Monday, February 07, 2011

Hemorrhoids or Anusitis?

So I was chatting with my family doctor a few months ago, and said I really wanted a second opinion regarding my ongoing problem of hemorrhoids. I said I had been seeing a doctor who specializes in colonoscopies and he had told me that there was nothing he could do about my hemorrhoids.

I had been seeing this specialist for about 10 years now, and he has been doing my colonoscopies every two or three years. Why so frequently, when everyone else has them every 5 years? Well, the first time he found a polyp several cm in diameter; he removed it and found it was benign, but it seems when they find something, they opt to be on the safe side and do them more frequently. Believe me - if you ever had a colonoscopy, you really don't want to have them too frequently; the actual procedure itself is not so bad, since the patient is sedated and often does not feel anything. However, the prep the two days before is a killer - you spend nearly all the time on the porcelain throne and by the time you have pretty well purged yourself, the bum is raw and sore.

Anyway, I digress. My family doctor suggested I go to the Rudd Clinic in downtown Toronto. Apparently, they are the authority on all things bum and bowel related. I had to wait about a month or so to get in, but considering their reputation and specialization, that was really not that bad a wait. When I got there, I was surprised that I was seen by Dr. Warren Rudd himself.

I went into the exam room and he asked what the problem was. I said I had really bad hemorrhoids that hurt like hell and burned like hell. In fact, I had even taken a picture of them with my iPhone and took it out to show him. He did not seem surprised that I had a photo of my hemorrhoids, but after taking a look, he immediately said, "That's not hemorrhoids." I said, "What do you mean? Look at all those bulging bubbles there." At that point, he asked me to drop my pants so he could have a better look. Once again, he said it was not hemorrhoids. He said it is a condition called Anusitis, sometimes called Anal Itch, which is often caused by diet, and cured by changing diet. He asked if I drank coffee, and I said just decaf. He said it did not matter - caffeinated or decaf - I had to immediately stop drinking coffee and colas, as well as chocolate, and anything hot or spicy. He then asked if I read while on the toilet, and I said of course, whereupon he said I have to break that habit: never sit on the toilet more than 2 minutes!

He then asked if I read his book. What book? Knew nothing about it. I asked if he had one there, and he popped into his office and returned with a copy. I asked how much, and he said $20 - no tax. "Read chapter six", he said. Actually, he said read the whole book and especially chapter six, which deals with my specific condition of Anusitis.Click to enlargeHe then told me to go downstairs to the drugstore and buy a device called Anurex. He said it is small device, about 3 inches long and about half an inch in diameter, with a knob about an inch in diameter at the top. He said to put it into the freezer for about 2 hours and then insert it into my anus. It works like a cold compress that you would put onto your arm or leg if you sprained it. Only, this works 'internally' in the anal canal. The device is reusable - just wash it thoroughly afterwards, and put it back into its container and return it to the freezer. It comes with a small container of aloe lubricant, but that is a very small container, and he said I could get a tube of KY lubricant instead.Quite frankly, I think I still have hemorrhoids, but he claims differently, and he is the expert. What bothers me is that my colonoscopy doctor, and family doctor, both mis-diagnosed this problem, and I have been living in pain for over 15 years.

I have been using the Anurex device for several weeks now, and have also changed my diet to mostly bland foods. And, oh yes, I have a high fibre cereal (Fibre 1) each morning. He insisted on this - said this is the only cereal with 15 grams of fibre per serving, and that I needed this each day. For the first week I did not notice any difference, in fact, it seemed to make my more constipated, which aggravated the problem down below because it made me force each bowel movement. I called him up about this, saying it sort of negated the effect of the Annurx device if I had to exert so much force for a bowel movement. He asked if I was drinking water with the cereal - I said no. He then said that eating fibre is useless unless it is accompanied by a bottle of water. Apparently, water is the catalyst that makes the fibre work in the bowels. So, I started drinking water each morning with the cereal, and actually taking a bottle with each meal, and I can't believe the difference. I now have the recommended 2 to 3 firm, but not hard, bowel movements each day.

However, the 'hemorrhoids' are still there, and still as sore as ever. I have a followup appointment with him this Friday. I am not expecting miracles, but he did say it may take 3 to 4 months till the anusitis goes away.