TCM for Hemorrhoids: Damp-Heat and Sinking Qi

1. The TCM View of Hemorrhoids

Hemorrhoids — swollen and inflamed veins in the rectum and anus — are understood in TCM as a condition where damp-heat has accumulated in the lower body and intestines, combined with Spleen Qi that has sunk and can no longer hold tissues in their proper position. To understand why these two patterns develop, it helps to look at how TCM views the digestive system as a whole. For foundational knowledge, see our gut health guide.

The Large Intestine is the organ most directly involved. Its partner organ is the Lung, and together they belong to the Metal element. The Large Intestine's job is to absorb water and eliminate waste. When heat and damp accumulate in the Large Intestine — from a diet high in spicy, fried, and greasy foods, from alcohol, or from chronic constipation that traps waste and heat — the tissues become inflamed and swollen. This is the damp-heat pattern, and it accounts for most acute, painful hemorrhoids.

The Spleen Qi sinking pattern is more chronic and constitutional. The Spleen has a lifting and holding function — it holds the organs in their proper position and keeps the blood within the vessels. When Spleen Qi is chronically weak (from poor diet, overwork, or worry), the lifting function fails and tissues begin to sink or prolapse. This is why hemorrhoids often coexist with other signs of sinking: fatigue, a feeling of heaviness in the lower abdomen, and in severe cases, organ prolapse.

2. The Two Primary Patterns

Most people with hemorrhoids have elements of both patterns, but one usually dominates. The table below helps you distinguish them.

Damp-Heat Pattern (Most Common)

The damp-heat pattern is what most people experience during a flare-up. The hemorrhoids are swollen, red, and painful, with a burning sensation. Bleeding is common — bright red blood may appear on toilet paper or in the stool. The person may also experience constipation (dry, hard stools that aggravate the hemorrhoids), a bitter taste in the mouth, dark urine, and a red tongue with a yellow, greasy coating. This pattern is acute and driven by heat.

The heat comes from three main sources: diet (spicy foods, fried foods, lamb, excessive alcohol), constipation (when waste sits in the Large Intestine too long, it ferments and generates heat), and emotional stress (which causes Liver Qi stagnation that can transform into heat and affect the intestines). For more on the diet-digestion connection, see our foods for digestion guide.

Spleen Qi Sinking Pattern

The sinking pattern is more chronic. The hemorrhoids may be less painful but are prolapsed — they protrude and may need to be pushed back. There is a feeling of heaviness or bearing-down in the lower abdomen and rectum. The person is fatigued, has a pale complexion, may have a low voice and shortness of breath, and feels worse after standing for long periods or at the end of the day. The tongue is pale with a thin white coating, and the pulse is weak. This pattern develops over months or years of Spleen weakness. For a comprehensive guide, see our Spleen health guide.

3. Acupressure for Hemorrhoids

Three acupressure points are most useful for hemorrhoids. Each addresses a different aspect of the condition: clearing lower-body heat, lifting sinking Qi, and strengthening the Spleen.

• BL57 (Chengshan) — located on the back of the calf, in the center of the muscle belly, about midway between the back of the knee and the ankle. This is the most important point for treating hemorrhoids because it clears heat and damp from the lower body and directly reduces swelling and pain in the rectal area. Press firmly for 2-3 minutes, twice daily, on both legs. When pressed, you may feel a deep, aching sensation that radiates downward — this is normal and indicates the point is active.
• GV20 (Baihui) — located at the crown of the head, on the midline, at the highest point when the ears are folded forward. This is the highest point on the governing vessel and has a powerful lifting function. It is the primary point for treating Spleen Qi sinking and prolapse. By lifting Qi upward, it counteracts the downward sinking that causes hemorrhoid prolapse. Press gently with the fingertip for 2-3 minutes, twice daily. You can also tap the point lightly 50-100 times.
• ST36 (Zusanli) — located four finger-widths below the kneecap, one finger-width lateral to the shinbone. This strengthens Spleen Qi and supports the body's lifting function. It is essential for both patterns — for damp-heat it helps the Spleen transport and resolve damp, and for sinking Qi it tonifies the Spleen's lifting capacity. Press firmly for 2-3 minutes, twice daily, on both legs. See our ST36 guide.

4. Food Therapy for Hemorrhoids

Diet is the most important factor in both treating and preventing hemorrhoids. The right foods clear heat, resolve damp, strengthen the Spleen, and prevent the constipation that worsens hemorrhoids. The wrong foods — especially spicy, fried, and alcoholic — are the primary cause of flare-ups.

For Damp-Heat Pattern (Cooling and Draining)

• Mung beans — the premier food for clearing heat and damp from the lower body. Mung bean soup should be a daily staple during flare-ups. See our mung bean guide.
• Celery — cooling and damp-draining. Eat steamed or in soups.
• Lotus root — cools blood and stops bleeding. Ideal for bleeding hemorrhoids. See our cooling foods guide.
• Watermelon — clears heat and promotes urination (drains damp). Eat in moderation in summer.
• Coix seed (Yi Yi Ren) — drains damp-heat and strengthens the Spleen. Cook as porridge.
• Spinach — cooling, moistening, and promotes bowel movements.

For Spleen Qi Sinking Pattern (Tonifying and Lifting)

• Chinese yam (Shan Yao) — tonifies Spleen Qi and stabilizes the intestines.
• Jujube dates (Da Zao) — tonify Spleen Qi and nourish blood. Add to congee or tea.
• Lotus seeds (Lian Zi) — strengthen Spleen and astringe (help hold tissues in place).
• Rice congee — the most Spleen-strengthening and easily digested food. See our congee recipes.
• Pumpkin and sweet potato — strengthen Spleen Qi.

To Prevent Constipation (Moistening)

• Sesame seeds (black and white) — moisten the intestines and prevent dry stools. Take 1-2 tablespoons daily.
• Honey — moistens the intestines. Stir into warm water on an empty stomach each morning.
• Pear — moistens Lung Yin and intestines. Eat steamed.
• Warm water — drink throughout the day. Cold water worsens Spleen weakness; warm water supports digestion and softens stools.

5. Lifestyle Habits to Prevent Recurrence

Beyond diet and acupressure, several lifestyle habits are essential for preventing hemorrhoid recurrence.

• Do not strain on the toilet. Straining increases pressure on rectal veins. If a bowel movement does not come within 3-5 minutes, get up and try later. Never force it.
• Do not sit on the toilet for extended periods. Reading or using your phone on the toilet prolongs pressure on the rectal area. Limit toilet time to 5 minutes.
• Use a squatting position or footstool. Elevating your feet on a small stool while on the toilet aligns the rectum for easier passage and reduces straining.
• Do Kegel exercises. Gentle pelvic floor exercises strengthen the muscles that support the rectal area. See our pelvic floor guide.
• Avoid prolonged sitting or standing. Both increase pressure in the rectal veins. If you sit at a desk, stand up and walk every 30 minutes. If you stand for work, sit and rest periodically.
• Warm sitz baths. Soaking the rectal area in warm water for 10-15 minutes, 2-3 times daily, reduces swelling and pain during flare-ups. Add a handful of salt or a few slices of ginger to the water.
• Manage stress. Chronic stress causes Liver Qi stagnation, which can transform into heat and affect the intestines. Practice qigong, meditation, or breathing exercises. See our qigong for stress guide.

Frequently Asked Questions

How does TCM view hemorrhoids?

TCM views hemorrhoids as primarily caused by two patterns: damp-heat accumulating in the lower body and intestines (causing swelling, pain, and bleeding) and Spleen Qi sinking (causing prolapse and a feeling of heaviness). Damp-heat can come from a diet high in spicy, fried, greasy foods and alcohol, or from chronic constipation that traps heat in the intestines. Spleen Qi sinking occurs when chronic Spleen weakness causes the body's lifting function to fail, allowing tissues to prolapse. Most cases involve both patterns to varying degrees. For foundational understanding, see our gut health guide.

Which acupressure points help with hemorrhoids?

The most helpful acupressure points for hemorrhoids are BL57 (Chengshan) on the back of the calf — this clears heat from the lower body and reduces swelling and pain in the rectal area; GV20 (Baihui) at the crown of the head — this has a strong lifting function that counteracts Spleen Qi sinking and prolapse; and ST36 (Zusanli) below the knee — this strengthens Spleen Qi and supports the lifting function. For bleeding hemorrhoids, add LI4 (Hegu) between the thumb and index finger to clear heat from the Large Intestine. Press each point for 2-3 minutes, twice daily. See our ST36 guide.

What foods help hemorrhoids in TCM?

For damp-heat hemorrhoids, eat cooling, damp-draining foods: mung beans, celery, watermelon, coix seed (yi yi ren), lotus root (especially for bleeding), and spinach. For Spleen Qi sinking, eat lifting and tonifying foods: Chinese yam, jujube dates, lotus seeds, and rice congee. To prevent constipation that worsens hemorrhoids, eat moistening foods: sesame seeds, honey, pear, and warm water. In all cases, strictly avoid spicy foods (chili, pepper, curry), fried and greasy foods, alcohol, and excessive lamb — these generate heat and worsen hemorrhoids. Drink warm water throughout the day.

Why do hemorrhoids bleed in TCM?

In TCM, bleeding hemorrhoids are caused by heat in the blood (Xue Re). When damp-heat has accumulated in the intestines for a long time, the heat enters the blood vessels and forces blood to move recklessly outside its proper pathways — this is called heat forcing blood to move recklessly (re xing wang xing). The blood is typically bright red and may appear before or during bowel movements. Treatment focuses on clearing heat from the blood using cooling foods like mung beans, lotus root, and celery, and strictly avoiding all heating foods (spicy, fried, alcohol). If bleeding is heavy, dark, or persistent, seek medical attention to rule out other causes.