By Enyeribe Ejiogu
In the Nigerian setting where people love to eat cassava-based solid meals like garri and fufu (which is variously known in local parlance as packet shirt, akpu, loi loi, among other descriptives) and other heavy carbohydrates (whole wheat meal, bread, pounded yam), most individuals do not have the habit of intentionally drinking enough water in the course of the day.
Interestingly, the Yoruba describe people who eat relatively hard eba (garri meal) as “aj’okuta ma m’omi” which roughly translates to a person who swallows hard eba without drinking water. For such people, once the bolus of eba can be lubricated with soup that facilitates its trip down the gullet into the stomach, then they are fine and okay. Of course, such people may just take a few sips of water and carry on with the day’s activities. In the stomach, digestive enzymes begin to break down the food, and the process continues and finishes in the small intestine, where the nutrients from the digested food are absorbed into the blood stream and transported to the cells of various tissues in different body organs for metabolic processes that support life to take place.
From the small intestine, the undigested/semi-digested food material is pushed into the large intestine where water is recovered from the semi-solid mass. The recovery of water, electrolytes and additional nutrients helps sustain the fluid levels of the body at the right volume, to prevent dehydration and the life-threatening dangers associated with it. As the large intestine continues to squeeze out water from the undigested mass, it begins to harden. The mass is pushed towards the rectum, which is the lower end of the large intestine, thereby becoming a faecal mass ready to be passed out through the anus, when the urge to answer nature’s call comes. As noted earlier, the large intestine is designed to re-absorb water. So, for individuals who do not habitually empty the bowel daily, the large intestine continues to squeeze out water, thereby making the faecal matter form into roundish, hardened clumps that assume the cylindrical shape of the rectum. When this happens, the person has to strain to pass stool as a result of constipation. This leads to the development of haemorrhoids.
Haemorrhoids aren’t a rare, strange condition. Just about anybody can have haemorrhoids, which form when the vessels in the anal region swell up with blood and become painful. Haemorrhoids may form without the person being aware of them, unless the area becomes painful. In about 50 per cent of cases, people who have haemorrhoids may experience some bleeding or feel pain as they try to pass stool. Some women may also have haemorrhoids during pregnancy.
Generally as noted earlier, the area around the anus is vascularised – that is, it has a lot of blood veins embeded in the muscles of the lower rectum.
When the veins swell or bulge, they’re called haemorrhoids. They may occur inside or just on the edge on the outside. Ususally they do not constitute any problem, but sometimes thay can become very unpleasant.
Medical science has clearly not pinpointed the immediate, direct reasons why haemorrhoids may form, but some people are more predisposed to having them.
People who are often constipated and therefore have difficulty passing stool, as stated earlier, are more likely to have haemorrhoids. Again, it has been determined that people who strain to lift heavy things or who are overweight are also prone to having haemorrhoids. Beyond these instances, it occurs more ofteh as one ages.
Signs to watch out for
One of the most common signs is painless bleeding, usually seen when a person cleans the anus after defecating or blood drops into the toilet bowl along with feaces. Sometimes there may be itching in the anus or little bulges around the anal opening.
Please see a doctor
It is to be noted that some other medical conditions can manifest in the same manner as haemorrhoids do. That is why it is best to go to a doctor, to have a physical examination of the anal area done by the doctor. The doctor may use a gloved finger to check inside the rectum or use an anoscope, which is a small tube inserted into the anus to look inside the rectum. From the doctors from the preliminary examination, he may send you further and advanced dignostic tests such as flexible sigmoidoscopy or colonoscopy.
Types of hemorrhoids
There are two main types of haemorrhoids – internal and external. When a haemorrhoid from inside pushes outside or “prolapses,” it can bleed, hurt, and itch. It may go back in on its own as the swelling goes down, or you can gently push it back into the body. When a blood clot forms in a haemorrhoid just under the skin outside, it is called thrombosis. It might get hard and sore and could bleed if it breaks. If the clot goes away, it may leave behind a little piece of skin called a skin tag that can bother you.
Eat right to avoid haemorrhoids
As in several other medical conditions, dietary pattern change and other lifestyle modifications can make a world of difference to a person’s health. To avoid constipation eat more fibre rich foods to make your stool softer. Fall in love with vegetable soup, especially the type made with large amout of waterleaf and pounded okazi (Gnetum guiniensis); eat the soup generously. Eat fruits and lots of beans. Take whole-wheat bread and cereals with fibre such as oatmeal. After licking orange, chew the white fibrous part to get roughage. Drink lots of water to soften your stool, make it easier to pass out.
Treatment at home
When you have hemorrhoids, you can use non-prescription creams and wipes or even a small ice pack, to ease pain and swelling. You can also get an over-the-counter stool softener that can help make it easier to pass stool.
Treatment by a doctor
When at-home remedies don’t work, your doctor may put special rubber bands or rings around internal hemorrhoids to cut off the blood supply until they shrink. This process is called ligation. They can use heat to get rid of internal haemorrhoids (a process known as coagulation). Your doctor could also inject a chemical into the swollen tissue to break it down. This is called sclerotherapy. In some instances, surgery performed by a urologist may be the best solution.