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I'm a 24 year old male in good shape (former athlete in high school and I haven't gotten lazy), who eats healthy, definitely gets enough fiber and fruits and vegetables.  About a year ago, I got my first hemorrhoid.  It was external, and hurt pretty bad, but the pain and inflammation subsided in about three days.  About eight months later, it returned, in the exact same location, only it was a little bit bigger this time.  Again, after a few days, the hemorrhoid went away.  Two days ago, it came back, with a vengeance.  It is larger, more painful, and darker in color than before, almost like dark cranberry juice in color.  Sitting, standing, walking, all are immensely unpleasant.  This is the first time I decided to get proactive about it, and do sitz baths, topical analgesics, etc.  The pain is still there and getting worse.

Any suggestions?  It is only the one hemorrhoid that gets inflamed and causes discomfort.  Given that it keeps returning and is getting larger each time and more painful each time, would surgery to have it removed be an option?  I can deal with a week or two of discomfort if it means this won't happen in the future.  Any thoughts?

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I am a hemorrhoid surgeon.  First, let me assure you there is help out there.  I would recommend you get examined by a general surgeon.  There are many treatments for hemorrhoids, but the surgeon is the holder of the most effective cures.  With recurrences like you describe it sounds like you are in for more trouble in the future.  Fortunately, this is benign and can be taken care of.  Get to a doctor who treats hemorrhoids and have an exam.  Discuss your options and educate yourself in the right environment.  The internet is too variable.  Do not rely upon it for real health problems.  See a professional.  Best of luck.

DrD
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I just went through a horrible thrombosed hemmorhoid experience. The first surgeon I spoke with tried to take me into surgery during the visit but I got a bad vibe off of him and decided to wait on it as I had heard that the recovery from a hemmorhoidectomy was long and painful. The next day I went to the ER the pain was so bad that I regreted not taking the surgeon up on his offer to remove it the day before. In the ER they lanced the rhoid, which was almost painless thanks to a local anesthetic and took maybe 2 minutes. The swelling started going down immediatly and the rhoid was gone in 7 days.

Bowel movements were still painful for the next few days, but I got some Viscuous lydicane from the ER doc and that helped ALOT.

I've been to a proctologist since who told me that even if I had the hemmorhoidectomy there was still a chance that it would come right back. Knowing that I am VERY glad I decided not to get the rhoidectomy, the lancing was faster easier and recovery started instantly. If it comes back and thromboses again I'll head straight to the ER to have the sucker lanced again before it gets as bad as it did this time

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There may also be other problems at play, which are causing the hemorrhoids, such as  colon cancer or Crohn's disease, that's why the hemorrhoids keep recurring. It's good to get a thorough check-up with a specialist to get a proper colonscopy to see if there's any root cause.
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GO TO YOUR DOCTOR! It might seem embarrassing but they have seen it all before and take it all in their stride. I've had a couple of probs and each time got myself all worked up about it before eventually seeing a doctor. Each time it was easy to sort out but definitely would have persisted and got worse if I hadn't. It's not necessarily pleasant at the time but you'll be so relieved afterwards  There is really no need to suffer unnecessarily and don't rely on the internet to diagnose yourself. 

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