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Haemorrhoid

He is only six but he has got a Haemorrhoid.

Question

My six-year old son has a haemorrhoid, which is only visible after he goes to the loo. Because our GP could not see it, nothing has been done. My son doesn't complain of pain or itchiness but I’m worried that it might get worse and don't understand why he has this problem. He eats lots of fruit and vegetables and drinks plenty of fluids. Please can you advise me?

Answer

Haemorrhoids (also known as piles) are a common problem, affecting up to half of all people at some time in their lives, through they are relatively rare in children. Haemorrhoids are basically swollen veins, similar to varicose veins in the legs. They may be external (around the anus) or internal (inside the rectum).

Sometimes internal haemorrhoids grow so large that they push out of the anal sphincter: these are called prolapsing haemorrhoids. I think this is probably what you are describing. If they are exposed to the air in this way, the mucus around them dries up and the salt that is in all body fluids crystallizes. These salt crystals can irritate the nerve endings on the surface of the haemorrhoids, causing itchiness. If the mucus gets totally dehydrated, the itchiness progresses to being painful. In some cases, the pain may become almost unbearable and the sufferer may also experience bleeding especially when passing stools.

Other symptoms include a discharge of mucus from the anus and a feeling that the bowels have not been emptied properly.

The most usual cause of piles is constipation. When a person strains to eliminate the stool mass, the pressure in the veins around the anus increases, causing the walls of the veins to blow up like balloons and form piles. The more one pushes- the more pressure is created and the more the walls swell up.

I know your son eats fruits and vegetables and drinks a lot of fluids, but some people have a tendency to constipation irrespective of their diet. Treating a six-year-old with dietary measures is not easy, but if you explain that this will help, children are usually very good.

Here are my suggestions, these measures will help at all ages:

    Diet

  • Eat spinach soup and cooked spinach (use frozen if fresh isn't available) every day; this helps to soften the stools.
  • Also at half a small ripe papaya every day for a month; the enzyme papain, which it contains, is a tenderiser and also softens the stools.
  • Don't eat pizza or any other yeast foods, such as Marmite, ready-made sauces, bread, buns and cakes - except as a treat once a month. The yeast produces gas and very time you try to pass it, the haemorrhoids will get worse.
  • Avoid fizzy drinks of all kinds, which also produce gas.
  • Avoid fried foods such as chips and crisps because they have excess salt in them, which can cause irritation. Many prepared foods, including canned products and fast food, contain excess salt - even sweet ones such as chocolate pudding. So avoid all these. Aim for a diet of fresh seasonal foods, organic if possible.
  • Supplements

  • Take lsabgol psyllium husks. For children, mix one tablespoonful (two tablespoonfuls for adults) in a mug of warm organic milk with honey (preferably manuka) to taste. This will form a jelly-like mixture, which should be drunk at bedtime to help keep the stools soft and make the bowel movements easier.
  • Take Hamdroid or Pilex : two a day washed down with water after main meals; if a child cant swallow them whole, crush them in a little water. They will help shrink the piles and relieve constipation.
  • Take time on the loo

  • Drinking a large glass of warm water, slowly, in the morning is good, and rubbing the tummy clockwise before spending as much time as it takes on the lavatory - rushing is very bad. Children could take a comic with them; adults often like to take a book.
  • Use wet tissues

  • Rather than dry paper, after going to the lavatory. Ask your son to push the haemorrhoid inside the rectum again with a wet tissue, so that it remains moist and doesn’t hurt. He can apply a lubricant such as Vaseline, if that helps.
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