Dr Christian: Mr Webster, hi. I’m Dr Jessen. Please take a seat for me.
Mr Webster (Nick): Good afternoon doctor.
Dr Christian: Come and take a seat for me. What can I do for you?
Nick: I’ve come to see you today about haemorrhoids.
Dr Christian: Right, how long have you had those for?
Nick: For a number of years, since my early teens really.
Dr Christian: How old are you now?
Dr Christian: Why have you just come to see me now about this?
Nick: Well, I suppose it’s one of those illnesses you tend not to do anything about.
Dr Christian: Ok, Well, I think we should have a look at these piles. So if you turn onto your left side.
Dr Pixie V/O: Around a third of us will develop piles. They are caused by blood vessels in or around the anus being put under pressure and swelling to form lumps.
Dr Christian: Right. Well, you certainly do have haemorrhoids. You’ve got quite a lot. Are they sore if I’m touching you around here?
Nick: A little bit.
Dr Christian: A little bit sore?
Dr Christian: Ok, what I’m going to do then is pop a finger up and have a feel around the inside.
Dr Pixie V/O: This is why constipation and pregnancy are a common factor in getting piles. Sitting on cold surfaces or standing for long periods, however, aren’t.
Dr Christian: So, I’m going to pop a finger up and have a feel on the inside. If it’s sore just tell me and we’ll stop, ok.
Dr Christian: Here we go. Is that ok?
Nick: Yes, that’s fine.
Dr Christian: That feels fine; I think all the haemorrhoids that you’ve got at the moment are on the outside. Why don’t you pop your jeans back on and have a seat. They are quite bad, they’re quite big and they’re only going to get worse and the reason I wanted to do something about them really is because of this (shows photo). These are haemorrhoids that are not actually dissimilar to yours, they’re pretty large. And you can imagine when she is going to the loo they’re really going to get in the way. And what I don’t want to happen is for you to get to this stage (shows second photo). These are quite severe haemorrhoids, all right, and you can see there is a lot coming right out the bottom. They’re bleeding, they’re sore and that’s a bit of a mess.
Nick : Mine are nothing like that.
Dr Christian: Yours are nothing like that, but I suspect if we let them go on they may well end up like that. What I think we are going to do is refer you to a surgeon to have a look and to decide what the best procedures will be for those, all right?
Dr Pixie V/O: Nick Webster was diagnosed with a bad case of piles. Today he’s having them removed. Nick’s having a new procedure that involves replacing a ring of rectal tissue with a circular staple. This will hopefully lead to a life of strain without pain.
Dr Richard (Surgeon): I describe it as a sort of face lift down below. It pulls the anal canal back inside and interrupts the blood supply to the haemorrhoids. The advantage of this procedure is that it is less uncomfortable afterwards and indeed some patients have very little discomfort. And also there are no wounds, so no mucky bottom after the procedure.
Dr Pixie V/O: A few weeks after his operation Nick Webster is back at the clinic for one final check up.
Dr Christian: Nick, hi.
Nick: Hi, good to see you again.
Dr Christian: Nice to see you again, have a seat for me. So tell me, how did it all go?
Nick: Very well indeed, very pleasantly surprised.
Dr Christian: Yeah.
Nick: Just a little bit of discomfort. But on the whole…
Dr Christian: And going to the loo and things?
Nick: The first one was a little bit nervous, shall we say, but since then it’s been fine.
Dr Christian: I think what we should do today is have a look just to check there’s no signs of infection and that everything is healing properly. And also I will be very interested to see what a nice job they’ve made. I don’t want to see any more haemorrhoids. Would that be all right with you?
Nick: Yes that’s fine.
Dr Christian: Let’s pop you up on the couch. If you stand up for me. Gosh, what a difference! That looks so much better.
Dr Christian: Yep, there’s nothing coming out. How are you feeling about it all now?
Nick: No itchiness, no soreness.
Dr Christian: And not bleeding?
Nick: No bleeding, no discharge. And you will see that I’m wearing white underwear.
Dr Christian: Which is the first time in a while?
Nick: Which is the first time in many years. I’m kicking myself for waiting so long. When I think of the years I have put up with the discomfort and the worry and everything.
Dr Christian: And you’re happier now?
Nick: I’m a lot happier, yeah.
Dr Christian: Fantastic.
Around one third of us will develop haemorrhoids (or piles as they are more commonly called). Dr Christian Jessen diagnoses one particularly bad case from series one of Embarrassing Illnesses, and refers his patient for surgery to remove the offending items.
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