Hemorrhoid treatments are many
DEAR DR. DONOHUE: What kind of doctor removes hemorrhoids? Mine are very irritating. Can they be removed in ways other than surgery? — D.E.
ANSWER: Regular surgeons and proctologists remove hemorrhoids. Proctologists are specialist surgeons who deal with the surgical treatment of the colon, rectum and anus. Many family doctors treat hemorrhoids. Surgery isn’t the only treatment.
You can get an accurate picture of hemorrhoids by thinking of them as being similar to the varicose veins of the legs. They’re not veins; they’re cushions of tissues that contain small arteries and veins, but the varicose vein comparison isn’t far from the mark.
Hemorrhoids that lie close to the anal opening are “external” hemorrhoids. They have a rich nerve supply, so they can be most painful and often are itchy.
Hemorrhoids farther up the rectum are “internal” hemorrhoids. They can become so enlarged that they protrude through the anus. Clots in both kinds of hemorrhoids make them painful.
One simple measure is soaking in a tub of warm water in such a way that the water bathes the anal opening; it’s called a sitz bath, and it can shrink hemorrhoids. The knees are bent upward so that only the hips, buttocks and feet are submerged in the water. Soak for 15 minutes at a stretch. It takes several baths for this treatment to work. Fiber or stool softeners prevent stool from hardening. Hard stools require straining to evacuate, and that enlarges hemorrhoids. Doctors have many methods for treating them. Rubber bands can be slipped on the base of a hemorrhoid with a special instrument. Deprived of their blood supply, the hemorrhoids shrink and are sloughed off. Infrared photo (light) coagulates hemorrhoids, another simple procedure for getting rid of them. Stapling can be accomplished relatively easy. It sounds painful, but it’s not. The choice of treatment depends on the hemorrhoids’ location and other considerations. I have not mentioned all possible procedures.
DEAR DR. DONOHUE: Several months ago, my doctor referred me to a specialist because my blood counts were dropping. The hematologist did more bloodwork and a bone marrow biopsy, and said everything looked good. His report states there is pancytopenia. Can you explain a bit more for me? The definition I found on the Internet scared me, because it said it’s related to HIV. I have never been sexually active, being a celibate priest. I have given blood plasma. Could infection have been passed that way? — P.D.
ANSWER: You can stop worrying. You don’t have HIV, and your condition isn’t at all affecting your health or your life span.
Pancytopenia is a decrease in the number of all blood cells — red, white and platelets, the blood-clotting cells. Its significance depends on how low the counts are. You’ve had a marrow biopsy. The marrow is the place where blood cells are made. Nothing bad was found there. That eliminates most bad causes of pancytopenia. Your count must not be very low, or you’d have symptoms. You don’t. Furthermore, the hematologist assured you all was well. You’re doing fine. Worry isn’t warranted.
DEAR DR. DONOHUE: I just had a flu shot. How long does it take after the shot before am I protected against infection? — D.J.
ANSWER: The shot rouses the immune system to make antibodies, the body’s bullets against infecting germs. Antibody production peaks approximately two weeks after the shot.
Protection from the shot lasts for at least six months.
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. Readers may also order health newsletters from www.rbmamall.com.