Dear Dr. Gott: Seven or eight years ago, you suggested using Vicks VapoRub for relief of the discomfort associated with anal haemorrhoids. It has worked really well for me. I have used both the Vicks and store-brand equivalents. I have no more pain from my two haemorrhoids but now wonder if I should keep using the product or have the haemorrhoids removed. I am a 67-year-old male.

Dear Reader: I had all but forgotten this advice for the treatment of haemorrhoids, so thank you for writing to inform me of your positive results.

Haemorrhoids are swollen, inflamed veins in the lower rectum and/or anus. They can be internal or external and are usually the result of straining during bowel movements, chronic diarrhoea or constipation, or from increased pressure on the veins due to obesity, pregnancy and more. The condition is common, with an estimated 50 percent of adults over age 50 having had symptoms at least once in their lifetimes.

Symptoms include painless bleeding during bowel movements (bright red blood on toilet tissue or in the bowl), foecal leakage, pain or discomfort, a sensitive or painful lump near the anus, anal itching/irritation or swelling and protruding veins.

It is always advisable to see a physician if any of the above symptoms are present in order to rule out other, more serious disorders, since colorectal and anal cancers can cause similar symptoms. After receiving a diagnosis from a medical doctor, he or she will likely recommend home treatment of the haemorrhoids because most cases respond favorably and do not require medical treatment.

Home therapy includes over-the-counter topical haemorrhoid creams and/or suppositories, ice packs to relieve swelling, taking several warm baths or sitz baths daily, using unscented, alcohol-free moist towelettes to pat the area clean after a bowel movement, and using OTC oral pain relievers.

If these conservative measures don't help, it's time to return to your physician. He or she may recommend a minimally invasive procedure, such as rubber-band ligation, which cuts off blood flow to the affected area; injecting a chemical solution into the tissue to shrink the haemorrhoid (may be less effective than banding); and using one of several methods to harden and shrivel smaller hemorrhoids (a procedure associated with a higher rate of recurrence).

For large or resistant hemorrhoids, surgery may be recommended. Haemorrhoidectomy involves removing all the excessive tissue causing the bleeding. It is the most effective and complete way to remove the hemorrhoids but is also associated with the highest rate of complications.

Stapling blocks blood flow, causing the vein to dry. It is associated with less pain and faster healing time but also has a greater risk of recurrence and for the development of a condition known as rectal prolapse, in which part of the rectum protrudes from the anus.

It is possible to prevent haemorrhoids by increasing the amount of dietary fibre consumed or taking supplements and drinking plenty of fluids. Each can soften and add bulk to the stool, which makes it easier to pass. Be sure to relieve yourself as soon as you feel the urge to defecate. Don't strain, and don't stand or sit for too long, as each function can increase pressure on the lower rectal veins. Exercise reduces pressure and can also help with weight loss.

My advice is, if you are not having a problem, then stick with what you are doing. Even doctors recommend home treatment for haemorrhoids, since medical/surgical treatments may cause unwanted complications and cause haemorrhoids to recur.

Dr. Peter H. Gott is a retired physician and the author of several books, including "Live Longer, Live Better," "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook," which are available at most bookstores or online. His website is www.AskDrGottMD.com.