What is the effect of pelvic floor exercises on hemorrhoid symptoms, supported by physiotherapy studies, and how do outcomes compare with standard care?
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 Myanmar222.
My “research method” was living. I ate with the locals3. I saw the “ground truth.”
And in 30 years, I’ve seen pressure.
I’ve sat for 18 hours on a “VIP” bus in Vietnam. I’ve ridden a motorbike 4 over bumpy roads for days. I’ve squatted for hours in a market in Laos, sharing a meal.
This is the “ground truth” of pressure on the system.
Now, I live a second life. I’m a systems analyst by training5. Since I retired from government service6, I’ve built a career as a professional digital marketer. It’s a job that earned me a ClickBank Platinum Award in 20227.
My new job is to analyze data. I run over 40 websites 8, and I research the “high intent keywords” of a US audience9. I see what they fear.
And the fear I see in the data is explosive, but hidden:
“hemorrhoid pain won’t go away.”
“why am I bleeding?”
“is surgery the only fix?”
My “ground truth” (the pressure of the “old way”) and my “data” (the fear of the “new way”) have collided.
This is a systems failure.
As a systems analyst, I had to understand why.
😵 The “System Failure” (What is a Hemorrhoid?)
First, my “systems analyst” brain.
This is not a “sickness.” This is a plumbing problem.
- Your “system” has “cushions” (veins) in the “exit pipe” (the rectum).
- These “cushions” are supposed to be there.
- The problem is PRESSURE.
- My “ground truth” (the 18-hour bus ride, the straining from traveler’s constipation, the squatting) proves this.
- This “pressure” floods the “cushions.” The “blood” gets stuck. It can’t get out.
- This is a “Traffic Jam” of blood.
- A “stuck” cushion swells, hurts, bleeds, and falls down (prolapse).
This is not a “sickness.” This is physics.
🩹 The “Standard Fix” (The “Patch”)
This is what my “data” (my keyword research) shows everyone is doing.
This is “Standard Care.”
- The “Patch” (Creams/Wipes): This is anesthetic. It numbs the “scream” (the pain). It does nothing to fix the “traffic jam.”
- The “Fuel Fix” (Stool Softeners/Fiber): This is smart. It fixes the “fuel” (the stool) so you stop straining. This stops the “pressure.”
- The “Mechanic” (Surgery/Banding): This is the technical fix. The “plumbing” is broken? You cut it out.
My “systems analysis” is this:
This is all “patch” work.
It “patches” the pain. It “patches” the fuel. It “patches” the broken part.
None of it “fixes” the system that caused the “traffic jam” in the first place.
🏋️♀️ The “Ground Truth” Fix (The “System” Fix – PFE)
This is the “old way.” This is the work.
This is what the physiotherapy studies (the “data”) prove.
This is Pelvic Floor Exercises (PFE). (Kegels).
My “systems analyst” brain loves this. This is not a “patch.” This is a “Systems Fix.”
The “data” (the physiotherapy studies) shows it “fixes” the “system” in two ways:
- The “Sump Pump” (Venous Return):
- This is the magic. The “traffic jam” is stuck blood.
- The squeezing (the PFE) of the “hammock” (the pelvic floor) physically pumps the stuck blood out of the “cushions.”
- It fixes the “traffic jam.”
- My “ground truth”: When I’m on that 18-hour bus, I have to “clench” and move. This is the same. You are pumping the “stuck” blood home.
- The “Support” (The “Hammock”):
- The other problem is the “cushions” falling down (prolapse).
- Why? The “hammock” (the pelvic floor) is weak. (The “new sickness” of sitting all day breaks the “hammock”).
- The work (PFE) strengthens the “hammock.”
- A strong “hammock” holds the “cushions” up. It fixes the hardware of the “system.”
This is the real “fix.” It fixes the plumbing and the hardware.
📊 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”) |
| Standard (Creams) | “Signal Patch” (Numbing) | The Symptom (The Pain) | The “Patch.” Stops the “scream,” not the “traffic jam.” |
| Standard (Fiber) | “Fuel Fix” (Softening) | The Cause (The Straining) | Step Zero. You must do this. (This is “clean fuel”). |
| PFE (The “Work”) | “Sump Pump” (Pumps blood) | The Cause (The “Traffic Jam”) | The “System Fix.” (This is the real “plumbing” fix). |
| PFE (The “Work”) | “Support” (Strengthens “hammock”) | The Cause (The “Weakness”) | The “Hardware Fix.” (This re-builds the “system”). |
📊 Table 2: The “Traveler’s” vs. “Data” Toolkit (My “Field Guide”)
Here is my “field guide” as both a traveler and an analyst.
| The “Problem” | The “Traveler’s Fix” (The “Old Way”) | The “Analyst’s Fix” (The “Data”) | My “Hotsia” Verdict (The “System Fix”) |
| The “Pain” (Symptom) | A sitz bath (hot water). | Anesthetic Cream. | Both. The “old way” (heat) fixes the blood flow. The “data” (cream) fixes the pain. |
| The “Traffic Jam” (Stuck Blood) | Movement. (My 30 years of walking). | PFE (The “Sump Pump”). | The “Data” wins. The PFE is the specific “work” that fixes the specific “system”. |
| The “Weakness” (Prolapse) | (No “old way” for this). | PFE (The “Hammock”). | The “Data” wins. This is new “work” to fix the “new sickness” (sitting). |
| The “Cause” (Pressure) | Not sitting for 18 hours! | Stool Softeners / Fiber. | Both. Fix the “fuel” (the “data”) and fix the lifestyle (the “ground truth”). |
🌏 A Traveler’s Final Word: The “System” is the “Ground Truth”
I am 56 years old. I’ve seen the “old way” (the work) and I’ve analyzed the “new data” (the studies).
And they are the same.
My “data” (my US keyword research) shows fear and embarrassment.
My “ground truth” (my 30 years of pressure) shows the cause.
The “data” (the physiotherapy studies) is undeniable:
“Standard Care” (the “patch”) fails (vs. “the work”).
The “studies” prove that the “work” (PFE) dramatically reduces bleeding, pain, itching, and prolapse… while the “patch” group (Standard Care) stays the same.
The “new sickness” (a sedentary life, sitting all day) is what breaks the “hammock” (the pelvic floor).
The “old way” (the work) is the only “fix.”
You must fix the “system,” not just “patch” the “symptom.”
🙋♂️ My Research FAQ (Frequently Asked Questions)
1. Is this just Kegels?
My “systems analyst” answer: Yes. But it’s not just “squeezing.” It’s a “program.” It’s squeezing (the “pump”), holding (the “hammock”), and relaxing (the “release”). You must do all three.
2. How long does this “work” take?
My “data” answer: The studies show “data” (improvement) at 6-12 weeks. This is work, not a “pill.” You are re-building a “system.”
3. Is it “too late” if I’m 60?
My “ground truth” (traveler) answer: No. I have seen 70-year-old women work (farming). Your “system” (muscles) wants to “work.” It is never “too late” to start the “work.”
4. What about my travels (Mr. Hotsia)? (The “Pressure”)
My “ground truth” answer: This is my “risk.” The 18-hour bus ride is the enemy. The sitting (as a YouTuber 10and marketer 11) is the enemy. I must do the “work” (PFE) and the “movement” (my travels) to fix the “system.”
5. What’s the #1 thing?
My “systems analyst” answer: Stop the “Pressure.” Fix the “fuel” (eat fiber). Stop straining. Then, start the “work” (PFE) to fix the broken “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 |