Hemorrhoid

Hi -

I am a healthy 27 year old white male.  When I was in college, I developed an external hemorrhoid, but with home treatment it went away in about a week.  Since then it may flare up once or twice a year at the most.  Several weeks ago, I was under stress and in a hurry and I was straining and sure enough, the hemorrhoid flared up.  I used peperation H for a few days and felt it was getting better, then I went to the gym and did heavy lifting, and then a few days later it was worse, very uncomfortable, little bit of pressure and pain.  After about 48 hours it felt better but was still there, I felt I was on my way and agin went to the gym, heaving lifting, a few days later it was back to being painful, uncomfortable, etc.  Again this lasted about 24-48 hours.  I am avoiding heavy lifting.  Also, it wasn't until after the second time I did heaving lifting did it occur to me that the lifting may have caused the hemorrhoid to flare up worse.  Right now it feels ok, its not uncomfortable.  Currently I am using 1% hydrocortisone in an attempt just to get it to recede.

My concern is that its been 3 weeks since this flared up, I am use to with home treatment it receding in about a week, week and half.  I may have made it worse with heaving lifting at the gym, but its taking a long time to go away.  It has not been uncomfortable for over a week, and it is a little smaller.  The skin looks fine, not like a blood clot, that I can tell.  What is the fastest way to get this medium sized external hemorrhiod to recede back to normal?  Thanks

[Kevin Pho, MD]

If the steroid cream doesn't help with the treatment, you can consider several minimally invasive procedures.  This can include band ligation, infrared or laser coagulation, sclerotherapy, laser hemorrhoidectomy, or cryotherapy.  

If these options are not feasible, surgical options can then be pursued.

In the meantime, things like stool softeners and increasing fiber can be considered to help minimize the symptoms of the hemorrhoid.

I would discuss these options with a referral to a surgeon.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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