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From: ((Steven B. Harris))
Subject: Re: hemorrhoids
Date: 07 May 1995

In <3oj3g6$> Earl Paxton
<> writes:

>Help, I've had severe hemorrhoids since the birth of my 3rd
>child (10 months ago).  I haven't seen a physician yet.
>Before I do I'd like to know if anyone has any good advice on
>remedies.  Thanks.  Liz.

Really painful hemorroids are usually the result of a thrombus (also
called a thrombosis) in the swollen vein which is the hemorroid.  You
want your body to dissolve this faster than it can build up.  Talking
aspirin every day helps this a lot, and I suspect (but cannot prove)
that vitamin C and E do also (these have antithrombosis activities in
other studies). It's also VERY important to change your diet with
hemorroids to get enough bulk so that you don't do damage every time you
defecate.  I recommend eating three bananas a day, like medicine, one
with each meal. Or, if you hate bananas, try large apples (keeps the
proctologist away).  Failing this, there are lots of psyllium seed
products on the market, like Efferpsyllium.  Warm sitz baths also help
pain, and may help resolve clot.  Herbalists would recommend bilberry
and pycnogenol, but I know of no studies of them with hemorroids, so you
have to weigh their possible effect against your pocketbook (they are
quite expensive.)

    Good luck.

                                           Steve Harris, M.D.

From: Steven B. Harris <>
Subject: Re: External hemorroid- does suppository help?
Date: Sun, 04 Mar 2001 20:47:39 GMT

>ABC wrote:
>> I have a new external hemorroid just forming. i want to do something to
>> help . On top of fibre and hot bath I want to use some medicine.
>    Probably some exercise, avoiding fast food as your primary food and
>straining. On the subject of sitting, hard chair causing hemorrhoids, we
>have those hard chairs throughout the school, yet none of my friends have
>complained about hemorrhoids.
>> Does any of the Anusol or Preparation H suppositories help with
>> external piles?  Or am I restricted to usint ointment and cream
>> externally?
>   I have the feeling theres no magic cream you could put on to cure
>it.  Most OTC medications reduces symptom by depressing or bypassing the
>senseation or body reaciton.  Cold medicine doesn't cure cold, it reduces
>symptoms.  Ummmm. coagulate it using soldering iron or wrapping it around
>with nichrome wire and connecting it to a battery?

That was funny unless intended seriously. External hemorroids "form"
because a vein has gotten a clot in it. Unless you want somebody to
cut into the vein and take the clot out (possible but usually not
necessary) treatment is aimed at tipping the balance between clot
formation and clot disruption, until the thing slowly shrinks and
diappears. That means going on an aspirin a day, 400 IU vitamin E
with meals, and possibly a bioflavonoid supplement.

Local treatment is aimed at controlling itching. Anusol HC or some

Clot disruption is helped by heat. Very warm sitz baths (ie, your
butt's in the water) as long as you can, and as many times a day as
you can, are recommended. Plan on doing this for a month or so.

Prevention is entirely a matter of that aspirin a day (it can even be
baby aspirin, vitamin E), and fiber in the diet. Some psyllium or
other fiber product EVERY time you eat. Better yet, a banana (world's
best overall GI treatment food-- we're modified monkeys after all).
But no meals without the conscious fiber included. Even skipping one
will give you a "block" and then off you go.


From: "Howard McCollister" <>
Subject: Re: hemorrhoids
Date: 11 Aug 2003 10:45:49 -0500
Message-ID: <3f37b86b$0$35868$>

"benjo" <> wrote in message
> The other day i went to the toilet and, about to finish up, noticed what i
> believe was a hemorrhoid protruding from my anus. It went bak in and there
> is no bleeding or pain but something doesnt really feel right some of the
> time.. I started taking fibre and drinking more water.. but it still happens
> everytime i go to the toilet. What should i do to get rid of this
> happening???

Astringents such as Preparation H or Anusol may shrink the hemorrhoid a
little, but if you indeed have a prolapsing hemorrhoid that bothers you, you
should see your doctor, or more likely a surgeon, to see if it is
appropriate to ligate it. That would be a painless way to get rid of an
internal hemorrhoid (if that's what you have). The procedure is painless and
outpatient. A very tight rubber band is placed arount the hemorrhoid to
strangle it, and it dies and falls off in about 2 weeks.


From: "Howard McCollister" <>
Subject: Re: Hemorrhoids surgery, PPH, what to expect
Date: 23 Nov 2003 16:35:43 -0600
Message-ID: <3fc13569$0$42201$>

"bogus name" <> wrote in message
> Hi.  I'm a 36 year old male that suffered from hemorrhoids for well
> over a decade.  They say that heredity is a factor with hemorrhoids
> (could be, my dad had them bad), but in my case it was years of travel
> in Latin America that caused things to pop, bleed and dangle.  I spend
> hundreds of evenings grunting, pushing, straining and spraying the
> contents of my bowels into toilets all over America Latina.  From
> "turista" in Mexico, to giardia in Venezuela to Amoebic dysentery in
> Bolivia - I've shat it all.
> No matter how careful I was, a small indiscretion always let me get
> sick.  It could have been the ice in a glass of juice, a slightly
> undercooked vegetable, or the dog-turd taco that I drunkenly bought
> off some-guy-with-a-hibachi on the street.  Years of this gave me
> hemorrhoids - bad hemorrhoids.  Painful hemorrhoids.  Recurring bad
> painful hemorrhoids.
> If you've never suffered hemorrhoids you'd probably not have read this
> far.  Just in case though, hemorrhoids are part of your bum's
> physiology.  They are longitudinal veins (not really, but close
> enough) that fill with blood to control what comes out.  They play an
> important role in keeping you continent (pooping only when you mean
> to) and in ensuring that your duke gets formed into a shape that your
> bung can pass.  If you strain too hard they can get inflamed, which
> causes pain, bleeding, and tenderness.  If you REALLY strain too much,
> they "overinflate", stretch out of shape, and can hang out your ass.
> Once they are stretched out of shape, blood can clot inside of them
> (called a "thrombosed" hemorrhoid) and this feels kind of like a
> broken bottle is being rotated in your rectum.  Doctors grade
> hemorrhoids from class 1 to 4 (1=quit whining you baby, 4=a cluster of
> grapes is hanging out of your bung and you can't push them back in).
> "Ass Tulips" are either grade 3 or 4 - and they hurt worse than they
> look.
> After being laid off, I remained on my ex-employer's health plan for
> the duration of my severance package.  Coincidental with my
> termination was a notably bad flare-up of hemorrhoids (note to reader
> - generally H's come and go, and you forget how bad they are until the
> next flare-up).  The stars had aligned - I had insurance, time on my
> hands, and an opportunity to thank my employer for firing me by
> getting them to pay for my ass surgery.  Perfect.
> The first step was to choose a surgeon - I ended up with an
> ex-military guy.  If he was good enough for our forces, then he was
> good enough for me.  The first "introductory visit" consisted of him
> introducing his index finger to my poop-chute and then sticking a wee
> "colon cam" up me to get a turd's-eye view of my hemorrhoids.  He
> confirmed that I had a pretty bad set of hemorrhoids, and he outlined
> my options as:
> * keep doing nothing
> * "band them" which would be 3 really painful visits and recoveries
> and a decent chance of recurrence (banding is that they snap a rubber
> band over the H and wait for it to die and drop off - really)
> * PPH - a stapled hemorrhoidechtomy, kind of like pulling up your
> socks by cutting 1" out of the middle of the sock.
> I chose the PPH option (more later), and scheduled my next
> degradation.
> The following week, I returned to get 'scoped.  The initial "peekaboo
> cam" was like foreplay to the sigmoidoscopy that the doctor now wanted
> to perform.  Apparently, bad hemorrhoids were sufficient justification
> for the doctor to be able to bill the insurance company for sticking a
> 4' digital anaconda up my backside.  The rationalization was "to see
> if anything else is going on up there", but I wasn't going to argue
> with a guy that would shortly be elbow-deep in me.
> The sigmoidoscope was a pretty high-tech piece of gear.  Imagine a 40"
> heavy black whip (1/2" diameter, maybe 3/4") with a lens and nozzles
> on the far end.  The near end (DR end) has a steering control knob and
> cables coming out to a monitor.  The business end has spray and return
> nozzles (to hose off what it is photographing) and an air outlet that
> is used to inflate your colon to make it more photogenic.  Yes, this
> thing is stuck 3 1/2 feet up your ass while hosing you out with saline
> and inflating you with air.  Big wet farts ensue, and if it makes you
> uncomfortable, think about the poor guy driving.  I got  clean bill of
> health.  The nurse joked that "this was nothing compared to a
> hemorrhoidectomy".  Nice.
> What is a PPH?  "Procedure for Prolapse and Hemorrhoids" sounds pretty
> innocuous, kind of like calling an amputation "ERP" for "Extremity
> Reduction Procedure".  There's lots of good info on PPH, but
> essentially it involves using a cross between a kitchen machinery and
> a Stanley stapler to cut out a 1" length of your rectum to "pull up"
> the hemorrhoids back into your rectum (pull them in so that they don't
> hang out your red-eye, to be specific).  Repeat - the process cuts a
> length (~1") out of your rectum, staples the two ends together, and
> thereby gives you a "bung lift".  Nice.  A dilator (traffic cone) is
> stuck up your anus, a stapler/cookie cutter is inserted inside the
> traffic pylon, and the surgeon does some tricky stitching to pull in a
> section of rectum to be clipped out and the ends stapled.  Sounds
> awful, but everything I read made it seem like the right solution.
> The alternatives are even more barbaric (tie it off with a rubber
> band, inject caustic chemicals into the H, burn it off with a laser,
> etc.) and this one made the most sense from an engineering
> perspective.
> Getting ready for the big day, no food that day, two enemas before I
> leave for the hospital, nothing to drink (apparently important, I was
> asked to confirm this at least 5 times).  I got there, waived all
> rights, got an IV and remember saying "Don't worry" to my wife before
> the IV sedation hit.  A millisecond later I woke up in a different
> bed, in a different room with a sore ass.  Total discontinuity, almost
> immediate wakeup.  Ass hurt.  Ass hurt a lot.  More later.
> I was discharged after being told to not drive heavy machinery, to
> drink a LOT and then my wife drove me home.  Unless I blacked out, I
> didn't get ANY coaching on what to expect (which is why I'm writing
> this).  There were minimal side effects from the anesthetic (Propofol
> IV, dry mouth is all I noticed), no bruising from the IV, but a really
> sore bum.  If the worse hemorrhoid flare up that I ever had was a 3
> out of 10, this was an 8.  I would have called it a 10, but childbirth
> probably hurts more.  Think being Mike Tyson's cellmate.  Think
> falling from a height onto/around a parking meter.  Think the worst
> spastic "oh-god-I-have-to-crap" cramp ever, that keeps getting worse
> and doesn't let up.  Sore bum.  As near as I can tell, everyone
> involved up to and including the operation did a great job, it was
> only my discharge from the hospital that seemed like being pushed from
> a speeding car.
> Percocets had been prescribed, and when my wife brought them home I
> gobbled two of them.  Now I was sore and stupid - sleep seemed
> appropriate and I did nod off for a bit.  I had been told to "keep
> hydrated, drink a LOT" which I of course had done.  I drank at least 2
> liters (call it 4 quarts) of liquid and then realized that I couldn't
> pee.  Couldn't pee.  Not "had difficulty peeing", not "peed with
> discomfort" but couldn't pee.  Bladder as big as a football, contused
> asshole, shortened rectum and I couldn't pee.  In hindsight it seemed
> obvious that 30CC of Novocain injected to your anus would spread a
> bit, but after guzzling 2l of juice (as per direction) it is small
> comfort at 4AM to think "it's probably all the anesthetic they shot
> into my pooper".  Very scary, and the prospect of running back to the
> hospital to get catheterized was not attractive.  After soaking in the
> bath I was finally able to loosen up enough to piss in the tub (at
> 4:30 AM, or 12 hours after surgery - very classy, but I would have
> peed in the aquarium if I could have).  Shame on the hospital for not
> warning me about this.  My advice would be "drink little fluids until
> you verify that you can pee, then catch up by drinking a gallon".
> Other than that little surprise, it was pretty uneventful.  The first
> day was the bad one, the second day was just like "a really bad
> flare-up" until I pooped out the surgical remnants (apparently called
> "packing") and enough methane to be detected from space.  This
> operation apparently (short term at least) tightens your bung
> considerably - gas does NOT pass as easily as before, and I had
> bottled up enough to be really uncomfortable.  As well as tightening,
> it appears to have pulled my sphincter at least 3/4" inwards (not
> surprising, but pretty odd to wipe your ass and miss).  Again, none of
> this was mentioned in the brochure or in the post-op handoff.
> Overall (day 2 is when I'm writing this) I would do it again.  The
> first day is BAD, but for me it got much better very quickly.  Sleep a
> lot, don't overdo the narcotics, and don't forget to take stool
> softeners as constipation after this would be bad.  The recurrence
> rate after this process is apparently quite low, but I'll be following
> the diet guidelines to play it safe.
> For anyone considering this I'd summarize:
> * relax, buy reading material for your recovery and make sure that
> your fridge is stocked.
> * Ask if there is a probability of not being able to pee and what you
> should do.
> * Don't even think about being good for much for at least two days.
> * Make sure that they don't kick you out of the hospital until you are
> comfortable with "what to expect while recovering".
> Hope that this is helpful and amusing to someone.

I, for one, found it both helpful AND amusing. I've not HAD a PPH, but I've
done several. It seems that you had a little more pain than most patients I
have seen, but I found your whole report here to be generally accurate to
what has been reported to me by patients. It does sound like you were
short-changed on the "informed consent" matter.

Hemorrhoidectomy (conventional) is (can be) an extraordinarily painful
operation. I hate doing them, but PPH has at least ameliorated a lot of
that. My partner and I do product development consulting for Ethicon
Endo-Surgery (make PPH system among other things). As it coincidentally
happens, we fly to Cincinnatti tomorrow for such a conference. I plan on
printing out your description above and taking it with me.

Thanks for posting this.


From: "Howard McCollister" <>
Subject: Re: Hemorrhoids surgery, PPH, what to expect
Date: 14 Dec 2003 06:21:06 -0600
Message-ID: <3fdc5528$0$17080$>

"CaptainBloodfart" <> wrote in message
> My God, that was so darned funny it took me 20 minutes to read it.
> Funny, but enlightening. Thank you.

That post is widely circulating at Ethicon Endo-Surgery headquarters in
Cincinnatti. They are the company, division of Johnson & Johnson, that makes
the PPH hemorrhoid stapling equipment. The PPH product manager and director
of product development thought it was hilarious.


From: "Howard McCollister" <>
Subject: Re: External Hemorrhoid Questions...
Date: 22 Feb 2004 14:35:32 -0600
Message-ID: <403911f6$0$99750$>

"Steve" <> wrote in message
> Hi, I am in my late 20's and just got my first hemorrhoid, an external
> one which I believe to be thrombosed based on my internet research. It
> is just outside the front of the anus, slightly larger than a pencil
> eraser, firm to the touch, and a deep shiny blue in appearance. I have
> had it for about 10 days now with little to no change in size from day
> 1 when it suddenly appeared. It may be slightly smaller, but not by
> much. Pictures of thromobosed external hemorrhoids I have found are
> identical to what mine looks like but without the "severe" pain they
> say normally comes with such a hemorrhoid.
> Hate to go to the doctor if this will just clear up in time, how long
> might this take? While I can clearly live with it just fine if this is
> as bad as it gets... I want it gone. :-)

It will help to set the stage for healing the acute problem if you   a) use
astringents (Preparation H, Anusol, etc)    b) use stool softeners     c)
take oral mineral oil with the stool softeners.

A thrombosed external hemorrhoid can be very painful. If that is indeed what
you have, you basically have four options:

1) do nothing. The thrombosis will gradually resolve over a matter of a
couple of weeks and the painful inflammation will subside. The problem with
this is that the hemorrhoid is still there and will very likely re-thrombose
some day in the future.

2) see your doctor and have the thrombosis incised and clot removed. This
will result in a shorter-term decrease in the pain and a faster resolution
than above. The problem with this that the hemorrhoid is still there and
will very likely re-thrombose some day in the future.

3) see a surgeon and have the thrombosed hemorrhoid completely excised.
Depending on the hemorrhoid, this may be able to be done in the office under
local anesthesia. This will eliminate the chance that that particular
hemorrhoidal vein (which is apparently prone to thrombosis) will thrombose
again. The problem with this is that the local anesthesia hurts a lot
(albeit briefly) and you would have a fair amount of pain (maybe more than
what you are suffering now) for a couple of weeks.

4) see a surgeon and have a complete hemorrhoidectomy. This would markedly
decrease the chance of having hemorrhoid problems in the future. The problem
with this is that it hurts A LOT, and hurts A LOT for weeks.

Some of these options may be more or less adviseable depending on what is
seen on examination and from a more detailed history. As you can see,
treatment of hemorrhoid problems is a matter of choices, and balancing short
term pain against long term resolution. The question always comes down to
"At what point does the long term recurrent problem become
frequent/irritating/nuisance enough to make it worth the pain of definitive
treatment?" Hemorrhoid disease is a non-fatal problem, so only you can
answer that question.


From: "Howard McCollister" <>
Subject: Re: External Hemorrhoid Questions...
Date: 22 Feb 2004 21:02:15 -0600
Message-ID: <40396c9e$0$91680$>

"Steve" <> wrote in message
> "Howard McCollister" <> wrote in message
> news:40392f53$0$98855$
> >
> > "Steve" <> wrote in message
> > news:tQ8_b.376644$xy6.1947831@attbi_s02...
> >
> > Yes, a hemorrhoid is an enlarged vein. Like a varicose vein of the
> > leg, but in a more inconvenient location. They cause pain, bleeding,
> > itching when they become inflamed. Once the vein is enlarged, it's
> > usually always enlarged. Sometimes, chronic inflammation or repeated
> > acute inflammation with cause the hemorrhoid to fibrose, but probably
> > you can expect to have more problems with this hemorrhoidal vein (or
> > others) throughout the rest of your life.
> ok but what improvement am i expecting? will the small pencil sized bump
> go away and then appear normal until it potentially flares up again at
> some point at the future? or is it unless i contemplate surgery this
> small lump will always exist 24/7 forever? what am i trying to fix at
> this point because besides extremly mild pain when washing or wiping,
> the main concern is the strange sensation of this hard firm lump in a
> less than ideal location. while the pain sympotoms of a thrombosed
> hemorroid are not there, the size, shape, and appearance are identical
> to several dozen photos on the net of external thrombosed hemorrhoids i
> have seen. it is also firm as opposed to soft which i read is an
> indicator of a thrombosed hemorrhoid. i just want this lump gone!!!
> also is anusol HC the same thing as Preparation H Hydrocortisone...
> because the the P-H Hyrdrocortisone lists none of the witch hazel and
> phenlyephrine that the other P-H's have for "temporarily shrinking
> hemorrhoidal tissue." i just don't want to buy the hydrocortisone
> version of P-H for itching that isn't there and up not shrinking this
> lump...
> thanks for your help... this is a very embarassing topic despite so many
> people having it. i am just trying to clear up what kind of improvement
> i can expect if i don't resort to surgery. basically again, i was hoping
> for the lump to disappear.

It's more than likely that the eraser-lump will just disappear and become a
plain old external hemorrhoid again. As such, it will be prone to periodic
flare-ups like this over the years, something you can modify to some extent
with stool softeners and spending as little time on the toilet as possible
(remove all reading material from your bathroom). The lump is acutely
inflamed right now, either due to irritation or due to thrombosis (probably
the former). It doesn't matter which, except that a thrombosis will take
longer to resolve. When it does resolve, it is likely that the lump will go

I don't know the relative merits of Preparation H with hydrocortisone vs.
Anusol HC, but I usually prescribe Anusol HC over the other.

Your body will heal itself. Anusol HC may hasten that healing, and the
hydrocortisone will decrease the inflammation, as will hot sitz baths.


From: "Howard McCollister" <>
Subject: Re: External Hemorrhoid Questions...
Date: 23 Feb 2004 07:10:03 -0600
Message-ID: <4039faf9$0$6807$>

"Steve" <> wrote in message
> "It's more than likely that the eraser-lump will just disappear and
> become a plain old external hemorrhoid again."
> what is a plain old external hemorrhoid? something you can still see or
> feel?

Sometimes yes, sometimes no. It depends on the size of the hemorrhoid, and
whether it's truly an external hemorrhoid, or a prolapsed internal

You would be best served by seeing a doctor. Your questions are passing from
general advice into the realm of those that can't be answered without a
history and examination.

I would recommend that you see your doctor if he/she is well-versed in
hemorrhoid diagnosis and treatment. If not, see a general surgeon, or
colon-rectal surgeon because they certainly will be, and may be able to
provide in-office treatment such as rubber-band ligation of any internal
hemorrhoids that may be contributing.


From: "Howard McCollister" <>
Subject: Re: Howard Mcalester help! (Was:How big can an internal hemroid get)
Date: 1 Jun 2004 17:59:31 -0500
Message-ID: <40bd02d1$0$70212$>

"Don" <> wrote in message
> Can an internal hemroid get as large as a small egg?
> How far up can they occurr? Can they start as a spot as small as a
> dime and get bigger?
> I noticed in April a spot that was very hard up my rectum about 3
> inches or so. Just last week I noticed that it has "grown" down to
> about an inch or so from the outside world (So to speak)
> It is not a sharp pain I am having like hemroids but a dull ach that
> comes and goes. I have even noticed it in my tailbone.
> Last November I had a colonoscopy for constipation which was normal.
> Last week I went to a gastroenterologist. he did a digital rectal said
> he could not find it. he used an anoscope and just said i have
> internal and external hemroids.
> He said eventually I may need surgery or botulism injections. (I am
> almost sure that is what he said).
> I am frustrated he did not feel what I have. This is stupid but is
> there any way to "mark" the area with a marker or something that he
> could see?
> I am in my 30's and my wife and I are expecting our next child in
> December. I am worried plus the dull ach is frustrating to ignore. If
> it was cancer could this thing have gotton that much bigger in less
> than 2 months?
> I have no proctologists in my area but only gastro docs. This one
> prescribed for me a nytroglycerin cream but it does nothing.
> Thanks for any help you can provide on what I should do next.

Don, without being able to examine you, I'm afraid I can be of little help.
You might draw some comfort from the fact that a DRE and anoscopy by a
doctor that is ostensibly experienced at these things didnt' find anything
obviously dangerous. Cancers of the rectum start on the inside lining, and
should always be detectable by DRE, anoscopy, and a colonoscopy 6 months

The botulinum toxin injections he implied and the nitroglycerine cream he
prescribed was for your fissure. The concept is to let the internal
sphincter relax enough to heal. It's unlikely that a fissure can cause the
mass effect that you are experiencing.

There are very few hard things in the perianal-perirectal area. The only
thing there that I would classify as hard would be the tailbone, something
that might be readily felt in very thin persons. Having seen a
gastroenterologist, I'd suggest seeing a surgeon. Colorectal surgeons
specialize particularly in this particular area of the body, unlike a
gastroenterologist. But if a colorectal surgeon is not immediately
available, any competent general surgeon should be able to address your
issue with authority and I would suggest you go that route.

Colorectal cancer is not common in 30-something people and the odds are that
you're dealing with something else substantially more benign. Nevertheless,
see a surgeon, for you own peace of mind if nothing else.

Good luck.


From: "Howard McCollister" <>
Subject: Re: Relief of Internal Hemmorhoids
Date: 25 Nov 2004 08:17:19 -0600
Message-ID: <41a5e909$0$33678$>

"KerryIn08" <> wrote in message
> What can I take to relieve Internal Hemmorhoids in my rectum. I had a
> scope done and the doc showed me 2 hemmorhoids, up there together, about
> 5 inches up my butt. When I go to crap, the 2 damned hemorhoids swell up
> like small bladders, and pinch off the rectum. I have great trouble
> passing intestinal gas, too, cause they won't allow gas (farts) to vent
> out. Causes bloating and much pain.
> I have looked at older postings here on the News Groups. I see something
> about Cortisone suppository prescriptions, also I see fake promotions
> for some Hemmorhoid cream at a huge inflated price. Also, someone
> suggested applying Witch Hazel up your anus and into the rectum. It
> would hard for me to be able to do this, since the damned hemmorhoids
> are a good 5 inches up there, just at the point where the rectum turns
> left into the sigmoid of the colon.

Hemorrhoids are entirely related to the anus and certainly not 5 inches up
there. Hemorrhoids at the rectosigmoid junction are basically impossible. If
there is indeed something in the rectum that far up, it's far more dangerous
than a hemorrhoid and needs to come out immediately. You had better re-check
with your doctor, because if he indeed told you that you had hemorrhoids 5
inches up at the rectosigmoid junction and didn't recommend removal, then
he's an idiot, and you need to see a real doctor to get these colon polyps

Assuming you have misinterpreted what you saw, their location, and what the
doctor told you, and that you do indeed have prolapsing internal
hemorrhoids, you can treat the problem with astringents like Anusol, witch
hazel, Preparation H, etc as well as mucilage-based stool softeners
(metamucil, citrucel) combined with a lubricant like mineral oil. And spend
as little time on the toilet as possible. Pain is best managed with hot sitz

Cortisone-containing suppositories or creams might be helpful, and some
Anusol HC suppositories may be helpful.


From: "Howard McCollister" <>
Subject: Re: Small external hemorrhoid won't seem to go away!!
Date: 2 Feb 2005 18:22:03 -0600
Message-ID: <42016dff$0$97762$>

"Tanya Turner via" <> wrote in message
> I'm 22, active, normal weight.  I've had this small Q-tip-size external
> hemorrhoid for at least 6 months (maybe more).  I also still have some
> bleeding during a bowel movement even if I am having them reguarly and
> usually with ease.  I very rarely experience iching, if ever.  Otherwise,
> no other complaints.
> I do increase my fiber intake when possible and try to drink enough water.
> Perhaps I am still not getting enough fiber?  I don't think I eat enough
> FOOD to get as much fiber as they recommend! Is it ever going to go away?
> It's simply a aesthetic thing-- it just makes me feel a little self-
> conscious (I know this must sound absurd).  And the blood is always a
> little unnerving.
> Should I just continue with increased fiber attempts or look into the
> rubber-band removal?

If it is really an external hemorrhoid, then rubber band ligation is
generally not done because of the rather astonishing amount of pain that
causes. Rubber banding is done almost exclusively for internal hemorrhoids
since they are well above the anal skin and have no pain fibers.

Your only real option, if OTC methods don't work, is to have it surgically
excised. Ouch.


From: Steve Harris <>
Subject: Re: Small external hemorrhoid won't seem to go away!!
Date: 2 Feb 2005 19:28:15 -0800
Message-ID: <>

But this woman may be using the wrong "OTC" methods. Hemorrhoids hurt
only when they are thrombosed (clotted up) and in such cases (and all
clots) the body is in a constant tug of war between new clot formation
and clot breakdown. That can go on for months. Even 6 months (though by
then, one side or the other usually wins out).

To see if you can tip the balance toward clot breakdown, try a few
months of several aspirin a day (you never know how many it will take,
and some people are resistant to the standard 81 mg), and some
antiinflammatory treatment which won't increase clotting, such as 10
grams a day of cold water fish oil.  Heat is also anti-inflammatory in
the long run, and if you keep the water only up to your waist, you can
stand it a lot hotter of longer than totally submerged. That's the
whole point of so-called "sitz baths".  Long and hot.


From: "Howard McCollister" <>
Subject: Re: Small external hemorrhoid won't seem to go away!!
Date: 3 Feb 2005 06:55:03 -0600
Message-ID: <42021ea7$0$94876$>

Steve Harris <> wrote in message
> But this woman may be using the wrong "OTC" methods. Hemorrhoids hurt
> only when they are thrombosed (clotted up) and in such cases (and all
> clots) the body is in a constant tug of war between new clot formation
> and clot breakdown. That can go on for months. Even 6 months (though by
> then, one side or the other usually wins out).
> To see if you can tip the balance toward clot breakdown, try a few
> months of several aspirin a day (you never know how many it will take,
> and some people are resistant to the standard 81 mg), and some
> antiinflammatory treatment which won't increase clotting, such as 10
> grams a day of cold water fish oil.  Heat is also anti-inflammatory in
> the long run, and if you keep the water only up to your waist, you can
> stand it a lot hotter of longer than totally submerged. That's the
> whole point of so-called "sitz baths".  Long and hot.

Good points, and worthwhile recommendations. Hemorrhoids aren't dangerous in
any way and the OP certainly has time to try every possible treatment in an
effort to avoid surgery.


From: Steve Harris <>
Subject: Re: My hemorrhoid hurts so much can I pop it safely with a pin?
Date: 23 Sep 2005 18:35:02 -0700
Message-ID: <>

Bonnie Willoughby wrote:
> My new case of piles hurts so much I desperately plan on popping the
> quarter-sized external hemorrhoid with a pin but I don't know if that
> self care would make me bleed forever (would the prolapsed anorectal vein
> never heal?). My grapelike hemorrhoid hurts so much I'm ready to do almost
> anything, even something drastic.
> However, before I pop the prolapsed bulging vein to relieve the pressure, I
> ask if anyone has been successful in cutting open a hemorrhoid who can advise
> me so as to reduce the chance of infection.


They do rupture spontaneously, sometimes. And no, this does not cause
bleeding to death and it does sometimes help the pain a lot. It's a
clotted up vein, after all, so there's a limit to how much it can

If you try to do it yourself you'll find the blood pool and clot is
quite a bit deeper than it looks, though. Not recommended.

You probably have an external hemorrhoid, which won't respond well to
banding. Really, the only thing that works is a week of heat and
therapy to make sure the clot disolves faster than it can continue to
form. That means lots of hot sitz baths, and at least a couple of
regular aspirin a day (resistance to aspirin varies, so you want to
make sure you've done the job). Fish oil (5 grams a day) and vitamin E
(400 IU twice a day) also are antiinflammatory and anti-clotting. If
you're taking estrogen in any form, you may want to stop for a while.

A good surgeon (preferably a specialist, as with all surgeons) might
very well be able to take a look at your problem and make a guess at
whether clamping it, opening it, removing the clot and sewing it up,
will produce a result that is likely to heal any faster than
"conservative treatment" which is what is described above. No way to
tell over the internet.



An old anonymous work:

From the depths of the crypt of St Giles
Came a scream that echoed for miles.
Said the Vicar, "Good Gracious,
Has father Ignacious
Forgotten the Bishop has piles?"

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