Dr Fergal McNamara

and hopefully pass without straining.

Exercise is very good.

It improves the blood flow in the area.

Avoiding prolonged sitting.

Now, this has been kind of a controversial one that sitting down all the time necessarily causes them.

It is associated with them, but the evidence is mixed.

But what we do know is that sitting on the toilet for prolonged periods, especially over five minutes, has a huge increase in your risk of haemorrhoids.

Okay, this is the straining you were talking about.

Yeah, yeah, yeah.

Absolutely.

The reason we set up the clinic myself and Cillian Keogh set up the clinic almost five years ago now, it was our experience in hospital and as GPs,

where you were seeing people turn up to emergency departments who had severe bleeding, who were in severe pain.

I remember one poor man one night in Bowman Hospital emergency department who was on morphine because he had an incarcerated hemorrhoid.

It prolapsed out the back passage, yeah.

Poor man was in terrible pain.

So there wasn't a lot of treatment options out there.

We went looking for this option that you can treat in the community.

We got it over from the UK and we've been using it with good success since.

Absolutely.

So I suppose you start with the topical treatments, so that's the ointments and the suppositories.