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Forum Name: Gastroenterology Topics

Question: When to get a hemorrhoid lanced?


 castanza - Sun Feb 05, 2006 1:58 pm

How do you know when to just suffer through how many days it might take to go away, or to go get one lanced? It's been years since I've had one, due to eating much better, but a bad cough recently caused the biggest one I've ever had to flare up. Probably the size of a grape! (is this normal?). It's very swollen like it's going to pop, and boy does it hurt. I've read that having it lanced can result in immediate relief, but that it may just clot right back up again - in which case, why bother?

ANY advice appreciated....
 Dr. Tamer Fouad - Sat Feb 11, 2006 1:42 pm

User avatar Hello,

In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.

Operative resection (hemorrhoidectomy) is reserved for patients with grade III and grade IV external or internal hemorrhoids, patients who fail nonoperative therapy, and patients who also have significant symptoms from external hemorrhoids or skin tags.

Hemorrhoidectomy involves the excision of the entire thrombosed hemorrhoid with the patient under local anesthesia. Incision and drainage of the clot are avoided because they typically lead to rethrombosis and exacerbation of symptoms.

The best approach would be left for your doctor to decide based on his assessment of your condition.

Best regards.
 castanza - Sat Feb 11, 2006 5:39 pm

So does that mean it will not go away and that the clot will not be "reasorbed" by the body? In the past, smaller ones (pea size) have done that in 1-2 weeks. This one is larger (cashew sized) and it's been a week. It's still about the same size, doesn't hurt quite as much as the first few days. Would removing the whole thing result in it never happening again? (at least in that spot). The procedure sounds very, very painful and seems suprising this could be done with only local anesthetic and on an outpatient basis - is this true?

Thank you for your advice.
 Dr. Tamer Fouad - Sat Feb 11, 2006 5:48 pm

User avatar On the contrary. It should heal by itself, at least according to your doctor's assessment. I was just explaining the various surgical procedures because I felt you wanted to know more about them from your post. Yes the procedure can be done under local anaesthesia and the patient is discharged a few hours later.
 castanza - Sat Feb 11, 2006 6:12 pm

Wow thanks so much for your quick replly! So how long should I expect to wait for it to "reasborb"? Will it suddenly be gone one day, or should I expect it to get smaller and softter over time? It's been one week now, can it take up to 4? I'm doing 1-2 sitz baths per day, eating higher fiber, taking a stool softener, using hydrocoritsone suppositories, and drinking a LOT of water each day.

Any thoughts on whether or not swimming would help? In the past, I swear there is something about cool chlorinated water that does something.

Thanks again - just curious how long I will have to wait this out and I will not keep hounding you. :) I will probably revisit my doctor mid week this week just to make sure too.
 Dr. Tamer Fouad - Sat Feb 11, 2006 6:28 pm

User avatar Hello again,
Most hemorrhoids tend to heal within a week or two.

Best regards.

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