Hemorrhoids

[345medhelpFAN]

Hi.  I am a healthy 31 year old male.  I first had a hemorrhoid pop up about 10 years ago in college, induced from straining.  It subsided on its own after a few weeks.  They have reoccurred a few times over the years, but always went away.  About two years ago, I seemed to suffer from some winter constipation, my doctor said I had mild IBS.  I increased fiber and water in my diet.  I am regular and do not to strain anymore.  That being said, the anal area has been a bit puffy/swollen with hemorrhoids since that time, so its been about two years.  They do not bleed or hurt or appear to have gotten any worse.  But they won't go away.  I use moist wipe clothes now instead of paper, never strain, and have tried hydrocortisone and other OTC meds, with little help.  I would like them gone and was wondering what is the easiest, most effective treatment options.  To my knowledge I do not have internal hemorrhoids, just external.  I made an appt with my primary care doc for Monday.


Thanks.

[J.M. Keyes, MD]

There are several treatment options for hemorrhoids, but if what you have is simply a skin tag from an old external hemorrhoid that has now healed, and it is not giving you any trouble, it may not be worth it to have a procedure to remove it.   You should have your physician take a look on Monday, because you may have prolaspsed internal hemorrhoids which are not painful. Procedures like banding, laser, and sclerotherapy can be used to treat such hemorrhoids.  I would discuss these options with your primary care doctor, and get a referral to a surgeon if appropriate.
In the meantime, and for the long haul, continue to get lots of fiber (about 30g/day), exercise, and drink lots of water, to prevent your stools from being hard and therefore preventing the need to strain.

Good luck.
JMK MD