DEAR DR. DONOHUE: With almost every bowel movement, I have some blood on the paper. I suppose I have hemorrhoids. I remember how much pain my father had after he had hemorrhoid surgery. Is there any other treatment for them? – F.T.

Hemorrhoids would probably place first on a list of causes for blood on toilet tissue, but they are not the only possibility. You must have an examination to discover the source of this blood.

Yes, there are many alternatives to the routine surgical treatment for hemorrhoids. However, keep in mind that surgery can sometimes be the most appropriate treatment. It is not something people look forward to with pleasure, but it is not unbearable torture either.

Hemorrhoid stapling is a relatively new and minimally painful procedure. The hemorrhoids are tacked back in place with a device that looks a lot like an ordinary paper stapler. It’s a relatively fast and easy solution for hemorrhoids.

Doctors can encircle the base of a hemorrhoid with rubber bands. The rubber bands cut off blood supply to the hemorrhoid, and in five to seven days it shrivels and is sloughed off.

Lasers, radio frequency waves and electric current are other methods of shrinking hemorrhoids. They can also be injected with solutions that cause them to collapse. That’s sclerotherapy.

The choice of procedure depends on the location of the hemorrhoids, how bad they are and the doctor’s skill in one of the above techniques.

You might be able to bypass all these procedures. Keeping the stool soft by eating lots of fiber can lessen the size of hemorrhoids and lessen their bleeding. Fiber holds water in undigested food, keeping it moist and easily moved through the digestive tract. Straining to relieve oneself fills hemorrhoids with blood and stretches them.

DEAR DR. DONOHUE: I work at a job where it is very hot. My work is physical, and I sweat profusely. The skin in my groin area is quite red and tender. How do I go about treating it? – M.P.

The first step is finding out what this redness represents. It might be a fungal infection, and the answer to that would be antifungal creams or ointments.

It might also be intertrigo. It happens when two overlapping skin surfaces rub against each other. Examples are under the breasts and in the groin. In addition to the friction created by rubbing, heat and moisture contribute to the problem. The skin reddens, and fissures appear.

Dryness combats intertrigo. People can use a compress soaked in Burow’s solution as a drying agent. The compress is applied to the skin for 20 minutes several times a day. Burow’s solution – aluminum acetate – is available in drugstores.

Once the redness and rawness resolve, keep the skin dry with daily applications of a drying powder. Your pharmacist can help you pick one out.

DEAR DR. DONOHUE: I have ridges that run the lengths of my fingernails. Is this an indication of a vitamin deficiency or an illness? I feel good, but my nails don’t look good.

Would you answer another question? How long does it take for a fingernail to grow out? Can you take anything to make them grow faster? – P.T.

Nail ridges that run from the base of the nail to its tip are not a sign of any deficiency or illness. They happen with aging. I don’t know why, and I don’t understand the mechanism that causes the ridges to form. They just do.

It takes six months for a fingernail to grow from its base to its tip. Toenails take two or three times as long to grow from the base to the tip. I don’t know anything that makes nails grow faster. In popular lore, gelatin is said to toughen nails and encourage their growth. There is no proof of gelatin’s effectiveness as a nail grower or toughener.

DEAR DR. DONOHUE: I get a physical exam every year. Every year the doctor looks into my eyes with a handheld instrument that has a bright light. I have always wanted to ask him why he does so, but I get self-conscious and don’t. How about you giving me the answer? – M.T.

The instrument is an ophthalmoscope. Every doctor has one. The lenses and the light allow the doctor to see all levels of the eye’s interior, from the very front to the very back.

The doctor gets a good look at the lens in the front part of the eye. He or she can spot any cloudiness of the lens. That is the makings of a cataract.

At the backmost portion of the eye, the doctor inspects the retina. That is the light-sensitive layer of the eye. It transmits images to the brain. It is here that macular degeneration takes place. That problem is the one responsible for dimming many older people’s vision.

The back of the eye is the only place in the body where doctors can clearly see arteries and veins. They can tell if arteries are beginning to harden or if high blood pressure has taken its toll on them. This is also the place where the vision-threatening complications of diabetes take place.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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