Update *Lumbar stenosis* Hemorrhoid

Triathlon Forum
1

I’m 35 years old. I’ve had a feeling of a pain in the butt for 3 or 4 months. I stopped riding a bicycle then.
I saw a general physician doctor last week and he said he saw one external hemorrhoid and gave me Hydrocortisone 2.5% Rectal Cream and
Amitiza 8mcg capsules. I’ve been having a constipation feeling too.

I’m just looking for advice please. This is frustrating. I don’t feel relief yet. I’m anxious to get back into riding my bike.

Yes, I have searched this topic here. And reading the word “surgery” is making me more depressed.

This is my first time with a pain in the butt feeling. I do have a follow up appointment with the doctor for next week.

Cool, thanks! :frowning:

2

first off good luck, can be a real… pain in the butt.

You’ve got stuff to treat the effect, the next step I’d suggest is finding the cause. Obviously I’m sure you’ve seen online by now, a ton of things can lead to it or aggravate it to the point you’re at now.
You mention feeling constipated… lots of stuff could lead to that, but diet is as good a place to start looking as anywhere.
Bathroom “habits” can also lead to trouble… straining is something people do without even realizing it, and if you’ve got 30+ years of ingrained habits, it can be tough to break even if you’re trying to consciously avoid it.

3

Agreed. Also ran into this around 35. Took a while to change habits and find what works. In my case and everyone is obviously different it wasn’t a lack of fiber that was causing my constipation but a bacteria issue. The doctors continually tried to push more fiber and the issue kept getting worse. Mainly because I was already eating a very high fiber diet. The fix for me came with eating fermented foods and live culture yogurts. As well as changing bathroom habits.

4

One other thing.

If you start losing a reasonable amount of blood from it for a period of time (and assuming a doc confirms its from that and not ‘deeper within’ - as bleeding when going to the bathroom can be a sign of bowel cancer if not from piles) then keep an eye on iron levels / signs of anaemia too.

Speaking from the experience of a friend 🙄 low haemaglobin levels really suck when doing endurance sports.

5

One other thing.

If you start losing a reasonable amount of blood from it for a period of time (and assuming a doc confirms its from that and not ‘deeper within’ - as bleeding when going to the bathroom can be a sign of bowel cancer if not from piles) then keep an eye on iron levels / signs of anaemia too.

Speaking from the experience of a friend 🙄 low haemaglobin levels really suck when doing endurance sports.

^ This.

Mine had been bleeding for a few years, but I didn’t realize how much blood I had been losing until last January, when I completely imploded on an easy flat bike path ride. Saw my doctor and got blood tests a few days later, and my hematocrit was down to 25.6, hemoglobin was 8.5. I was put on iron, B12, and folic acid, and even though the 'roid hasn’t gotten any better, the bleeding has only sporadically shown up since then, and never as bad as it was before. Levels were back up to normal range in a bit over a month, and I’ve felt and been riding better than in the last few years. I had surgery scheduled after that to take of the damn thing, but then COVID shut down all elective surgery…

6

I’m 35 years old. I’ve had a feeling of a pain in the butt for 3 or 4 months. I stopped riding a bicycle then.
I saw a general physician doctor last week and he said he saw one external hemorrhoid and gave me Hydrocortisone 2.5% Rectal Cream and
Amitiza 8mcg capsules. I’ve been having a constipation feeling too.

I’m just looking for advice please. This is frustrating. I don’t feel relief yet. I’m anxious to get back into riding my bike.

Yes, I have searched this topic here. And reading the word “surgery” is making me more depressed.

This is my first time with a pain in the butt feeling. I do have a follow up appointment with the doctor for next week.

Cool, thanks! :frowning:

Purchase some bromelain at your local health food store. It works as an anti-inflammatory. I have seen it work for quite a few folks, including myself!

7

Feel your pain. I had one big incidence of this about 8 years ago and it was horrendous. I had to brace myself to stand up off my office chair as I felt like my insides were about to fall out of my behind. A constipation feeling accompanied this. With time and hemorrhoid cream it slowly cleared up but I was struggling to walk let alone run or cycle for a while. I was on the cusp of going to the doctor but as it got better with rest, time and hemorrhoid cream I didn’t bother.

I occasionally get a flare up when I let my diet become poor and eat a lot of processed food. It might be worth consulting with a dietician to see if there’s any red flags or things that could be eliminated/minimised to help alleviate the issue in the short term. In general, if I feel the slightest issue then I go straight to the hemorrhoid cream and have also used a suppository with similar ingredients to the external cream to good effect, even if feels a little demeaning to poke a little capsule up your back passage :-/

8

In addition to what others have said, I VERY highly recommend the Tushy bidet. Keeping the area clean and minimizing wipe irritation has made a world of difference in my household.

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Cool! Thanks! I looked it up. I’ll be getting some!

10 
  OK thanks, but "live culture yogurt."  I gave up pizza last year, because I think I'm lactose intolerant.  I'm assuming the yogurt would give me diarrhea.
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OK, thanks that’s good advice. Seeing a dietician would be nice. Yup this issue is embarrassing.

12

OK, thanks. Months ago I had a very itchy ass crack for like 1 day or maybe it lasted for a few days, if I recall correctly. And I only have noticed blood in my stool like once or twice. And it wasn’t much, less than a packet of ketchup.

I can’t believe I’m typing about this on the internet.

13

If an external hemorrhoid is fairly big it often has a blood clot in it and if you don’t cut it open and express the clot (pop it out) it often is painful for days maybe a few weeks. Pop it out and almost instant relief for pt. It takes some local freezing (hurts to put it in) to do procedure. I do in office and problem solved for pt. Lots of general docs don’t do that because they are not comfortable doing procedure/not trained/don’t want to take the 15 min and hassle to do procedure. I only get paid by gov’t 20 bucks to do procedure (I am in Canada) so it is a money loser too. But who cares not many things are instantly solved so it is kinda cool to do. It is easy to prescribe cream which sometimes works and takes about 30 sec to do.

No way of knowing if that is your problem or all of your problem without seeing you. If it does not get better that might be the solution. Pain in the ass to be referred to surgeon for a simple problem if that is what you need.

14

Wow!!! OK thanks man. It’s OK. Fine. Whatever. It wouldn’t be my first time under the knife. I appreciate the heads up. I understand.

15 
  OK thanks, but "live culture yogurt."  I gave up pizza last year, because I think I'm lactose intolerant.  I'm assuming the yogurt would give me diarrhea.

It sounds like you didn’t do a proper test to find out if you’re indeed lactose intolerant. If that’s true, you absolutely should, because it would have broad implications for what your diet should or shouldn’t look like. That said, live culture yogurt is something that’s actually good for lactose intolerant people. During the fermentation process, bacteria already break down a lot of the lactose in the milk, and they produce the enzyme (lactase) that helps your body break down the residual lactose. Also, counter to what the name “lactose” (“milk sugar”) suggests, milk is not really highest on the list of lactose-containing food items. Processed foods such as chips/crisps, cold cuts, sausages etc., where lactose is added as cheap filler material, are much worse.
Also also, as someone else already said, get a bidet-type toilet seat (fast option) or a proper Toto washlet (luxurious option). Makes a world of difference.

16 
  OK thanks, but "live culture yogurt."  I gave up pizza last year, because I think I'm lactose intolerant.  I'm assuming the yogurt would give me diarrhea.

You can also do other fermented foods and drinks like kombucha and cold sauerkraut.

17

Sorry to hear, it happens though. Sounds like you had a thrombosed external hemorrhoid, completely different than an internal hemorrhoid. Internal hemorrhoids bleed, are usually painless, external hemorrhoids hurt and ‘‘usually’’ don’t bleed. Current recommendation for mild internal hemorrhoids is bind ligation which can usually be done in office. Recommendation for severe, grade IV thrombosed external hemorrhoids can be excised if you get to a doctor within the first 72 hours. recurrence rates are reported to be between 5-30%. Unfortunately, once you have disrupted the architecture down there, you will be more susceptible to getting hemorrhoids.

18

To expand on my own n-1 (and let me say right now this isn’t medical advice, just my own experience)

I was embarrassed about it and went for years with almost daily discomfort.

Mine would flare after a bm, then generally calm down by mid afternoon. Daily.

Eventually, it got worse and even after reading all the surgery horror stories I resigned myself to it. I gave myself a time limit, a couple of months if it wasn’t better I’d go under the knife. I tried a shitton of “miracle cures” on amazon, everything reddit could suggest, etc. Nope, all I did was spend a bunch of money.

Eventually, I tried some “extreme” diet changes. Went fully vegetarian, juice, etc. It didn’t “work” but I went from 0/7 days without issue to maybe 2/7 without issue. That was a huge win in itself, but what it really told me was there was “something” related to what I was ingesting that had an effect. So I went down that rabbit hole.

Eventually, after I bunch of trial and error I stumbled on a poop test from Onegevity. Now full stop, I don’t think these gut bio tests are terribly useful (definitely not as advertised) but again, I had already thrown a ton of money at bullshit miracle cures, so why not. Overall, the info back was not terribly useful, but it did show me one very useful thing. The probiotic I was taking did not have the lactose strain that the test showed I was low in… so I bought a different probiotic and tried it.

Also, while anything that even smells of “Fad diet” I generally thing is BS… keeping track of FODMaps and recording what I had was very enlightening. There are a good number of foods that I was loading up on that in theory should be “good” for Hems (beans, fruit, Psyillium, etc - high fiber stuff that you’d think would help) that when I cycled off of, it actually had a huge effect on my BM’s.

Again, let me re-emphasize, I don’t think that’s a cure all panacea and it’s almost certainly dependent on each situation. It worked for me, roughly 2 years in at this point I went from a daily hassle to maybe once every other month if I let my diet/etc really fall off.

19

Do you know anything about a laser removal process?

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OK, thanks for the insight. Do you know if running is bad to do for someone like me now? Or if cycling is too, if I can put up with the discomfort? I thought I read blood flow is good for this issue.