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Case 135: Painful prolapsed lump

1. What is the diagnosis?

Circumferential prolapsed haemorrhoids. There is a central infarcted internal haemorrhoid.

2. What are the options for treatment?

The options are either conservative or surgical.

Conservative treatment would consist of analgesia, salt baths, topical creams and gels, suppositories stool softeners etc.

Once there is a strangulated and infarcted haemorrhoid surgery is often required. Although an operation is painful, a limited excision of the offending infarcted haemorrhoid will speed recovery, reduce the level of pain and hopefully lessen the rare incidence of significant perianal sepsis which may eventuate if a necrotic haemorrhoid is neglected.