Is It Hemorrhoids? Symptoms and Treatment Options

Q: Is It Hemorrhoids? Symptoms and Treatment Options

Hello： In response to your question, based on your description, it seems that the initial cause of the anal abscess was a bacterial infection, which is not directly related to hemorrhoids. <br>After the incision and drainage surgery, if it did not heal completely, it may have dev

I am not sure if it is hemorrhoids?

Hello Doctor: In February of this year, I experienced painful bowel movements with blood.
I thought it wasn't serious, so I ignored it.
Later, it developed into pain whenever I contracted my anal sphincter (like when sneezing or urinating).
By mid-March, I noticed some swelling around my anus, and the pain became unbearable, so I went to see a doctor.
The doctor said the swelling was an abscess...
At that time, a minor surgical procedure was performed to drain the pus, and I felt much better afterward.
A month has passed, and the wound has healed, but I still feel a strange sensation around my anus, with occasional itching and some discharge (which has a fecal odor).
I thought this might be normal after the wound healing, so I didn't pay much attention to it! I often have a habit of staying up late, enjoy eating chicken, don't exercise much, and sit for long periods, but I didn't realize these were bad habits that could lead to hemorrhoids.
Around early May, I started feeling a bloated and warm sensation during bowel movements, and there was blood again.
I immediately searched online for information and felt like I might have hemorrhoids.
Since then, I've made changes to my lifestyle, such as not staying up late, eating more vegetables and fruits, exercising, and taking warm sitz baths! I also apply hemorrhoid cream in the morning and evening.
While applying the cream, I felt 1-2 small bumps near the anal sphincter that feel like pimples; they hurt when I touch them.
I'm not sure if these are hemorrhoids.
After changing my lifestyle, I feel that my bowel movements are less uncomfortable, but I can still feel those two bumps, although they seem less prominent now.
Doctor, can you confirm if my symptoms indicate hemorrhoids? I suspect the abscess was caused by hemorrhoids, but I didn't understand hemorrhoids at that time; is that possible? Will taking hemorrhoid pills be effective? With this treatment, when can I expect the hemorrhoids to resolve? Or will I need surgery?

A Bu, 20~29 year old female. Ask Date: 2011/05/23

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, based on your description, it seems that the initial cause of the anal abscess was a bacterial infection, which is not directly related to hemorrhoids.
After the incision and drainage surgery, if it did not heal completely, it may have developed into an anal fistula.
Currently, the anal fistula might have healed and is asymptomatic.
The "pimple" at the anal opening could be the opening of the fistula or a hemorrhoid, and it would be best to have a physician examine it to confirm.
Regardless of whether it is an external hemorrhoid or an anal fistula, taking hemorrhoid medication will not resolve external hemorrhoids.
If there is no pain or bleeding, treatment may not be necessary.
However, the fistula can only be definitively treated through surgical excision.
Therefore, I still advise you to consult a physician to accurately diagnose the issue so that appropriate treatment can be administered.

Reply Date: 2011/05/23

More Info

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. Based on your description, it seems that you may indeed be experiencing symptoms consistent with hemorrhoids, especially considering your history of rectal pain, bleeding during bowel movements, and the presence of lumps around the anal area.

Symptoms of Hemorrhoids
The symptoms of hemorrhoids can vary, but common signs include:
1. Bleeding: Bright red blood on toilet paper or in the toilet bowl after a bowel movement.

2. Pain or Discomfort: Pain during bowel movements or when sitting, especially if the hemorrhoids are external.

3. Swelling: Lumps near the anus, which may be sensitive or painful.

4. Itching or Irritation: Itching around the anal area, which can be exacerbated by hygiene practices or moisture.

5. Mucus Discharge: A feeling of moisture or discharge from the anus, which can sometimes have an unpleasant odor.

Possible Causes
Your lifestyle factors, such as prolonged sitting, lack of exercise, and a diet low in fiber, can contribute to the development of hemorrhoids. Straining during bowel movements, which can occur with constipation, is a significant risk factor. The fact that you experienced a painful abscess (the "膿傷" you mentioned) could also be related to hemorrhoids, as they can sometimes lead to complications such as thrombosis or infection.

Treatment Options
1. Conservative Management: Since you've already started making lifestyle changes, such as increasing your fiber intake, staying hydrated, and exercising, these are excellent first steps. Warm sitz baths can also help alleviate discomfort.

2. Topical Treatments: Over-the-counter hemorrhoid creams or ointments can provide temporary relief from itching and pain. However, if you are still feeling lumps or discomfort, it may be worth discussing with your doctor whether these treatments are effective or if a prescription medication is necessary.

3. Medications: Oral medications, such as "消痔丸" (anti-hemorrhoid pills), may help reduce symptoms, but their effectiveness can vary. It's essential to consult with your healthcare provider about the best options for you.

4. Minimally Invasive Procedures: If conservative treatments do not provide relief, procedures such as rubber band ligation, sclerotherapy, or infrared coagulation may be considered. These are typically performed in a doctor's office and can effectively treat hemorrhoids without the need for surgery.

5. Surgery: In cases where hemorrhoids are severe or do not respond to other treatments, surgical options may be necessary. This could involve hemorrhoidectomy (removal of hemorrhoids) or stapled hemorrhoidopexy.

When to Seek Further Help
If your symptoms persist despite conservative management, or if you experience severe pain, significant bleeding, or any signs of infection (such as fever or increased swelling), it is crucial to seek medical attention. A healthcare provider can perform a thorough examination and may recommend further diagnostic tests to rule out other conditions.

Conclusion
Based on your symptoms and the changes you've made, it is plausible that you are dealing with hemorrhoids. The presence of lumps and discomfort, along with your previous experience with an abscess, suggests that you should continue to monitor your symptoms closely. If you do not see improvement or if your symptoms worsen, please consult with a healthcare professional for a comprehensive evaluation and tailored treatment plan. Remember, early intervention can prevent complications and improve your quality of life.

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