The term asshole may sound stupid. Nevertheless, we can’t live without it. Much to the contrary, as stupid as it may be, it is also highly emotional. Yes, an asshole has feelings. When you neglect it, it gets angry and infuriated. It literally swells with soreness, turns red and hot, displaying all the signs and symptoms of inflammation. Not just that, it bursts with blood splashing all over your toilet bowl when it finally throws its tantrum. Hemorrhoid is the name of an angry asshole.
Hemorrhoids or piles are dilated bags of blood vessels of our so called anal cushion. Anal cushion is a layer of soft spongy padding around the anus. It has a very important function of saving us from embarrassment of leaking pungent gas or foul-smelling liquid stool at the wrong time or wrong place, for example during a dinner, a meeting or in the car with other passengers.
The bag of blood vessels together with its overlying layer of rectal wall forms a sponge-like pad of anal cushion that closes our anus snugly. These blood vessels will dilate and thin out when they are repeatedly congested or engorged. Those on the surface of the rectal wall that are subjected to the force of gravity and the repeated downward shearing force of stool during defecation may even force the bag of weakened and enlarged blood vessels to bulge. The bulging bags of enlarged blood vessels droop downwards as they enlarge, often appearing outside our anus. In more advanced cases, they may appear as few pouting reddish lips of spongy tissue with visible engorged blood vessels under their surface.
Around 50 percent of us will have had experienced an angry asshole by the time we reached 50. At any point of time, wherever we are, 5 percent of the people around us are having it. This disease is a pretty common disease. What makes our asshole angry? How can we keep it cool?
If you take a closer look at our so-called ‘modern lifestyle’ and the predisposing factors of hemorrhoids, you will realise that both of them are indeed a perfect match. The trappings of a modern lifestyle are all there: low-fiber foods from fast food outlets, a sedentary lifestyle with prolonged sitting; being bogged down with never ending tasks and targets so much so that one habitually procrastinates one’s call of nature; sitting longer on the toilet bowl while keeping busy with a digital gadget in one’s hand and straining to pass a stool when the impulse to do so has long dissipated with procrastination. They are indeed a fertile ground for the development of hemorrhoids.
Our asshole is naturally designed by the process of slow evolution that makes small changes over a long period of time. As what I have featured in my previous column, the accelerated quick change of our lifestyle in the last 50 years is not conducive for a natural design that is still largely ‘ancient’. Thus, it is not surprising to see more angry assholes among us in this modern era.
If you already have an angry asshole, do consult your family doctor to confirm the diagnosis, rule out other sinister causes such as cancer and to manage the disease. He may treat you with some medications, ligate the bleeding hemorrhoid, remove the painful clots underneath or if the hemorrhoids are really bad, he may refer you to a general surgeon to remove it.
For those not having hemorrhoids, prevention is better than cure. We ought to give our asshole enough attention and care, to keep it cool. How can we do it?
Eating high-fiber foods such as fruits and vegetables softens our stool and increases its bulk, which helps in initiating defecation and avoiding the need to strain to pass stool. Drinking plenty of water especially in this hot country also helps to keep our stool soft. At least six to eight glasses of water is recommended for each day. If nature’s call appears while you are at work, answer to it first. Do NOT procrastinate. If you wait till you finish your work, the urge will soon go away and your stool could become drier and harder to pass. Between nature’s call and the work that you are attending to, give priority to nature’s call before your asshole gets angry.
If you procrastinate and the urge goes away, soon you may not feel the need to go to the toilet. Mind you, your colon will continue to absorb water from stool non-stop, 24 hours a day. It will be another 24 hour of water extraction from the stool if your nature’s call comes only once a day. Surely the stool would be much harder, less slimy and more difficult to pass. Straining to pass stool may become necessary. Surely, your asshole is not going to keep cool.
The ‘magic pill’ of exercise helps in many ways. Do you realise that people who are bedridden often get constipated? Our guts tends to move when our body moves, Staying active helps prevent constipation and reduce pressure on the blood vessels which can occur during long periods of sitting. Sitting too long, particularly on the toilet, can increase the pressure on the blood vessels in the anus. Exercise also can also help us lose excess weight – bearing in mind that being overweight also contributes to the development of hemorrhoids.
Finally, the most important of all is not to strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the bag of blood vessels of our anal cushion. We must learn the gentle art of defecation, to harmonise and sail smoothly with the wave of the impulse when passing stool.
My next column will be on ‘More trees, better health.’
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skill in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977