Health: An unspeakable pain in an unmentionable place: When Mary Roberts found she had piles, her first thought was to keep it secret

I HAD always assumed it was a medical complaint that afflicted men over the age of 60 - until it happened to me.

And yet, almost instinctively, the moment I first experienced that burning pain in my nether regions - a sensation that in another time and place could have been attributed to a red hot poker - I knew it had to be that most ignominious of conditions, haemorrhoids, more commonly known as piles.

'But I'm 34, female and healthy. It can't be,' I wailed, limping from the bathroom back to the bedroom that fateful morning. For some reason, I could not quite bring myself to utter the dreadful word with all its loathsome associations.

Lying back down on the bed, gingerly shifting myself into a comfortable position, I realised that coping with the pain would be one thing, but coming to terms with the stigma of having piles would be quite another.

To begin with, how, I pondered, was I going to break the news to my partner? As if on cue, he nuzzled up closer for an early morning cuddle. 'Not now, darling,' I whispered in agony, 'I've got a terrible bottom ache.' Piles and passion are not necessarily mutually exclusive, but in my experience they make for unhappy bedfellows. Desire dissolved just as suddenly as my piles

protruded.

It was not enough to make me reach for the phone and dial the doctor. Embarrassment at having to bare my all to my male GP, and somehow delicately discuss unsavoury subjects such as bodily movements and other unspoken things, had me reaching instead for the shelf labelled health at my local library.

Most instructive and full of surprises was a booklet entitled Understanding Piles. Piles, simply put, are swollen blood vessels in or around the rectum, otherwise known as the back passage. And because they are the lowest vessels in the part of the circulation system that carries blood back through the liver to the heart, they are prone to stretching. It is one of the prices that we pay for standing on two legs instead of four. I decided that life as a millepede might be the one to opt for next time round.

Apparently, we humans can suffer from two kinds of piles: internal piles found in the rectum itself, or the external variety found around the outside of the anus. I wondered nervously which kind I had. The booklet explained that you can, for instance, have external piles for years and have no problems at all other than an occasional sharp pain when constipated. At times, though, and with no advance physical warnings, they can become inflamed, painful or itchy, and there might be a slight, blood-stained discharge. If the problem worsens with a lot of bleeding or becomes very painful, a doctor should be consulted.

Historically speaking, the word haemorrhoid, which means 'flowing of blood', comes from ancient Greek, and a medical document dating back to 1400 refers to 'a good medicine for the pylys and for the emerawdys'. Unfortunately, the booklet did not divulge what that medicine was, but in the 17th century the treatment for piles was a waxy preparation called spermaceti, which you swallowed. This was extracted from the head of a sperm whale. Nowadays, I was relieved to read, there are a variety of modern preparations in the form of creams, ointments and suppositories, all designed to help relieve the symptoms of piles.

The biggest surprise was the discovery that about 40 per cent of the population in the United Kingdom suffer from piles at some time in their lives. And although they are most common in the middle-aged and elderly of both sexes, they can occur at any age. So I was not a freak of nature, after all. Pregnant women are particularly prone to piles.

The 40 per cent figure, the booklet continued, is probably even higher because people are too shy and embarrassed to seek treatment. Perched uncomfortably on my south London library chair, I sent out a telepathic message of solidarity to all fellow secret sufferers, and resolved then and there to overcome my embarrassment and visit my GP.

It was not at all the ordeal I had anticipated. An examination was not necessary; a brief description of the symptoms sufficed. I was told to increase foods that were high in fibre, as constipation is thought to be the main cause, and a prescription was quickly scribbled out.

'I suppose I just swallow them?' I said. My GP looked momentarily taken aback but not as much as I did when he told me where the suppositories had to go. I should have known. I had just never had to think about it before.

I only wished, later that day, while grappling with my first, second and third suppository, that I had asked for precise instructions. I gave up after my third attempt and, frustrated at my failure, returned to the surgery the next morning with an appointment to see the nurse. She was wonderful, and explained that many people encountered this problem at first.

Just three days later, my painful piles had almost disappeared. The relief was so great that I felt like 24 again. So if you have been harbouring painful, unmentionable piles, swallow your embarrassment. First aid is at hand.

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