Dr. Natasha Campbell-McBride discusses hemorrhoids through the connection between gut flora, the liver and blood draining from the digestive tract. In Gut and Physiology Syndrome, she presents coffee enemas as an immediate-relief measure and the GAPS Nutritional Protocol as the long-term approach.[1]
The food advice needs a little care to understand. Her hemorrhoid FAQ warns that fiber can be damaging, while her constipation chapter recommends Full GAPS first for people who already depend on large amounts of fiber to pass stool. Those passages address different situations. Keeping them together helps you avoid turning one short answer into a rule for every meal.[1][2]
What the GAPS Book Says About Hemorrhoids
The portal system is the network of veins that carries blood from the digestive organs toward the liver. Campbell-McBride’s explanation is that a heavy flow of toxins from an unhealthy gut overloads the liver, slows its processing of that blood and raises pressure in the portal veins. She says that pressure can be high even when a general blood-pressure reading is normal.[1]
She describes veins bulging into the rectal wall beneath its mucous membrane, the moist tissue lining that area. In her account, stretching and damage to the covering can lead to ulceration, bleeding and obstruction. Her discussion connects those local symptoms with the wider gut-and-liver work of GAPS.[1]
That is the book’s explanation, not a way to diagnose the cause of your own bleeding or assess your liver from symptoms. Rectal bleeding needs medical assessment: hemorrhoids are not the only possible cause. If passing stool has become difficult, describe that clearly when arranging the assessment too.[3]
The Gut and Liver Connection
Campbell-McBride separates short-term relief from the longer work of changing gut flora and healing the gut. Her stated aim is to reduce the flow of toxins arriving at the liver so it can process portal blood without the backup she describes. The official hemorrhoid FAQ repeats that same reasoning.[1][2]
Constipation has a place in this discussion, but it is not interchangeable with hemorrhoids. The bowel chapter describes several contributors to difficult stool formation, including microbial balance, bile flow, dairy response, the kind of meat being eaten and fluids. Its discussion of bile explains that poorly digested fat can combine with alkaline salts into a sticky, soap-like material that contributes to constipation.[1]
The book also describes fecal compaction with overflow: loose stool can pass around retained hard material, sometimes with leakage or a feeling of incomplete emptying. Passing something loose does not, by itself, settle whether the bowel has emptied. The compaction and overflow guide explains that separate source account; it is not something to diagnose from one stool description.[1]
For the fuller food-and-stool discussion, read Constipation on GAPS or the bowel-management overview. They keep those different patterns together without treating every bowel symptom as the same problem.
Fiber and Active Hemorrhoids
In the official FAQ, a reader eight weeks into Intro asked about painful internal and external hemorrhoids that seemed to be partly obstructing bowel movements. Campbell-McBride answered that fiber can be damaging in hemorrhoids and named coffee enemas for short-term relief and the GAPS Diet for the longer term.[2]
That answer does not give a daily fiber target or a separate list banning every raw vegetable, nut and seed. It also does not say that every constipated person should remove more fiber. The existing constipation history matters, especially if passing stool already depends on large amounts of it. Keep that history beside the hemorrhoid question rather than following a blanket “more fiber” or “no fiber” rule.
Food form matters as well. Soft vegetables cooked in stock and a large raw salad are different meals. Note what you actually ate, its preparation and the bowel response. The dairy and fiber comparison helps you read those food distinctions alongside the relevant GAPS stage.
Relief and the Longer GAPS Approach
The 2020 book calls a coffee enema its immediate-relief remedy for hemorrhoids. It describes symptoms reducing or disappearing afterward and sometimes returning a few days later. Campbell-McBride presents that as temporary relief within a broader protocol, not as a promise that one procedure permanently resolves the problem.[1]
In the same passage, she emphasizes preliminary bowel clearing before coffee and describes homemade sour cream as a lubricant and a local application. Those are treatment recommendations in the book, not instructions to copy from a food recipe. My coffee-enema guide brings the author’s recommendation, reported outcomes and exclusions together without a DIY rectal procedure.
For the longer term, her hemorrhoid chapter directs readers back to the GAPS Nutritional Protocol and its gut-flora work. A temporary change after any remedy does not identify the cause of bleeding or replace an examination. Keep the symptom question and the food plan as related parts of the discussion, rather than assuming one answers the other.[1][3]
Coffee Enemas and the Book’s Limits
The hemorrhoid paragraph needs to be read with the exclusions in Bowel Management. That chapter says the coffee-enema mechanism is unclear, then proposes effects through the rectal capillaries and portal circulation and describes changes reported by the author’s patients. Those reports and her proposed explanation are different kinds of information.[1]
- Hyperactive thyroid function, particularly Graves disease: the book says to avoid coffee in any form, including coffee enemas.
- High blood pressure, transient ischemic attacks, anaphylactic coffee allergy and other life-threatening situations: the author identifies these as further concerns and says to seek medical advice if in doubt.
- Children: coffee enemas are generally not recommended. The book separately discusses possible use from age 14 for particular symptoms. That age statement is not a general invitation to copy an adult treatment into a child’s plan.
- Diarrhea with blood and mucus: the general enema exclusion applies before choosing an enema type. The book names ulcerative colitis, Crohn’s disease and other inflammatory bowel conditions. It says enemas may be considered only after enough healing has occurred, describing about a year on the diet rather than automatic clearance at a date.[1]
The author discusses use when needed rather than a fixed four-times-daily Gerson schedule for everyone on GAPS. Keep the actual reason, age and health history attached to the recommendation. The enema reading guide explains the shared bowel limits, and the coffee guide above covers that specific recommendation.[1]
When Symptoms Need a Closer Look
The official GAPS FAQ has a separate answer about anal fistulas. It begins with an abscess, a pocket of infection in the rectal wall that has opened near the anus. The answer connects some abscesses and fistulas with ulcerated, infected skin over enlarged hemorrhoids and returns to the same gut-flora and portal-pressure explanation.[2]
In that account, Campbell-McBride describes coffee enemas for the pressure and local applications of homemade kefir and sour cream for the skin. These are distinct rectal or skin applications, not simply advice to eat fermented dairy. The description is not a way to identify an abscess or fistula yourself, and this article does not provide insertion or application instructions.
Bring the actual symptoms to an assessment: where it hurts, whether there is swelling or bleeding, whether stool is difficult to pass and how long this has been happening. You do not need to decide on a portal-pressure explanation before asking what is causing the symptoms. The practical distinction is knowing what you have observed and what has actually been diagnosed.[3]
Full GAPS or Intro With Constipation?
The bowel chapter is specific about people with chronic constipation who already rely on large amounts of fiber to pass stool. Campbell-McBride recommends starting with Full GAPS and its fibrous vegetables and greens for that group. She says low-fiber Intro can make that situation worse. Intro can be considered later, once constipation has resolved, when the person is ready and if it is needed.[1]
This is different from constipation that starts after food changes during Intro, and different again from the hemorrhoid-specific FAQ about fiber. If both hemorrhoids and longstanding fiber dependence are present, bring both facts into the food review. Neither passage supplies one universal fiber amount that resolves the overlap.
The Intro-versus-Full comparison shows what changes on the plate, while the GAPS food list helps you check the actual foods and forms. Start with a meal you can prepare and eat in the approach being considered, rather than removing more foods without a replacement.
Food Choices at a Glance
These food distinctions come from the constipation passages. They are not a separate hemorrhoid cure menu, and they do not introduce a food before its GAPS stage or before it is tolerated.[1][2]
| Food or Question | The Source Distinction |
|---|---|
| Dairy form | For some people, high-protein whey, yogurt, kefir or cheese aggravates constipation. The book discusses replacing high-protein dairy with homemade cultured sour cream. It describes ghee and butter as almost pure fat; that description does not apply to sour cream. |
| Meat texture | For those whose constipation worsens with muscle fibers, especially lean meat, the chapter favors gelatinous soft tissues: joints, skin, marrow, tongue and feet. |
| Animal fats | The book describes increasing fats gradually according to digestion and discusses ox bile when fat digestion is difficult. A larger amount is not automatically the next step for everyone. |
| Fluids | More water helps in some cases in the author’s account. She also discusses homemade kvass as a drink supplying fluid, microbes and enzymes. |
| GAPS shakes | The chapter connects gradually introduced shakes of fresh juice, raw protein and fat with its bile-flow discussion. Its constipation FAQ places that milkshake first thing in the morning, about 20–30 minutes before breakfast. A shake has its own preparation and introduction context; it is not a hemorrhoid-specific prescription. |
| Fiber | The hemorrhoid FAQ’s caution and the Full-first advice for chronic fiber dependence need their own contexts. Neither becomes a universal food ban. |
For example, a meal review can name the soft cooked vegetables, the meat’s texture, the cooking fat and the amount actually eaten. That is more useful than recording only “soup.” Keep the preparation and stage with each food. The dairy guide explains dairy forms, and the juicing guide covers the separate GAPS shake discussion.
Constipation has been part of my family’s GAPS experience too. More meat stock liquids and Smidge probiotics helped in our house while we followed the diet. That is our experience with constipation, not a claim that we have used a hemorrhoid treatment.
Supplements and Daily Habits
The wider constipation chapter includes more than food swaps. It discusses magnesium chelates separately from occasional magnesium oxide, warning that regular magnesium oxide can irritate the gut. It also names spirulina, blue-green algae, chlorella and dunaliella as laxative supplements, with manufacturer guidance for amounts. Those are the source’s constipation measures, not a list of products every reader with hemorrhoids needs.[1]
The same chapter describes an evening enema, bath and external abdominal-oil routine for persistent constipation. It separately discusses external castor oil and occasional internal castor oil, which are different uses. Its toilet-position guidance uses foot support or leaning forward to bring the body closer to squatting. The complete constipation guide keeps these measures and their separate purposes together.[1]
The FAQ also connects constipation with microbial balance and the intestinal nervous system. It describes an overactive sympathetic response and a suppressed parasympathetic response, then discusses raw juices, animal fat and gelatinous meats in that context. In ordinary terms, this is the part of the book that also asks you to make bathroom time comfortable and less focused on straining. It does not say that a person is constipated because they failed to relax.[1][2]
If dairy is not tolerated, the FAQ does not make it compulsory. Its answer returns to gut flora and those other food choices. Keep the foods you can actually use in the plan instead of treating sour cream as the only option. The probiotics guide explains food and supplement roles without turning a brand into a requirement.
Frequently Asked Questions
Does GAPS Say to Avoid All Fiber?
No single fiber rule covers every passage here. The hemorrhoid FAQ says fiber can be damaging, while the bowel chapter directs a chronically constipated, fiber-dependent person toward Full GAPS first. Keep the symptom and starting history with the instruction instead of extending one answer to everyone.[1][2]
What Does the Book Say About Repeating Coffee Enemas?
It describes use when needed and reports that hemorrhoids may fill again after temporary relief. It does not give one fixed schedule for every reader. The age, bowel, thyroid, blood-pressure and allergy conditions above remain part of the discussion.[1]
What About Flax Seeds for Constipation?
In the official FAQ, Campbell-McBride does not recommend flax seeds, particularly early in the program. She describes their water-absorbing, gel-forming quality but also their fiber and other antinutrients. That answer should not be rewritten as a general hemorrhoid remedy.[2]
Does a Normal Blood-Pressure Reading Settle the Question?
No. The book distinguishes general blood pressure from the portal pressure in its explanation. A normal reading does not establish what is causing rectal bleeding, and the explanation is not a home test for liver disease. Have the bleeding assessed rather than using the reading to choose a remedy.[1][3]
For your next food-planning step, begin with the constipation guide if that is part of your situation. My Constipation-Friendly GAPS Kitchen course is listed in the WFLI Shop for readers looking for more help with the food side. Keep any assessment findings and treatment instructions alongside the meal plan.
References
- Campbell-McBride N. Gut and Physiology Syndrome. 2020. “A–Z: Haemorrhoids”; “Bowel Management,” constipation, fecal compaction, general enema exclusion and adult coffee-enema discussion.
- Campbell-McBride N. GAPS Frequently Asked Questions. “Diseases and Symptoms,” questions 25, 39 and 80; “Constipation,” questions 2–5.
- National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Hemorrhoids. “When Should I Seek a Doctor’s Help?” Accessed October 19, 2026.
Leave a comment