All you ever wanted to know about ...

Piles are distended veins in our bottoms - a part of our bodies we are brought up to think of as dirty and rude. The symptoms are equally unglamorous - an itchy bottom, bleeding after passing a stool, slime (mucous) or faeces leaking on to underwear and discomfort on opening the bowels (which may make you dread going to the toilet).

It can be excruciating to ask for pile preparations in a crowded chemist's, or to explain all to a GP. We know examination will include having to take off pants, lying on a couch with knees bent and having a finger and instruments inserted into the back passage. We assume treatment will be painful and possibly humiliating. No wonder the majority of us ignore bleeding from the back passage when it first occurs and that we delay an average 13 weeks between seeing blood and seeing a doctor.

We shouldn't really be so embarrassed; nearly half of all adults in the UK have piles. It may be a first for you, but the doctor you see will regard it as totally routine.

Some people prefer the Greek word "haemorrhoids". They are the same thing, though arguably the Greek sounds posher.

It's a shame to suffer, though, when there is a range of treatments to suit every case. Start with suppositories and creams or ointments to soothe inflamed piles (eg Anusol preparations).

If you are still suffering, you can be referred by your GP for injection of a chemical that makes the veins shrivel up. This can be done as an outpatient and causes minimal disruption.

For more severe or recurrent piles, you may want to have banding - a technique that puts a tight rubber band round the base of the pile. This is usually a day case.

For the really persistent cases, you can have an operation to remove the pile using a laser or knife (haemorrhoidectomy). A newish technique to staple the wound closed results in far less pain and bleeding after the operation.

As for avoiding piles altogether, follow these three tips, from a famous pile surgeon, for a "happy, healthy, bottom":

·Don't let your stool get hard - keep fibre and fluid levels up.

·Don't strain on the loo - use a glycerine suppository available over the counter, if necessary.

·And don't sit on the loo for more than four minutes at a time. It will not do your bottom any good.

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