“The common people call them piles, the aristocracy call them haemorrhoids, the French call them figs — what does it matter, so long as you can cure them?”
What John of Arderne, regarded as the first English surgeon, said in the 14th century is still applicable today.
Haemorrhoids are varicose veins in the anus. They are common, but rarely seen before the age of 30 except in pregnant women.
There are many factors associated with their cause. The condition is common in families, as are varicose veins of the legs. Some hereditary weakness of the veins is also believed to play a part.
Chronic constipation and the subsequent straining at stool may be the most important factor.
Developed nations’ highly processed diet, which is low in vegetable fibre, is believed to be associated with an increased risk, not only of developing piles, but also several other conditions, including cancer of the bowel, diverticulitis, appendicitis and varicose veins.
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In the past 10 years, there has been controversy about whether or not childbirth should be induced or be allowed to progress naturally.
There has been an increasing tendency for doctors to induce labor.
Associated with this has been a progression in childbirth technology, so that the strength of the contractions of the womb can be controlled by drugs and the progress of the baby closely monitored.
Those parents who see induced labor as too technological, and a complication of what should be a natural and shared family experience, have been increasingly vocal in demanding that their viewpoints be heard and considered.
Medical proponents of the management of labor argue that the method allows the whole medical team to be available to deal with any problems which may arise, whereas spontaneous natural labor may occur at night, on weekends or holidays when the full medical team is not available.
In a British Medical Journal review of reports from several centres, it was found that there can be different interpretations and different results from various groups in matters of usage and observation of natural or induced labor. And so the debate continues.
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