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A Pain in the Bum: Everything That Can Go Wrong Back There.

Let me tell you a story which is definitely not about me.

This pharmacist I know (let’s call him… Lloyd) was hiking through the Tasmanian wilderness when he was a young man. He was carrying all of his food and water, and rather than take adequate rations, he skimped on water. All he’d packed was bread and peanut butter. The day after his water ran out, and he finished his last bottle of wine (the folly of youth told him wine was necessary while water was not), he realised that he had not been to the toilet in three days. So he tried his best, and did some serious damage to his behind. More on this later, but again, definitely not me.

Most of us take our bums for granted. They do a lot of the dirty work for us, and never receive a word of thanks. Sometimes we get a pain in the bum, and rather than seek out help, we get a little embarrassed and hope it resolves itself in due course. No more. I am here to walk you through some of the things that happen to the old faithful servant that follows us everywhere we go.

Anal fissures

This is when you get a tear in the moist tissue that lines your anus. You might suffer from a fissure if a foreign object was inserted without adequate care, or if you pass a stool that is far too hard to break down properly. Sadly for old Lloyd, he fell into the latter camp. The lack of water mixed with a diet of entirely white bread meant that the stools forming in his lower intestine were rock hard, and as he made his first bowel motion, they tore him from the knave to the chaps. He tells me it was one of the most painful experiences of his life. Lesson here: eat a balanced diet, drink a lot of water, and don’t fool yourself into thinking that wine does the same thing ‘cos it’s a liquid right?’ Wrong Lloyd. Very wrong.

Haemorrhoids

HArd to spell, and harder to sit down with one of these guys hanging around. A haemorrhoid is a swollen vein in your lower rectum and anus. They can be both internal and external, and nearly 75% of adults will suffer from them throughout their lives. They tend to rear their ugly heads if you spend too long sitting down, particularly on the toilet. You might find yourself in that 75% if you feel an itchiness around your anus, swelling, bleeding (particularly during bowel motions) or general pain and discomfort. It’s not wildly enjoyable, and I recommend picking up some Proctosedyl ointment pronto. Proctosedyl ointment provides a bit of comfort from the pain by dispersing a local anaesthetic across the area so that you don’t need to wince everytime you sit down. Then, the active ingredient hydrocortisone (a steroid) begins to alleviate swelling in the area until the vein returns back to a normal size. We’ve always got some in stock, so pick up some proctosedyl ointment today and keep it in your cupboard. AFter all, 75% of people is a lot higher than you probably would have guessed.

Sexually Transmitted Infections

As if these needed to be any more annoying! Sadly, yes. Sexually transmitted diseases such as Herpes, Chlamydia and gonorrhea can spread to your anus as well. You can even develop anal wart that grow near your anus that look strangely like minuscile pink cauliflowers (it will be a long time before you can near that particular vegetable after seeing them), and they are usually called by the HPV virus. All you can do is seek medical advice and follow their treatments.

Pilonidal Cyst

Now we are getting into some uncharted territory. Your skin has pores on it, and your behind is no exception. Because your bottom is more likely to be hairy and sweaty (I know, this is getting unnecessarily graphic), these pores are more likely to become clogged with loose ingrown hair follicles. A cyst begins to form beneath your skin that is full of fluid, air or even clumps of hair. There are a reported 70,000 cases a year, but very few people realise they have one, and even fewer will admit it. Here’s a simple test: lie on a hard floor. Can you do a sit up staying completely central? Or when you crunch over your tailbone, do you veer to one side because it feels like you are sitting on a marble? If so, you might well have a pilonidal cyst. Here are the risk factors:

  • Being a man – we are three to four times more likely to develop a pilonidal cyst because tend to be more hairy
  • Being hairy – see above
  • Being between 14 and 40 – most people discover them around 20 to 35.
  • Spending too long sitting down – it puts more pressure on your behind and the cyst grows

Here’s the really bad news. It requires surgery to remove. And the recovery can be weeks. This is why a lot of people tend to shrug their shoulders and let it be. If it isn’t directly impacting your life, it might not be your most pressing need.

Colon Cancer

This one isn’t such a novelty. If you notice the following symptoms, go and seek medical assistance immediately:

  • Inconsistent bowel habits: This might mean a constant swing between diarrhoea and constipation
  • Blood in your stool or around your rectum
  • Constantly feeling crampy or uncomfortable around your abdominal
  • The persistent feeling that you haven’t got it all out when you go to make a bowel movement

In Australia alone, colorectal cancer kills over 5000 people annually, and is the third leading cause of cancer related deaths in men and women. Don’t wait for this to get better. Get on the front foot and kick it in the butt.

There you go. May you never mistreat your behind again.

Sincerely, 

Floyd.