Hmm, there is a swelling about the size of a soy bean behind the anus, towards your back. This part hurts? If you look closely, there is a part that looks blue-black, transparent through the skin.

Thrombosed external hemorrhoids(61KB)
This is called thrombosed external hemorrhoids, and it swells up and hurts as a result of a thrombosis, a clot that the blood hardens at the external hemorrhoids near the exit of the anus.

The pain will continue for a few days, or about a week at most. T here are two methods of therapy.

The first is done when you want to stop the swelling immediately. This method is done by taking out the thrombosis by making a litt le incision inside the skin, under local anesthesia. There will b e some blood from the area cut for a while, but you can take a bat h from the next day, and after a week you'll almost forget about t he whole thing.

The other method is taken when you do not want to have an incision . It is only a clot, so even if you leave it as it is, it will eventually disappear. The pain will continue for a week at the longest and it is endurable if you take painkillers during that time. But it will take a few weeks before the thrombosis will disappear completely, and you will probably feel some awkwardness in your anus during that period of time. If you are lucky, the skin at the surface will break by itself, and the thrombosis will melt and travel outside. When this happens, it will heal quickly,for it is like having an incision; but there will be some bleeding .

"Which do I prefer" is a difficult question. This is something to be decided with informed consent, with full understanding from the patient. The hospital will surely make more money out of an incision, though.

Okay. You are going to heal it without incision. That's what most of the patients at our hospital choose.

Then I'll prescribe a week's worth of painrelievers and ointment. The pain will be relieved greatly if you warm it with a bath.

Take care! If the pain continues even after a week, or if it gets worse, come see me again