Wednesday, April 30, 2008

Whats that swelling doc?

I always have these scenarios:

" Doc!! Saya berak berdarah le....."
"Kat bontot saya ada bengkak dan sakit doc"
"Lepas berak darah menitis-nitis doktor!"
"Saya kena buasir..."

A haemorrhoid
(piles) looks like a bulge or swelling of skin.It is a cushion of blood vessels and bowel lining tissue.Haemorrhoid can be internal(bulges into the rectum) or external(bulges around the anus).They can cause itchiness around the anus and they may also bleed or be painful especially when passing a bowel motion.

Haemorrhoid occur more commonly in people over 50 but people of any age can get them.And they are more common in males than females.( So cheer up ladies!)

What do the patient complaint(Sign and symptoms)?

1-Bulge of skin around the anus which may or may not be painful.
2-Itching or irritation around the anus.
3-Blood while or after passing motion. Might be dripping or noted while using a toilet roll.
4-Pain when passing motion.

What causes haemorrhoid?

Commonly due to straining to pass a bowel motion( meneran) which occurs when one is constipated.

Other things that may cause or worsen haemorrhoids are:-
1-Heavy lifting,vigorous work or activity( where your abdominal pressure is constantly increase)
3-Straining at childbirth
4-Being overweight
5-Chronic couhging
6-Severe liver disease
7-Excesive coughing,sneezing or vomiting
8-Cancer of the rectum or pelvis area.

Treatment available:

1-Suppositories or creams which is inserted into the rectum( to treat internal haemorrhoids)
2-Creams applied for external piles( basically anaesthetic cream for pain and itchiness)
3-Injecting haemorrhoid with chemical which shrinks the pile, but this is just a temporary measure.
4-Banding-applying a tight elastic band around the haemorrhoid to shrink the pile.
5-Surgical operation which is called Haemorrhoidectomy.Done under general anaesthesia(GA) and need few days in hospital.

Self Care:
External haemorrhoid often go off within a week but may leave a skin tag hanging outside the anus( not a comfortable feeling).
If you think you have haemorrhoids you should:-
1-try not to strain when passing motion.
2-Slowly and consistently increase high fibre intake( eg cereals,fruits) until your turd softens.
3-Drink between 6-8 glasses of fluids everyday.
4-Regular light exercise eg walking. Avoid exertion like weight lifting.
5-When the pile is swollen you can relieve them by applying a cold compression to help shrink the blood vessels.
6-Wash your anal/perineum arae after passing motion( basuh berak le tu)
7-Use wet wipes if toilet paper irritates.
8-Soak in warm salt bath which might relief pain( you need a tub or jacuzi)

Other causes of rectal bleeding(fresh bleeding)
1- Cancer colon or rectum
2-Ukcerative Cilitis
3-Crohn's disease.

Important to see you doctor if:-
1-Per rectal bleeding(with or after bowel movement) that doesn't clear up in 2 days
2-Recurrent bleeding per rectal
3-Persistent chronic haemorrhoids.


cakapaje said...

Salam Doc,

I had a surgical (no.5) and had to spend several uncomfortable days in the hospital. Oh, the hospital was nice and the nurses beautiful, I'm not complaining about that part one but. But, the pain was quite unbearable at time, especially when I had to soak myself in detol or whatever it was - had nearly a kilo of my backside remove! lol! Just exaggerating there...more like 5! :)

Zawi said...

Salam Doc,
It is good that u blog about something like this. It will make us aware of many ailment that we could avoid or take preventive meaures.
Though we can find it on the net elsewhere, we dont know which may be the common ones that can be regarded as priorities to be taken seriously. Stones are another problems that I think you should highlight.

Kerp (Ph.D) said...

ahh, asshole!

hehe...great info doc. didnt know that excessive coughing can cause hermorrhoid too. can we physically press the buasir thing back in ke doc? this is pretty embarassing i got it once but fortunately it wnet back in without me realising it. what could be the reason for that doc?

Akmal said...

Salaam Doc,
My dad had colorectal cancer, and was operated 2 years ago. If I am not mistaken, this cancer is one of the leading in US and also in Malaysia, right?

Hasrul Halid said...

Doc, some of my friends said that 'hot and spicy' food also contribute for piles. Is it true?

tokasid said...

Salam Shah:

Ouch!! That hurts!
Thats what ppl call: Pain in the ass!

tokasid said...

Pak Zawi:

InsyaALLAH I'll write some common ailments on and off.

tokasid said...


Excessive coughing increases the intra-abdominal pressure.Not only can it cause piles but it can cause hernia too( thats angin pasang or burut) and you don't want that to happen.

Small piles can regress on its own if we can take care of our food and avoid activities that increases abdominal pressure.

tokasid said...

Sorry to hear about your dad.
Apparently colorectal cancer is on the rise(so is other forms of cancer).

How's your dad now?

tokasid said...


Betoi syeh.Kalau dah ada buasir esp internal piles, kalu makan banyak pedaih2 akan contribute.Tapi tidak semestinya.

Daphne Ling said...

Hey Doc,

"7-Excesive coughing,sneezing or vomiting"...

Who would have thought irritating symptoms 'up there' will have problems 'down there'?!?

I read somewhere that soaking in a tub with oatmeal helps with the pain and itch too...Just like some people advise women who get candidiasis to soak in oatmeal to help with the itch...

Dunno if it helps though...=)

Thanks for sharing!

Mat Salo said...

Buasir... mudah mudahan tak kena bende ni Doc. Yang takut sekarang ni colon cancer. Incidence dah mendadak dangdut kebelakangan ini. Dengar tetangga down south is a world leader in this area, betul ke?

Hehee.. Airto Moreira. I like! Bro.. ko tau tak masa kita Pom Pai Boney M datang main kat Stadiun Negara. I wasn't there of course but guess who the percussionist was?

Paulinho Da Costa...

Tak sangka mat tu pun diskangkong. Cari makan.. hehee...

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