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What are Hemorrhoids?

Hemorrhoids or piles are swollen, painful, and inflamed veins in and around the anus and lower rectum. It is a common condition in both men and women, usually occurring due to straining when passing stool which is common in chronic constipation. Women are prone to develop hemorrhoids, especially during pregnancy and childbirth. The most common symptom is the passage of bright red blood while passing stool or when wiping after a bowel movement.

Fissures of the heel and soles, commonly referred to as cracked heels or chapped soles are very common, especially during the winter season when the skin tends to become dry. Although any part of the soles of the feet may be affected and become chapped or crack, it is the heels that are more commonly affected. The condition is also more common in females than males mainly due to wearing shoes that unevenly distribute the body weight and shoes that are opened at the back. Hormonal factors may sometimes be involved.

Not only are cracked heels and soles unsightly to look at, they can cause pain or discomfort in the feet. Bleeding may occur in severe cases. Infection may also occur, particularly if the person is diabetic. Simple measures such as proper foot care, with particular emphasis on keeping the feet well-moisturized, may help to prevent cracked heels and soles of the feet. If not dealt with early, the skin around the heels may become thick and callused with deep fissures in it, which will make healing more difficult.

Jock itch is often mistakenly thought to be a skin infection that affects only males but it can also occur in females. It is a fungal infection of the skin of the groin – the area between the thighs and torso. These infections are common and can extend to the external genitalia or the upper part of the inner thigh. Jock itch is just another form of athlete’s foot – one arises on the groin area while the other is seen on the genitalia. The correct medical term for this type of fungal infection is tinea cruris but apart from jock itch, it is also known by many common names across the globe such crotch itch, gym itch, groin ringworm and dhobie itch.

Abdominal Distention During Periods

Most women experience some degree of abdominal distention particularly before and during menstruation. It can be a temporary inconvenience for many, although some women will experience recurrent episodes of distention throughout the month irrespective of menstruation. There is often a misconception that this distention, referred to as menstrual bloating, is due to fluid. In fact many women may complain of retaining water in the abdomen and some may even use water pills to counteract the bloating. However, abdominal distention during menstrual periods is unlikely to be caused by fluid retention. It most instances it is actually functional bloating – a condition that occurs by an unknown mechanism apparently in response to hormonal changes. Functional bloating is not related to any underlying disease and will resolve spontaneously with no need for medical attention. Fluid retention in the abdomen, however, is not as innocuous.

Normally the acidic contents of the stomach remain within the stomach and pass out into the neighboring duodenum (first part of the small intestine) in small quantities. The stomach has mechanisms to withstand the highly corrosive acid and the small intestine has its own mechanisms to neutralize the acids. It is abnormal for stomach acid to enter the esophagus and backward flow of stomach contents into the esophagus is prevented by the action of the lower esophageal sphincter (LES). Food that enters the mouth passes down the throat and into the esophagus where the LES opens in a controlled manner to allow it to pass into the stomach.

Sometimes the acidic stomach contents flows backwards into the esophagus where it cause severe irritation of the delicate inner lining of the esophagus. This acid reflux is felt as a burning chest pain known as heartburn. It is usually acute and can be easily treated and may then never occur again. However, sometimes there is ongoing reflux irrespective of the usual trigger factors. Acid reflux is more correctly known as gastroesophageal reflux disease (GERD), although the latter term is usually used to refer to the more chronic state.

The quantity of blood lost during the monthly periods varies among women. It is estimated to be about 20 to 60ml throughout the menstruation which can vary between 2 to 7 days but averages about 3 to 5 days in most women. Despite these difference, every woman has a fair idea of the usual amount of blood lost as a result of menstrual bleeding. Sometimes this can be excessive in which case it is known as menorrhagia – heavy vaginal bleeding or prolonged vaginal bleeding. An isolated period which is heavier or longer than normal is not a cause for concern but if it persists or is recurrent then it needs to be investigated further as it may be a symptom of some underlying disease.

Gynecologic or female reproductive system cancers include cancers of the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. Surgery, radiation therapy, chemotherapy, and combination therapy are the standard treatment options available for most gynecologic cancers. Hormone therapy may be used for hormone-dependent tumors. In advanced cases where a cure is not possible, the main aim of treatment is to limit further growth of the cancer and offer relief from pain and other distressing symptoms. This is known as palliative therapy.

Miscarriage is the lay term for what is medically referred to as a spontaneous abortion. It refers to the loss of a pregnancy in the early stages, usually prior to 20 weeks or before the the fetus reaches 500 grams, where it is not viable for the fetus to exist outside of the uterus. It is also known as early pregnancy loss before 12 weeks although this term may also include an induced abortion where a woman purposefully undergoes any medical or surgical treatment to end the pregnancy. Late miscarriages occur after the first 12 weeks and before the first 24 weeks of pregnancy. Up to 20% of pregnancies (2 out of 10) end in miscarriage and in the majority of cases this occurs in the first trimester (12 weeks).  However, miscarriage is mainly a once  off occurrence and a woman may go on to have a health full term pregnancy afterwards. Less than 1 out of 100 women will experience 2 to 3 consecutive miscarriages.

Menstrual blood is usually bright to dark red and may or may not have some clots. It should not be brown to black and if it is then it needs to be investigated further. The main reason why blood may appear these colors is due to degradation of the blood cells either due to exposure to air (oxidation) over time, the action of bacterial enzymes or exposure of blood to certain chemicals that may cause rapid degradation and discoloration. A brown to black vaginal bleed in a pregnant women particularly if it is accompanied by abdominal pain should be investigated immediately.

A miscarriage is not an unusual event in pregnancy but should always be investigated further to ascertain the cause. This is important to identify underlying disorders that could be life threatening for the mother or jeopardize future pregnancies. Miscarriage is the common term for spontaneous abortion. It means the the pregnancy is terminated spontaneously without purposeful intervention to end the pregnancy as is the case in induced abortion. It occurs before 20 weeks of pregnancy. A spontaneous abortion can be further classified as an early abortion if it occurs before 12 weeks of pregnancy (first trimester) or between 12 and 20 weeks.