British doctors estimate over 40% of their patients suffer from haemorrhoids, or piles, some time in their lives.
Piles are swollen blood vessels in or around the rectum. It is one of the prices of evolution, standing up on 2 legs, rather than on all 4's. Piles occur when blood vessels in the rectum become swollen with blood.
They are most common in middle-aged men and women, and the elderly, or with the extra pressure of a baby during pregnancy and childbirth.
Causes: Mainly persistent constipation, combined with straining when defecating. Occasionally, more severe conditions (e.g. liver complaint), affect the blood circulation in the area of the rectum.
Tales about contracting piles from sitting on cold or damp surfaces, hot radiators, etc. are unfounded, although they can irritate the condition.
Generally, internal or external piles are only occasionally painful, when they become inflamed, itchy and give off a slight blood stained discharge.
Prevention
° Improve your diet and increase intake of fibre and fluids (see 'About Your Diet' supplement); this helps keep faeces soft, preventing constipation
° Try not to strain when defecating (lean forward from the hips to reduce straining)
° Certain drugs can cause constipation (e.g. pain-killers), and so increase the fibre in your diet even further.
° Laxatives should only be used for short periods and as a last resort.
To prevent skin infection improve personal hygiene (keep anal area clean and dry) and wear cotton underwear, it absorbs moisture and lets skin breathe.
HICCUPS
Repeated and involuntary spasms of diaphragm, normally after large meals, hot drinks or large quantities of alcohol.
Hiccups usually automatically stop within 10-20mins. If they persist more than one day, suggesting underlying abnormalities, seek medical advice.
Hiccups are inhibited by carbon dioxide. Simply holding your breath will allow carbon dioxide to build up in the body.
Breathing in and out of a bag is very effective, but do not use a plastic bag as this may obstruct respiration which can be fatal.
HRT
Hormonal Replacement Treatment (HRT), the artificial supplement of oestrogen, administered by tablet, skin patches or implant.
The major advantage to menopausal women is that it reduces risk of osteoporosis (see 'Osteoporosis' section).
Other advantages may include:
° Control of 'hot flushes'
° Improved skin complexion
° Improved hair
° Improved physical well-being
° Improved sex-drive
° Relief from depression
Disadvantages may include:
° Return of periods
° Occasional breast tenderness
° Possible link with breast cancer
Medical evidence suggests the advantages of HRT for menopausal women outweigh the disadvantages.
For other women, HRT offers some protection against cancer of womb and cervix. However, there is thought to be a higher incidence of breast cancer. Therefore, all women using HRT should have their breasts examined every year.
INDIGESTION
A minor discomfort after meals. Symptoms include: Feeling bloated, discomfort in upper abdomen, flatulence, nausea hiccups, heartburn.
Sometimes, symptoms are caused by a serious underlying disease (e.g. duodenal ulcer), and so if the discomfort persists or becomes worse, seek medical advice.
Avoidance:
° Determine which foods cause indigestion (often rich, fatty or highly spiced) and avoid them
° Try to eat regularly, 3-4 times a day
° Eat slowly
° After a large meal, allow 1/2hr for relaxation
Treatment:
° Rest in chair
° Take antacids
° Drink fluids in small amounts - not alcohol.
If you require antacids regularly, see your doctor to investigate the underlying cause of the problem.
To avoid nervous indigestion, reduce your level of stress (see 'Psychological Health' supplement).
INSOMNIA
Nobody knows why we sleep, but physical and mental damage results from sleep deprivation, and the fact all mammals sleep, indicates it has definite purpose.
Most people sleep an average of 7-8hrs/night. It doesn't matter how little, or much, as long as you feel rested and well the next day.
You may think you're an insomniac simply because of a misconception about how much sleep you actually need. Some require less than 4hrs, others more than 10hrs.
Sleep also tends to become more broken over the age of 55. It's perfectly normal to have an occasional night when it is difficult to fall or stay asleep.
Insomnia is when you regularly have difficulty falling asleep, waking at night or too early in the morning. 1:3 adults suffer insomnia at sometime in their life.
Insomniacs often sleep much more than they think, but tend to wake regularly. It is the quality, rather than quantity of sleep that is the problem with insomnia.
Here are the common causes:
° Worrying - the most common
° Erratic hours/lifestyle
° Depression (associated with early waking)
° Unsuitable environment (e.g. noise, travel)
° Upset body clock (e.g. shift-work, jetlag)
Treatment consists of finding and removing the problems that prevent sleep. These may help:
° Seek medical relief for pain or depression
° Try relaxation techniques
° Establish regular routines for going to bed and waking up
° Avoid napping during the day
° Establish regular routine for meals
° Don't go to bed within 3hrs of eating a full meal
° Reduce fluid intake during evening
° Fruit juices and herbal tea are thought to encourage sleep
° Exercise in afternoon (e.g. a stroll in fresh air)
° Don't take stimulants before bedtime (e.g. coffee, tea, cigarettes)
° Get a comfortable bed
° Take a hot bath before retiring
° If you share a double bed, go to bed at the same time as your partner
° Ensure a sleep conducive environment (if necessary, wear ear plugs and eye shade)
° Best bedroom temperature for sleep is 16-18C (60-65F)
The body has a regular 24hr clock (the circadian rhythm) which is synchronised to your sleeping hours. You may be out of phase if, for example, the previous night you stayed awake later than usual. This is why routine is so important, your circadian rhythm needs to be synchronised with sleeping hours.
Sleeping pills can't deal with the causes of insomnia and do not encourage natural sleep. If they are used regularly, the body develops a resistance and sleep becomes more difficult. It is better to avoid them altogether if possible and address the underlying problem that prevents natural sleep.
MALE URINATION
Common disorders of urination are pain, frequency, lack of control and abnormalities of urine.
With mild pain when urinating, take plenty of fluids and rest. If severe (burning sensation), or possibility of a sexually transmitted disease, seek medical advice.
Passing urine that is red or pink indicates bleeding in urinary system. Seek medical advice if the red cannot be attributed to something that you have eaten (some food dyes affect urine), or if the colour or smell of your urine changes.
Dark urine is a symptom of jaundice, blue or green urine is usually caused by medicines. Offensive or fishy smelling urine is often a sign of infection.
MENOPAUSE
A woman's last menstrual phase (more commonly associated with the few years around the last period), occurs between the ages of 40-55. It is caused when the ovaries lose the ability to produce oestrogen.
70% of women experience no symptoms, apart from the end of their periods. However, for some women, physical symptoms may include:
° Night sweats
° Sleeping difficulties
° Hot flashes
° Dry vagina
° Soreness during sexual intercourse
° Vaginal infections
° Palpitations
° Headaches
° Irritability
° Anxiety
° Depression
° Loss of confidence
° Poor memory
° Difficulty making decisions
° Loss of sex drive
If the symptoms are minor, try to be positive.
Menopausal symptoms should only last a few years and it does signify the end of monthly periods - an end to monthly period problems and eventually, no further need for contraception.
Here are a few tips which should make the process easier:
Hot Flushes
Wear layers of clothing (so you can take them off and put them on easily). Wear cotton night-clothes and use cotton sheets (they absorb sweat more easily and allow the skin to breathe, which will keep you cooler).
Keep a deodorant in your handbag or near the bedside. Check in a mirror when you suspect you're having a hot flash, it might not be as noticeable as you think!!
Dry Vagina
Vagina walls naturally become thinner. If intercourse is painful seek medical advice. Avoid tight clothes, stress and extremes of temperature, which can make vaginal infections more likely.
If the symptoms significantly affect your lifestyle, medical treatment is available. This is done by artificially supplementing your levels of oestrogen, administered by tablet, skin patches or implant.
This is known as HRT or Hormonal Replacement Treatment. However, the major use of HRT is to reduce the risk of osteoporosis (see 'HRT' and 'Osteoporosis' sections).
OSTEOPOROSIS
Osteoporosis is where the body's bones become porous, fragile and more prone to fracture.
Although osteoporosis is a natural process, affecting both men and women in later life, statistics show that women after menopause are much more vulnerable (1:4 women initially and 1:2 by 75yrs).
Medical evidence indicates that osteoporosis is caused by the body losing its ability to absorb calcium from food. This may be due to some interaction with a lack of oestrogen when a women experiences menopause.
There is a greater risk if you've been on a long course of cortisone, have a diabetic disorder, or smoke or drink heavily.
In the view of many doctors, HRT can be used to prevent osteoporosis (see 'HRT' section). Medical opinion is, however, divided because of possible long-term side effects.
In the USA, where the Federal Drug Administration has approved oestrogen's to prevent osteoporosis, the number of recorded fractures has been reduced by 50%.
Natural ways to prevent osteoporosis are based on increasing the amount of calcium in diet, preferably before menopause.
Calcium is contained in cheese, milk (skimmed milk contains as much calcium as whole milk), oily fish, broccoli, spinach, green beans, wholemeal bread.
Other preventive measures include not smoking and regular exercise.
PENIS
Pain felt at the tip of the penis during urination. This could be a number of disorders which may be associated with other parts of the body.
It is important to avoid sexual intercourse and seek medical advice immediately. Any lump, swelling or open sore on the penis may be a symptom of disease, even if it causes no pain. Seek medical advice.
PERIODS
Many women suffer pain or discomfort during menstruation, often a dragging or cramping sensation in the lower abdomen.
Other common problems include irregularity, emotional upset, puffiness, migraine, pain, heavy discharge and bleeding after menopause.
Painful periods are more a fact of life than a sign of ill health. If, however, you feel pain, seek medical advice.
Periods normally start between the ages of 11-14 (but CAN vary between 9-17) and finish permanently during middle age (menopause).
If they haven't started by 14, consult your doctor for reassurance. An absent period may indicate pregnancy, but can also be attributed to illness, stress or strenuous activity. It rarely implies an underlying disorder.
Pre-menstrual Syndrome (PMS or PMT), covers a wide range of physical and emotional symptoms during the week before a menstrual period.
90% of women at some time suffer PMS, which although troublesome, is harmless. It's caused by natural changes in the balance of hormones, which leads to a build-up of salt and fluids in the body. Symptoms may include:
The best solution is to explain your condition to close family and friends and adjust your routine to avoid extra stress.
Sometimes, taking exercise, eating a balanced diet and reducing salt intake can help. PMS usually disappears after a few years or after pregnancy.
If it becomes intolerable to you and your friends, seek medical advice. Hormone treatment and psychological counselling may be recommended for women with serious PMS.
Irregular periods and blood loss between normal periods may include occasional light spotting or heavier bleeding between periods, especially if accompanied by pain, or if it occurs in older women, may be a sign of serious underlying problem. Seek medical advice.
TESTICLES
Any pain, swellings or deformities of the testicles require immediate medical advice. Seek medical advice if the pain is acute or associated with swelling, or if there is swelling without pain.
Testicular cancer is rapidly increasing, but is one of the easiest to treat, if diagnosed early. It generally occurs after puberty and is most common in young and middle aged men.
The risk of testicular cancer is higher in men who have a history of undescended testicles. It most commonly appears in the form of a firm, painless swelling of one testis.
The cure rate is high. Even a mild injury may result in testicular pain, but there is usually no damage, unless by a direct blow.
Self-examination is covered thoroughly in its own section. However, when looking specifically for signs of cancer, the golden rule is be familiar with your own body and examine yourself every month to look for changes.
WIND
Excess wind or gas in the digestive system can cause an uncomfortable distended feeling in the abdomen and may produce rumbling noises in the intestines.
Passing of wind through mouth or anus to relieve the symptoms, although embarrassing, is rarely a sign of underlying disease.
An 18th century English gentleman was expected to pass wind after eating; this signalled his enjoyment of the meal!
Generally, it's caused by swallowing air (including smoking), or certain foods not being properly broken down by the digestive juices, leaving residual ferments, which produce gas in the intestines.
If you suffer embarrassment with gas, eat food slowly, avoid fizzy drinks and foods which give rise to residual ferments (e.g. beans, onions, cabbage).
