[46F] Concerns about persistent external hemorrhoid

Patient Description

A 46-year-old female is experiencing persistent symptoms of an external hemorrhoid that developed a couple of weeks ago. The patient describes the hemorrhoid as having painful swelling and a feeling of fullness, rating the pain as 3 or 4 out of 10. The swelling has decreased but is still present. The patient has been applying ice compresses, which provide some relief. There are no other associated symptoms, no known drug allergies, no current medications, and no pre-existing conditions or chronic illnesses. The patient is inquiring about the necessity of lancing the hemorrhoid due to its prolonged presence.

Arora's Assessment

What might be happening

Based on the information you've provided, it sounds like you are dealing with external hemorrhoids. Hemorrhoids are swollen veins in the lowest part of your rectum and anus. When the walls of these vessels are stretched, they may become irritated and bleed.

External Hemorrhoids: These are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed. They can also clot, leading to a thrombosed hemorrhoid. This might be the case with the dark purple hemorrhoid you mentioned. Thrombosed hemorrhoids can be very painful, but usually aren't serious.
- Treatment: Over-the-counter creams, ointments, suppositories or pads designed to treat hemorrhoids contain ingredients such as witch hazel or hydrocortisone that can lessen pain and itching. These products are often effective, but don't use them for more than a week unless directed by your doctor.

What you can do

Here are some things you can do to help alleviate your symptoms:

Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent.
Soak regularly in a warm bath or sitz bath. Soak your anal area in plain warm water for 10 to 15 minutes two to three times a day.
Keep the anal area clean. Bathe (preferably) or shower daily to cleanse the skin around your anus gently with warm water. Avoid alcohol-based or perfumed wipes.
Apply cold. Apply ice packs or cold compresses on your anus to relieve swelling.

What you should look out for

You should seek medical attention if your symptoms don't improve with home treatments, or if you experience severe pain or bleeding. Your doctor may be able to relieve the pain by removing the blood clot in case of a thrombosed hemorrhoid, which is what lancing refers to. This procedure, done under local anesthesia, can bring prompt relief.

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional who can examine you and take a full history.

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1 yr ago

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