Horror, it's Hemorrhoids -- Self-care Tips for Common Problem
By about age 50, more than half of adults have dealt with hemorrhoids. The November issue of Mayo Clinic Health Letter covers home treatments that can relieve symptoms of this common and embarrassing problem.
Hemorrhoids are blood-engorged veins in the lower rectum (anal canal) that form tiny sacs (anal cushions) when too much pressure is exerted on the veins serving the pelvic and rectal areas. Increased pressure can result from straining during bowel movements, sitting on the toilet for an extended time, chronic diarrhea or constipation, obesity, lifting heavy objects, sitting or standing for long periods and pregnancy.
Symptoms can include painless bleeding during bowel movements, leakage of feces and mucus, severe pain, swelling or inflammation. Embarrassment aside, it's important to talk with a doctor about any rectal bleeding. While hemorrhoids generally don't cause serious problems, other, more serious concerns, such as polyps, cancer or inflammatory bowel disease, can cause bleeding, too. A colonoscopy may be needed to determine the cause of bleeding.
Mild pain, swelling and inflammation from hemorrhoids often can be managed with self-care measures. Options include:
Topical over-the-counter remedies: Nonprescription hemorrhoid creams, suppositories containing hydrocortisone or pads containing witch hazel or a topical numbing agent may provide relief. They shouldn't be used longer than a week unless directed by a doctor.
Cleanliness in anal area: Taking a warm sitz bath several times a day can be helpful. A sitz bath, where only the hips and buttocks are immersed, can be done in a regular bathtub or using a plastic tub that fits over the toilet. The tubs are readily available from medical supply stores and pharmacies.
Swelling relief: Ice packs or cold compresses on the anus can relieve swelling.
Pain relievers: Nonprescription pain relievers such as acetaminophen (Tylenol, others), or ibuprofen (Advil, Motrin IB, others) may provide relief.
Hydration and fiber: Softening and bulking up stool for easier passage is helpful. Strategies include drinking six to eight glasses of water or other nonalcoholic beverages daily, eating high-fiber foods, and taking fiber supplements such as Metamucil and Citrucel.
In addition, it's best to head for the bathroom when the urge occurs and to avoid straining or breath-holding when passing stools, as this strains the veins in the lower rectum.
When self-care measures don't work, a doctor can discuss several minimally invasive surgical procedures for consideration.
Interactive Video Games Have a Role in Good Health
Advanced interactive games are making inroads as health and wellness tools, according to the November issue of Mayo Clinic Health Letter.
Researchers are finding that interactive game systems are especially helpful for people with chronic health conditions. Playing the games increases physical activity and can even improve the ability to care for oneself.
The system that's attracting the most attention is Nintendo's Wii (pronounced WEE) and its activities package called Wii Fit. The Wii combines a virtual environment and wireless motion-sensitive remote controllers that allow participants of different abilities to play games such as golf or bowling. Wii games also simulate daily living skills such as driving or cooking.
Health professionals who work in rehabilitation or retirement living centers are using Wii to create a virtual environment tailored to an individual's abilities and mobility, even if that person requires the use of a cane, walker or wheelchair. For instance, gamers can bowl sitting down, or they can mimic the typical bowler's motion.
While these interactive systems are fun and games, researchers are taking them seriously. One pilot study shows that people with Parkinson's disease who played Nintendo's Wii a few times a week for a month experienced improvement in their symptoms. Rigidity, movement, fine motor skills and energy levels all improved and most saw depression levels decrease to zero.
In Scotland, a study is under way involving people over age 70 to determine if their balance might be improved and risk of falling might be decreased with regular use of Wii Fit. Another study is using the Wii and a game called Dance, Dance Revolution, which gets people moving to musical and visual cues, as therapy for those who have had a stroke.
Mayo Clinic therapists already are convinced of the benefits for some patients. They say playing interactive games might be useful in improving balance, eye-to-hand coordination, problem-solving skills and social interactions.
Heart Failure: Proven Treatments not Always Used
Fewer than one-third of patients with heart failure are taking the three types of medications that are most effective in prolonging life and improving quality of life. The November issue of Mayo Clinic Health Letter provides an overview of treatments recommended by national guidelines.
Heart failure generally begins when heart muscle is damaged, from a heart attack or other factors such as high blood pressure, heavy alcohol use, diabetes, heart infection, faulty heart valves, heart rhythm problems or sleep apnea. Effective treatment can help slow or stop progression of heart failure.
Three classes of drugs, and sometimes a pacemaker or defibrillator device, can increase longevity. Medication categories are:
Angiotensin-converting enzyme (ACE) inhibitors: Medications in this category -- enalapril, lisinopril and others -- reduce production of angiotensin, a substance that causes blood vessels to narrow and blood pressure to rise. Lower blood pressure reduces workload on the heart.
Beta blockers: Drugs in this class -- metoprolol, bisoprolol and others -- slow the heart rate and lower blood pressure. Beta blockers are the single most effective drug at improving heart function and symptoms, possibly prolonging life for those with heart failure.
Aldosterone antagonists: This category, which includes spironolactone and eplerenone, removes sodium and water from the bloodstream. These drugs also block aldosterone, a hormone that can stress the heart.
For some patients, implanting a pacemaker to coordinate heartbeats can improve the heart's efficiency. Implantable cardioverter-defibrillators also may be recommended to detect and stop dangerous heart symptoms.
Studies have shown survival rates are 92 percent at two years for heart failure patients taking recommended medications from each category. Only 65 percent of patients who did nothing survived beyond two years.
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