Hemorrhoids: When to Seek Medical Advice

Hemorrhoid Confusion

Hello, doctor.
I would like to ask...
On the evening of December 30, 2016, I noticed a lump near my anus, which I instinctively thought was a hemorrhoid.
It was quite large, and since I was leaving for Japan the next day, I decided to endure the discomfort and went on my trip.
From December 31 to January 3, I felt a sensation of a foreign body in my anus, which was somewhat painful due to friction, and even getting up from a chair was painful.
There was also slight pain during bowel movements.
On the night of January 3, I bought a hemorrhoid suppository.
Since that day, I noticed daily improvement in my symptoms.
I continued using the medication until January 8, after which I stopped.
During the treatment, every morning when I woke up, the hemorrhoid seemed to have been pushed back inside by the medication, so I didn't see it in the morning.
However, by the end of the day, it would protrude outside the anus again, but the discomfort gradually disappeared.
I also noticed that it seemed to be getting smaller.
After January 9, I found that although the lump was still there, it had become very small at the anal opening, and I had to specifically push it out to see it.
Bowel movements have been smooth, with no sensation of a foreign body, as if this had never happened.
Doctor, did the use of the hemorrhoid suppository cause the originally large hemorrhoid to shrink? I read some articles online stating that as long as it doesn't affect daily life, one can coexist peacefully with hemorrhoids.
I was initially worried that the size would require surgery for me to return to a normal life, but now, as I mentioned, bowel movements are smooth, there is no sensation of a foreign body, and there is no bleeding, as if this had never happened.
Do I need to see a doctor? Thank you.

Xiao P, 30~39 year old female. Ask Date: 2017/01/12

Dr. Ke Fangxu reply Surgery

Based on your description, it seems that you are experiencing acute hemorrhoidal swelling.
If it is not severe, this type of issue typically resolves on its own within one to two weeks.
Therefore, your current condition likely does not require medical attention, let alone surgery.
In the future, just be sure to pay more attention to your lifestyle and bowel habits, as there is a possibility of recurrence otherwise.

Reply Date: 2017/01/12

More Info

Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Your experience with a "meatball" sensation and discomfort in the anal area aligns with typical symptoms of hemorrhoids.

From your description, it seems that you initially experienced significant discomfort and pain, which prompted you to seek over-the-counter treatment with a topical medication. The fact that you noticed improvement in symptoms, including a reduction in size and discomfort, suggests that the treatment may have been effective in managing the inflammation and irritation associated with your hemorrhoids.

When to Seek Medical Advice
While it appears that your symptoms have improved, there are specific circumstances under which you should consider seeking medical advice:
1. Persistent Symptoms: If you continue to experience discomfort, pain, or the sensation of a lump after a few weeks of self-treatment, it may be time to consult a healthcare professional. Chronic symptoms can indicate more severe issues or complications.

2. Bleeding: If you notice any fresh blood during bowel movements or in your stool, it is essential to seek medical attention. While hemorrhoids can cause bleeding, it is crucial to rule out other potential causes, such as anal fissures or colorectal conditions.

3. Severe Pain: If the pain becomes severe or unbearable, or if you experience significant swelling, it may indicate a thrombosed hemorrhoid, which may require medical intervention.

4. Changes in Bowel Habits: If you notice any changes in your bowel habits, such as persistent diarrhea or constipation, or if you experience unexplained weight loss, these could be signs of a more serious condition that warrants evaluation.

5. Infection Signs: Symptoms such as fever, chills, or increased redness and swelling around the anus could indicate an infection, which requires prompt medical attention.

Management and Treatment Options
In many cases, hemorrhoids can be managed with lifestyle changes and over-the-counter treatments. Here are some common recommendations:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements.

- Hydration: Drinking plenty of water can help prevent constipation and promote regular bowel movements.

- Topical Treatments: Over-the-counter creams, ointments, or suppositories can provide relief from itching and discomfort.

- Warm Baths: Soaking in a warm bath can help soothe the area and relieve discomfort.

- Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate hemorrhoids.

If conservative measures fail to provide relief, or if your hemorrhoids are particularly large or painful, medical treatments may be necessary. Options include:
- Rubber Band Ligation: A procedure where a rubber band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: Involves injecting a solution into the hemorrhoid to shrink it.

- Infrared Coagulation: A technique that uses infrared light to cut off blood supply to the hemorrhoid.

- Surgical Options: In severe cases, surgical removal of hemorrhoids (hemorrhoidectomy) may be recommended.

Conclusion
Given your current symptom improvement, it may not be necessary to seek immediate medical attention. However, it is essential to remain vigilant for any changes or worsening symptoms. If you have any concerns or if your symptoms do not continue to improve, consulting a healthcare professional is advisable. They can provide a thorough evaluation and discuss appropriate treatment options tailored to your specific situation. Remember, early intervention can often prevent complications and lead to better outcomes.

Similar Q&A

When to Seek Medical Help for Hemorrhoids: A Guide

Hello, doctor. I used to have the habit of using my phone while on the toilet, which led to the development of hemorrhoids. I have since changed this habit, and I usually don't feel any discomfort from the hemorrhoids. However, when I am tense, under pressure, or strain too ...

Dr. Ke Fangxu reply Surgery
The three indications for hemorrhoid treatment are bleeding, pain, and prolapse. However, if none of these symptoms are severe, over-the-counter ointments and suppositories can be used initially. If the symptoms are severe enough to affect daily life, medical evaluation and treat...

Dealing with Severe Hemorrhoids: When to Seek Medical Help

Hello Doctor: My hemorrhoids have recurred, and this time they are very swollen, bleeding, and I cannot push them back inside the anus. What should I do? Should I see a doctor? Thank you.

Dr. You Ligang reply Gastroenterology and Hepatology
Hello, you should see a doctor and consider medication. If you frequently experience abdominal issues, it indicates that dietary or lifestyle changes may not be sufficient for improvement, and you might need assistance from a surgeon. Wishing you good health. Sincerely, Dr. You L...

Dealing with Hemorrhoids: When to Seek Medical Attention

Hello Dr. Hou: Due to working excessively during the summer (lifting heavy objects and standing for long periods), along with insufficient hydration, I am now experiencing issues with hemorrhoids! I have read a lot of information online, and it seems to be what is referred to as ...

Dr. Hou Yongji reply Surgery
Hello: 1. Please consult a colorectal surgeon to check for thrombosed hemorrhoids. 2. If it is a thrombosed hemorrhoid, pain typically alleviates in about a week, while swelling may take around four weeks to resolve. 3. The most important aspect of managing hemorrhoids is mainten...

Understanding Hemorrhoids: When to Seek Treatment and Management Tips

Doctor, I’ve heard that everyone has hemorrhoids to varying degrees, and asymptomatic hemorrhoids are considered normal physiological tissue. I previously experienced constipation and anal fissures, but they were not severe enough to require treatment. A few days ago, I noticed s...

Dr. Ke Fangxu reply Surgery
If hemorrhoids are not accompanied by bleeding or pain, there is generally no reason for aggressive treatment. Swelling is often related to prolonged bowel movements. It is recommended to avoid constipation during this period and to shorten the time spent on the toilet. Spicy and...