It all took place near the village of Waterloo, about 12km south of Brussels.

According to Dr Jim Leavesley in his book Mere Mortals, Napoleon, never really in perfect health, was now fatter than before, his concentration span was much reduced and he suffered embarrassing symptoms related to a recurring bladder infection.

And from the French point of view there were inconvenient delays to the beginning of the battle. At a critical stage during the Battle of Waterloo, Napoleon returned to his quarters to seek relief from the pain of his haemorrhoids. Whether relief was gained we don’t know, but we do know for the “little general” the battle was lost.

No time is convenient to suffer with haemorrhoids; and how many emperors today are similarly discomforted is hard to say, but Napoleon had been all day in the saddle, and any horse rider would surely say having haemorrhoids is not much fun. The reality is, of course, having haemorrhoids is no fun for anyone – it’s a very sensitive issue in more ways than one.

Haemorrhoids are just like varicose (swollen) veins inside or around the anus. They are very common, with 80% of people estimated to have suffered with haemorrhoids at some time in their lives.

Symptoms include pain and irritation – the pain is usually a dull ache, often worse when passing a bowel motion; and the irritation is usually a burning, itching sensation. Fortunately these symptoms can generally be treated effectively with medicines, diet and attention to hygiene.

Rectal and anal discomfort can also be caused by conditions other than haemorrhoids. Therefore, if we are unsure whether haemorrhoids are actually the cause of the discomfort, we should see our doctor in the first instance.

Non-prescription topical preparations containing combinations of local anaesthetics, corticosteroids, astringents and healing agents are soothing and give at least temporary relief of symptoms – they should normally be used twice a day and after each bowel motion. However, long-term relief may need some diet and lifestyle modification.

Constipation or straining to pass a bowel motion are common causes of haemorrhoids, so judicious use of laxatives can be useful in addition to an increase in fibre and fluid intake. We should also recognise that medicines (often prescribed medicines) can be a cause of constipation. Your pharmacist can advise you if this is likely to be the case.

With this in mind, paracetamol is the first choice “over the counter” oral analgesic to relieve the pain of haemorrhoids. So-called compound pain relievers containing codeine should be avoided as they can also cause or aggravate constipation.

Keeping the area around the anus clean will help reduce itch and irritation. As soap can itself cause irritation to the already sensitive area, non-soapy cleansers are a better option, as are the use of flushable moist towelettes instead of toilet paper.

If you want to participate in the equestrian events at the next Olympics, perhaps cycle to the local shops, or even sit down for dinner without too much discomfort, check out the new Haemorrhoids fact card. It’s available from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information – log on to www.psa.org.au and click on Self Care Pharmacy Finder. There are other relevant cards, too: Fibre and Bowel Health, Constipation and Pelvic Floor Exercises.

©2010 Pharmaceutical Society of Australia

Just like the moon watchers of 1969, Captain James Cook was looking skyward when not quite by accident, but certainly secondary to his main aim, he came across the east coast of Australia.

In 1769 Captain Cook’s primary role was to observe the transit of Venus. His ‘discovery’ the following year of what he named New South Wales led to the visit and permanent settlement of Arthur Phillip’s First Fleet 18 years later.

Philip sailed into Botany Bay just a few days before French navigator, the Comte de La Perouse. It’s debatable if the French had arrived before the British whether the Tour de France would include Australia; however, different timing of events in 1815 really would have meant our red, white and blue flag may have had a very different design.

Apparently at a critical stage during the Battle of Waterloo, Napoleon returned to his quarters to seek relief from the pain of his haemorrhoids. Whether relief was gained we don’t know, but we do know that for the ‘little general’ the battle was lost.

No time is convenient to suffer with haemorrhoids; and how many emperors today are similarly discomforted is hard to say, but Napoleon had been all day in the saddle, and any horse rider would surely say that having haemorrhoids is not much fun. The reality is, of course, having haemorrhoids is no fun for anyone – it’s a very sensitive issue in more ways than one.

Haemorrhoids are just like varicose (swollen) veins inside or around the anus. They are very common, with 80% of people estimated to have suffered with haemorrhoids at some time in their lives.

Symptoms include pain and irritation – the pain is usually a dull ache, often worse when passing a bowel motion; and the irritation is usually a burning, itching sensation. Fortunately these symptoms can generally be treated effectively with medicines, diet and attention to hygiene.

Rectal and anal discomfort can also be caused by conditions other than haemorrhoids. Therefore, if we are unsure whether haemorrhoids are actually the cause of the discomfort, we should see our doctor in the first instance.

Non-prescription topical preparations containing combinations of local anaesthetics, corticosteroids, astringents and healing agents are soothing and give at least temporary relief of symptoms – they should normally be used twice a day and after each bowel motion. However, long term relief may need some diet and lifestyle modification.

Constipation or straining to pass a bowel motion are common causes of haemorrhoids, so judicious use of laxatives can be useful in addition to an increase in fibre and fluid intake. We should also recognise that medicines (often prescribed medicines) can be a cause of constipation. Your pharmacist can advise you if this is likely to be the case.

With this in mind, paracetamol is the first choice ‘over the counter’ oral analgesic to relieve the pain of haemorrhoids. So-called compound pain relievers containing codeine should be avoided as they can also cause or aggravate constipation.

Keeping the area around the anus clean will help reduce itch and irritation. As soap can itself cause irritation to the already sensitive area, non-soapy cleansers are a better option, as are the use of flushable moist towelettes instead of toilet paper.

If you want to participate in the equestrian events at the next Olympics, perhaps cycle to the local shops, or even sit down for dinner without too much discomfort, check out the Haemorrhoids fact Card. It’s available from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information – go to www.psa.org.au and click on Self Care Pharmacy Finder. There are other relevant cards: Fibre and Bowel Health, Constipation and Pelvic Floor Exercises.

©2009 Pharmaceutical Society of Australia

Apples are a good source of fibre and vitamins – especially vitamin C, but some other vitamins and minerals as well. In the fibre department, apples contain both soluble fibre – such as pectin which helps prevent the build-up of cholesterol in the lining of the blood vessels – and insoluble fibre, which provides bulk in the intestinal tract. This bulk enables a quick passage of food through the digestive system – just what the doctor ordered.

Creative commons licensed image

Probably the best known Australian apple is the “Granny Smith”. In 1838, Thomas and Maria (Granny) Smith migrated from Sussex, England to Ryde in NSW. It was some 30 years later that the famous green skinned apple was developed – apparently from the remains of some French crab-apples grown in Tasmania.

However, it’s the red apple which has greater significance this month. The red apple is the symbol of the Bowel Cancer and Digestive Research Institute; and Red Apple Day on June 10 aims to increase awareness of bowel cancer and other gastro-intestinal problems.

Other than skin cancer, bowel cancer is the commonest of all cancers affecting both men and women. There are 10,000 new cases of bowel cancer diagnosed every year; and there are twice as many deaths from bowel cancer in Australia as from motor vehicle accidents. One Australian dies from bowel cancer – also known as colorectal cancer (CRC) – every two hours.

Perhaps because these statistics are so frightening, there’s a reluctance for us to seek medical attention or even acknowledge the possibility of CRC. Nevertheless, bowel cancer is both treatable and curable.

In the early stages, bowel cancer often has no symptoms; but blood in the bowel motions, persistent changes in bowel habits (diarrhoea or constipation) frequent “wind” pains and loss of weight for no known reason, should all be investigated by your doctor. If a close relative has had bowel cancer, your own risk increases significantly, and a regular check-up is necessary.

If you turn 50, 55 or 65 before the end of 2010, you’re eligible to receive a free bowel cancer screening test as part of the Australian Government’s National Bowel Cancer Screening program. The test should arrive in the mail around the time of your birthday. Otherwise you can purchase a Rotary Bowelscan from participating pharmacies or log on to the website (www.bowelcanceraustralia.org). These simple to use tests identify so-called faecal occult blood – blood in the stool which may be an early sign of bowel cancer.

Bowel cancers usually begin as small growths called polyps. Most polyps cause no problems. However, over time, some polyps may become cancerous and their growth is then uncontrolled. It’s important therefore, to remove polyps as soon as they are detected. This procedure is carried out by means of a colonoscope – a long flexible tube which allows the operator (a specialist gastroenterologist) to visually assess the health of the rectum and the colon, and cut out any suspicious bowel tissue for further examination.

Apart from the existence of polyps, bowel cancer appears to be more common in people whose diet is high in fat, and low in fibre, fruit and vegetables. Smoking and alcohol consumption may also add to the risk. So just crunching an apple a day won’t mean we have no need for a regular check-up; but along with other fruit and vegetables the apple may reduce our bowel cancer risk. We also need to limit our alcohol intake to no more than two drinks a day and we should definitely not smoke. It seems regular physical activity also reduces the risk.

Pharmacies providing the Pharmaceutical Society’s Self Care material can give you more information about bowel cancer. For the location of your nearest Self Care Pharmacy check out the PSA website at www.psa.org.au or phone 1300 369 772 and ask the pharmacy for the fact cards titled Fibre and Bowel Health and Fat and Cholesterol. They contain some great hints on how to keep your bowel and also the rest of your body healthy and functioning well.

©2009 Pharmaceutical Society of Australia

It’s a risky process and can only be undertaken under medical supervision.

Of course nuts are not the only source of adverse reactions to foods. Perhaps less spectacular, but certainly more common, is the reaction to certain cereals – specifically cereals containing the protein gluten.

If you are sensitive to gluten, you’re deemed to have coeliac (pronounced see-lee-ak) disease; and you’re likely to experience such symptoms as bloating, diarrhoea, nausea, wind and chronic fatigue.

Stomach cramp or pain and constipation sometimes occur. Children with coeliac disease fail to thrive; adults are more susceptible to mouth ulcers and osteoporosis. Unexplained weight loss, hair loss, skin problems, even infertility and recurrent miscarriages can result from coeliac disease.

Sometimes symptoms are very vague and may be confused with irritable bowel syndrome (IBS) or simply wheat intolerance; sometimes symptoms may be put down to stress or just getting older.

The cause of coeliac disease is not fully understood; but it seems that people with this condition may be born with an enzyme deficiency so causing abnormal breakdown of gluten and a build-up of a toxic substance. Gluten is the protein found in wheat and rye and to a lesser extent in oats and barley. It is often present in bread, cakes, biscuits, pasta, pizzas and many processed foods – meats, soups, sauces and so on. Another theory on the cause of coeliac disease is that the immune system over-reacts to the “foreign” protein.

Whatever the cause, the result can be disastrous. Damage to the intestine leads to deficiencies in vitamins, iron, folic acid and calcium because of the poor absorption of nutrients. Sugars, proteins and fats are poorly absorbed as well. In some very severe cases coeliac disease can be fatal.

Each year, National Coeliac Awareness Week (13-20 March) highlights the need for us to consider coeliac disease when “stomach problems” persist. Despite the markedly varying symptoms and sometimes their extreme severity, treatment is usually simple and effective.

Early diagnosis of coeliac disease is important. (Evidence suggests that only 1 person in 5 with coeliac disease has had the condition diagnosed.) However, the good news is that, once diagnosed, the treatment for coeliac disease is extremely successful. It very simply involves strict adherence to a gluten-free diet.

This might sound difficult but it’s well worth the challenge of finding gluten-free foods on the supermarket shelves. Once started on a gluten-free diet, coeliac disease sufferers will pick up quickly and regain their energy and good health.

Be aware, however, that a gluten free diet is not a fad diet; certainly not for the more than 200,000 Australians who suffer with these gluten triggered symptoms. And a gluten free diet should not be started before the appropriate blood screening or other tests your doctor can order. Otherwise diagnosis may prove difficult or inconclusive.

Your local Coeliac Society or the web site www.coeliac.org.au can provide more information. They have dietary advice, recipes, information on where to buy gluten-free food, and above all the support needed to achieve effective control over the condition.

You can also get advice about intestinal and bowel problems from pharmacies providing the Pharmaceutical Society’s Self Care health information. Call 1300 369 772, or check out the Pharmaceutical Society website at www.psa.org.au, for the nearest location. There are fact cards on Heartburn and Indigestion, Vomiting and Diarrhoea, Constipation and Irritable Bowel Syndrome.

©2009 Pharmaceutical Society of Australia