Many of us over the past year have spent hours sitting at a desk engrossed in work and may even forget to drink adequate amounts of water or even walk occasionally. We may be thinking about back and neck pain as well as other lifestyle diseases BUT this new pattern may be an invitation to a guest you would hardly have considered; haemorrhoids.

Depending on who you listen to or consult, haemorrhoids aka piles aka “kooko” may be found in every part of the body and not even our eyes will be spared. My “comrades” especially the bus-inspired “health and motivational speakers” are extremely convincing in that regard but kindly disabuse your minds from now. If it is not in the anal/rectal area then it CAN’T possibly be haemorrhoids aka kooko and that is FINAL!!

We all have haemorrhoids. Yes we do and not just one but two; an internal set and an external one. And they are found ONLY in the anal/rectal region. At all times these haemorrhoids which are a group of blood vessels remain “quiet” no bleeding, not visible. Just minding their own business, which includes probably helping to maintain the integrity of the anal sphincter. In simple words haemorrhoids help to prevent one soiling himself especially when you ply the slippery slope of determining if it’s liquid or gas that is attempting to escape.

Kooko is common. By age 50 most people would have had at least one challenge that makes the often quiet haemorrhoids enlarge and begin to show where power lies.

WHAT PLACES US AT RISK OF DEVELOPING KOOKO
1. Genetic factors; some families have a weakness in the structure of these strategically positioned .blood vessels
2. Increased venous pressure from various causes. Anything that causes pressure in the abdomen to increase
3. Rectal tumors & causes for incomplete evacuation of stool
So to expand on the above; some factors we can easily associate with
• Straining, constipation and chronic diarrhoea
• Pregnancy
• Obesity
• Prolonged sitting especially on the potty since you unconsciously strain
• Heavy lifting
• High socioeconomic status; maybe too much refined food?
• Other family members have it
• Rectal surgery/colon cancer
• Anal intercourse

HOW MAY HAEMORRHOIDS aka KOOKO SHOW OF
• Painless bleeding from the anus
o Bright red blood splashes in toilet bowl and also on toilet paper when you clean up.
• Anal itch
• Anal pain or burning sensation
• Discomfort in the anus when sitting: causing people to perch right at the tips of their seats
• Swelling in the anus
ANY COMPLICATIONS?
• Anaemia from chronic bleeding leading to tiredness, headaches etc.
• Strangulation or clot formation both of which lead to pain
• Infection that also leads to pain and can spread through the blood stream
• Gangrene
• Prolapse; a swelling that comes out through the anus when you strain. May return on its own but as worsens it no longer “returns” even if you tried to push it back
A PRESCRIPTION WORTH TRYING
• Watch what you eat – fibre/roughage is king
o Treat your gut right; more whole fruits and vegetables, less refined foods such as white bread and white perfumed rice.
• Increase water intake
o This softens stools and reduces constipation as well
o Please the caffeinated (coffee, tea etc.) drinks cause dehydration and so do not assume they are replacing your daily water intake. Get more water!
• Exercise ; hmmmm it’s a love-hate relationship here
o Exercise makes your body healthy and easy to move your bowels but those that require you to strain e.g. as you work out with weights increase pressure within the haemorrhoids making it rear its ugly head
• Careful with laxatives but may need stool softeners
• Don’t find the urge, go if you have to go
o Please I am not advocating for open defaecation. Find a convenient spot and go.
o Don’t be like those who claim their butt knows only their “pot” at home.
• Avoid straining for long periods
o If it ain’t coming maybe it’s not time and don’t assume you have to go everyday like some others do
o If you have a library in your toilet where you spend hours on end reading, sleeping, chatting on the phone etc. then friend it’s time to close that library. As you sit for long periods you unconsciously strain and you know what that means.
• Get positioning right if that is what it takes
o So the open air-brigade as they position themselves with knees towards chest tend to have the large intestine with rectum and anus in the perfect alignment to be assisted by gravity to download your “goods”. If you have a challenge while seated on your comfortable pot, you could still sit on the potty and have your feet on a stool or books (did I really type books?) or get one of the fancy gadgets so you can mimic the position nature intended it to be.
WHEN PAIN/DISCOMFORT STRIKES & STRIKES BAD!
• Wrap ice-packs in gauze and place on affected area
• Sitz baths; the steam from the water gives a soothing effect
• Be wise in your choice of what you sit on
• Use of suppositories/soothing creams
• Take a painkiller
• GET PROFESSIONAL HELP!!!!
I paraphrase a quote I heard some time back but can’t remember its source “IF YOU TREAT YOUR GUT RIGHT, YOUR BUTT WILL LOVE YOU FOR IT”
Finally except for menstrual flow (even that can be abnormal sometimes) every bleed from any part of the body is abnormal, so get checked even if you are so certain you are dealing with kooko.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd/Mobissel/St. Andrews Clinic
(www.healthessentialsgh.com)

*Dr. Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy, fitness nutrition and corrective exercise.
Thought for the week – “17th May was World Hypertension Day and the theme for this year is; MEASURE YOUR BLOOD PRESSURE ACCURATELY, CONTROL IT, LIVE LONGER.”
Assistance from:
1. Professor Jonathan Laryea. Colorectal Surgeon, USA
2. Dr. Dakubo, Sugeon. Korle Bu Teaching Hospital