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Good Health and Bad Medicine:
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 Constipation - Part 1

 Constipation - Part 2

 Spastic Constipation



 'gas' And Bloating

 Alkalizers And Acidosis


 Diet - Part 1

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( Originally Published 1940 )

PILES, or hemorrhoids, is a widely prevalent and trouble-some, though usually preventable, disorder. In a small percentage of cases, hemorrhoids are caused by an organic disease such as tumor of the rectum or disease of the liver, or by injuries incident to childbirth. Generally, however, they are caused by improper bowel hygiene, and above all by the cathartic habit.

Constipation, particularly that type known as dyschezia or rectal constipation, in which the stool is retained in the rectum and pelvic colon and becomes hard and dry, is likely to cause hemorrhoids. The pressure of the hard stool in the rectum and the excessive straining that is associated with defecation, produce a congestion of blood in the veins and permits them to become stretched and enlarged and finally infected.

But the most important cause of hemorrhoids is the use, or rather the abuse, of laxatives. Laxatives frequently cause explosive evacuations which bruise the veins of the rectum and anus, making them susceptible to infection and to the development of piles. Cathartic salts and drugs are not the only laxatives capable of producing hemorrhoids. Often hemorrhoids are caused by habitual use of large doses of mineral oil (usually more than one ounce daily), or by the

y scratching of the intestines and rectum by bran and roughage foods.

Contrary to advertising circulars, the symptoms which often accompany hemorrhoids — headaches, weakness, in-digestion and lack of appetite—do not indicate any connection between hemorrhoids and the spinal cord or brain. The headache and other symptoms may be due to the pressure of the stool in the rectum, or to mild intoxication by liquid stools produced by laxatives.

Hemorrhoids may be responsible for the appearance of fresh blood in the stool. One should never assume, however, that the blood is caused by hemorrhoids unless it is so proven by an examination of the rectum. Sometimes the bleeding is caused by a severe infection or by a tumor, and it is very important for every person troubled by rectal bleeding to have a complete medical examination.

The prevention of hemorrhoids is not difficult. Good bowel habits will make defecation easy and prevent accumulation of hard dry stools. It is important to avoid undue straining. But, most important is to avoid habitual use of irritating laxatives; not only Epsom salts and Ex-Lax, but also roughage such as bran and psyllium seeds.

A good routine of personal cleanliness after defecation will also help in preventing irritation of the skin and mucous membrane of the anus. When the tissues are healthy and there is no trouble with the rectum or anus, the use of a fairly soft toilet paper will be sufficient. However, when the tissues are already injured or slightly diseased, or subject to constant strain during defecation, it is desirable to be more scrupulous in cleaning the parts. A piece of cotton or gauze moistened with water should be used after the toilet paper.

When an attack of painful hemorrhoids has occurred, there are several things that can be done to ease the pain until a doctor can be visited. A cloth or gauze dressing may be soaked in witch hazel and laid over the anus. The dressing should be kept wet constantly. If witch hazel is not avail-able, a cold boric acid solution may be used (i teaspoonful of boric acid to i glass of tap water). Burow's Solution is also excellent. One part of the solution should be diluted with about to parts of cold tap water. Even better than compresses is sitting in a basin of cold Burow's or boric acid solution for about half an hour.

A suppository containing tannic acid or benzocaine may be tried. They are best prescribed by a physician since, if improperly used, they may aggravate the condition.

If the pain is not relieved by the cold wet applications, a soothing ointment may be applied. Cold cream is soothing, but if the pain is severe it may be helpful to use an ointment containing an anesthetic such as benzocaine. A useful ointment is:

Benzocaine 1 gram

Lanolin 15 grams

Nupercaine and Butesin Picrate, proprietary preparations containing local anesthetics, may also be found very useful.

If the attacks are frequent or if the hemorrhoids persist and are associated with pain, bleeding or difficult defecation, it is essential to consult a physician so that adequate treatment can be obtained.

Operations for hemorrhoids, if suggested by a physician, should not excite apprehension. In skillful hands there is little discomfort and no danger. The hemorrhoids are either cut out or injected with a special solution. The latter tech-nique is reserved for hemorrhoids confined within the rectum. When the hemorrhoids protrude beyond the anus or arise at the margin of the anus, they must be removed surgically.

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