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A real pain in the bum

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There is a reason the idiom ‘a pain the bum’ has enjoyed such continual usage in the English language for centuries. It is because everyone knows just how irritating and painful an affliction of the rear end can be. The pain when you try to lower yourself into a car; the inability to find a good spot on a sofa; and bike riding? Forget about it… I am going to run you through a number of different afflictions which can take the joy out of cycling, and various treatments which are available to you.

Hemorrhoids

Sometimes referred to as ‘piles’ , these are the lumps that can emerge in and around the anus. They rear their ugly heads when the side of the anal canal weakens, which leads to the thickening of the lining. The veins swell and become hemorrhoids. It’s not much fun. They can be both internal and external, and in some cases, an internal hemorrhoid might become so large that it begins to protrude outside the anus, known as a prolapse. 

About 75% of adults will experience hemorrhoids in their lifetime. But the experience varies significantly.

  • First degree hemorrhoids might bleed a little bit after you go to the toilet. You usually notice it whilst wiping. They are internal and not overly painful
  • Second degree hemorrhoids bleed and stick out when you are pooping. After you’ve finished, they retract back into the anus themselves. How you would know this, I’m not sure, unless you’ve rigged up a mirror inside your toilet. It’s best to let a doctor diagnose this.
  • Third degree hemorrhoids have to be pushed back inside the anus after pooping, and can be pretty painful
  • Fourth degree hemorrhoids permanently protrude from the anus and even if you were game to try, you can’t get them back inside. The blood clots and they continue to grow larger.

So what do you do? First port of call is going to be seeking the advice of a health professional. Your second action ought to be picking up proctosedyl ointment. This is going to save you much discomfort. Proctosedyl ointment contains hydrocortisone which is a steroid that works to reduce the swelling of the hemorrhoid. The second ingredient is cinchocaine hydrochloride which is an anaesthetic to reduce the immediate discomfort and itching. It is important that you tell a health professional if proctosedyl ointment causes a rash around the anus.

Fissures

Anal fissures are a small tear in the mucosa that lines the anus, and it can be super painful. It is incredibly common in young children, yet they don’t often have the language to explain this beyond ‘my bum hurts’. It often feels like you’re passing razor blades, and it gets much worse when you are mid poo as it is effectively stretching out a wound. 

They will often go away on their own, but there are a few things you can do to hurry that process on. Firstly, you can increase your fibre intake to make sure that you don’t have to strain to push out large stools (poo, in medical jargon). The less you are pushing, the less you are stressing the wound. Secondly, proctosedyl ointment can prompt quicker healing and sort out the pain that comes with an anal fissure (it even sounds painful when you say it aloud!). Finally, you can consider a sitz bath to keep it all as clean as possible.

Pilonidal cyst

Now, this is a really interesting one because most people have no idea what it is, even though they might have one at this very moment. At the very tip of your tailbone, at the top of your bottom crack, there is a cyst that can become swollen or infected. Effectively, it begins to feel like a marble on your tailbone and if you try to roll from your back to a sitting position, it reaches a painful pinch point. They begin to get infected when a hair follicle becomes irritated from exercise, tight clothes or sweat. It begins gathering hair into the cyst and it needs medical intervention to fix the problem. This might just be the draining of the cyst, or it might need the surgical removal altogether. The down time? It can be anything up to twelve weeks! Daily salt baths, daily removal and repacking of dressings… Again, a real pain in the bum.

How do we avoid this? Well, it can be tricky. Some people are born with them. People who have more hair below the waistline are more susceptible. The most important thing is to keep the area very clean and to avoid wearing tight clothing at all times. You need to give your bum room to breathe and be free.

Worms

I saved this one for last. Until I studied at University, I believed that this was an old wives tale, but alas! They exist, and they are extremely unpleasant. They usually manifest in anal itching, especially when you lie down to sleep at the end of a long day. You can check yourself for worms by examining your stool (again, the poo not furniture). If you can spot little white worms crawling around, you might have a problem. And worst of all, they can spread through households, so even if you pride yourself on your cleanliness, someone you live with can bring them home without your knowledge (I’m looking at you, children’s daycare). 

You can treat these pesky critters with mebendazole, and reduce your risk of infection by making sure you wash your hands thoroughly, and hot washing all of your linens.

As mentioned, all of these afflictions are a genuine pain in the bum. But thankfully, there are options available that can nip these in the butt (pun intended, and yes, I know it should be bud). Shop our wide range of treatments – keep an eye out for proctosedyl ointment – so that you aren’t walking around in unnecessary discomfort. You’re welcome!

All the best,

Floyd – Senior pharmacist