
Suggest Treatment For Internal Hemorrhoids

I have been having trouble with external hemorrhoids for about 15 years now, off an on. No big deal. A little
Preparation-H and within a few days they typically "pop," bleed a bit and go away until the next round either a few months or a few years later, typically.
However, recently--over a month ago now--I developed what I assumed was another hemorrhoid, but it behaved differently. First, it was much larger than any hemorrhoid I've ever had. It showed up near the right side of my anus and was unusually large. It was at least the size of a large pea. Otherwise, however all the symptoms were the same: lots of burning pain, lots of itching, very difficult to sit and constant irritation. So I started my normal routine of Preparation-H about four times a day along with sitz baths.
Here's the issue: First, it took *A LONG* time to go away this time. About four weeks. And this time it never "popped" and bled, it just eventually disappeared. It seemed to come and go as well. Meaning that some times during the day, the skin felt almost "flat" like the hemorrhoid had gone away, but later it the day, the pea size bump returned. This happened over and over again. Also, when I went to "wipe" after using the toilet, it seemed to flatten out this hemorrhoid bump, but again, the bump would return later in the day. As I mentioned, it did finally eventually go away.
Here's the part that is really worrying me:
UNDERNEATH where the hemorrhoid was--basically right under and around my anus--I am feeling a lump. This lump has not gone away along with the hemorrhoid. It seems to move around. For example, if I am sitting on the toilet, I feel it mostly on my right side, but if I am standing in the shower or sitting in a bath tub, I can generally feel it around both sides of my anus. It's hard to judge the size, but I would say it feels like a large grape, maybe a bit larger. Sometimes this lump feels quite hard, and at other times it feels much softer. This lump feels almost like muscle tissue. I can press in on it and it does give a bit. It does seem to move around a bit. Also, it sometimes increases in size and sometimes it gets smaller. There are times I can literally feel it (I don't mean with my fingers--I can always feel it with my fingers--I mean just standing or sitting) when it seems to swell, and then when it seems to get smaller, I can't feel it. It is not causing any pain whatsoever. When I can feel it, I would say it feels like something stuck in my buttocks, or perhaps a feeling of "fullness," but it doesn't feel like the urge to use the toilet. It's a very strange feeling, but it does not hurt.
When I had the hemorrhoid, it literally felt like it was connected to this larger lump. The best way I know how to describe it, it felt like the portion of the hemorrhoid that is external--the pea sized lump that was hard and painful (the portion I was applying Preparation-H to)--was connected to this much larger lump like thing literally underneath the hemorrhoid.
I have recently lost 70 pounds. And let me stress: YES this weight loss was intentional. I have been on a diet and exercise program and have dropped from 230 to 160 and have lowered my body fat per cent from nearly 30% to about 15%. I have lost around 10 pounds a month, or so. I mention this because I have noticed normal things in my body that I didn't know I had since losing a whole bunch of fat that was of course covering those things in my body. So I am wondering if maybe this lump is normal, and I just have never felt it. I've been overweight since I was a child. Perhaps it is a normal part of my anus or rectum and I have never felt it before.
In any event, I am very worried about this lump and am trying to figure out what is might be. Should I be worried about a tumor? Anal cancer? Etc.?
Any advice would be greatly appreciated.
Thank you!
Kirk
Possible internal hemorrhoids,need to investigate.
Detailed Answer:
Hi XXXXXXX
I have gone through your medical history carefully and understood your concerns.
First, congratulations for your weight loss. Hope you will continue intentionally lose other extra weight you might have in order to live a healthy life.
With regards to hemorrhoids issues, they are often connected to your bowel habits: if you are always constipated and stool is not soft (instead hard), then, hemorrhoids will continue to be present.
Apart preparation-h, you should :
- increase water consumption
- increase fiber intake through eating more fiber-rich foods and/or by taking psyllium supplementation
- use lactulose to soften your stool (but remember: not for longer periods)
- exercise will also help reduce hemorrhoids as it will help improve blood circulation and bowel movements
With regards to the lump you felt, most probably, it might have been internal hemorrhoids. It is common for external hemorrhoids to be associated with internal hemorrhoids.
To put your mind at peace, I advise to:
- consult with a proctologist (he will do a digital examination of your anal area to check for pathologies)
- run colonoscopy/anoscopy for further evaluations.
- do regular check ups for your age (which will include tumoral factors)
Such examinations are highly recommended at your age.
Once again, there is nothing to be freaked out in here although I advised to run such examinations.
All the best!
Dr.Albana


Thank you for your reply.
I have suspected that this lump may very well be an internal hemorrhoid as well, but let me ask:
Is it common for an internal hemorrhoid to last this long? I first felt this lump in mid-August (around the same time as I noticed the external hemorrhoid). So it's been close to two months now, and while the lump has at times decreased in size, it has also consistently increased in size, but in all this time it has not gone away fully.
Is that normal for an internal hemorrhoid? I haven't treated it with anything at all. I've only used Preparation-H externally for the external hemorrhoid that appeared at the same time.
Also, as I mentioned, this lump is pretty darn hard. It isn't as hard as say a marble or a rock would be, but it's pretty hard. At times it feels much firmer and harder and at other times it is softer and gives a bit when I press on it, but in general, it's pretty hard most of the time.
I don't know much about internal hemorrhoids. So far as I know, I've never had one, although I have been dealing with external hemorrhoids for more than 20 years or so.
Does this truly sound like an internal hemorrhoid to you? Yes I will go to my doctor, but in the mean time, how should I treat it? Should I use Preparation-H internally?
I look forward to your reply.
Thank you.
Kirk
Yes,could be,need further confirmatory tests...
Detailed Answer:
Hi back XXXXXXX
Yes, it is normal for both internal and external hemorrhoids to appear and disappear according to pressure or laceration of anal mucosa especially when feces are hard.
My first suspect is toward internal hemorrhoids as they can be commonly associated with external hemorrhoids.
Another suspect is anal abscess or other types of masses. That's why, if I was your caring doctor would advise to run the tests as mentioned earlier to determine the final diagnosis. Proctologist consultation is also advised.
Meanwhile, you should avoid :
- constipation
- straining during bowel movements
- go to the toilet each time you feel to, do not delay
Hope it helped!
Dr.Albana

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