Is surgery REALLY the best way to deal with hemorrhoids? DR. SCURR has the answer…

I have been offered surgery to remove a prolapsed hemorrhoid but I fear this will be painful and make me incontinent.

Robert Cherry, Bedford.

Dr. Scurr replies: Hemorrhoids, or hemorrhoids, are swollen veins in the lower rectum or anus.

Risk factors include constipation, straining during bowel movements, pregnancy, and heavy lifting, as these all increase pressure in the blood vessels, making hemorrhoids more likely.

Symptoms include pain, bleeding, itching and discharge.

Small hemorrhoids often get better on their own if you address the underlying cause (such as eating more fiber), but in the meantime, you can buy over-the-counter creams to soothe the pain and irritation (with ingredients like zinc oxide, which protects the pile from irritation such as feces). Painkillers, cold compresses, and constipation treatments can also help.

Large hemorrhoids can protrude through the anus – or ‘prolapse’: they can retract, but for chronic hemorrhoids, removal is the only effective treatment.

Non-surgical options include banding, which involves placing a tight surgical elastic around the hemorrhoid, cutting off the blood supply, causing the hemorrhoid to wither and then fall off (this can take about a week).

Other non-surgical alternatives include infrared light, gentle electrical currents and injections of a chemical solution: these all ‘destroy’ the damaging blood vessels, reducing the size of the haemorrhoid.

You have been offered the surgical option, a hemorrhoidectomy, in which the hemorrhoids are excised under general anesthesia. While I understand your concerns, the surgery has been refined over the years: any discomfort should disappear within a week or two.

The operation does carry a risk of damage to the anal sphincter, the muscle ring that holds the contents of the intestine in place, which can lead to incontinence, but this is rare and should not be a reason for you to have the reject surgery. You say that you are 78 and generally fit, so the anesthesia does not pose any major risk. I encourage you to go ahead with the surgery.

My partner has been given an appointment for another Covid vaccination, this will be his eighth or ninth; he has asthma. Is another Covid shot necessary?

A. Haywood, Newport, South Wales.

Dr. Scurr replies: I have been asked this many times and I fear that the problem here relates to an error in public health reporting, which your letter gives me the opportunity to correct. The fact is that there has been too much misleading speculation about the Covid boosters and their benefits – which is worrying considering Covid is now with us forever. The thing about a booster – any booster – is that it doesn’t guarantee you won’t get sick. I personally caught Covid after six injections in July, and the productive cough lasted for weeks.

But without the injections, the consequences of an infection could be much worse. Research shows that while vaccines cannot prevent infections, they can prevent serious illness, hospitalizations or death.

And the reason we need a new booster every year is because the virus, SARS-CoV-2, continues to mutate, meaning it can evade any immunity you may have acquired from previous infections or previous vaccinations. The vaccines are being updated to protect against newly emerging strains.

Vaccines, like all medicines, carry the risk of side effects and there is no doubt that a small group of people have suffered the consequences of their AstraZeneca Covid jabs, as we have seen in the reports of their attempts to seek compensation to demand.

There is a rare risk of myocarditis, inflammation of the heart muscle; most cases occurred in younger men and were mild, with full recovery. I have seen such a case, a colleague of 60 years old, but I emphasize that this complication is rare and, in my opinion, does not outweigh the benefits. I would urge your partner to get both shots.

IN MY OPINION…Cooking classes are vital for children

Chefs In Schools is a charity dedicated to reducing childhood obesity by training school chefs to prepare nutritious meals from scratch

All of us who work in healthcare are concerned about the obesity crisis and the burden it places on individuals and the already overburdened NHS.

I am convinced that if we are going to find a solution to changing the way our country eats, it will come from raising our children.

That means training their taste buds to appreciate simple, good-quality foods from an early age, rather than developing a craving for junk food and ultra-processed foods loaded with salt, sugar and saturated fats, which are easy to overeat. So I was delighted when I heard about Chefs In Schools, a charity dedicated to reducing childhood obesity by training school chefs to prepare nutritious meals from scratch, baking daily bread and teaching this approach.

It may be too late to captivate many adults with a new way of eating, but this approach must become mainstream to save our children.

The key to this is offering attractive wages to chefs. Is this really too much to ask when the health of a future generation is at stake?

• Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk – please include your contact details. Dr. Scurr cannot enter into personal correspondence. Always consult your own doctor if you have health problems.