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I've done a lot googling/forum research about hemorrhoids. It seems that for internal hemorrhoids, there are many intermediate steps that can be considered before a full hemorrhoidectomy is usually considered:
*IRC
*banding
*sclerotherapy
*atomizing (google "Atomizer Wand") – I'm not sure if this is for real as I haven't seen anyone in the forums post their experience with this technique.
*HALO

For an external hemorrhoid, it seems the only thing that can be done is an excission to remove the clot of a thrombosed hemorrhoid. Other than that, it's the fiber/water/diet/etc home treatment, unless your doctor feels a hemorrhoidectomy is in order. Sclerotherapy seems like a valid procedure for an external hemorrhoid, but isn't used very often.

My main question is, are there any other "intermediary" techniques to possibly remove an external hemorrhoid that I didn't mention above, which I should ask my colo-rectal surgeon about?

About my situation. I've had a hemorrhoid for a few months that my GP says is external.  It's actually just inside my anus(sphincter) and the hemorrhoid feels like it is attached to the skin on the outside of my anus, so don't think it's a grade 3 internal. However, it does show up on the outside during a BM (probably because my sphincter is relaxed just prior to a BM). Also, I've never had any bleeding and the GP said there weren't any internals, but he didn't use an anoscope. The problem is I can't stand for more than 15-20 minutes at a time because my anus starts to swell and feels very uncomfortable, almost like something down there is stretching/pulling.

I've completely changed my habits: more fiber/water/diet and spend the minimal time on the toilet with no straining, but this hemorrhoid won't go away. I finally have an appointment with a colorectal surgeon and want to make sure I'm prepared to make a decision on the spot, if need be. 

Thanks for any tips.




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I just wanted to update my experience after seeing the Dr.

After he took a look, he felt he could do IRC on a couple small hemorrhoids that were close to the dentate line. We decided to do that.

I also had an internal one that's really low which he couldn't get because (he said) it would be too painful. However, he said he  can irc it if I'm under anesthesia (general? or local maybe). I was surprised by this because everything I read said you couldn't do irc on external hemorrhoids because the area below the denate line is regular skin and the irc can't penetrate it.  I have another appointment with the Doctor in a few weeks and will ask him about this.
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Hi tim2010, can you give followup feedback

thans

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Sorry, I haven't been on this board for a while.

Apparently, I was unique in that I had a hemorrhoid that was half-in/half-out. The doctor ended up doing IRC after a local anesthesia shot in my anus. Without the anesthesia, it would have been too painful for the IRC. Note, this was all done in the normal office visit.
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Sorry, I haven't been on this board for a while.

Apparently, I was unique in that I had a hemorrhoid that was half-in/half-out. The doctor ended up doing IRC after a local anesthesia shot in my anus. Without the anesthesia, it would have been too painful for the IRC. Note, this was all done in the normal office visit. This definitely helped me. I still have to be careful with my diet and avoid strenuous exercises like squats, stair climber, etc....

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Where did you have this done?
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