| Martin Faber |
Mannheim, Germany (dpa) – Reading may make you smart, but it’s not a smart thing to do in the bathroom, a German expert on haemorrhoids is saying.
According to Alexander Herold, a colonproctologist and spokesman for the Rectum and Colon Centre in the German city of Mannheim, it’s not the reading per se that’s bad; rather, it’s the extended time sitting on a lavatory bowl.
This, he is pointing out, puts strain on the pelvic floor and promotes haemorrhoids.
“You should only stay on the toilet when you really have to,” he added.
Felt by many people to be too embarrassing to talk about, haemorrhoids, also known as piles, are abnormally enlarged, ring-shaped vascular cushions behind the anal sphincter muscles in the anal canal.
“Everyone has these cushions,” Herold said. “They seal off the rectum and prevent stool residue from leaking out and irritating the sensitive skin of the anal region. If pressure is put on their veins for an extended period, the blood can’t drain, the veins become enlarged, and the cushions’ delicate connective tissue becomes stretched.”
This allows mucus to leak from the lower rectum, causing the skin around the anus to itch, burn and bleed.
A common ailment, haemorrhoids are thought to affect nearly one in three people over 30 years of age, and one in two over 50, since the tissues that support the veins in the rectum and anus tend to weaken and stretch with age.
Other causes include congenital weakness of the rectal connective tissue, overstraining during bowel movements and constipation due to a low-fibre diet.
Left untreated, haemorrhoids become larger over time. Doctors distinguish between four stages. In the first, the enlarged vascular cushions aren’t visible and produce only a few symptoms, for example bleeding or skin irritation.
“In the second stage, they protrude through the anus during bowel movements but then retract on their own,” said Bernhard Lenhard of the German Dermatological Society.
In the third stage, they can protrude through the anus even during heavy physical exertion and extensive walking. “Then they no longer retract on their own, so the patient has to push them back in,” Lenhard said. In the fourth stage, they cannot be pushed back in by the patient.
Haemorrhoids oughtn’t be neglected so long, however.
At the latest, people should see a proctologist – a specialist for the anus, rectum and lower colon – when blood appears in their stool – “if for no other reason than to rule out serious illnesses in time,” Lenhard said. “Intestinal cancer, for example, has very similar symptoms.”
Although many patients are fearful of an examination, “it’s generally painless because haemorrhoids are covered by bowel mucosa that lacks pain nerve fibres,” he explained. The doctor first carefully probes the rectum with a gloved, lubricated finger.
“Any nodular growths or constrictions can be felt this way, and the pressure and tension of the sphincter muscles can be checked,” said Bernhard Strittmatter, chairman of the German Association of Colon Proctologists.
“The soft tissue of the haemorrhoids normally can’t be probed digitally, though.”
For this reason, a proctoscope – a small metal tube with a light at the tip enabling the doctor to see inside the rectum – is inserted into the anal canal.
“When there’s bleeding that can’t be explained by what’s seen in the rectum, then the area behind it, and if necessary the entire colon, should be examined as a precaution,” Strittmatter said.