I have been offered an operation to remove a prolapsed hemorrhoid but I am worried it will be painful and leave me incontinent.
Robert Cherry, Bedford.
Dr. Scurr responds: Hemorrhoids, or piles, are swollen veins in the lower part of the rectum or anus.
Risk factors include constipation, straining during bowel movements, pregnancy and lifting heavy objects, as these all increase pressure in the blood vessels, increasing the likelihood of hemorrhoids.
Symptoms include pain, bleeding, itching, and discharge.
Risk factors for hemorrhoids include constipation, straining during bowel movements, pregnancy, and lifting heavy objects, as all of these factors increase pressure in the blood vessels, making hemorrhoids more likely (image of the model).
Small hemorrhoids often get better on their own if the underlying cause is addressed (such as eating more fiber), but in the meantime, you can buy over-the-counter creams to relieve pain and irritation (which contain ingredients like zinc oxide, which protects the battery against stool irritation, for example). Pain relievers, cold compresses, and constipation treatments can also help.
Large hemorrhoids can protrude (or “prolapse”) through the anus: they can shrink, but for chronic hemorrhoids the only effective treatment is removal.
Non-surgical options include banding, in which a tight surgical elastic band is applied around the hemorrhoid, cutting off its blood supply and causing it to shrivel and then fall off (this can take about a week).
Other non-surgical alternatives include infrared light, gentle electrical currents, and injections of a chemical solution: all of these “destroy” stubborn blood vessels, reducing the size of the hemorrhoids.
He has been offered the surgical option, a hemorrhoidectomy, in which the piles are removed under general anesthesia. While I understand your concerns, the operation has been refined over the years: any discomfort should resolve within a week or two.
Surgery carries a risk of damage to the anal sphincter, the ring of muscle that holds the contents of the intestine in place, causing incontinence, but this is rare and should not be a reason to refuse surgery. He says he’s 78 and generally fit, so anesthesia shouldn’t pose much of a risk. I encourage you to continue with the operation.
My partner has been scheduled for another Covid vaccine, this will be the eighth or ninth; has asthma Is another Covid injection necessary?
A. Haywood, Newport, South Wales.
Dr. Scurr responds: I have been asked this often and I fear the problem here is a flaw in public health messaging, which your letter gives me the opportunity to correct. The fact is that there has been too much misguided speculation about Covid boosters and their benefits, which is worrying as Covid is now with us forever. The point with a booster dose, any booster dose, is that it is no guarantee that you will not get sick. I myself, after six injections, contracted Covid in July and the productive cough lasted for weeks.
But without shots, the consequences of infection can be much worse: Research shows that while vaccines may not prevent infection, they do prevent serious illness, hospitalization or death.
And the reason we need a new booster every year is because the virus, SARS-CoV-2, continues to mutate, meaning it can evade immunity it might have gained from previous infections or previous vaccines. Vaccines are updated to protect against emerging strains.
Vaccines, like all medicines, carry a risk of side effects and there is no doubt that a small group of people have suffered as a result of their AstraZeneca Covid injections, as we have seen in reports of their efforts to claim damages. .
There is a rare risk of myocarditis, inflammation of the heart muscle; Most cases have occurred in younger men and have been mild, with full recovery. I have seen one such case, that of a 60-year-old colleague, but I emphasize that this complication is rare and, in my opinion, outweighed by the benefits. I urge your partner to take both hits.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk; include your contact information. Dr. Scurr cannot correspond personally. Always consult your GP if you have any health problems.