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Treatment for bleeding from RUPTURED HEMORRHOIDS.

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More than a week ago, I had a hemorrhoid rupture/start bleeding. It included some small, dark pea-sized objects that I assume were part of the clot (I have not had any pain or pressure associated with the hemorrhoid since this happened). Now, more than a week later, it's not still bleeding badly, but I'm still having to wear pads to prevent a few spots from ruining all my underwear. I recently looked at the area in the mirror. There is still a protrusion but not as large as it was originally, and it has a flat surface with a dark red to almost black color that looks sort of like a scab. In the last few days it has developed a very dry, raw, crusty sensation. I've become concerned that it doesn't seem to be healing and still produces some minor bleeding. I've keeping the area dry and clean and have been using hemorrhoidal wipes with witch hazel. I've occasionally used hemorrhoidal cream, but the other day that made it unbearably itchy. I've been wondering if I should use some kind of anti-biotic ointment on it since it looks like an open wound.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 31 Doctors Online

Hello. Thank you for posting your query at DoctorSpring.com
I understand your concern.
You seem to have external hemorrhoids and since its just pea sized it is probably still Stage I. Mostly this can be managed by conservative management, however in your case it has been bleeding intermittently. Since it has already become crusted, i will advise you to apply Preparation H around 2 times daily for the next 5 days, it will act as a local vasoconstrictor and will stop your bleeding. Also to prevent excessive itching, a combination of topical hydrocortisone and mupirocin ointment can be applied right after applying the preparation H, with a 10 minutes gap between both the doses. After the medicines have absorbed, you can use the wipes as you have been using.
In case it is infected, mupirocin will surely help and hydrocortisone will reduce the itching. If the bleeding is not settling down with preparation H, then i will advise you to get yourself examined by your local general surgeon. There are other non surgical very effective methods such as rubber band ligation and sclerotherapy. They are very effective in controlling the bleeding and it does not recur. After examination, if the doctor feels you need to be operated, then you can go ahead and get yourself operated, since properly operative hemorrhoidectomy has a recurrence rate of only 2-5 %.
Feel free to discuss further,
Regards


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
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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