When you drive off the north exit from the PLUS highway to Sungai Petani, you’ll come to a crossroad. There are traffic lights there. What confuses first-time visitors to the area is, there’s a road straight ahead to the Western Bypass but there’s no lane marked for vehicles that want to go straight. I wonder whether the MPSPK (Majlis Perbandaran Sg Petani, Kedah) knows about this problem.

Next, is the issue of traffic from the opposite direction. There are 2 lanes for traffic. The left lane is marked with a straight arrow and the right lane is marked with a straight and right-turn arrow. The problem is, there are many more vehicles intending to turn right than go straight to the highway. So, some drivers use the left lane to turn right when there’s a long queue on the right lane.

I expect that accidents may occur when a driver uses the right lane (which he has the legal right to) to go straight. Besides, the queue on the right lane becomes longer than is has to be at this junction because the left lane is underutilised. All it takes to correct it is to change the arrows to allow vehicles to go straight and turn right from the left lane and, of course, to use the right lane exclusively for turning right only.

Here are the photos of the stapled haemorrhoidectomy instruments, as promised.

Here’s another view of a pile.

I planted grass in the yard. It’s going to take a few months before they grow to cover the whole surface. Got some trees from the Department of Agriculture to plant in the compound. They sell the saplings for RM1.00 each. I suppose that it is to encourage the public to plant trees. Planted mango, ciku, jambu, soursop and limau purut in the backyard. I’m looking for a longan tree. Check back in a few years’ time, and maybe I’ll have the photos of the fruits, haha!

Treatment of piles may be conservative (=without surgery) or operative (=by operation).

Almost all piles will eventually shrink. The key is to allow them to shrink. Avoiding straining at motion allows piles to shrink.

Lifestyle changes include taking a high fibre diet to produce soft bulky motion. Both hard motion and loose motion cause straining at motion. Loose motion (diarrhoea) causes straining because the patient tries to evacuate “everything” to avoid going to toilet again too soon. However, there’s nothing to evacuate from the rectum, so it results in futile straining. Straining leads to increase in the piles.

Visiting the toilet only when there’s an urge to void helps to reduce straining at motion.Going by the clock may result in futile straining at an empty rectum.

There are various oral and topical preparations that may help shrink acute swelling of piles.

Rubber-banding is a simple, cheap and painless method of treating piles. The rubber band strangles the piles. They end up shrunken and drop off. The lining of the rectum becomes scarred and prevents recurrence of piles. Here’s a diagram of banding piles:

Haemorrhoidectomy (haemorrhoid=piles, ectomy=cut away) is the operation of choice for piles with a large external part. This may be open (wound left open after operation) or closed (wound closed after operation).

Stapled haemorrhoidopexy may be used for 3rd and 4th degree piles. The advantage of staplers is less pain compared to haemorrhoidectomy.