Carter's "Injury"
Treating those hemorrhoids
When the White House forthrightly announced that Jimmy Carter was insevere pain from a bad case of hemorrhoids and that surgery was beingconsidered, inevitably there were some jokes. It is not an ailment anindividual elects to advertise unless, like Carter, he must in order tocancel a day's schedule without giving the stock market a heart attack.There was also a great deal of sympathy, tacit and expressed. Wrote oneEgyptian: "May Allah cure you. This illness should have been inflictedon an unjust leader rather than you, O Carter."
Hemorrhoids, or piles, are one of civilization's oldest medicalcomplaints. They afflict perhaps half of all adult Americans. Onefamous sufferer was supposedly Napoleon, who is said to have had suchexcruciating pain at Waterloo he could not sleep or sit on his horse.Carter's "physical injury," as he described it, was less debilitating.It only cost him, besides that one day's appointments, his dailyjogging and a quail hunt.
Hemorrhoids are a swelling of veins in the rectum and anal canal. Thesevessels can become so distended that they protrude, rupture and bleed.If piles develop near sensitive nerve endings, they can be extremelypainful. No one is quite sure just what starts the swelling, butheredity seems to play an important role. Says Dr. Norman Nigro, chiefof colon and rectal surgery at Detroit's Wayne State University:"Hemorrhoids run in families. People inherit veins that are apt tobecome dilated." Habit may also be a factor, including the "bathroom aslibrary" syndrome. Explains Los Angeles Proctologist Michael Freilich:"We were not meant to sit on toilets, we were meant to squat in thefield." The American diet is also a culprit. Heavy on processed foods,light on fiber for bulk, it can produce constipation and straining.Obesity and pregnancy, too, may contribute to hemorrhoids because ofthe extra pressure.
Fearful of the cost and trauma of traditional surgical cures, or simplyembarrassed, most sufferers medicate themselves. Popularover-the-counter preparations can indeed relieve some symptomstemporarily. So can hot baths and a change in diet and bowel habits.But doctors emphasize that whenever rectal bleeding occurs, thereshould be a prompt proctological examination; while hemorrhoidsthemselves are not life-threatening, such bleeding may be a sign ofcancer or some other serious ailment. Happily, most hemorrhoidcomplaints can now be treated simply and almost painlessly in thedoctor's office.
If the hemorrhoids are internal, away from the lower rectum's nerveendings, physicians often rely on a technique known as rubber-bandligation. A tiny rubber band is looped tightly around the swollenregion. No longer drawing nourishing blood, the hemorrhoid withersaway. Carter, plagued by hemorrhoids since college, had just such aprocedure in 1974. Some doctors inject a special solution into nearbytissue that constricts the vessels and thus cuts off the blood supply.Still another technique involves dilating, or widening, the anus withstretching devices.
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