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Internal Hemorrhoids.

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I have had mild internal hemorrhoids for over 10 years that haven’t caused me much more than discomfort. One month ago, over the course of several long haul trips, I developed a small pea size lump just over my anus, no pain. Three days ago, after yet another long bus ride, the lump grew bigger (about the size of a thumb), red, warm and very tender. It got to the point where I had to lay of my side and take ibuprofen because everything else was painful. Yesterday, the lump burst and there was a significant discharge of pus and blood and the pain instantly went away. I cleansed the area thouroughly with antiseptic wipes, and this morning, apart from a little more pus and blood, it is looking even better. The lump is still there, but more like a pea size again. It is “connected” to a haemorrhoid that is sticking out of the rectum that ressembles a string of flesh, but apart from discomfort when I wipe and to the touch, I have almost no pain.

I am a 32 year old female, 5’7”, 120 lbs. I am very active and eat a balanced, fibre rich vegetarian diet. My bowel movements are very normal, but I have had a history of diarrhoea in the past. My father had Chronh’s disease, but I was never diagnosed with anything of the like, nor have I had any symptom, apart from sporadic diarrhoea.

I am currently travelling in Thailand for an extended period of time far from a big hub and it would be difficult to see an english speaking doctor at the moment. I would appreciate an opinion on the matter.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 21 Doctors Online


Thank you for choosing DoctorSpring.

The small pea size lump is most likely to be an infected cyst or furuncle. This is unrelated to the haemorrhoids you have. Since the pus has been drained, healing should take place naturally. Generally no treatment is required, but in your case I would recommend applying a local antibiotic cream. This is because a complication can lead on to ruputre of haemorrhoid due to its proximity.

You can apply an antibiotic ointment like Betadine ( Povidone Iodine ) which is OTC and should be easily available. It might not be easy for you to get an antibiotic ointment meant for anal fissure/fistula - so Povidone Iodine will be a good choice. Apply it twice daily. Do not apply into the anal canal. Just apply twice daily.

As with the haemorrhoids - do not strain, have a high fibre diet (make sure you are not constipated). This should heal without any issues.

Later when you are back a definitive treatment of haemorrhoids can be considered.

Hope this helps
Thank you

Patient replied :


Thank you very much for the prompt reply. I have just returned from the pharmacy prior to reading your answer and I have bought fusidic acid 20mg in a cream base along with isopropyl alcohol wipes.

Are these also ok to use close to the anus?

Many thanks!

Hello, you can use fusidic acid 20mg, as it is also any antibiotic. You can use the wipes too. Like I mentioned earlier, apply it twice daily. Do not apply it into the anal canal.
Make sure you wash your hands well before application to avoid further infection.

Hope this has helped.
Get well soon.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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