Severe Hemorrhoids: Symptoms, Treatment, and Concerns

Hello, Dr. Chang. I have already visited the large hospital?

The situation has become more severe.
I always thought I had hard stools, but it turns out I have hemorrhoids.
Can hemorrhoids really become that swollen? Did I mistakenly think it was due to hard stools and excessive pressure? I went to a large hospital, and the doctor said this is not rectal prolapse but rather prolapsed hemorrhoids.
He suggested a procedure to aspirate it, but I refused because I was afraid of having a strong reaction that could cause unnecessary complications.
So, the doctor prescribed various anti-inflammatory and pain relief medications and ointments for me to apply.
He advised that if I experience any discomfort, I should go to the emergency room; otherwise, I should wait for my follow-up appointment.
That day, I was experiencing a lot of watery stool...
After having a bowel movement, I kept thinking there was still hard stool...
This strange sensation has made me very anxious.
The protrusion looks very much like rectal tissue, but the doctor confirmed it is hemorrhoids.
Additionally, the watery stool is very foul-smelling...
currently the worst odor I've encountered...
Photos: Prolapsed hemorrhoids https://imgur.com/a/u4AZ5bq AND watery stool https://imgur.com/a/Xm8FuM4.
Although after soaking in warm water, the discomfort from the swelling has improved somewhat, it is still swollen.
I can push it back in, but I can't fully insert it, and the current swelling has made it difficult for me to distinguish whether I have stool or not...

Mr. Chen, 30~39 year old female. Ask Date: 2022/09/12

Dr. Zhang Shuhao reply Surgery

The image appears to show a prolapsed hemorrhoid, and at this stage, surgical intervention is usually recommended.
If you are still hesitant about surgery, it is advisable to perform warm sitz baths, along with the use of topical ointments and oral anti-inflammatory medications, while avoiding constipation or diarrhea to prevent irritation.
If the prolapsed hemorrhoid becomes trapped and causes ischemic ulceration, resulting in severe pain, surgery should be performed as soon as possible.

Reply Date: 2022/09/12

More Info

Severe hemorrhoids, also known as piles, can indeed cause significant discomfort and distress. They are swollen veins in the lower rectum and anus, similar to varicose veins. Understanding the symptoms, treatment options, and potential concerns associated with severe hemorrhoids is crucial for managing this condition effectively.

Symptoms of Severe Hemorrhoids
The symptoms of severe hemorrhoids can vary but typically include:
1. Pain and Discomfort: This is often the most distressing symptom. Pain can be sharp and may worsen during bowel movements.

2. Swelling: Hemorrhoids can become swollen and protrude from the anus, leading to a feeling of fullness or pressure.

3. Bleeding: Bright red blood may be seen on toilet paper or in the toilet bowl after a bowel movement.

4. Itching and Irritation: The area around the anus may become itchy and irritated due to inflammation.

5. Mucus Discharge: Some individuals may notice a mucus discharge, which can contribute to irritation and itching.

Causes and Contributing Factors
Hemorrhoids can develop due to various factors, including:
- Straining During Bowel Movements: This is a common cause, often due to constipation or hard stools. Straining increases pressure on the veins in the rectal area.

- Prolonged Sitting: Sitting for extended periods, especially on the toilet, can increase pressure on the rectal veins.

- Pregnancy: The increased pressure from the growing uterus and hormonal changes can lead to hemorrhoids.

- Obesity: Excess weight can put additional pressure on the pelvic veins.

- Chronic Diarrhea or Constipation: Both conditions can lead to straining and increased pressure in the rectal area.

Treatment Options
Treatment for severe hemorrhoids typically involves a combination of self-care measures and medical interventions:
1. Home Remedies:
- Warm Baths: Soaking in warm water can help reduce swelling and relieve discomfort.

- Over-the-Counter Creams: Anti-inflammatory creams and ointments can provide temporary relief from pain and itching.

- Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Staying hydrated is also essential.

2. Medical Treatments:
- Minimally Invasive Procedures: If home remedies are ineffective, procedures such as rubber band ligation, sclerotherapy, or infrared coagulation may be recommended to treat hemorrhoids.

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

Concerns and Considerations
- Fear of Procedures: It’s understandable to feel anxious about medical procedures. Discussing your concerns with your doctor can help alleviate fears and clarify what to expect.

- Potential Complications: Severe hemorrhoids can lead to complications such as thrombosis (blood clots), which can cause severe pain and require immediate medical attention.

- Impact on Quality of Life: Chronic discomfort and anxiety about bowel movements can significantly impact daily life. Seeking treatment is essential for improving quality of life.

Conclusion
If you are experiencing severe symptoms, it is crucial to follow up with your healthcare provider. They can help determine the best course of action based on the severity of your condition. While hemorrhoids can be distressing, effective treatments are available, and many individuals find relief through a combination of lifestyle changes and medical interventions. Remember, it’s essential to address any concerns you have with your doctor, as they can provide personalized advice and support tailored to your specific situation.

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