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Have hemorrhoid after constipation, not painful. Is it a small thrombosed hemorrhoid?

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Internal Medicine Specialist
Practicing since : 2001
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For about 3 weeks now after a bout with constipation, I have been dealing with Hemerrhoids. For the most part the major swelling and bothersome swelling has gone down and there is one small, possibly XXXXXXX hemerrhoid left. The problem
Is that while this looks and feels like a normal non painful hemerrhoid, there is a hard pea sized bump on or in it. This concerned me a great deal and I have been to the ER and to my general practitioner about it. The Emergency room doctor told me that it was a small hemerrhoid with some thrombosis. He prescribed cortisone suppositories. I followed up with my General Practioner who quickly looked at it with a light and said it was a tiny thrombosed hemerrhoid and I should keep using the cortisone and give it some time to go away, because it was too small to worry about surgery or anything like that. This was a week ago. My concern is that while both doctors say this is a small thrombosed hemerrhoid, I've read that they are painful. This is not painful. It aches sometimes when sitting on a hard surface for a long time, but no serious pain. Also I've read that thrombosis is usually blue, purple, or red. What I have is either the same color as my skin or sometimes white looking. Is it possible for a small thrombosed hemerrhoid to be nearly painless and white? Also while the rest of the hemerrhoid is going away the hard pea sized bump seems to be doing nothing, maybe even getting a little bigger. I will be out of cortisone tomorrow and I'm wondering if these things are normal or if I should be seeking a third doctor's opinion as soon as possible. I'm worried it is more serious than what these doctors have said.
Posted Sun, 23 Sep 2012 in Digestion and Bowels
Answered by Dr. Ram Choudhary 17 minutes later
Thanks for writing in to Healthcare Magic!
The thrombosed piles are painful but that is a dull boring pain rather than a sharp pain.
The color would depend on the vascularity. If the hemorrhoid is chronic it may have thrombosed partly in the past and got fibrosed and now having a fresh addition.
So painful as well as white.
It is having organised thrombus and would take long time to subside if at all.
I would advise you to get it surgically resected along with others if they are there rather than suffering further.
It is nothing serious to risk life but it is surely a source of morbidity.
Please consult a surgeon and follow his advise and if required manage time to get it resected
If you have any further query please let me know I would try to answer it for you.
Wish you a great health!
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