Stage 4 Hemorrhoid Experiences Please!

[24601]

Even though I've had severe Crohn's for 17 years now this is my first, or at least by far the worst, stage 4 hemorrhoid. Needless to say it is large and PAINFUL.

I would love to hear others' experiences - whatever treatments, surgical, non-surgical, successful, unsuccessful, any and all, you may have tried.

Right now I don't want to move at all and even staying still it verges on mind-numbing pain. I'm really hoping it won't continue like this. So much information out there on the internet seems to say that stage 4 hemorrhoids require surgery but I've always been told by my doctors in previous conversations about hemorrhoids that they would never do surgery because I have Crohn's. I don't like the way that could work out if both really are true. :yrolleyes:

Thank you so much to anyone who can share on this

 

[ronroush7]

A year before I was diagnosed with Crohn's Disease, I had hemmorhoids. I don't know at what stage they were at. I just remember bleeding and bad itching. They did surgery to remove the surgery. I wish you the best.

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[24601]

Thanks for your reply! I'm kind of concerned either way - one that I can't have surgery or rubber band ligation because my doctors won't do it because of the Crohn's but also about complications and pain if I do have those treatments!

I guess it's the old "can't win with Crohn's" thing.

And it seems crazy that such a small (although I wish it were a lot smaller!!!) thing can cause so much trouble when we have much more serious things to worry about. But it quite literally is such a pain in the a**.

 

[AJC - Australia]

they wont do surgery, but i cant see why they wont do 'banding'…..i have had it three times in 3 months and i have crohns. They basically strangle the roid!!!! It takes a few days to fall off….the colorectal surgeon should be able to take a quick look up there and see if it is do-able. I would get him/her to have a look regardless, they have to be able you an option. Having 4 of them is just making every toilet visit even more annoying…..good luck friend

 

[24601]

Thanks for your reply! Could you tell me a bit more about your experience with banding? Was it painful? I think I sound whiny but I really just want this to go away...I feel like I could cope better with my upcoming surgery and stem cell transplant if I was just in less pain and not feeling so debilitated by this thing. And really wishing that I hadn't ignored the whole stage 3 thing and expected it to get better eventually or turn into a largely painless skin tag like my others

Also were you told there was a risk of infection with the banding? I read that...but then there's pretty much always a risk of infection with everything especially if you're immunosuppressed like all of us.

Anyway I'm really pleased to hear that it's been working for you...and not so awful that you wouldn't do it again!

 

[LodgeLady]

What does surgically removing hemrroids have to do with Crohn's? I have stage 2 and if they get any worse I am by all means getting them removed .


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[UnXmas]

Thanks for your reply! I'm kind of concerned either way - one that I can't have surgery or rubber band ligation because my doctors won't do it because of the Crohn's but also about complications and pain if I do have those treatments!

I guess it's the old "can't win with Crohn's" thing.

And it seems crazy that such a small (although I wish it were a lot smaller!!!) thing can cause so much trouble when we have much more serious things to worry about. But it quite literally is such a pain in the a**.

Have they given you a specific reason for not having surgery? I had haemorrhoid surgery with no problems. Surgery does always come with risks, but I wonder if there is something particular about your Crohn's that it contradicts surgery? And yes, surgery comes with risks and pain... but then haemorrhoids come with pain too. Haemmorrhoid surgery isn't that big a risk as far as surgeries go.

 

[24601]

As I understand it the reluctance to surgically remove hemorrhoids for Crohn's patients (which in my experience a lot of doctors will express as a flat out blanket statement of "no hemorrhoid surgery for Crohn's patients") is to do with the increased risks that all Crohn's patients will have. The disease affects our digestive tract from mouth to anus and so doing anything invasive to any bit of it comes with a risk of aggravating/igniting a manifestation of Crohn's in that area, or so I am told, and we on average heal less well, which of course can have some nasty complications like infection or forming abscesses.

I believe we will also pretty much all have a higher risk of infection aside from the poor healing - I guess because our immune systems don't work in an ideal way and because so many of us are on immunosuppressant treatments.

I'm not worried about the general risk of surgery - anaesthesia, infection, those regular things. And I'm not worried about being in pain, after all I am already in pain.

But I do want to try and make a judgement about the likelihood I will be trading one pain in the a** for another worse one. Or some other fine complication of Crohn's.

And to compare the risks and benefits of banding (or laser or coagulation or whatever!) to surgery for a Crohn's patient with a stage 4 hemmie.

My doctors have always told me "leave well alone/we can't do anything" but I feel that sort or advice is what has got me here. And I am in too much (and constant) pain to not try something.

@UnXmas It is so so good to hear that you had a good experience of surgery. How long was your recovery? Were you on any meds at the time? To put my concerns about the risks in perspective, I'm having my 4th laparotomy soon for (yay!) more strictureplasties (I have lost count!) and after that a stem cell transplant so my concerns about the risks are simply am I choosing the right course of action for this condition. Will I end up with an improvement in these symptoms, that sort of thing, rather than ending up thinking that I went through something painful with a long recovery and it wasn't worth it. I know no one can know for sure but this is quite a sharp turnaround in thinking for me because of everything I have repeatedly been told by all my doctors so it's really useful for me to know that there are real Crohn's patients out there who have had surgery successfully. Oh and to answer your question, all the reasoning I have been given about not having surgery has been completely general and i don't really think there would be anything specific to my disease since it's all small bowel involvement.

Sorry for such a long response....I have had no sleep and writing helps distract me a little from the pain too

 

[AJC - Australia]

banding is not that radical…you could have it done on a lunch break…it is more embarrasing than painful….in fact i will go as far to say it doesnt hurt at all..…you might need more than that….i think in your case though, go and poke your bottom into the face of an expert colorectal surgeon and get an expert opinion on how to fix the symptom…………it is a symptom of having crohns and not doing healthy poos………………….then i guess the next bit is to try and get healthy and avoid the problem in future…easier said than done….good luck!!!

 

[24601]

Thanks so much for sharing your experience! Such a relief to hear that it wasn't painful for you. Doing too much research about others experiences will always bring up some bad ones so it's lovely to know it wasn't like that for at least one person! Then again this research has also really helped me because now I know that what my doctors have been telling me - that I can't have these treatments with Crohn's - simply isn't true! That makes me so happy - I want to add a jumping up and down smiley but to be clear at the moment I am keeping quite quite still

 

[UnXmas]

I actually had the haemorrhoid surgery at the same time as having a rectal prolapse repaired and some other things (my surgeon found more problems whilst carrying it out, so it got more major than I expected). My recovery was longer for that reason, but I think I was pretty much back to my normal after a couple of weeks. It wasn't particularly painful - nowhere near as painful as abdominal surgeries I've had.

The prolapse recurred though, and I think it's quite likely haemorrhoids can recur too, if you're prone to them, and all the diarrhoea that comes with Crohn's can contribute to them coming back too. I've now had an ileostomy (for other reasons, obviously, but not having all those rectal issues is an added bonus!), so no more for me!

I wasn't diagnosed with Crohn's at the time (though with hindsight I know I had it and was getting symptoms) so I wasn't on meds for Crohn's. I have had two routine surgeries for other things since being diagnosed though, and my surgeon didn't think operating on a Crohn's patient was an issue at all. If you're on immune suppressing meds that might be an issue, but for a minor surgery it shouldn't contradict it completely. If you're on prednisone or meds that can shut down adrenal function you might need additional meds prior to any surgery to ensure you can cope with the physical "shock" of surgery, but your doctors will know this - just make sure they know what you're taking.

Think about banding first - it's less invasive - but surgery might be an option.

 

[24601]

Thanks for sharing your experience. I saw an ER doc yesterday and they prescribed percocet - obviously not a long term solution but I am coping a bit better for now using that and some TUCKS fast relief spray which seems more effective for me than lidocaine. [Edit: I don't think the TUCKS spray contains any anaesthetic but I do find it to relieve the pain a bit and have a bit of a numbing effect.]

She took a look, described it as large and consulted a colorectal surgeon on the phone. Pre-phonecall she seemed to be thinking surgery might be the way to go, but after talking to the surgeon she said she thought probably surgery wouldn't be appropriate as we didn't want to leave me "with a whole mess of other problems like fistulas" and we should just try to make it smaller and relieve some of the pain.... but I will go show the colorectal surgeon and hear what she says when she actually sees it! Maybe her opinion will change. At no time was banding mentioned and by the time the doc came back with a treatment plan, the percocet had started to kick in so I'll have to ask the surgeon about that too.

I really just wanted to say thank you for responding! I'll continue to update this thread in case it's useful to anyone else reading or someone in the future!

Edit:
Here are all the treatments the doc prescribed in case it helps anyone -
1) pain killers (we discussed tylenol etc. but since my pain level was high she chose percocet)
2) Sitz baths 3-4 times a day
3) lidocaine 5% anaesthetic gel
4) Tucks medicated wipes with witch hazel
5) Stool softener (so far I haven't used those since the Crohn's means it's kinda unnecessary at the moment :ylol