Preventative Health

[HEMORRHOIDS]
Hemorrhoids also called piles, are swollen veins in your a**s and lower re**um, similar to varicose veins. Hemorrhoids can develop inside the re**um (internal hemorrhoids) or under the skin around the a**s (external hemorrhoids).

Nearly three out of four adults will have hemorrhoids from time to time. Hemorrhoids have a number of causes, but often the cause is unknown.

Fortunately, effective options are available to treat hemorrhoids. Many people get relief with home treatments and lifestyle changes.

Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.

EXTERNAL HEMORRHOIDS
These are under the skin around your a**s. Signs and symptoms might include:

Itching or irritation in your a**l region
Pain or discomfort
Swelling around your a**s
Bleeding

INTERNAL HEMORRHOIDS
Internal hemorrhoids lie inside the re**um. You usually can't see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:

Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
A hemorrhoid to push through the a**l opening (pr*****ed or protruding hemorrhoid), resulting in pain and irritation.

THROMBOSED HEMORRHOIDS
If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result in:

Severe pain
Swelling
Inflammation

A hard lump near your a**s.

Don't assume re**al bleeding is due to hemorrhoids, especially if you have changes in bowel habits or if your stools change in color or consistency. Re**al bleeding can occur with other diseases, including colore**al cancer and a**l cancer.

Seek emergency care if you have large amounts of re**al bleeding, lightheadedness, dizziness or faintness.

CAUSES
The veins around your a**s tend to stretch under pressure and may bulge or swell. Hemorrhoids can develop from increased pressure in the lower re**um due to:

1.Straining during bowel movements
2.Sitting for long periods of time on the toilet
3.Having chronic diarrhea or constipation
4.Being obese
5.Being pregnant
6.Having a**l in*******se
7.Eating a low-fiber diet
8.Regular heavy lifting

RISK FACTORS.
As you age, your risk of hemorrhoids increases. That's because the tissues that support the veins in your re**um and a**s can weaken and stretch. This can also happen when you're pregnant, because the baby's weight puts pressure on the a**l region.

COMPLICATIONS
Complications of hemorrhoids are rare but include:

Anemia.
Rarely, chronic blood loss from hemorrhoids may cause anemia, in which you don't have enough healthy red blood cells to carry oxygen to your cells.

Strangulated hemorrhoid.
If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be "strangulated," which can cause extreme pain.

Blood clot.
Occasionally, a clot can form in a hemorrhoid (thrombosed hemorrhoid). Although not dangerous, it can be extremely painful and sometimes needs to be lanced and drained.

PREVENTION
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:

Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.

Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft.

Consider fiber supplements. Most people don't get enough of the recommended amount of fiber — 20 to 30 grams a day — in their diet.

If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause or worsen constipation.

Don't strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower re**um.
Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could dry out and be harder to pass.

Exercise. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that might be contributing to your hemorrhoids.

Avoid long periods of sitting. Sitting too long, particularly on the toilet, can increase the pressure on the veins in the a**s.

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[ERECTILE DYSFUNCTION] (IMPOTENCE)

Erectile dysfunction is the inability to get and keep an er****on firm enough for s*x.

Having er****on trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an er****on can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you're concerned about erectile dysfunction, talk to our doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments

SYMPTOMS
Erectile dysfunction symptoms might include persistent:

Trouble getting an er****on
Trouble keeping an er****on
Reduced s*xual desire
When to see a doctor
A family doctor is a good place to start when you have erectile problems. See your doctor if:

You have concerns about your er****ons or you're experiencing other s*xual problems such as premature or delayed ej*******on
You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
You have other symptoms along with erectile dysfunction.

CAUSES
Male s*xual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your s*xual response might cause anxiety about maintaining an er****on. The resulting anxiety can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction
In many cases, erectile dysfunction is caused by something physical. Common causes include:

1. Heart disease
2. Clogged blood vessels (atherosclerosis)
3. High cholesterol
4. High blood pressure
5. Diabetes
6. Obesity
7. Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
8. Parkinson's disease
9. Multiple sclerosis
10. Certain prescription medications
11. To***co use
12. Peyronie's disease — development of scar tissue inside the p***s
13. Alcoholism and other forms of substance abuse
14. Sleep disorders
15. Treatments for prostate cancer or enlarged prostate
16. Surgeries or injuries that affect the pelvic area or spinal cord
17. Low testosterone.

Psychological causes of erectile dysfunction
The brain plays a key role in triggering the series of physical events that cause an er****on, starting with feelings of s*xual excitement. A number of things can interfere with s*xual feelings and cause or worsen erectile dysfunction. These include:

Depression, anxiety or other mental health conditions
Stress
Relationship problems due to stress, poor communication or other concerns

RISK FACTORS
As you get older, er****ons might take longer to develop and might not be as firm. You might need more direct touch to your p***s to get and keep an er****on.

Various risk factors can contribute to erectile dysfunction, including:

Medical conditions, particularly diabetes or heart conditions

COMPLICATIONS
Complications resulting from erectile dysfunction can include:

An unsatisfactory s*x life
Stress or anxiety
Embarrassment or low self-esteem
Relationship problems
The inability to get your partner pregnant.

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