Miram Stoppard says anal fissures and other “embarrassing problems” can cause real distress, especially if people are reluctant to seek medical help
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A friend of mine, also in her eighties, has an embarrassing problem that really upsets her.
She had severe rectal pain after going to the toilet properly – so severe she feared she had cancer.
I tried to reassure her that cancer is not often painful, nor is pain specific to a single event, such as going to the site of pain.
What I think is more likely is an anal fissure.
These are tears in the skin of the anal canal and they are common, especially in middle-aged adults, children, and infants.
Acute anal fistula becomes chronic after 12 weeks.
Usually, people are reluctant to talk to a doctor about a complaint about an embarrassing part of the body, so the diagnosis is delayed.
The cause of the fissure is rarely obvious, but it can be due to constipation or diarrhea.
And as Artaza Gilani of University College London and Gillian Tierney of the University of Nottingham say, pain can become part of a vicious cycle – pain… muscle spasms… exacerbation of a fissure… more pain.
So treatment is aimed at relieving muscle spasms and improving blood supply to the tear, thereby reducing pain, breaking the cycle, and healing.
Diet and lifestyle both contribute to the repair of cracks and long-term comfort. It is essential that stools be kept soft, with plenty of roughage, so that they can be passed easily and without straining.
You also need to re-educate the intestines to meet the need for timely bowel movements.
Regular exercise – 150 minutes of moderate-intensity activity per week – keeping a healthy weight, drinking plenty of water, and a well-balanced diet will all help.
Soluble and insoluble fiber are great for constipation, and we know it also reduces the risk of diseases, including heart disease, type 2 diabetes, plus colorectal and cancer. breast.
When you’re increasing your fiber intake, do it gradually so you don’t feel bloated and bloated.
The anesthetic ointment will relieve pain after going to the bathroom, but it can take 30 minutes to work.
If you have pain, take paracetamol and an NSAID but try to avoid codeine as it causes constipation.
Two other treatments promote healing – glyceryl trinitrate (GTN) and topical diltiazem.
They are pain relievers, so will ease the pain. GTN often causes headaches, so you should take paracetamol before applying it.
Wrap cling film around your finger and apply ointment on it to prevent systemic absorption to reduce the risk of headaches.
Diltiazem can also cause headaches, but they’re not serious. It is wise to complete a course of six to eight weeks, even if symptoms are in remission before then.
And never be afraid to share your worries. We all have stories to tell.
https://www.mirror.co.uk/lifestyle/health/people-reluctant-discuss-embarrassing-body-26341870 'People are reluctant to discuss embarrassing body complaints so diagnosis is delayed' - Miriam Stoppard