Too much medicine?

EDITOR- to me the anus is one part of our body where
"medicine's power to harm individual patients and whole
populations"( 1 ) is evident. There is a lot of money to be
made from telling people "haemorrhoids and their symptoms
are on of the most common afflictions in the Western
world".( 2 ) Unfortunately and tragically, patientes
suffering from any symptoms related to the lower bowel and
anus assume all too frequently and often incorrectly that
their symptoms are due to haemorrhoids.

In my proctological
clinic various types of anal dermatitis were found more
frequently than haemorrhoids in patients examined for rectal
bleeding.( 3 ) Additionally doctor's advice for anal
cleansing like "Keep the area clean by washing after every
bowel action and night and morning"( 4 ) or "If you are away
from home or good toilet facilities when you have to pass a
motion ase medicated wipes such as Wet Ones or Baby Wipes"(
4 ) is causing harm to thousands of individual patiens
according to what I see at my proctologic clinic.( 5 ) But
much more important, this advice has never been tested by
randomised controlled trials. Anal dermatitis heals if
patients stop with anal cleansing, and avoid showers,
baths,swims, moist tissue, Sitz baths until healing.( 5 )