Among the subjects men least enjoy discussing, Hemorrhoids rank right alongside impotence. (Some body parts are supposed to swell up; others definitely should not.) Unfortunately, they are quite common, affecting one-half of all men by age 50.

Hemorrhoids are veins under the rectum or around the anus that become dilated from repeated pressure. The condition, which tends to run in families, is commonly associated with straining due to constipation, chronic diarrhea, or heavy lifting. Because the area is the lowest point in the system carrying blood from the liver to the heart, gravity also plays a role. After a while, the veins lose their elasticity and their ability to properly transport blood, which subsequently pools and balloons the tissue.

Internal hemorrhoids develop inside the passageway of the anus; they can also protrude outward, appearing as small, grapelike masses. Usually painless, internal hemorrhoids can cause vague discomfort and they may rupture and bleed. External hemorrhoids, also known as pries, develop around the rim of the anus; they tend to be dark red or purple, quite painful, and they can grow as large as golf balls.

Symptoms of hemorrhoids include: bright red blood or mucous discharge; rectal tenderness or itching; a lump that can be felt in the anus; and uncomfortable, painful bowel movements (especially with straining).

Rectal bleeding is the most common symptom, but it can occur for other reasons, which is why it's important to always have a physician take a look. "Not only do you rule out more serious rectal diseases, but you can determine the extent of the problem," says Joseph R. Duba, M.D., of the Family Health Center in Shortsville, N.Y. "View an external hemorrhoid as a possible `tip of the iceberg.' If you have the disorder, you'll tend to have flare-ups of the problem if you don't manage it properly."

While hemorrhoids are a literal pain in the butt, they are seldom a serious health problem. You usually can treat them with dietary and lifestyle modifications, according to Peter A. Cataldo, M.D., associate professor of surgery at the University of Vermont College of Medicine.
First, take daily measures to produce soft, easily passed stools. Drink six to eight glasses of water and eat foods high in fiber such as whole-grain cereals and breads, fresh fruits, and vegetables such as beans, broccoli and carrots. Set a goal of 25 to 30 grams of fiber daily, but add these foods to your diet gradually to avoid intestinal discomfort. Also, take warm baths, avoid perfumed soap that can cause irritation, and use ice packs or cotton pads soaked in witch hazel to reduce pain and swelling.

Stimulate bowel function by exercising regularly, especially if you sit or stand for long hours. "But avoid exercise that increases intra-abdominal pressure--especially weight training--which can aggravate hemorrhoids," says Duba. Instead, do aerobic training or take brisk 20-minute walks. You can ask your physician about over-the-counter products, such as stool softeners, aloe vera gel, zinc oxide creams (better known as Preparation H and Hemorid), medicated wipes (Tucks) and medicated suppositories. Be mindful that these products only relieve mild itching and irritation, though the lubrication may help decrease ruptures. Try not to rely on laxatives, which can do more long-term harm than good.

Finally, it's wise to follow a protocol while on the can. Relieve yourself as soon as you feel the urge. (If you wait, your stool may become dry and be more difficult to pass.) Don't strain or hold your breath during a bowel movement; lean forward from the hips to help reduce pressure. Use moist towelettes or damp toilet paper. And don't sit for too long (no Sunday Times crosswords, please), as this can restrict blood flow around the anal area.

Sometimes external hemorrhoids "strangulate" when trapped blood starts to clot, causing extreme pain. Your doctor can make a small incision to remove the clotting. Other medical procedures for severe piles include freezing them or tying them off, which cuts the blood supply and lets them wither. There's also surgical removal via a hemorrhoidectomy--followed by lots and lots of painkillers.

The worse the symptoms, the longer they take to heal, yet minor hemorrhoids usually improve in several days. But that doesn't mean the problem has gone away. Drop your fiber intake or your cardio sessions, and your hemorrhoids will be back on the spot.

10-SECOND TIP

To reduce constipation, place your fingertips two or three inches below your navel and gently press in about one inch until you sense a firmness. Hold for three minutes while breathing deeply and slowly.

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