hemorrhoid pain during bowel movement

September 13, 2024 8:52 AM

I have been strugging with h for a bit. (dont feel like typing out the word each time).

I have both external and internal and they are level 2 so far. I've had banding done 2 or maybe 3x by a really good specialist. I think it was 2, and after both times I had the urge to have a movement and they were quite large and ended up pushing off at least 1 band. I also find the procedure REALLY painful (and I think I have a strong pain tolerance but I'm also an auburn-head).

However: lately the h are not too bad EXCEPT on the left side I have one external one that I know my dr. said is maybe...a thrombosed vein? I am not sure BUT I have very very acute burning pain from this whenever I have a bowel movement and I have come to dread them. There is also always bright red blood in the toilet (my dr. is aware and hasn't said it's abnormal or concerning). Oddly, I am not having pain or burning after a bowel movement, which I've definitely had at other times lasting quite awhile after.

I am seeing her in 5 weeks so I'd love any suggestions of how I may get relief during a bowel movement til then.

I know that you're not my/a dr. and won't give me medical advice--just what's worked for you or someone you know.

posted by anonymous to Health & Fitness (14 answers total)

Bidet (you can get the manual/travel ones too). Basically anything that minimizes rubbing.
posted by DoubleLune at 8:59 AM on September 13 [4 favorites]

How soft are the bowel movements. Our pediatrician said 6 months of soft movement is critical. So we use restoralax and lots of chia seed pudding. (4 liquid to 1 chia seed soaked overnight.)
posted by St. Peepsburg at 9:07 AM on September 13 [1 favorite]

Bidet, witch hazel wipes, the non-Metamucil fiber supplement (comes in a purple bottle and it’s a white powder that you have to take with lots of water for smooth poops, I forget the name), preparation H, limit the amount of time you’re on the toilet (weirdly, sitting for a long time on the toilet can actually exacerbate h!)
posted by seemoorglass at 9:08 AM on September 13 [1 favorite]

Miralax. Up to three time daily. Your poops should be like squeezing toothpaste from the tube
posted by genmonster at 9:13 AM on September 13 [3 favorites]

I use straight up psyllium husk - had better results than the more processed Metamucil (ymmv). Fibre was huge improvement for me. Hope you get cush tush soon.
posted by whatevernot at 9:24 AM on September 13

Any chance this is a fissure? The pain and bright blood make me think it could be. If it is a fissure, you need different treatment than if it’s a hemorrhoid, including a special prescription cream and soaking your bum in a sitz bath a few times a day. If there is any way you can get in to your doctor sooner, it might be worth it; I thought my fissure was a hemorrhoid for too long and ended up needing more aggressive treatment because my self-care for hemorrhoids made it worse.
posted by stellaluna at 9:37 AM on September 13 [3 favorites]

If you are having butt problems, you should be cleaning your anus in the shower with soap after you poop, and when you encounter any dangling h you should tuck them back inside where they can heal. Source: me, and how I got rid of a thrombosed h without seeing a doctor and just being patient as my body resorbed the clot. And, yes, red blood is an anal fissure which means you're probably wiping too much and should... clean your butt in the shower with soap.

If you don't like the idea of touching your butt with your hands or pushing h back in your anus with your fingers, get over it. Soap and water cleans it all up and you'll be fine.
posted by seanmpuckett at 10:21 AM on September 13 [3 favorites]

OTC creams like anusol applied straight after cleaning/wiping can help with the pain.
posted by terretu at 11:00 AM on September 13 [1 favorite]

rather than use wipes, I buy witch hazel extract in liquid form as a splash-on. Less wiping, cheaper, and no wipes to throw away/flush. Then add to that something with lidocaine; I use either Bactine with the pain-relief label, or the kind of aloe vera gel with lidociane.
posted by The otter lady at 1:47 PM on September 13

Get a supplement with 90% diosmin and 10% hesperidin (500mg capsules). They’ll be called things like Vein Ease. That’s a prescribed drug (Daflon) for h in some countries.

https://en.wikipedia.org/wiki/Daflon

^ there’s dosage and other information there. “For acute hemorrhoidal attack, the dosage is 6 tablets daily for 4 days, followed by 4 tablets daily over the next 3 days”
posted by cotton dress sock at 2:23 PM on September 13

I’m told a fissure makes pooping feel like like you’re pooping ground glass.

A bidet was very very helpful to the person in my life with a fissure and Hs.
posted by needs more cowbell at 2:34 PM on September 13

My husband had this pain and it is excruciating. He eventually got surgery. In the meantime, what worked for him was soaking in hot water, pushing the hemorrhoid in and (unexpectedly and important) LIDOCAINE. We don't know why it worked but it did. We were super desperate and called everyone in the middle of the night and this was the only medication that worked for him. Not sure if it would work for you.
posted by ichimunki at 6:05 PM on September 13 [1 favorite]

I wrote two 20-page answers previously that would still be me answers to this.

TL;DR of those is that massively increasing your fiber intake will help immensely - though that means more than taking a couple of spoonsful of metamucil every now and then (that will get you literally about 5% of the way there).

I will agree with those above suggesting Miralax or equivalent. The technical name for this is Polyethylene Glycol Powder and there are all sorts of different brands & generics out there - you don't have to buy the brand name. Also you dr. might write a prescription for this if you ask, which can help with the cost depending on your prescription plan.

Polyethylene Glycol Powder just absorbs a (literal . . . ) shit-ton of water as it passes through your digestive system, keeping everything nice and soft. Polyethylene Glycol itself just passes right on through without being digested or absorbed at all, so it is usually very well tolerated by almost everyone.

Whenever you increase your fiber (whether via Polyethylene Glycol Powder, a fiber supplement, or just good food) be sure to stay well hydrated as they all work by retaining more water in the stool. FWIW if your digestion is normal-ish at all, you can give yourself a pretty decent case of constipation, or at least very, very hard, dry stools, or normal stools, or quite loose stools simply by varying your fluid intake. One of the ways your body regulates its internal fluid levels is by absorbing or releasing water in the very last stage before elimination. If you're somewhat towards the dehydrated side you can give yourself pretty hard/dry/painful stool even if you're doing most everything else right.
posted by flug at 8:10 PM on September 13

This is unexpected, but the Mother Love Rhoid Balm is better than anything else on the market for hemmorhoids, in my opinion. Prep H is fine - this stuff has been incredible for me. I recommend it to everyone dealing with this.
posted by coldbabyshrimp at 10:05 PM on September 13 [1 favorite]