Rectum

Sure, it''''s a dirty job, but some body part has to do it. The chore in question belongs to the rectum--a short, muscular tube at the bottom of the large intestine that gathers feces and stores them. To finish its task, the rectum passes things along to the anus. You know the rest of the story.

But there''''s often an unhappy ending to this short saga. As many as half the people in the United States suffer from piles, or hemorrhoids. "Hemorrhoids are quite common, especially in women who''''ve had multiple pregnancies and deliveries," says Bruce Wolf, M.D., chairman of the public relations committee for the American Society of Colon and Rectal Surgeons.

We all have small veins in the anal area, called the hemorrhoidal plexus. When these veins become abnormally swollen, they cause symptoms such as pain and bleeding.

Some hemorrhoids are external. They can be felt with a finger--and resemble soft swellings around the anal opening.

Internal hemorrhoids, however, if they are small, cannot be felt or seen without instruments, because they are hidden inside the anal canal.

Many people assume that any anal or rectal malady indicates hemorrhoids. But such assumptions can be dangerous. Pain, bleeding and other symptoms may indicate other disorders. It would be wise to get checked by a proctologist or gastroenterologist who can diagnose your problem accurately, says Sidney Wanderman, M.D., co-author of the book Hemorrhoids.

Sitting Easier

Although hemorrhoids can itch and burn when they''''re at their worst, helping ease the discomfort is not too difficult, says Dr. Wanderman.

Get into a soothing sitz-uation. Take a 15-minute sitz bath several times a day, after bowel movements if possible. Just fill the tub with a few inches of hot--but not burning hot--water. Ease in and take a rest. The hot water reduces swelling and eases spasms of anal sphincter muscles. Do not add anything to the bath water, such as bubble bath, Epsom salts, bath oil or soap. These extras can irritate swollen hemorrhoids, says Dr. Wanderman.

Ease onto your knees.The position may not be graceful, but doctors say it helps temporarily relieve the pull of gravity on hemorrhoidal veins. Kneel on the floor, bend forward and rest your left shoulder and the left side of your face on the floor, with your buttocks lifted in the air. Breathe slowly and deeply. Staying in this position for even a few minutes is beneficial. If you can keep the pose for a half-hour or so--while reading or watching television--that''''s even better, says Dr. Wanderman.

Wipe with care. Wiping too hard with toilet paper can irritate hemorrhoids and cause bleeding. Doctors suggest you try using moistened cotton balls. Or rinse with water after a bowel movement and pat dry. Tucks anal pads are also useful.

Soften things up. When a hard, dry stool passes from the body, it may irritate hemorrhoids and cause bleeding. A stool softener (not a laxative) softens the stool by making it absorb more liquid. The stool then becomes easier to pass and creates less friction on hemorrhoids.

Ensure a smooth passage. The basic ingredient in any hemorrhoid medication is a lubricant that lessens friction and irritation. Modern hemorrhoid remedies contain cod-liver oil, vegetable oil, cocoa butter, lanolin, glycerin, petrolatum and, most peculiarly, shark-liver oil. Plain petroleum jelly inserted into the anal canal with a finger is just as effective as any of these, according to doctors. It''''s also cheaper. Be sure to wash your hands thoroughly afterward.

Piles Prevention

Just because so many women have them doesn''''t mean you need to join the group. Here are the top tactics for preventing hemorrhoids that doctors recommend, says Dr. Wanderman.

Bulk up your diet. Add bulk and roughage to your diet by eating raw vegetables and fruits, bran and other whole grains. Bran is especially useful, because it absorbs many times its weight in water, making stools softer and easier to pass.

Refined, processed foods with little fiber content and meats and animal fats do not provide the bulk and roughage that the intestines need to form an easily passed stool, says Dr. Wanderman.

Don''''t allow drought. People on weight-loss diets that call for eight glasses of water a day have often been surprised by the resulting improvement in bowel movements. The water helps soften the stool so it''''s not as much of a strain to pass, notes Dr. Wanderman.

See also Digestive System