Internal and external Haemorrhoids

Dear Ask The Doctor: Hello. A few months ago, I noticed that after wiping my bum there was a couple of dots of blood on the tissue. After pooing, a round, pea-sized bag-like lump is on my anus, and at other times is there but less noticeable. Pooing can sometimes be painful, particularly after drinking alcohol. Also, how often I poo can be quite erratic - sometimes twice a day, sometimes once, sometimes none. Once, 3 times. On one occasion, my anus discharged a foul smelling liquid. Now I have noticed a hard lump along the bottom of the inside of my anus. Thanks for the help, David

Dear David: The pain and swelling in the back passage you are experiencing may be due to constipation or haemorrhoids. Malignant disease in someone of your age is extremely rare. Haemorrhoids are dilated and inflamed veins in the rectum and anus, they may be internal or external and from time to time they bleed. The best way to prevent haemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Exercise, including walking, increased fluid intake, and increased fibre in the diet (such as fruits, vegetables and cereals high in fibre) help reduce constipation and straining by producing stools that are softer and easier to pass. I advise attending your family doctor for a detailed history and clinical examination. He can correctly diagnose the problem and arrange appropriate treatment.