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| Salem
- Thu Feb 03, 2005 5:49 pm |
I am a 27 y/o female and I have what I am pretty sure is hemorrhoids, possibly thrombosed. I am wondering if it is always necessary to visit a doctor (for a thrombosed hemorrhoid) or if this can resolve on its own.
What I am wondering is that all the information I find says that thrombosed hemorrhoids are painful, but this is not painful just irritating as it feels like a 'foriegn' object (ie I can noticeably feel it when I sit down, but it isn't painful). Should I wait a few days to see if it resolves itself or go on to the doctor?
I should mention that it appears to be a small lump in the skin (smaller than a pea), is smooth, is a dark bluish color that can be seen under the skin color, no bleeding, and is in the outer skin of the rectum. I'm sure that it is a hemorrhoid because it appeared after I had a painful bowel movement after being slightly constipated. I had some sharp pain for a few hours afterward, that is now gone, and the next day I noticed the bump. It has been about three days and I just wanted to know how serious this could be.
Any information or advice is appreciated. Thanks.
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| erfnp
- Mon Jan 12, 2009 7:37 am |
My emergency department employs doctors as well as mid level providers such as myself. I am a family nurse practitioner with specialization in emergency medicine and cardiovascular medicine. The nurse practitioners and physician assistants do most of the procedures- suturing lacerations, draining abscesses, and relieving the pain of thrombosed hemorrhoids. In fact, I just did one tonight in a middle-aged man who was suffering from one. He had no known history of hemorrhoids and was not sure what the painful lump on his anus was. He was heterosexual with no history of constipation or straining. In fact, he had a few day history of diarrhea. After cleaning and adequately numbing the hemorrhoid (using 1% lidocaine with epi to decrease bleeding), I made a small incision with a # 11 blade and removed several large clots. There was very little bleeding and almost complete relief of the pain. The procedure is quick and relatively painless, so do not be afraid to have it done if needed. Sometimes it may be necessary to consult a surgeon to have them removed completely, but this is done under anesthesia or with an epidural.... an emergency department family nurse practitioner who loves her job!
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| John Kenyon, CNA
- Thu Feb 05, 2009 7:36 pm |
 Hello -
I've been asked to respond to the question, so here goes: This does indeed sound like a thrombosed hemorrhoid. Since hemorrhoids are often "falling" or pendulous in nature, they are frequently treated by deliberat thrombosing anyway, either via rubber band strangulation (in which case the hemorrhoid dies, withers and sloughs off), or by injection with a thrombolytic causing the same effect. This is done more often when the hemorrhoid is less accessable, as in the case you describe.
I'd give this a few days, since although these can be painful, they are usually described as you have done, as an "annoyance", as they are, for all practical purposes, foreign bodies. This one may follow its own course and resolve on its own, and I'd give it a week at most. If it's still there, still uncomfortable, and/or becomes more bothersome, I would of course suggest being seen with an eye toward having it and/or the clot removed, per the post by erfnp, above, who graphically describes the simple surgical removal of thrombi in cases where the hemorrhoid isn't amenable to thrombolytic or strangulation therapy. Yours may not be, as it appears to be not fully pendulous, at least not yet.
I hope this is helpful. Best of luck to you and please follow up with us as needed.
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