stubborn external hemorrhoid

[raymond in sj]

i have had a thrombosed external hemorrhoid occur three times in the last three years. each time it takes longer to recover completely. four months ago it recurred and it is still with me. the thrombosis itself is gone but there is still swelling and pain. the pain occurs when i stand for more than about 5 or 10 minutes. it is not severe but it is the pain that warns me that if i do not lay down it will thrombose again and that really is severe pain.
i have seen two surgeons and 2 or 3 internists. they all say that it really isn't bad enough to remove. so i'm really stuck. i've basically been laying down for 4 months. my diet is under control with metamucil and i have 1 or 2 easy bowel movements each day. i also try to walk for a few minutes each day. i am 40 and used to be  healthy and fit.
any suggestiions would be welcome. does anyone know of a doctor or clinic specializing in hemorrhoids in northern califonia? most seem to be on the east coast.

[raymond in sj]

fsrph,
the pain follows any activity other than laying down. it also precedes a bowel movement. laying down always clears up the pain in anywhere from a minute or two, to two or three hours.

i have used prep h and hydro cortisone off and on. i have feared using them constantly over extended time.

thank you all for responding.

raymond

[fds]

Hi Raymond,

    I thought of a few questions that may help in understanding what is going on with your pain.

1.  Does your pain go away when you sit on the toilet or is it constant thru the day?  And does your pain vary thru the day--like is is less noticable in the morning and evening?

2.  When you had your thrombosed hemorrhoid did you use Preparation H for an extended period of time?  This is a longshot but I believe I did harm to myself by using Prep H for too long a period.  It affects the prostate which in turn can cause anal pain that presents a lot like a hemorrhoid.

Francis

[Beetle]

After delivering a baby, I had hemorrhoids which were extremely painful and which a surgeon thought would need to be surgically removed. Before he did surgery though, he suggested using saline solution to try to shrink them. It was applied on a gauze wrapped about the the hem's (room temperature - NOT hot solution or this will kill! ) After a few days of this (especially effective and stayed in place if applied overnight), I couldn't believe the difference. I'm not sure if it would work with a thrombosed hem. because I thought they had to be surgically removed (I've had two) Good luck and hope this helps.

[fds]

Hi Raymond,

    I think I may have experienced a situation close to yours.  I had an extenal hemmorrhoid, it went away, but some pain and inflammation remained.  I thought maybe I was experiencing symptoms that were in my mind but over time I realized that they were real.  Are you sure that the pain is hemorrhoid related?  If the pain in in the anterior part (between your anus and testicles but more near the anus) the pain could be from chronic proatatitis (CP) rather than hemorrhoids.  CP pain is highly variable but it usually gets worse when you sit down although it can be present when you stand also.

    I don't know if these things will work for you but here is what I am doing.

1.  Make sure your BM's are soft and easy to pass.  It looks like you are doing this already--but I use Metamucil twice a day and Colace 100 mg twice a day.  If I still need something I add Lactulose 15-30 ml at bedtime.  Stay away from stimulant laxatives (like Senekot or Peri-Colace) for long term use, they will harm your bowels with long term use.

2.  If I am feeling pain or swelling and I notice it soon I use ice packs to the area.  But, after a few days it is better to use hot compresses to the area to help with the pain. Hot compresses seem to help a lot.

3.  Drink as much water as possible daily.

4.  Exercise--this releases endorphins and fight pain naturally.

   I wish I had better ways to relieve your pain.  But, if there was an easy fix I'm sure the doctors you saw would do it.  Sometimes the pain is from other sources--like CP, chronic male pelvic pain syndrome (CPPS), or even a very small rectal abscess.  The location of these types of pain are similiar to some hemorrhoids  So your doctor needs to explore these other causes of chronic pain not just assume it's from an old hemorrhoid.

Francis

[Baseball_Mom]

Hi Raymond - I'm going to have to guess that he used a laser.  He said that I had 2 6 inch incisions when he removed mine.  Please keep in mind I also had a rectal seal replacement done so part of my pain and discomfort was from that.  I believe I took pain killers daily for 7-10 days, with having a BM being the worst time.  Spent LOTS of time in the bathroom to the point that my husband just started calling me a duck.  I hate to see our water bill.  Things have gotten alot better.  Friday was 2 weeks since I had surgery.  I still have discomfort once in a while but I continue to take Citricel and Colace (a stool softner) and eat a high fiber diet.  Please let me know if you have any other questions.  I will do my best to try and answer them for you.  Take care!

[raymond in sj]

one was a colo rectal surgeon. he stated that he couldn't do anything until the thrombosis (clot) returns. i have no idea why.
was your surgery with a cold scalpel, laser, or harmonic scalpel?
what was your pain level and recovery time?

[Baseball_Mom]

Unfortunately I am on the East Coast in Virginia.  I just had a hemmrhoidectomy on the 1st of February.  I was having other surgery and the doctor asked why don't he just take those why he's doing other things.  He said I had two of the biggest hemmrhoids he had ever seen.  Mine were not bothering me.  I can't imagine why they won't do something if yours are bothering you so bad.  When I was in the Navy 20 plus years ago, I had to have the blood clot removed from the hemmrhoids.  That is very painful but they do it with a local anesthetic.  Maybe your doctor will do that.  You said you've seen a couple surgeons.  Are any of them colon/rectal specialist?  Just curious.  If they are bothering you that bad go see a colon/rectal specialist.  I bet they would remove it for you.  Take care and let us know how you are doing.