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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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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

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,

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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