External Hemorrhoid Questions...

(Steve) said:

1) In my readings some say you can't ever get rid of an external hemoroid without surgery

Absolutely false. Hemorrhoids rarely require surgery. Truly thrombosed hemorrhoids (and frankly, if
yours isn't hurting that much, it's probably not thrombosed) can be relieved with a simple office
procedure (technically not a hemorrhoidectomy) by any primary care physician.

Quoted message said:

2) Besides sitz baths (I try, but have little time for them),

Too bad; they work great.

Quoted message said:

Preparation H (just started this), and ensuring normal bowel movements what can I do short of
surgery to make this entirely disappear.

Try Anusol HC cream (now available over the counter). It contains hydrocortisone, which should help
with the discomfort and promote shrinkage of the hemorrhoid.

Quoted message said:

Hate to go to the doctor if this will just clear up in time, how long might this take?

It might take a few days/weeks to resolve, depending on how aggressive you are in doing the things
we discussed above. Again, if it's truly thrombosed, you may wind up needing to see a doctor.

"Steve" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi, I am in my late 20's and just got my first hemorrhoid, an external one which I believe to be
thrombosed based on my internet research. It is just outside the front of the anus, slightly
larger than a pencil eraser, firm to the touch, and a deep shiny blue in appearance. I have had it
for about 10 days now with little to no change in size from day 1 when it suddenly appeared. It
may be slightly smaller, but not by much. Pictures of thromobosed external hemorrhoids I have
found are identical to what mine looks like but without the "severe" pain they say normally comes
with such a hemorrhoid.

Hate to go to the doctor if this will just clear up in time, how long might this take? While I can
clearly live with it just fine if this is as bad as it gets... I want it gone. :-)

It will help to set the stage for healing the acute problem if you a) use astringents (Preparation
H, Anusol, etc) b) use stool softeners c) take oral mineral oil with the stool softeners.

A thrombosed external hemorrhoid can be very painful. If that is indeed what you have, you basically
have four options:

1) do nothing. The thrombosis will gradually resolve over a matter of a couple of weeks and the
painful inflammation will subside. The problem with this is that the hemorrhoid is still there
and will very likely re-thrombose some day in the future.

2) see your doctor and have the thrombosis incised and clot removed. This will result in a shorter-
term decrease in the pain and a faster resolution than above. The problem with this that the
hemorrhoid is still there and will very likely re-thrombose some day in the future.

3) see a surgeon and have the thrombosed hemorrhoid completely excised. Depending on the
hemorrhoid, this may be able to be done in the office under local anesthesia. This will
eliminate the chance that that particular hemorrhoidal vein (which is apparently prone to
thrombosis) will thrombose again. The problem with this is that the local anesthesia hurts a lot
(albeit briefly) and you would have a fair amount of pain (maybe more than what you are
suffering now) for a couple of weeks.

4) see a surgeon and have a complete hemorrhoidectomy. This would markedly decrease the chance of
having hemorrhoid problems in the future. The problem with this is that it hurts A LOT, and hurts
A LOT for weeks.

Some of these options may be more or less adviseable depending on what is seen on examination and
from a more detailed history. As you can see, treatment of hemorrhoid problems is a matter of
choices, and balancing short term pain against long term resolution. The question always comes down
to "At what point does the long term recurrent problem become frequent/irritating/nuisance enough to
make it worth the pain of definitive treatment?" Hemorrhoid disease is a non-fatal problem, so only
you can answer that question.

HMc

Quoted message said:

Quoted message said:

Preparation H (just started this), and ensuring normal bowel movements what can I do short of
surgery to make this entirely disappear.

Try Anusol HC cream (now available over the counter). It contains hydrocortisone, which should
help with the discomfort and promote shrinkage of the hemorrhoid.

Preparation H and Anusol both have versions that contain hydrocortisone. However Preparation H
advertises this as being for "itching" and in fact barely mentions it for "hemorrhoids" and makes it
clear it has no "shrinking" medicine in it. For example:

Prepartion H Hydrocortisone:

Quoted message said:

Quoted message said:

Preparation H (just started this), and ensuring normal bowel movements what can I do short of
surgery to make this entirely disappear.

Try Anusol HC cream (now available over the counter). It contains hydrocortisone, which should
help with the discomfort and promote shrinkage of the hemorrhoid.

Preparation H and Anusol both have versions that contain hydrocortisone. However Preparation H
advertises this as being for "itching" and in fact barely mentions it for "hemorrhoids" and makes it
clear it has no "shrinking" medicine in it. The normal prepartion H has medicines in it that list
tissue shrinking properties for external hemorrhoids.

I want shrinking... does hyrdocortisone do this?

Quoted message said:

1) do nothing. The thrombosis will gradually resolve over a matter of a couple of weeks and the
painful inflammation will subside. The problem

with

Quoted message said:

this is that the hemorrhoid is still there and will very likely

re-thrombose

Quoted message said:

some day in the future.

what does it mean "the hemorrhoid is still there?" is a hemorrhoid is an inflamed vein, then when it
shrinks doesn't it return to normal size? Do you mean it is forever damaged and therefore this will
keep happening again and again, or will it forever stay large and round?

"Steve" <[email hidden]> wrote in message
news:tQ8_b.376644$xy6.1947831@attbi_s02...

Quoted message said:

what does it mean "the hemorrhoid is still there?" is a hemorrhoid is an inflamed vein, then when
it shrinks doesn't it return to normal size? Do

you

Quoted message said:

mean it is forever damaged and therefore this will keep happening again

and

Quoted message said:

again, or will it forever stay large and round?

Yes, a hemorrhoid is an enlarged vein. Like a varicose vein of the leg, but in a more inconvenient
location. They cause pain, bleeding, itching when they become inflamed. Once the vein is enlarged,
it's usually always enlarged. Sometimes, chronic inflammation or repeated acute inflammation with
cause the hemorrhoid to fibrose, but probably you can expect to have more problems with this
hemorrhoidal vein (or others) throughout the rest of your life.

HMc

"Steve" <[email hidden]> wrote in message
news:zM8_b.243651$U%5.1567631@attbi_s03...

Quoted message said:

Quoted message said:

Quoted message said:

Preparation H (just started this), and ensuring normal bowel movements what can I do short of
surgery to make this entirely disappear.

Try Anusol HC cream (now available over the counter). It contains hydrocortisone, which should
help with the discomfort and promote shrinkage of the hemorrhoid.

Preparation H and Anusol both have versions that contain hydrocortisone. However Preparation H
advertises this as being for "itching" and in fact barely mentions it for "hemorrhoids" and makes
it clear it has no "shrinking" medicine in it. For example:

Itching is one of the manifestations of inflammation, and the hydrocortisone is an anti-inflammatory
medication. The Anusol part of the Anusol HC is the astringent and causes the "shrinkage".

HMc

"Howard McCollister" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Steve" <[email hidden]> wrote in message news:tQ8_b.376644$xy6.1947831@attbi_s02...

Yes, a hemorrhoid is an enlarged vein. Like a varicose vein of the leg,

but

Quoted message said:

in a more inconvenient location. They cause pain, bleeding, itching when they become inflamed.
Once the vein is enlarged, it's usually always enlarged. Sometimes, chronic inflammation or
repeated acute inflammation with cause the hemorrhoid to fibrose, but probably you can expect to
have more problems with this hemorrhoidal vein (or others) throughout the rest

of

Quoted message said:

your life.

ok but what improvement am i expecting? will the small pencil sized bump go away and then appear
normal until it potentially flares up again at some point at the future? or is it unless i
contemplate surgery this small lump will always exist 24/7 forever? what am i trying to fix at this
point because besides extremly mild pain when washing or wiping, the main concern is the strange
sensation of this hard firm lump in a less than ideal location. while the pain sympotoms of a
thrombosed hemorroid are not there, the size, shape, and appearance are identical to several dozen
photos on the net of external thrombosed hemorrhoids i have seen. it is also firm as opposed to soft
which i read is an indicator of a thrombosed hemorrhoid. i just want this lump gone!!!

also is anusol HC the same thing as Preparation H Hydrocortisone... because the the P-H
Hyrdrocortisone lists none of the witch hazel and phenlyephrine that the other P-H's have for
"temporarily shrinking hemorrhoidal tissue." i just don't want to buy the hydrocortisone version of
P-H for itching that isn't there and up not shrinking this lump...

thanks for your help... this is a very embarassing topic despite so many people having it. i am just
trying to clear up what kind of improvement i can expect if i don't resort to surgery. basically
again, i was hoping for the lump to disappear.

Quoted message said:

ok but what improvement am i expecting? will the small pencil sized bump

pencil "eraser" sized bump i meant...

"Steve" <[email hidden]> wrote in message
news:pBb_b.102774$jk2.471319@attbi_s53...

Quoted message said:

"Howard McCollister" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Steve" <[email hidden]> wrote in message news:tQ8_b.376644$xy6.1947831@attbi_s02...

Yes, a hemorrhoid is an enlarged vein. Like a varicose vein of the leg,

but

Quoted message said:

in a more inconvenient location. They cause pain, bleeding, itching when they become inflamed.
Once the vein is enlarged, it's usually always enlarged. Sometimes, chronic inflammation or
repeated acute inflammation with cause the hemorrhoid to fibrose, but probably you can expect to

have

Quoted message said:

Quoted message said:

more problems with this hemorrhoidal vein (or others) throughout the

rest

Quoted message said:

of

Quoted message said:

your life.

ok but what improvement am i expecting? will the small pencil sized bump

go

Quoted message said:

away and then appear normal until it potentially flares up again at some point at the future? or
is it unless i contemplate surgery this small lump will always exist 24/7 forever? what am i
trying to fix at this point because besides extremly mild pain when washing or wiping, the main

concern

Quoted message said:

is the strange sensation of this hard firm lump in a less than ideal location. while the pain
sympotoms of a thrombosed hemorroid are not

there,

Quoted message said:

the size, shape, and appearance are identical to several dozen photos on

the

Quoted message said:

net of external thrombosed hemorrhoids i have seen. it is also firm as opposed to soft which i
read is an indicator of a thrombosed hemorrhoid. i just want this lump gone!!!

also is anusol HC the same thing as Preparation H Hydrocortisone...

because

Quoted message said:

the the P-H Hyrdrocortisone lists none of the witch hazel and

phenlyephrine

Quoted message said:

that the other P-H's have for "temporarily shrinking hemorrhoidal tissue."

i

Quoted message said:

just don't want to buy the hydrocortisone version of P-H for itching that isn't there and up not
shrinking this lump...

thanks for your help... this is a very embarassing topic despite so many people having it. i am
just trying to clear up what kind of improvement i can expect if i don't resort to surgery.
basically again, i was hoping for the lump to disappear.

It's more than likely that the eraser-lump will just disappear and become a plain old external
hemorrhoid again. As such, it will be prone to periodic flare-ups like this over the years,
something you can modify to some extent with stool softeners and spending as little time on the
toilet as possible (remove all reading material from your bathroom). The lump is acutely inflamed
right now, either due to irritation or due to thrombosis (probably the former). It doesn't matter
which, except that a thrombosis will take longer to resolve. When it does resolve, it is likely that
the lump will go away.

I don't know the relative merits of Preparation H with hydrocortisone vs. Anusol HC, but I usually
prescribe Anusol HC over the other.

Your body will heal itself. Anusol HC may hasten that healing, and the hydrocortisone will decrease
the inflammation, as will hot sitz baths.

HMc

"It's more than likely that the eraser-lump will just disappear and become a plain old external
hemorrhoid again."

what is a plain old external hemorrhoid? something you can still see or feel?

"Steve" <[email hidden]> wrote in message
news:Ukf_b.378264$xy6.2021145@attbi_s02...

Quoted message said:

"It's more than likely that the eraser-lump will just disappear and become

a

Quoted message said:

plain old external hemorrhoid again."

what is a plain old external hemorrhoid? something you can still see or feel?

Sometimes yes, sometimes no. It depends on the size of the hemorrhoid, and whether it's truly an
external hemorrhoid, or a prolapsed internal hemorrhoid.

You would be best served by seeing a doctor. Your questions are passing from general advice into the
realm of those that can't be answered without a history and examination.

I would recommend that you see your doctor if he/she is well-versed in hemorrhoid diagnosis and
treatment. If not, see a general surgeon, or colon-rectal surgeon because they certainly will be,
and may be able to provide in-office treatment such as rubber-band ligation of any internal
hemorrhoids that may be contributing.

HMc

thank you.

"Howard McCollister" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Steve" <[email hidden]> wrote in message news:Ukf_b.378264$xy6.2021145@attbi_s02...

Quoted message said:

"It's more than likely that the eraser-lump will just disappear and

become

Quoted message said:

a

Quoted message said:

plain old external hemorrhoid again."

what is a plain old external hemorrhoid? something you can still see or feel?

Sometimes yes, sometimes no. It depends on the size of the hemorrhoid, and whether it's truly an
external hemorrhoid, or a prolapsed internal hemorrhoid.

You would be best served by seeing a doctor. Your questions are passing

from

Quoted message said:

general advice into the realm of those that can't be answered without a history and examination.

I would recommend that you see your doctor if he/she is well-versed in hemorrhoid diagnosis and
treatment. If not, see a general surgeon, or colon-rectal surgeon because they certainly will be,
and may be able to provide in-office treatment such as rubber-band ligation of any internal
hemorrhoids that may be contributing.

HMc