clean the area with witch hazel solution. Over-the-counter medications such as Preparation H won't cure hemorrhoids, but they can soothe the irritation. Aloe vera gel can help, too.

Most hemorrhoids disappear on their own after a few days, but some persist and may become hard, due to clotting of stagnant blood. These may require more invasive treatment. One method is ligation, in which a rubber band is placed around the base of the hemorrhoid. The band cuts off blood circulation and, as a result, the hemorrhoid withers away within days. Another method is sclerotherapy — injection of a chemical solution around the blood vessel to shrink it. A third technique relies on infrared coagulation to destroy the hemorrhoid by burning. And lastly, a surgical procedure known as hemorrhoidectomy is occasionally recommended for extensive or severe hemorrhoids to completely remove them. All of these are last resorts for persistent or severe cases that do not respond to simpler methods.

Green tea for genital warts?

Q. What can you tell me about using green tea extracts to treat genital warts?

A. Genital or venereal warts can occur singly or in clusters of rough, bumpy growths. In women, they typically develop around the anus, vagina and vulva, and sometimes on the cervix. The warts are less common in men, but when they occur, they develop in and around the anus, penis, groin or scrotal areas and can grow inside the urethra.

The warts are caused by infection with human papillomavirus (HPV), of which there are more than 100 types, 30 of which can be transmitted via sexual contact (during oral, vaginal or anal sex with an infected partner and via skin-to-skin contact during any type of sex with someone who is infected). About two-thirds of people who have sexual contact with a partner who has genital warts will develop the warts, usually within three months.

In women, some strains of HPV present an increased risk of both bladder and cervical cancer. (There's now a vaccine, Gardasil, against the types of HPV that can lead to cervical cancer.) In men, HPV can increase the risks of penile and rectal cancer. To detect any precancerous changes, women with genital warts should have vaginal and uterine pap smears every six months. There are no equivalent tests for men, but those who are exposed to HPV or develop genital warts should see their physicians for prompt treatment. Approximately 14 million people in the United States are infected with HPV, and each year an estimated 1 million more cases are diagnosed. In Europe, approximately 15 million people are infected.

In November 2006, the FDA approved an ointment for treatment of genital warts that contains an extract of green tea (Camellia sinensis) as its active ingredient. The product, Polyphenon E ointment, will be available by prescription. In studies prior to FDA approval, nearly 400 men and women with external genital and anal warts applied the ointment three times a day until their warts were gone. (However, new ones can develop as long as you're infected with HPV.) If you want to try the new green tea extract ointment, ask your physician about a prescription. Side effects seen during the studies included redness, itching, burning, pain/discomfort, ulceration, swelling and local hardening of the skin.

Other methods of removing genital warts include cryotherapy (freezing them), laser therapy and the loop electrosurgical excision procedure (LEEP), in which a loop-shaped instrument is passed underneath the wart to cut it out. There are also chemicals to dissolve warts over a period of weeks. None of these treatments completely eliminates an HPV infection, so the warts can always come back. Condoms may offer some protection against HPV, but don't cover all areas of the skin where the virus may lurk. Mind/body methods, such as hypnosis and guided imagery can be very effective in treating cutaneous warts and are worth trying for the genital variety as well.

● Ask Dr. Weil a question at www.drweil.com. Click "Ask Dr. Weil" and then "Ask Your Question." If your question is selected, look for Dr. Weil's response in an upcoming article. "Ask Dr. Weil" does not provide specific medical advice and is not intended as a substitute for the advice provided by your doctor. Always see your physician to discuss specific symptoms and conditions.