Exercise Your Brain

Exercise Your Brain.

According to Michael Merzenich, chief scientific officer with Posit Science in San Francisco, the key to memory longevity is lifelong learning. (Exercising your brain.)

“Often, as people age, they engage in less and less learning,” Merzenich told United Press International. “They rest on their laurels, and their environments, even if stimulating (such as a job or hobbies), do not drive new learning.” Apparently, their brains become weak and in need of exercising.

Merzenich’s company is pioneering brain-training exercises for aging adults that, like calisthenics, keep the organ flexible, in good physical shape and functioning well into the golden years. The company’s computer-guided exercises—which are being marketing to assisted-living and retirement communities—aim at augmenting memory and improving visual acuity and hearing. The memory exercises should be practiced five days a week for an hour a day for eight weeks—a demanding regimen, but one that researchers think may mitigate memory loss.
“As the brain gets into ruts, it is not challenged with new learning, and without crucial stimulation, the brain’s function can gradually erode over time, leading to decreased memory and cognitive function,” Merzenich explained.

Undertaking a rigorous “brain fitness” program later in life may be only part of the answer, said Dr. Thomas Crook, former chief of the National Institute of Mental Health’s Geriatric Psychopharmacology Program. Diet plays an absolutely key role in determining brain function later in life, he said, and establishing healthy eating habits early on can deliver dividends in old age.

“Diet is very important. A generalization would be that those things that are good for the heart are good for the brain as well,” Crook told UPI.

Likewise, exercise appears to contribute to better brain health, he said. A lot of research is showing that aerobic exercise is particularly helpful. Even 30 minutes of walking per day can help. Apparently, vascular changes in the heart also apply to the brain, and exercise benefits both. The worst thing you can do for your brain is to sit on the couch watching TV for hours.
According to a 2005 study by Harvard University researchers, fruit and vegetable intake is inversely related to cognitive decline—the more fresh foods you eat, the better your chances of maintaining brain health.

The Harvard group followed a cohort of female subjects from 1976 to 2001 and tracked their eating habits along with mental function over four decades. They found that the women who ate the highest amounts of green leafy vegetables (such as broccoli, greens and spinach) had the slowest mental decline.

“The finding with cruciferous vegetables, we believe, may be because they are nutrient dense—good source of vitamin C, beta carotene, B vitamins, which have all been found in some studies to be associated with better cognition,” said Jae Hee Kang, lead author of the Harvard study.
So— now that you’ve finished reading this don’t you want to go for a jog around the block and finish it off with an extra large glass of carrot juice. After all, you’re investing in the health of your brain.

Exercise Helps Prevent Age-Related Brain Changes

Older adults who exercise regularly show increased cerebral blood flow and a greater number of small blood vessels in the brain, according to findings presented today at the annual meeting of the Radiological Society of North America (RSNA).

The study, conducted at the University of North Carolina (UNC) - Chapel Hill, is the first to compare brain scans of older adults who exercise to brain scans of those who do not.

"Our results show that exercise may reduce age-related changes in brain vasculature and blood flow," said presenter Feraz Rahman, M.S., currently a medical student at Jefferson Medical College in Philadelphia. "Other studies have shown that exercise prevents cognitive decline in the elderly. The blood vessel and flow differences may be one reason."

The researchers recruited 12 healthy adults, age 60 to 76. Six of the adults had participated in aerobic exercise for three or more hours per week over the last 10 years, and six exercised less than one hour per week. All of the volunteers underwent MRI to determine cerebral blood flow and MR angiography to depict blood vessels in the brain.

Using a novel method of three-dimensional (3-D) computer reconstruction developed in their lab, the researchers were able to make 3-D models of the blood vessels and examine them for shape and size. They then compared the blood vessel characteristics and how they related to blood flow in both the active and inactive groups.

The results showed that the inactive group exhibited fewer small blood vessels in the brain, along with more unpredictable blood flow through the brain.

"The active adults had more small blood vessels and improved cerebral blood flow," said the study's senior author, J. Keith Smith, M.D., Ph.D., associate professor of radiology at UNC School of Medicine. "These findings further point out the importance of regular exercise to healthy aging."

Meditation Exercises

RELAXATION EXERCISE

Before each meditation exercise it is worth spending a few minutes relaxing the body. One way is to imagine/feel the tension moving out of your muscles and down your body so that all the tension finally runs through your feet and into the ground.

Sit with a straight back, but do not overdo it so that the back becomes tense. Concentrate on focusing your awareness/attention on specific muscles of your body. Starting with your head, feel the tension drain downward out of your face. Move your awareness down the neck – imagine that you can push the tension downward and that the muscles relax and soften. Continue down the body, especially work on the shoulders and stomach muscles. Keep moving the tension downward until you reach your feet. At this point imagine all the accumulated tension is forced out of your feet and into the floor. Now bring your awareness to the centre of your chest. Imagine that there is a vast sea of peace in the centre of your chest. Spend a few minutes enjoying the tranquillity within yourself.
Key points of exercise

* Get rid of the tension within the body.

* Be aware of the tension - and the tranquillity - within yourself.

Purpose of exercise

* Relaxing helps us to ‘centre’ and to feel that we are in the present moment

. Breathing into the heart centre

Please breathe in and hold your breath for a couple of seconds, and feel that you are holding the breath, which is life-energy, in your heart centre. This will help you to develop your inner meditation capacity.

2. Becoming aware of the breath

When you sit down to meditate, try to breathe in as slowly and quietly as possible, so that if somebody placed a tiny thread in front of your nose it would not move at all. And when you breathe out, try to breathe out even more slowly than you breathed in. If possible, leave a short pause between the end of your exhalation and the beginning of your inhalation. If you can, hold your breath for a few seconds. But if that is difficult, do not do it. Never do anything that will make you physically uncomfortable during meditation.

3 Breathing in peace and joy

The first thing that you have to think of when practising breathing techniques is purity. When you breathe in, if you can feel that the breath is coming directly from God, from Purity itself, then your breath can easily be purified. Then, each time you breathe in, try to feel that you are bringing infinite peace into your body. The opposite of peace is restlessness. When you breathe out, try to feel that you are expelling the restlessness within you and also the restlessness that you see all around you. When you breathe this way, you will find restlessness leaving you. After practising this a few times, please try to feel that you are breathing in power from the universe, and when you exhale, feel that all your fear is coming out of your body. After doing this a few times, try to feel that you are breathing in infinite joy and breathing out sorrow, suffering and melancholy.

4. Cosmic energy

Feel that you are breathing in not air but cosmic energy. Feel that tremendous cosmic energy is entering into you with each breath, and that you are going to use it to purify your body, vital, mind and heart. Feel that there is not a single place in your being that is not being occupied by the flow of cosmic energy. It is flowing like a river inside you, washing and purifying your entire being. Then, when you breathe out, feel that you are breathing out all the rubbish inside you—all your undivine thoughts, obscure ideas and impure actions. Anything inside your system that you call undivine, anything that you do not want to claim as your own, feel that you are exhaling.
This is not the traditional yogic pranayama, which is more complicated and systematised, but it is a most effective spiritual method of breathing. If you practise this method of breathing, you will soon see the results. In the beginning you will have to use your imagination, but after a while you will see and feel that it is not imagination at all but reality. You are consciously breathing in the energy which is flowing all around you, purifying yourself and emptying yourself of everything undivine. If you can breathe this way for five minutes every day, you will be able to make very fast progress. But it has to be done in a very conscious way, not mechanically.

5. Total breathing

When you reach a more advanced stage, you can try to feel that your breath is coming in and going out through every part of your body—through your heart, through your eyes, through your nose and even through your pores. Right now you can breathe only through your nose or your mouth, but a time will come when you will be able to breathe through every part of your body. Spiritual Masters can breathe even with their nose and mouth closed. When you have perfected this spiritual breathing, all your impurity and ignorance will be replaced by God's light, peace and power.

Imagine that you can see your breath entering your nose and slipping slowly and silently down into your lungs. Feel your breath is filling your chest cavity, energising your entire body. Keep your awareness in the centre of your chest. Imagine that you are in the centre of your own chest. Observe your breath coming in and bring with it all its positive energy. Then watch as your breath is exhaled carrying away negative feelings and emotions and even thoughts. Try to stay centred in your chest all the way through this exercise - keep your awareness in the centre of your chest.

Key points of exercise
* Feel your awareness is in the centre of your chest.

* Observe your breathing in a relaxed and detached way.

* Do not force your breathing.

Purpose of this exercise.

To slow, calm and relax your breathing – this in turn helps to calm and quieten the mind, to prepare yourself for meditation. It is important that our breathing is calm and relaxed before we attempt to focus on the next level which is single pointed concentration. We need to spend a few minutes “letting go” of our hectic outer activities and the impact they have on our mental state. A breathing exercise is perfect for this.
There are many different breathing exercises, this particular one also serves to help us become aware of a more subtle space within ourselves – the centre of the chest houses the Heart centre. The Heart centre is a sweet and peaceful space which we will use in subsequent meditation exercise.

Exercises in Concentration
1. The dot
If you want to develop the power of concentration, then here is an exercise you can try. First wash your face and eyes properly with cold water. Then make a black dot on the wall at eye level. Stand facing the dot, about ten inches away, and concentrate on it. After a few minutes, try to feel that when you are breathing in, your breath is actually coming from the dot, and that the dot is also breathing in, getting its breath from you. Try to feel that there are two persons: you and the black dot. Your breath is coming from the dot and its breath is coming from you.
In ten minutes, if your concentration is very powerful, you will feel that your soul has left you and entered into the black dot on the wall. At this time try to feel that you and your soul are conversing. Your soul is taking you into the soul's world for realisation, and you are bringing the soul into the physical world for manifestation. In this way you can develop your power of concentration very easily. But this method has to be practised. There are many things which are very easy with practice, but just because we do not practise them we do not get the result.
2. Vision and reality
Another exercise you can try is this. First make a very small circle on the wall at eye-level, and inside it make a black dot. It should be black; not blue or red or any other colour. Then stand facing the wall, about three and a half feet away, and focus your attention on the circle. Your eyes should be relaxed and half-open. Let the force of your concentration come from the middle of your forehead. After three or four minutes open your eyes fully and try to feel that, from head to foot, you are all eyes. Your whole physical existence has become nothing but vision, and that vision is focussed on the dot inside the circle. Then start making the object of your concentration smaller. After a few seconds try to feel that your whole body has become as tiny as the dot on the wall. Try to feel that the dot is another part of your own existence. Then enter into the dot, pierce through it and go to the other side. From the other side of the dot, look back and see your own body. Your physical body is on one side, but on the strength of your concentration you have sent your subtle body to the other side of the dot. Through your subtle body you are seeing your physical body, and through your physical body you are seeing your subtle body.
When you began to concentrate, your physical body became all vision. At that time the dot was your reality. When you entered into the dot, then vision and reality became one. You were the vision and you were also the reality. When you looked back at yourself from the dot, the process was reversed. At that time you became the vision outside yourself, and the place to which you returned—your body—was the reality. Then, the vision and the reality became one again. When you can see the vision and the reality in this way, your concentration is absolutely perfect. When your power of concentration can bring you to the other side of the point which you were calling reality, at that time your whole existence will be far beyond both vision and reality. And when you can feel that you have transcended your vision and your reality, you will have boundless power.
3. My heart-friend
Just as you can concentrate on the tip of your finger, or on a candle or any other material object, you can also concentrate on your heart. You may close your eyes or look at a wall, but all the time you are thinking of your heart as a dear friend. When this thinking becomes most intense, when it absorbs your entire attention, then you have gone beyond ordinary thinking and entered into concentration. You cannot look physically at your spiritual heart, but you can focus all your attention on it. Then gradually the power of your concentration enters into the heart and takes you completely out of the realm of the mind.
If you do not have purity in abundant measure, if countless earthly desires are in possession of the heart, then before concentrating on the heart you should invoke purity. Purity is the feeling of having a living shrine deep in the inmost recesses of your heart. When you feel the divine presence of an inner shrine, automatically you are purified. At that time your concentration on the heart will be most effective.

4. The heartbeat of life

Some seekers like to concentrate on their heartbeat. If you want to do this, do not be afraid that the heart will stop and you will die. If you want to be a real hero in your spiritual life, you can practise concentrating on your heartbeat. This is the golden opportunity for you to enter into the endless life. Each time you hear the sound of your heartbeat, immediately feel there your infinite, immortal life.

5. The inner flower

For this exercise you will need a flower. With your eyes half closed and half open, look at the entire flower for a few seconds. While you are concentrating, try to feel that you yourself are this flower. At the same time, try to feel that this flower is growing in the inmost recesses of your heart. Feel that you are the flower and you are growing inside your heart.
Then, gradually try to concentrate on one particular petal of the flower. Feel that this petal which you have selected is the seed-form of your reality-existence. After a few minutes, concentrate on the entire flower again, and feel that it is the Universal Reality. In this way go back and forth, concentrating first on the petal—the seed-form of your reality—and then on the entire flower—the Universal Reality. While you are doing this, please try not to allow any thought to enter into your mind. Try to make your mind absolutely calm, quiet and tranquil.
After some time, please close your eyes and try to see the flower that you have been concentrating on inside your heart. Then, in the same way that you concentrated on the physical flower, kindly concentrate on the flower inside your heart, with your eyes closed.

Concentration Exercise with Flower

“The Inner Flower. For this exercise you will need a flower. With your eyes half closed and half open, look at the centre of the flower for a few seconds. While you are concentrating, try to feel that you yourself are this flower. At the same time, try to feel that this flower is growing in the inmost recesses of your heart. Feel that you are the flower and you are growing inside your heart.

Then, gradually try to concentrate on one particular petal of the flower. Feel that this petal which you have selected is the seed-form of your reality-existence. After a few minutes, concentrate on the entire flower again, and feel that it is the Universal Reality. In this way go back and forth, concentrating first on the petal – the seed-form of your reality – and then on the entire flower – the Universal Reality.

While you are doing this, please try not to allow any thought to enter into your mind. Try to make your mind absolutely calm, quiet and tranquil.

After some time, please close your eyes and try to see the flower that you have been concentrating on inside your heart. Then, in the same way that you concentrated on the physical flower, kindly concentrate on the flower inside your heart, with your eyes closed.”

“Each time an undivine thought enters into your mind, throw it out of your mind. It is like a foreign element, a thief, that has entered your room.”

“In the beginning you may not be able to concentrate according to your satisfaction because the mind is not focused. The mind is constantly thinking of many things. It has become a victim of many uncomely thoughts... When your mind starts getting illumined, it will be very, very easy to concentrate for a long time, and also to concentrate more deeply.”

Heart attack

The goals of initial treatment are to minimize damage by restoring blood flow to the heart and to determine the amount of damage to heart tissue. It is critical to call for immediate medical attention if heart attack is suspected. Intensive research over the last 20 or more years has demonstrated that prompt treatment can decrease damage from a heart attack and increase the chance for survival.

The heart may develop irregular heart rhythms (arrhythmias) or stop beating (sudden cardiac arrest) during a heart attack. When the heart is unable to pump blood throughout the body, brain damage and death can occur within minutes.

Emergency medical personnel can quickly assess the situation and may perform an electrocardiogram (ECG) to measure electrical activity in the heart. If the patient is in cardiac arrest, or is experiencing an abnormal heart rhythm, a device called a defibrillator may be used to "shock" the heart into a normal rhythm.

Emergency medical personnel also can administer medications and begin treatments immediately that can help dissolve a blood clot and open a blocked coronary artery, restoring normal blood flow to the heart. If these therapies are initiated within 1 hour of the onset of symptoms, less irreparable damage may occur.

Even before emergency personnel arrive, cardiopulmonary resuscitation (CPR) can be performed if the patient has no pulse and a capable bystander is present. CPR is a combination of rescue breathing and chest compressions. Automated external defibrillators designed for CPR are available in some public places (e.g., airports, shopping malls, large office buildings). Defibrillators also are available without a prescription for home use.

Recent studies have shown that a procedure called cardiocerebral resuscitation may help improve outcomes for patients who suffer a heart attack outside of a hospital setting. In cardiocerebral resuscitation, emergency personal administer uninterrupted chest compressions for approximately 2 minutes (200 compressions), then perform regular CPR and use a defibrillator to administer an electrical shock, if necessary.

If the patient is still in cardiac arrest, the procedure is repeated as many as 3 times. Cardiocerebral resuscitation also involves administering epinephrine (drug that constricts blood vessels) as quickly as possible and with each cycle of 200 chest compressions.
Studies have shown that cooling the body temperature to between 89.6 °F and 93.2 °F may help to prevent brain damage in patients who survive cardiac arrest lasting more than a few minutes. This treatment, which is called mild therapeutic hypothermia, should be started as soon as possible after the patient is resuscitated and continued for 12–24 hours. Cooling blankets, ice packs, fanning, and intravenous (IV) solutions can be used to lower the patient's core body temperature.

Treatment may include the following:

Thrombolytic therapy
Heparin therapy
Aspirin
Beta-blockers
Nitroglycerin
IIb/IIIa Inhibitors
Primary percutaneous transluminal coronary angioplasty (PTCA)

Thrombolytic therapy

Several new "clot-busting drugs," called thrombolytic agents, can help dissolve blood clots and prevent further heart damage. Although clot-busting drugs (e.g., r-PA, t-PA, tnk-PA, streptokinase) are most effective when administered within the first several hours of a heart attack, they are beneficial when administered within 12 hours following the onset of symptoms.
These medications are not used in all cases, and whether they are used or not is determined primarily by electrocardiogram results. Thrombolytic agents carry a small risk for causing excessive bleeding, which can cause stroke if it occurs in the brain; however, potential benefits usually outweigh the risk.

Heparin therapy

Heparin is a drug used to "thin" the blood to help prevent further blood clot formation. This drug may be particularly useful in patients who experience intermittent blood clot formation within a coronary artery.
The older form of heparin, called unfractionated heparin, usually is administered via a continuous intravenous (IV) infusion. Frequent blood tests are required during treatment to monitor how "thin" the blood is.
Newer forms of heparin, called low molecular weight heparins, usually are administered via injection in the abdomen twice a day. These medications include enoxaparin (Lovenox®), dalteparin (Fragmin®), and nadroparin (Fraxiparin®). Low molecular weight heparins require less frequent monitoring and several studies suggest that this form of the drug prevents recurrent heart attack and death more effectively than unfractionated heparin.

Aspirin

Taking an aspirin during a heart attack and each day following a heart attack can decrease the risk of dying from the condition by almost 25%. Blood clots primarily are composed of platelets (microscopic particles that circulate in the bloodstream) that "stick" to ruptured plaques and to each other. Aspirin makes platelets less "sticky," decreasing the risk for further blood clot formation.
Studies have shown that some patients are resistant to the effects of aspirin therapy. Regular blood tests may be performed to monitor the patient's response; the results of these tests can be used to adjust the aspirin dosage or change the medication.

Beta-blockers

These drugs slow the heart rate and decrease the strength of the heart's contractions, reducing strain on the heart and its oxygen requirement. Commonly used beta-blockers include metoprolol (Lopressor®, Toprol XL®) and atenolol (Atenolol®). These drugs usually are administered intravenously (through a vein) at first and then orally.
Studies have shown that taking beta-blockers during and after a heart attack decreases the risk for recurrent heart attack and death. Therefore, patients without contraindications to beta-blocker therapy often take these drugs indefinitely. Beta-blockers may cause erectile dysfunction.

Nitroglycerin

Nitroglycerin is a chemical that opens up (dilates) arteries and veins and increases blood flow to the heart. During heart attack, nitroglycerin can be placed under the tongue, where it quickly dissolves and is absorbed into the bloodstream.

Nitroglycerin also can be administered via continuous intravenous (IV) infusion; applied to the skin in cream or patch form, where it is slowly absorbed; or administered as short- or long-acting nitrate pills. Isosorbide dinitrate (Isordil®) usually is taken 3 times a day and isosorbide mononitrate (Ismo®, Imdur®) is taken either twice (Ismo) or once daily (Imdur).
Because nitroglycerin dilates not only the coronary arteries, but also other blood vessels, it may cause severe headaches. In some cases, headaches are so severe that patients are unable to tolerate nitroglycerin therapy.

IIb/IIIa Inhibitors

These drugs help to prevent platelets from sticking together and forming blood clots. They also help dissolve existing blood clots. Studies show that treatment with IIb/IIIa inhibitors can reduce the risk for recurrent heart attack or death. IIb/IIIa inhibitors include eptifibatide (Integrelin®), tirofiban (Aggrastat®), and abciximab (ReoPro®).
Primary percutaneous transluminal coronary angioplasty (PTCA)

In some cases, primary percutaneous transluminal coronary angioplasty (PTCA), or angioplasty, is performed to obtain images of the coronary arteries, identify the blockage, and determine the best course of treatment.

Coronary angioplasty is performed in a catheterization laboratory (cath lab), under sedation and a local anesthetic. An iodine-based dye or other contrast agent is injected to make the arteries and blockage(s) visible on a monitor. Physicians use a monitor as a guide during the procedure.
During coronary angioplasty, the coronary arteries are accessed through a small incision made in the femoral artery, located in the groin, or the brachial artery, located in the arm. In most cases, the femoral artery is used. A pencil-sized plastic sheath is inserted through the artery and flexible catheters are passed through the sheath to the blocked coronary artery. Then, a device such as an ultra-thin wire, tiny balloon, or a small metal spring-like device called a stent, is used to stretch open the blocked artery.

Although angioplasty is relatively safe, complications can occur, including the following:
Allergic reaction to iodine-based dye
Arrhythmias
Bleeding at the insertion site
Infection at the insertion site
Kidney failure
Ruptured artery (dissection)
Stroke

Allergic reactions to iodine-based dye range from hives to anaphylactic shock, which can involve hives, rash, swelling (edema), vascular collapse, shock, and respiratory distress. Anaphylactic shock is life threatening and requires immediate medical attention.
Rarely, an inflated angioplasty balloon can tear the blood vessel wall (dissection). If this occurs, emergency bypass surgery is performed.

piles

What are they?
The tissue of the anus is rich in blood vessels. If these become dilated and swollen, they may project into the anal canal or out of the back passage (a prolapse) to form visible swellings. Some people describe them as varicose veins of the anus.
Piles are incredibly common - at least 50 per cent of people suffer with them at some time.
Causes
Piles tend to be caused by factors that cause the blood vessels to swell, including anything that increases pressure inside the abdomen such as constipation, pregnancy and being overweight.
Symptoms
Piles may cause no symptoms, especially if they're small, and many people don't realise they have them. However, they can also cause a range of problems:
A swelling protruding from the anus. Piles may be felt as small soft lumps at the opening of the back passage, sometimes compared to a 'bunch of grapes'. They're usually soft and fleshy but may become hard if thrombosis occurs. The piles may only appear after straining on the toilet.
Bleeding from the back passage. The mucosa that covers the piles is quite delicate and if it is damaged, for example as you open your bowels, there may be bleeding, which is usually seen as small amounts of bright red blood on the toilet paper or on the surface of the motions. Occasionally, piles cause severe bleeding.
Mucus discharge.
Itching. Piles can cause intense itching of the skin around the back passage.
Piles can be painful, but this is uncommon. Acute pain and the appearance of a hard lump protruding from the anus can signal thrombosis of the haemorrhoid.
Treatment
The treatment of piles depends on the severity of symptoms. Firstly, it's important to take steps to avoid aggravating factors such as constipation or being overweight. Keeping your bowel motions soft and regular will also help to avoid straining.
Make sure you eat plenty of fibre to provide bulk in your diet by including lots of bread, vegetables, cereal and nuts.
Consider fibre supplements.
Avoid dehydration by drinking plenty of water and fruit juice.
Keep to a regular bowel habit and go to the toilet when you feel the need to - don't try to hold it in.
Get plenty of exercise - this helps keeps the bowels regular.
Avoid causes of constipation, such as painkillers that contain codeine.
These measures may be all that's needed to allow small haemorrhoids to settle. More persistent piles may need specific treatments.
Pain-relieving creams and ointments, which may contain an anaesthetic, can help soothe the discomfort of piles and allow you to open your bowels more easily. If piles become thrombosed this can be acutely painful. Cold packs and strong pain relief may be needed.
Surgical options

Haemorrhoid facts

Piles are common and usually painless
There is no link between piles and bowel cancer, although your doctor may take the opportunity to check for bowel cancer while examining your piles
One of the most effective ways to prevent piles is to avoid constipation
Surgery may be necessary to treat persistent or very painful piles. Many different techniques are used including injecting the piles with a chemical to make them scar and shrink, putting a tight band around the pile until it scars and drops off (ligation), or freezing or cutting them off.
Another operation which is often done to help piles is to gently stretch the anus (while the person is under anaesthetic) as there may be overactivity of the internal anal sphincter (a muscly control valve).

Recent research has looked at injections of botulinum toxin or creams containing nitroglycerine ointment to relax the muscle sphincter.
Haemorrhoidectomy, or surgical removal of the piles, is necessary when clots repeatedly form, ligation fails to work or there is persistent bleeding. Haemorrhoidectomy is usually done under general anaesthetic in hospital. There is a small risk of anal stricture (a scarred narrowing of the anal canal) and injury to the sphincter.