There are the diseases you don't want to get because they'll kill you. Then there are the diseases you don't want to get because you are too embarrassed to discuss them out loud, even with your doctor.
Hemorrhoids often fall into the latter category.
By age 30, more than half the population has one or more hemorrhoids symptoms. It's one of the most common ailments, and yet talking about the extreme pain, bleeding, and itching in your anal or rectal area is another story. Heck, even typing that sentence made me blush.
Studies show only a third of patients with symptomatic hemorrhoids actually seek medical help. Most would rather suffer in silence.
In fact, Google stats show a disproportionate number of you type the word "hemorrhoid" into that search box, and come to CNN looking for help.
As a member of the medical team, let me personally thank you for trusting CNN to give you accurate medical information. We are a great first step. But sometimes you really should talk to a doctor, even if it's hard to choke out words for problems like "hemorrhoids," "herpes," "toenail fungus" or anything else "down there," as one patient called their pelvic region.
"It is so important for you to be able to talk to your doctor, because your health is at stake," said Carrie Bernat. Bernat works at the University of Michigan Medical School training medical students to offer better patient-centered care. Your relationship with your doctor "needs to be based on trust and respect, otherwise information will be missed on either side and it will have a negative impact."
In other words, a failure to communicate with your doctor can hurt your health.
Thankfully, hemorrhoids are not all that dangerous. The veins near your anus or rectum have gotten swollen. There are topical creams you can buy at the drugstore to treat them. You can make dietary changes like adding more fiber and drinking more water to reduce your chances of having them. You could even try something called a sitz bath to make them feel better.
But sometimes hemorrhoids are beyond the help of home remedies. They can become so painful you need surgery. Hemorrhoids can come back even after you treat the symptoms and stay a real pain in the -- well you know. A doctor can help.
It's also good to talk to a doctor for peace of mind. What if it's not really hemorrhoids? What if it's something else?
"Letting go of the idea that something is embarrassing is important, because the physicians are trained to handle all these things in a confidential way," Bernat said. "I know that's easier said than done, but they can't take care of you if they don't know what is going on."
We've got the medical studies to prove it.
For instance, one study found that poor communication between a doctor and a patient when it came to a less embarrassing disease, asthma, may be one of the reasons minorities have less effective treatment outcomes.
"Good communication is essential to help me find the sweet spot as far as treatment," said Dr. Greg Diette who was a co-author on the study and works at Johns Hopkins.
Diette tries to work around a patient's reticence. He starts each appointment with open-ended questions.
He's mindful not to interrupt. He builds rapport. "Then when there are things I need to know, only then do I ask specifics," he said. And he's always sure to ask a final question.
"At the end, I always ask 'Is there anything so far that we have not talked about?' and that's often when I get the great questions," Diette said.
Some doctors call these the "hand-on-the-door questions."
He says some doctors also try to work around this discomfort by having you fill out a survey before you go in to see them. The thinking is that you will feel more comfortable filling that out, rather than talking about a problem. Then it will be the doctor prompting you with questions.
If you get a sense that your doctor is in a hurry, don't let that get to you, even if that may be easier said than done. A 2012 study found that patients didn't want to ask too many questions because they worried they would be perceived as "difficult," particularly when they sensed the doctor had a time constraint.
"Asking questions, discussing preferences or disagreeing with a recommendation are communication skills used in everyday life," the study said. But "for many patients these may be novel in the context of a medical consultation."
So be sure to be an empowered patient and take your time and advocate for yourself when you go in to get things checked out. Doctors are used to talking about all sorts of medical issues, even if you are not.
Write down what you want to say ahead of time or put together a checklist so you can be sure to cover all your questions. Be honest on those surveys you get before you go into the office. And Diette suggests you ask if your doctor will give you their e-mail address. Sometimes he thinks it's easier for some of his patients to put things in writing, rather than say them out loud.
If all that doesn't work and you still don't feel comfortable communicating with your doctor, Bernat has a simple suggestion: Find one you can talk to.
It's that important.
"People don't want to offend or hurt anyone's feelings, but medicine is a customer-based process," she said. "Find someone you are comfortable with. It's essential so that getting information out of you is not a tug of war."