Hemorrhoids - A plea - Do you have them - what do you do about them - my story

[rahvin]

Personally I would rather see a mature discussion of hemmeroids than YAGT or YACT or any of the other million inane AOL threads around this place.

 

[episodic]

Originally posted by: AEnigmaWI
if you have streaks of blood, it's highly likely IMO that you have a fissure.

Most general surgeons won't properly diagnose a fissure, because it's not a real well researched thing.

You really need to get a colorectal specialist to take a look. He/She can tell you right away in 5 secs with out using any instruments if you have hemorrhoids and/or a fissure.

If it's a fissure, you might try the following:

1) Get some 0.10% nitroglycerin ointment. It has to be compounded at a pharmacy. Pre-prepared nitro ointment is in 10% concentration and is too strong for what you want. They will give it to you in a little plastic jar most likely. Rub some around the periphery of your sphincter, and try and push a little inside with just the tip of your finger.

Nitro ointment increases blood flow, and will relax your muscle down there. It can help with healing, and with continued use (3 - 4 times a day) will lower the amount of pain you are in.


Can I get this without a prescription? If so what do I ask for exactly (will they know what this is if I mention it as .10% nitroglycern?

I hear ya about going immediately. Unfortuantly, I have a job where I have to hold it frequently (a dispatcher). On top of that I have to sit for long periods, etc. Many times there is no relief for me to go right then and there. . . I took a week off this week in fact just to try to heal things up some

I do the high fiber cereal, I guess I need to get a taste for broccoli . Just to ask, are there any fruits that have the same reaction as broccoli? Fruit is easier to carry to work, too.

I am doing the metamucil now as well (just started that).

I do the shower thing to clean with as well (when I'm home). Another person suggested witch hazel wipes when I'm out - I'm going to get those asap.

The stool softner the doc told me to get after looking at it turns out to be the 'sodium kind'. . . sheesh, I'll find the calcium kind. I never thought about that, however makes total sense, especially after I tried a fleets enema last week to help and ended up in extreme pain because dumb me did not read and notice that basically it was a saline solution (ouuuch, I'll never do that again).

I drink lots of fluids, no alchohol, - but I do drink lots of caffeine (I'm southern so sweet tea is the norm). So caffeine really effects this? If so I guess I need to drink water or caffeine free diet cokes (eccck). . .Thanks for the suggestion.

LMK about how to ask for that nitro ointment

Thanks!!!!

 

[Rudee]

A few years back I got a case of nasty hemorrhoids from spending too much time at my computer during my summer vacation. This has since happend one other time. What happens is that leaning back on my chair was pinching off the blood flow as my legs were restricting blood flow by being pressed against the edge of my computer chair for too long. The result, nasty 'roids! nasty!

 

[Pliablemoose]

I've had a colonoscopy and there is nothing else wrong.

Honestly, I think you're looking for zebras in a horse barn if you think it's an anal fissure.

 

[Nitemare]

Originally posted by: Pliablemoose
For the love of god, go get them removed & never post another thread like this.

Do I have a second?

Agreed and also why did I click on links in this thread

 

[Spamela]

i'm sure they're painful, but sympathy on ATOT is scarce,
unless you're dying.

 

[episodic]

Originally posted by: Spamela
i'm sure they're painful, but sympathy on ATOT is scarce,
unless you're dying.

I'm tough

 

[Shelly21]

I don't feel so bad now about my mole or lack of.

 

[AEnigmaWI]

"zebras in a horse barn"

Anal fissures aren't uncommon at all.. and his symptoms are a lot more like a fissure than hemorrhoids. Most people think anything they have down there is a hemorrhoid, mostly because that's what we see ads about on TV. You don't need a colonoscopy to detect an anal fissure.. it's fundamentally external. If your doc had a mirror, he could show it to you just by gently spreading things.

You have to have a perscription for nitro ointment. It isn't something you can get without one. There are some realities to using it as well.. think about relaxing muscles and the effect it might have, plus ointment in that area.

As far as portable fruit fibre.. Apple skin is ok, but too many apples will not be a good thing. I would suggest maybe AN apple or A pear etc.. don't eat citruis fruits, or things high in acid, like tomatoes.

Here is the best thing on the web I have found about fibre. It explains how it works, what it does, and what you should eat. link

Psylium, the fiber in metamucil, has been shown to decrease the pain associated with bowel movements. It is the ONLY kind of fiber that has had this result. Hence the recommendation for metamucil. Other fiber supplements like citrucel are NOT the same.

Be careful of the witch hazel wipes. Witch hazel is an astringent, and if you have something open and bleeding, astringent = ouch. Witch hazel are used for external hemorrhoids because they can help shrink them if they are painfully enlarged. Btw, if you have external hemorrhoids, you can see them yourself with a little creative positioning in front of a mirror.

Caffeine dehyrates you, as does tea. This water is removed from your body tissues, and will, you guessed it, make your stool hard. Avoid dehydrating foods like tea, and anything with caffeine. Additionally, caffeine can increase your ambient pain if you are uncomfortable btw bowel movements. Drink clear soda, water, juice that isn't citrus, etc.. Some people think high fructose syrup is bad for you and slows healing. This is just anecdotal tho.

Try and find some way to use the bathroom in a timely fashion. This is more important than anything else if you want to heal.

 

[Pliablemoose]

Originally posted by: AEnigmaWI
"zebras in a horse barn"

Anal fissures aren't uncommon at all.. and his symptoms are a lot more like a fissure than hemorrhoids. Most people think anything they have down there is a hemorrhoid, mostly because that's what we see ads about on TV. You don't need a colonoscopy to detect an anal fissure.. it's fundamentally external. If your doc had a mirror, he could show it to you just by gently spreading things.

You have to have a perscription for nitro ointment. It isn't something you can get without one. There are some realities to using it as well.. think about relaxing muscles and the effect it might have, plus ointment in that area.

As far as portable fruit fibre.. Apple skin is ok, but too many apples will not be a good thing. I would suggest maybe AN apple or A pear etc.. don't eat citruis fruits, or things high in acid, like tomoatoes.

Be careful of the witch hazel wipes. Witch hazel is an astringent, and if you have something open and bleeding, astringent = ouch. Witch hazel are used for external hemorrhoids because they can help shrink them if they are painfully enlarged. Btw, if you have external hemorrhoids, you can see them yourself with a little creative positioning in front of a mirror.

Caffeine dehyrates you, as does tea. This water is removed from your body tissues, and will, you guessed it, make your stool hard. Avoid dehydrating foods like tea, and anything with caffeine. Additionally, caffeine can increase your ambient pain if you are uncomfortable btw bowel movements. Drink clear soda, water, juice that isn't citrus, etc.. Some people think high fructose syrup is bad for you and slows healing. This is just anecdotal tho.

Try and find some way to use the bathroom in a timely fashion. This is more important than anything else if you want to heal.

You forget that he had a colonoscopy & they detected roids, now if you want to claim he has both...

I still call zebra.

Now lets convince him he has anal leprosy...

 

[AEnigmaWI]

I did mention that he might have both before. He didn't say the colonoscopy found hemorrhoids, it said there was nothing else wrong.

Also, like I said above, a colonoscopy isn't going to even show a fissure.. it's looking way up in there, not right outside.. and many general surgeons or internal medicine people that would perform a colonoscopy might not know what to look for if you had a fissure.

If he has hemorrhoids, he can see them himself too. It's highly likely that he has both, or at least some inflamation that is adding to the problem.

btw zebra calling person, do you know anything about hemorrhoids or anal fissures? I think maybe not.

 

[Pliablemoose]

Originally posted by: AEnigmaWI
I did mention that he might have both before. He didn't say the colonoscopy found hemorrhoids, it said there was nothing else wrong.

Also, like I said above, a colonoscopy isn't going to even show a fissure.. it's looking way up in there, not right outside.. and many general surgeons or internal medicine people that would perform a colonoscopy might not know what to look for if you had a fissure.

If he has hemorrhoids, he can see them himself too. It's highly likely that he has both, or at least some inflamation that is adding to the problem.

btw zebra calling person, do you know anything about hemorrhoids or anal fissures? I think maybe not.

I've got a terrible case of hemorrhoids

8 or so years as an ICU RN, 7 or so ER RN, currently triage nurse for medicine clinic, ACLS certified, med surg certified.

Want to discuss how an intra aortic baloon pump works?

One of those little rules is to not look for zebras in a horse barn, treat the horse first, if it doesn't work, then start looking for zebras.

Perhaps its an anal condyloma.

 

[AEnigmaWI]

Originally posted by: Pliablemoose


I've got a terrible case of hemorrhoids

8 or so years as an ICU RN, 7 or so ER RN, currently triage nurse for medicine clinic, ACLS certified, med surg certified.

Want to discuss how an intra aortic baloon pump works?

Nice time to out your credentials. Are you trying to pick fights or something?

And please let's not try and scare people with scientific terms. I am just offering advice, that you should agree is sound, even if he doesn't have a fissure nothing I am saying is gonna hurt him. Why are you so angry?

 

[AEnigmaWI]

Besides the fact that working in medicine doesn't mean you know all there is to know about it every health condition in the world. I am sure you are a better traige nurse than me, but I might just happen to know something about anorectal health.

 

[AEnigmaWI]

Anal condyloma.. you think he has anal warts? Since those are typically painless, I don't so much think he for sure has that..

 

[GalvanizedYankee]

I was learning a thing or two, until you two started squabbling. Stop it please.

 

[Pliablemoose]

Originally posted by: AEnigmaWI

Originally posted by: Pliablemoose


I've got a terrible case of hemorrhoids

8 or so years as an ICU RN, 7 or so ER RN, currently triage nurse for medicine clinic, ACLS certified, med surg certified.

Want to discuss how an intra aortic baloon pump works?

Nice time to out your credentials. Are you trying to pick fights or something?

And please let's not try and scare people with scientific terms. I am just offering advice, that you should agree is sound, even if he doesn't have a fissure nothing I am saying is gonna hurt him. Why are you so angry?

Really no, I'm not looking to pick a fight, it's just dangerous to take advice from a computer hardware forum over your physician's.

And honestly WebMD has made a lot of physicians red faced when the patient correctly rediagnoses themselves.

I've used google @ work during a triage to see what the hell a patient is talking about sometimes, no-one knows it all, and I'm the first one to admit it.

 

[Shockwave]

God God thats honestly at its finest from the OP!!! :Q

 

[Pliablemoose]

I'll shut up, sorry guys

 

[AEnigmaWI]

sorry to get prickly. I wouldn't expect him to take advice from here over a physician.. which why I keep saying to go to a colo-rectal specialist.

He said he didn't have time.. =)

btw, very cool using the internet during triage. Seriously, it's awesome when technology actually helps people, and it's also awesome when people are willing to look for information and not just fly by the seat. Doctors sometimes need to do this more IMHO.

 

[Pliablemoose]

Originally posted by: galvanizedyankee
I was learning a thing or two, until you two started squabbling. Stop it please.

Does my temp of 101.3 earn me back some karma points? Stayed home from work today & I get crabby @ around 100 or so I got up to 103 last night.

 

[iliopsoas]

Originally posted by: Pliablemoose

Originally posted by: AEnigmaWI
I did mention that he might have both before. He didn't say the colonoscopy found hemorrhoids, it said there was nothing else wrong.

Also, like I said above, a colonoscopy isn't going to even show a fissure.. it's looking way up in there, not right outside.. and many general surgeons or internal medicine people that would perform a colonoscopy might not know what to look for if you had a fissure.

If he has hemorrhoids, he can see them himself too. It's highly likely that he has both, or at least some inflamation that is adding to the problem.

btw zebra calling person, do you know anything about hemorrhoids or anal fissures? I think maybe not.

I've got a terrible case of hemorrhoids

8 or so years as an ICU RN, 7 or so ER RN, currently triage nurse for medicine clinic, ACLS certified, med surg certified.

Want to discuss how an intra aortic baloon pump works?

One of those little rules is to not look for zebras in a horse barn, treat the horse first, if it doesn't work, then start looking for zebras.

Perhaps its an anal condyloma.

Please. Being ICU RN or ER RN or whatever, you may not be familiar with the bread and butter outpatient medicine types of problems.

 

[DrNoobie]

The Jackass Doctor vs. The Cool Nurse

Who will win? Tune in next time for the exciting conclusion...

 

[iliopsoas]

Originally posted by: AEnigmaWI
if you have streaks of blood, it's highly likely IMO that you have a fissure.

Most general surgeons won't properly diagnose a fissure, because it's not a real well researched thing.

You really need to get a colorectal specialist to take a look. He/She can tell you right away in 5 secs with out using any instruments if you have hemorrhoids and/or a fissure.

If it's a fissure, you might try the following:

1) Get some 0.10% nitroglycerin ointment. It has to be compounded at a pharmacy. Pre-prepared nitro ointment is in 10% concentration and is too strong for what you want. They will give it to you in a little plastic jar most likely. Rub some around the periphery of your sphincter, and try and push a little inside with just the tip of your finger.

Nitro ointment increases blood flow, and will relax your muscle down there. It can help with healing, and with continued use (3 - 4 times a day) will lower the amount of pain you are in.

2) Eat 35 grams of insoluble fiber a day. There are many kinds of fiber. Not all of them are the same. Oatmeal, many kinds of fruit etc.. have soluble fiber in them. This is great for health, but has no laxative effect. You need the kind of fiber in wheat or broccoli. A good diet is a bowl of high fiber cereal (not necessarily more than ) for breakfast.. a salad for lunch, some stemed broccoli, a small amount of protein like a chicken breast, and some fibrous carb, like brown rice, wheat bread, etc.. for dinner. It is important to have something like a salad at some point during the day because it increases the amount of water in your colon, and promotes sofer stools.

3) Take Surfak stool softener once a day. It's ducosate calcium. Dulcolax stool softener gels are ducosate sodium, and I don't think you want anything that has a chance of having lots of sodium in it passing by something that is open and bleeding. Ouch.

4) Take a tbsb of metamucil twice a day. If you tend to harder stools, take it with at least 14oz of water. This will also help keep your stools from being hard. Metamucil is a bulking agent, and will also help keep you from having diarreah. It seems like you don't want bigger stool, but really a bulking agent makes it soft and pliable but still formed.

5) Drink plenty of fluids. Don't drink alcohol, or anything with any amount of caffeine in it.

6) This is the hardest and most important thing.. when you feel the urge, go IMMEDIATELY. This is very, very important. When you retain stool, your colon dries it out, and it will be insanely painful to pass.

7) Use a showerwand or similar to bathe your anal area with very warm water right after bowel movements. This will relax the muscle and relieve a lot of the pain. Spasming of your sphincter causes much of the pain of a fissure once the BM is over.

Agreed with your assessment.

To the original poster:
Although you may have hemorrhoids, I think you probably also have anal fissures from your history. You should go see your internist and ask about nitroglycerin paste. Apply a small amount to the rectal area 30 minutes or so prior to your anticipated bowel movement. The potential side effects are headaches and dizziness/lightheadedness (nitroglycerin dilates blood vessels and can cause your blood pressure to fall).

Physicians will usually prescribe fiber, stool softeners and sitz baths (which is a fancy name for sitting in a bath tub with some warm water). But they often overlook the use of nitroglycerin paste, which is actually very useful and effective.

 

[iliopsoas]

Originally posted by: DrNoobie
The Jackass Doctor vs. The Cool Nurse

Who will win? Tune in next time for the exciting conclusion...

noobie, why don't you show off some more and spew out more fancy medical terminologies to impress these folks with your superb medical education.

If you really want to educate and inform people, try using simple language.