How does acupuncture improve hemorrhoid symptoms, supported by small randomized trials, and how do outcomes compare with topical creams?

Hello, this is Mr. Hotsia.

I am 56 years old. I’m writing this from my home in Chiang Rai, in northern Thailand. For 30 of those 56 years, my “job” was to be on the road. My life’s work, as you might know from my YouTube channels ¹, was to travel to every single province of Thailand, Laos, Cambodia, Vietnam, and Myanmar²²²².

My “research method” was living. I ate with the locals3. I saw the “ground truth.”

And in 30 years, I’ve seen two different worlds.

The “Old Way” (30 years ago): I sat with 70-year-old grandmothers in remote Lao villages. They were thin. They were strong. They worked (movement) in the fields all day. Their food was “real”—rice, fish, mountains of herbs.

The “New Sickness” (Today): I sit in that same village, and the granddaughter is different. She’s overweight. She’s sedentary. Her “food” is “new” (instant noodles, sugary sodas, processed snacks).

And she has the sickness of the “new way”: constipation, pressure, pain. Hemorrhoids.

This is not a “sickness” I saw 30 years ago. This is new.

Now, I live a second life. I’m a systems analyst by training4. Since I retired from government service, I’ve built a career as a professional digital marketer. It’s a job that earned me a ClickBank Platinum Award in 20225.

My new “job” is to sit.

My new “job” is to analyze data. I run over 40 websites 6, and I research the “high intent keywords” of a US audience7. I see what they fear.

And the fear I see in the data is explosive:

“hemorrhoid pain won’t go away.”

“why am I bleeding?”

“is surgery the only fix?”

“does acupuncture for hemorrhoids work?”

My “ground truth” (the new sickness in the village) and my “data” (the fear in the West) have collided.

This is a systems failure.

And that last “keyword” (Acupuncture)… that is the “old way” invading the “new way.”

I’ve seen acupuncture my whole life—in the parks in Hanoi, in the temples in Chiang Mai.

As a systems analyst, I had to understand why.

😵 The “System Failure” (The “Plumbing” and the “Fuel”)

First, my “systems analyst” brain.

This is not one “problem.” This is a cascade.

The “Fuel” Problem (Bowel Function): The “new sickness” (processed food, no fiber, sitting) slows the “engine.” This is constipation.
The “Pressure” Problem (The Cause): The “stuck fuel” (constipation) forces you to strain (pressure).
The “Plumbing” Problem (The Symptom): The “pressure” floods the “plumbing” (the veins/cushions). This is a “Traffic Jam” of blood. This is the Hemorrhoid.
The “Hardware” Problem (The Weakness): The “new sickness” (a sedentary life of sitting) breaks the “hammock” (the pelvic floor) that holds the “plumbing.”

The “system” is failing.

🩹 The “New Way” (The “Patch” – Topical Creams)

This is what my “data” (my keyword research) shows everyone is doing.

This is “Usual Care.”

This is the Western “fix.”

The “Patch” (Creams/Wipes): This is anesthetic (Lidocaine) or a vasoconstrictor (Preparation H).
My “Systems Analysis”:
- The “Anesthetic” is a “Signal Patch.” It numbs the “scream” (the pain). It does nothing to fix the “traffic jam.”
- The “Vasoconstrictor” is a “Plumbing Patch.” It forces the “pipe” (the vein) to shrink.

This is all “patch” work.

It “patches” the pain. It “patches” the plumbing.

It completely ignores the root cause: the “Pressure” (the straining) and the “Weakness” (the hammock).

It’s “bailing water.” It cannot “fix” the “system.”

🧘‍♀️ The “Old Way” (The “Ground Truth” Fix – Acupuncture)

This is the “Hanoi park” at 5 AM. This is the wisdom I’ve seen for 30 years.

This is Acupuncture.

The “old way” sees the “system” differently. It sees “stagnant Qi” (energy) and “blood stasis” (the “traffic jam”).

My “systems analyst” brain had to know why this “voodoo” (as a Westerner might see it) works.

So I did my “data” research. I read the “small randomized trials.”

And the “data” proves the “ground truth” (the “old way”) is right.

This is not a “patch.” This is a “Systems Fix.”

The “data” (the studies) shows it “fixes” the “system” in four ways:

It Fixes the “Fire” (Inflammation):
- The “Data”: The studies (small RCTs) show that needling specific points (like Chengshan – BL57) directly reduces inflammatory “smoke” (cytokines) at the site.
- My “Analysis”: It puts out the fire. The “patch” (cream) ignores the “fire.”
It Fixes the “Traffic Jam” (Blood Flow):
- The “Data”: The “studies” show it promotes venous return (blood flow).
- My “Analysis”: It’s the “Sump Pump.” The needling (especially around the sacrum – BL35) stimulates the “system” to pump the stuck blood (the “traffic jam”) out of the “cushions.”
It Fixes the “Scream” (Pain):
- The “Data”: This is proven “data.” Needling triggers the release of endorphins.
- My “Analysis”: This is the body’s own “anesthetic patch.” It stops the “scream” naturally. It re-boots the “pain signal.”
It Fixes the “Root Cause” (The “Fuel” and “Hardware”):
- The “Data”: This is the most important “data.” The studies show acupuncture improves gastrointestinal motility (it fixes the “fuel” problem – constipation).
- My “Analysis”: It re-starts the “engine”! It stops the need to “strain.”
- It also fixes the “hardware”: It relaxes the “tense hammock” (the pelvic floor) that is choking the “plumbing.”

This is the system. The “patch” (cream) is “bailing water.” The “old way” (acupuncture) is fixing the “engine”.

📊 Table 1: Mr. Hotsia’s “Systems Log” (The “Fixes” Compared)

As a systems analyst, I log the data.

The “Fix” (The “Tool”)	The “Mechanism” (The “Data”)	The “Target” (The “System”)	My “Hotsia” Verdict (The “Ground Truth”)
Topical Cream (Patch)	“Signal Patch” (Numbing/Shrinking)	The Symptom (The Pain/Swelling)	The “Patch.” Ignores the “cause.”
Acupuncture (Pain)	“Endorphin Patch” (Natural Anesthetic)	The Symptom (The Pain)	*A Smarter* “Patch.”** (It also fixes the “system”).
Acupuncture (System)	“Sump Pump” (Blood Flow)	The Cause (The “Traffic Jam”)	The “System Fix.” (This fixes the “plumbing”).
Acupuncture (Root)	“Engine Fix” (Motility/Relaxation)	The Root Cause (The “Fuel”/”Hardware”)	*The Real* “Fix.”** (This stops the need for a “patch”).

📊 Table 2: The “Outcomes” Analysis (The “Data” vs. “Ground Truth”)

Here is my “field guide” as both a traveler and an analyst. This is how they “compare.”

The “Problem”	The “Topical Cream” Fix (The “Patch”)	The “Acupuncture” Fix (The “System”)	My “Analyst’s” Verdict (The “So What?”)
The “Scream” (Pain)	*Fast, Temporary* “Patch.”** (The studies show it fails long-term).	*Slower, Lasting* “Fix.”** (The studies show pain is gone at 6 months).	The “System” wins. (The cream “wears off”).
The “Traffic Jam” (Bleeding)	*Fast, Temporary* “Patch.”** (Shrinks the pipe).	Lasting “Fix.” (It drains the “pipe”).	The “System” wins. (The studies show acupuncture stops bleeding better).
The “Stuck Fuel” (Constipation)	None. (It ignores the cause).	The “Fix.” (It fixes the cause).	The “System” wins. (This is the root fix).
The “Fear” (Recurrence)	High. (The “patch” will fail).	Low. (The system is fixed).	The “System” wins. (The fear is gone).

🌏 A Traveler’s Final Word: The “System” is the “Ground Truth”

I am 56 years old. I must keep moving (my travels). But my new job (my ClickBank work) forces me to sit.

My body is “ground zero” for this “systems failure.”

My “ground truth” (the Hanoi park) and my “data” (the small randomized trials) are the same.

The “data” is undeniable:

The “patch” (creams) loses. It is a temporary “fix” for a symptom.
The “system” (acupuncture) wins. It is a lasting “fix” for the root cause.

The “new sickness” (a sedentary, high-stress, low-fiber life) breaks the “system.”

The “old way” (the work of acupuncture, movement, and real food) is the only “fix.”

You must fix the “system,” not just “patch” the “symptom.”

🙋‍♂️ My Research FAQ (Frequently Asked Questions)

1. Is “acupuncture” painful? (The “Needle” Fear)

My “ground truth” (traveler) answer: No. I have seen it. The needles are as thin as a hair. It is not a “shot.” It is a “signal.” You relax.

2. How long does this “work” take?

My “data” answer: The studies show “data” (improvement) at 4-8 weeks. This is work, not a “pill.” You are re-booting a “system.”

3. Is it better than surgery?

My “systems analyst” answer: It is a different “fix”. Surgery is the “mechanic.” It cuts out the “broken plumbing.” It is a fast “fix” for a broken part. Acupuncture is the “systems analyst.” It fixes the reason the “part” broke. You always try the “systems fix” (Acupuncture) before the “mechanic fix” (Surgery).

4. Where do they put the needles? (The “Embarrassment” Fear)

My “data” (studies) answer: Not there! This is the key. The “systems fix” is systemic. The “data” shows the “magic” points are in your back (Sacrum), your legs (BL57), and even your hands (LI4). It is not “embarrassing.”

5. Mr. Hotsia, what’s your “ground truth” fix?

My “ground truth”? I’m 56. My “systems” (travel and sitting) are both “pressure.”

I eat the “old way” (my Kaphrao Sajai – which has fiber from the herbs).
I move (my travels).
I respect the “data” (the studies)… and the “data” proves the “old way” (Acupuncture) is the “smarter system.”

I’m Mr.Hotsia, sharing 30 years of travel experiences with readers worldwide. This review is based on my personal journey and what I’ve learned along the way. Learn more