October 9, 2014 7:42 AM   Subscribe

YANMD. Never had hemorrhoids before, trying to figure out if that's what I'm experiencing now.

Last week Thursday pooped 3 times in a day, and the last didn't feel too good, required some straining. Soon after that, started feeling a lot of soreness and discomfort. On a pain scale it's maybe a 4-5, definitely uncomfortable but not excruciating. Since then, it's happened every time I poop, which has been about once a day.

I don't experience pain while actually pooping, maybe slightly more discomfort than usual. No bleeding. The soreness doesn't happen right away, but started maybe 5-10 minutes after I'm done. It lasts for a long time, but does decrease so by the time I poop again I usually feel mostly better. There doesn't seem to be anything external, so this would be internal hemorrhoids if anything I guess?

I've cut out coffee (my usual intake is pretty high) and been drinking a lot of water. Any recommendations for foods? Anything else I can do to improve the situation?
posted by mean cheez to Health & Fitness (14 answers total) 1 user marked this as a favorite
Generally speaking true "internal" hemorrhoids don't cause pain, however a cursory self inspection can easily miss an external hemorrhoid, so I wouldn't worry too much about that one way or another.

The deal with hemorrhoids is that for the vast majority of people all you want to do is prevent them from getting worse and treat the symptoms when they bother you. The symptoms will usually strike for a few days to a week after a particularly strain-y bowel movement and then subside on their own.

In order to encourage them to subside faster, you are right to stay hydrated so as to avoid constipation. Coffee affects different people in different ways -- if you're capable of staying well hydrated while drinking it, there's no reason you need to cut it out, but maybe you'd rather cut out coffee than drink more water. Your choice. You will probably want to increase your fiber intake, especially soluble fiber, which helps to bulk the stool but also makes it more slippery, so it slides out more easily without irritation. Metamucil is a good source of soluble fiber, so is applesauce. I would encourage you to chew your food very well and avoid foods that come out in sharp pokey form, like nuts and seeds, until you feel like your situation has calmed down.

Finally, from a lifestyle perspective, try to limit the amount of time you spend sitting on your keister. Clean yourself thoroughly but gently after bowel movements -- use a squirt bottle of warm water and dab dry, or use baby wipes. Avoid thong underwear and tight pants for a little while.

Most importantly, don't strain. A lot of people swear by squatting to poop instead of sitting down to make evacuation easier and minimize straining. If you're flexible, you can squat ON your toilet seat, otherwise you might need some kind of contraption to elevate your feet while you're on the throne. Or maybe you have access to a squat toilet! That would be nice.

I hope this helps. They are super annoying, and almost everyone gets one eventually, but I bet $20 yours will quiet down pretty soon.
posted by telegraph at 7:58 AM on October 9, 2014 [5 favorites]

Go see a doctor, stat. These are exactly the symptoms of an abscess or fistula...if it's an abscess, you definitely want it taken care of before it becomes a fistula as the treatment for that is horrid and takes forever to heal.
posted by sexyrobot at 8:12 AM on October 9, 2014 [2 favorites]

(the key symptom is the time delay...because poop getting into the abscess is irritating it. They can definitely be caused by straining too much/constipation/tearing)
posted by sexyrobot at 8:28 AM on October 9, 2014

You can't go wrong by adding Metamucil to your diet and cleaning gently (the squirt bottle of warm water is a great idea). Look for those squirt bottles used for perineal cleaning after childbirth - they're perfect for this application.

However, I think hemorrhoids usually cause pain DURING excretion - so per sexyrobot's suggestion you should probably take the better-safe-than-sorry route and get a doctor to have a look.
posted by telepanda at 9:09 AM on October 9, 2014

A fistula or abscess would be a constant pain that is worse during evacuation. The area would be hot, red, and swollen. You might have drainage coming from the area and, if so, it would be gross. You would feel like (pardon my French pun) shit. You might have chills or a fever. The pain would be bad.

I am not your doctor and I certainly can't tell from my armchair if you have an abscess. But I don't think it's likely and I do think "these are exactly the symptoms of an abscess or fistula" is unnecessarily alarmist (if not just false).
posted by telegraph at 9:28 AM on October 9, 2014 [3 favorites]

From an anonymous commenter:
I have had a rectal abscess that led to a fistula. I think you probably have hemorrhoids (which I also have), but NB:

There is not necessarily horrible pain, fever, or obvious drainage from an abscess or a fistula. I did experience a moderate amount of pain after pooping, not usually during. Before I was treated with a surgically-inserted drain, I would have flare-ups that were quite painful, and they always took place after I'd had pooping troubles. But, it was the kind of pain that got you to Urgent Care, not the ER. It took months for doctors to figure out that I had an abscess/fistula.

It's MUCH more likely that you have hemorrhoids (or some other butt issue), than an fistula or an abscess. But I encourage you to see a doctor, because butt issues (even hemorrhoids) can get worse pretty fast. Please take care of your butt!
posted by restless_nomad at 10:26 AM on October 9, 2014 [2 favorites]

You want Preparation H. INSTANT relief and shrinks the tissue, at least for me. Even internally.
posted by harrietthespy at 11:14 AM on October 9, 2014

You should out this site for more info, it was very helpful to me: Bowel movement info. Also, do not strain! That will make it worse. Focus on your breathing and if you can't evacuate, get off the pot as they say. Also, witch hazel is the active ingredient in prepH I believe, so you can use that for soothing. Coconut oil is fantastic and healing and can be used internally to treat hemorrhoids as well. Try aloe vera juice to ease the bowel movement and only go when you have to and as soon as possible if you feel the urge. IANA/YD but that's what's helped me personally. And whole wheat fiber cereal or oatmeal every morning and drinking plenty of water.
posted by lunastellasol at 11:41 AM on October 9, 2014

You want Preparation H. INSTANT relief and shrinks the tissue, at least for me. Even internally.

It does seem to work that way for most people, but it always made things worse for me. I'd dab some H on and within seconds I would be bleeding and in excruciating pain. No idea why. Apparently I have a rare and special hiney. I finally tried Ma Ying Long ointment and it worked wonderfully well. If you do have hemorrhoids, I highly recommend it.
posted by Pater Aletheias at 12:41 PM on October 9, 2014

You should go see a doctor. There's a bunch of stuff that could be causing this pain (yeast infection, yep it's possible to get there there, psoriasis, etc.). It's better to get it checked out!
posted by Lingasol at 2:58 PM on October 9, 2014

Could be an anal fissure. You're going to need to get a doctor (or perhaps a very understanding friend or relative, for starters) to look at your bumhole.

If your poops are particularly hard or wide you may like to up your water intake and introduce psyllium husk into your diet to soften them and lessen the irritation.

You may also find it useful to insert some coconut oil into your bumhole before doing a poop.

posted by turbid dahlia at 3:20 PM on October 9, 2014

Hemorrhoids can seem like fissures, and vice versa. The problem is, the treatments for hemorrhoids focus on shrinking and constructing blood flow, while treatments for fissures aim to increase blood flow to heal the fissure. Because of this difference, it's important to get a proper diagnosis - off to the doctor you go.
posted by analog at 6:40 PM on October 9, 2014

You don't need to see a doctor "stat" for minor rectal discomfort - but you ought to see one in a routine "I have a problem" appointment kind of timeframe. It's very hard to diagnose yourself (and even harder to get diagnosed over the internet) with something that needs to be seen and/or felt to be identified, in a location where you can't get a good look, and probably aren't familiar with what normal/different types of abnormal feels like.

As reassurance, hemorrhoids are an extremely common cause of rectal discomfort, while abscess and fistula (particularly fistula) are quite rare, especially in an otherwise healthy person.
posted by treehorn+bunny at 8:35 PM on October 9, 2014 [1 favorite]

Thanks guys, I really appreciate all your comments. I think I'm going to wait a few more days and see how it feels, then hit the doctor if there's no improvement. I'm stuck going to a wedding this weekend anyway and won't be able to go until Monday.
posted by mean cheez at 7:47 AM on October 10, 2014

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