Brief Answer:
?Strangulated Hemorrhoids with severe pain

Detailed Answer:
Provisional Diagnosis-?Strangulated Hemorrhoids with severe pain
HI,Dear,Thanks for the query to HCM.
Its very difficult to diagnose and pinpoint the cause of the pain,especially when your second query update the word hard pain,as it could be associated with serious growth inside the rectum.
The hard paining piles,in your case may indicate strangulated piles,which are hard due to congested venous blood
For your age many risks are there and hence I would advise consultation with ER Surgeon, who is the right specialist to treat the painful piles you have.
Still on the facts given,your piles pain could be due to-
-Strangulated Internal piles,
-or could be due to external thrombosed piles.
Conservative-Treatment for reduction of pain-
Trendlenberg's position of the Bed-Lower end elevated- while taking rest
Cold compresses for relieving acute pain in strangulated piles
Reposing the Internal piles after soothing the pain with local xylocain gel
Anti-inflammatory medicines x 5 days time
Antibiotics with metronidazole -in case of infection x 5 days
Sitz bath x 2 times a day with warm anti-septic liquid x 7-10 days
But for the reasons of your age,You need to give more information for the final planning of its treatment-
Any painless bleeding was there in the past?
If such event has happened in the past?
Could it be reposed in the past?
Once the pain and edema/swelling gets reduced (mostly after 2 weeks of conservative treatment)you need to have surgical consultation from ER Surgeon, for planning definitive treatment as follows-
Procotoscopic Examination/USG examination /Colonoscopic examination to rule out any rectal/Colonic growth with these piles (and for finding the feeder artery),as it could be hidden factor and would get missed,with recurrence of the problem with spread of the growth,if proper care is not taken in planning the treatment of such cases.
You may need Cryosurgery or Laser ablation of the feeder vessels/HALO(Hemorrhoidal de-arterialisation Operation) for any hemorrhoids with anal dilatation,if it is only piles.
Else if colonic /or rectal growths are associated and detected,you may need special procedures which would be decided by your attending Surgeon.
Hope this would take care of the painful Hemorrhoids problem and would help you to plan treatment with your ER Surgeon.
Write excellent review after reading this reply,if you find it helpful to you,so that your comments and reviews would help in rating my services for more HCM patients.
Welcome for any further query in this regard to HCM and to ME.
Any direct questions in this regard would be appreciated for more personal suggestions.
Wishing fast recovery out of the current emergency.
Have a good day.
Dr.Savaskar M.N. XXXXXXX Surgical Consultant.

---

Brief Answer:
Conservative Treatment for Painful episode of Strangulated Hemorrhoids

Detailed Answer:
Conservative Treatment for Painful episode of Strangulated Hemorrhoids
Hi,dear thanks for the update query.
To relive bad painful hemorrhoids,I would suggest your following treatment plan,which you need to take up under prescription from your family doctor-
Tab Ofloxacin with ornidazole x 1 tab 2 times per day x for 5 days time
Voltaren gel locally (pain killer medicine gel)
Bland liquid diet x 5 days time
Anovate ointment to reduce swelling
Xylocain gel locally to reduce pain urgently.
Tab ofloxacin with ornidazole 1 x 2 times per day.
Rest in Head Low (Trendlenberg's )position
Sitz bath x 2 times per day.
This treatment with the above medicines would give you relief soon.
But due to your high risk age group, I would advise you to URGENTLY consult ER Surgeon for proctoscopic examination and further needful treatment.
Hope this would resolve your immediate need to reduce sever pain.
Write excellent review after reading this reply,if you find it helpful to you,so that your comments and reviews would help in rating my services for more HCM patients.
Welcome for any further query in this regard to HCM and to ME.
Wishing you fast recovery.
Dr.Savaskar M.N. XXXXXXX Surgical Consultant.

---