Few men are lucky enough to have a haemorrhoid-free existence. Most will have at least one or two bouts of these uncomfortable little swellings at some point in their life. Of course, women get them too, but medical literature shows that twice the number of men complain of the symptoms.
It used to be thought that haemorrhoids were enlarged or varicose veins, but we now know they are not vascular structures. Rather, they arc part of a prolapsing mucosal cushion.
Just inside the anal ring, everyone has three mucosal cushions. These are highly sensitive and are important in fine tuning continence, as they have receptors that receive signals about initiating bowel actions.
When these cushions become stretched, engorged or prolapsed, a man is said to have haemorrhoids. These cushions may fall out and be trapped outside the body and become strangulated. Alternatively, if the muscles around the anus are stretched because of long-term overstraining, they may be weakened and unable to contract efficiently to retract the haemorrhoids.
One way to overstrain is to loll about on the loo. Men who retreat to the toilet for some respite and then sit there reading may feel relaxed, but they are also allowing a build-up of pressure in the lower abdomen, which can enable blood to collect and the tissue to become engorged.
There used to be a theory that humans were particularly vulnerable to haemorrhoids because they walk on two legs and gravity eventually takes its toll on the lowest regions of their abdomens. This theory was supported by the fact that four-legged animals never get them but was undermined by the fact that people in developing countries and ‘primitive’ societies don’t get them cither. Probably the main reason that people in developing countries are not troubled by haemorrhoids is that they don’t eat a Western diet.
After enjoying universal praise for a considerable period, fibre received some bad press recently when it was reported that it didn’t do as much for bowel health as previously suggested. Thinking on this subject has changed again, however, and it is currently believed that increasing your fibre and fluid intake and avoiding excessive straining can often help avoid them.
Haemorrhoids that persist are usually easy to manage. About 90 per cent of men who seek medical help will be given the standard treatment: a simple ‘low tech’ procedure that involves lying off the haemorrhoid with an elastic band and/or injecting it. This is cheap, effective and quick. In many cases it can be done in a lunch hour.
From time to time new haemorrhoid treatments surface, but none has yet made a significant dent in the popularity of the standard procedure, which works the first time in about 60 per cent of cases and the second time in a further 20 per cent of cases. The remainder may require more complicated treatment. In severe cases haemorrhoids can be surgically removed. Other methods of treatment, such as infra-red coagulation and laser removal, do not provide better outcomes, and freezing is not recommended.
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