The medical detective:Privy to a haemorrhoidal habit

Mr W.G., a 28-year-old chef with a penchant for pickled chillies, came to see me complaining of an intermittent dull ache in his lower back and coccyx (tail bone). The pain, which had begun three years ago, seemed to extend up inside him, in front of the lumbar (lower back) spine. To describe it, with difficulty, he said: “I feel as though I am literally sitting on my pain. It seems to become worse on rising after I have sat down for a while.” He also mentioned that sitting on the toilet provided some pain relief – and allowed him to catch up on his reading, too.

My first thought was that this was a case of coccydynia (tail-bone pain), a common-enough osteopathic symptom. However, on examination, Mr W.G. showed no abnormal physical signs in his sacrococcygeal joint (where the pelvis meets the tailbone). Instead, I found two sizeable, thrombosed haemorrhoids lying between the anus and rectum that were sensitive to the touch.

I then recalled a study that had found that reading on the toilet can give you haemorrhoids (Lancet, 1989; i: 54). Researchers at the John Radcliffe Hospital in Oxford had compared the habits of 100 people suffering from haemorrhoids with 100 unaffected individuals, and found that a much larger proportion of the group suffering from piles habitually read while on the loo. Of course, it’s not the reading per se that’s bad for you – it’s that the extended periods of sitting on the lavatory causes undue pressure on your bottom, said the experts from Oxford.

So don’t leave your copy of What Doctors Don’t Tell You anywhere near your toilet.

Varicose veins and haemorrhoids are considered to be forms of chronic venous insufficiency. However, studies have shown that haemorrhoids are not only a matter of venous congestion, but have connections with the arteries, too.

I prescribed a thoroughly reliable ointment that is specially made up by a homoeopathic pharmacy. In Mr W.G.’s case, it was applied both internally via a flexible tube, and externally straight from the container. The ointment comprises Paeonia officinalis 1DH 12 g; Sedum acre 1DH 0.56 g; Ratanhia 1DH 0.56 g; Aesculus hippocastanum 1DH 0.56 g; and Vaseline q.s.p. 100 g. It can also be made up in suppository form.

Mr W.G. was also asked to stop eating pickled chillies, which I suspected were aggravating his condition. Foods to which an individual is sensitive are frequently a significant contributory factor in the development of piles.

At the same time, I put him on a course of three types of flavonoids, which have a long history of reliably treating haemorrhoids, as well as varicose veins and ulcers. The flavonoids are rutin (Am J Ophthalmol, 1948; 31: 671-8), hesperidin (Del State Med J, 1959; January: 19-22) and the anthocyanosides, of which a rich source are bilberries (Minerva Med, 1977; 68: 3565-81).

Mr W.G. himself took the initiative to enjoy warm Sitz baths on a daily basis.

After 10 days, his haemorrhoids had partially shrunk and the pain in his lower back, to his delight, had completely vanished.

Harald Gaier is a registered naturopath, osteopath, homoeopath and herbalist based at The Health Equation, 11 Harley Street, London W1G 9PF; tel: 020 7612 9800/07917 662 042.

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