Have a bad case of hemorrhoids. Is there cause for alarm?

I’m afraid I have to post on a pretty gross topic here, so will include spoiler blurs in places.

I’ve had hemorrhoids for years, but for a long time, they were minor enough that I didn’t need to address them in any way. However, I recently had a bout where the previously very small external hemorrhoid I had (which would often disappear) got unusually big. It reduced itself after a while, but a week ago, it swelled up again, got to a very big size, bigger than it ever was, and it has stayed that way. I now have an enlargement just outside my anus about the size of a grape, big enough to cover the opening.

Since then, pretty much every time I’ve gone to the toilet, it has been quite painful
when the feces touches the hemorrhoid,
often excruciatingly so. To the point where I feel pressure in my abdomen (or even my chest?), am left gasping for breath, and my heart races - the kind of pain that seems like it would be unbearable for more than a short period of time.

On Saturday, I first went to the pharmacy and got an ointment, something similar to Preparation H. It helped a little to calm down the irritation, but it did little or nothing to reduce the swelling. On Tuesday, I went to the doctor, who performed a quick examination. He scheduled me to see a visiting proctologist - on Thursday next week. That person will presumably decide on what treatment will ultimately be necessary. In the meanime, the doctor prescribed me a pill called detralex and an anal suppository called Faktu. I have been taking them regularly, but haven’t seen much improvement since Tuesday. The external hemorrhoid is still more or less as big as ever.

What is most disturbing is that, while on Wednesday it was a mite easier to go to the toilet, yesterday it was very painful even to pass gas, the evacuation of which has also been an effort (let alone to defecate - I passed practically no feces yesterday) unless I did so standing up. Today in the morning it was as bad, although in the afternoon, I was able to pass a very little bit of feces with relatively little pain).

Based on my description so far, how much cause for concern is there? Imagine that I remained in this state until Thursday’s appointment at the proctologist’s and that the swelling of the hemorrhoid did not go down until then. I don’t know how long I can hold in whatever is currently in my bowels and whatever will accrue in my bowels till then. I obviously can’t be completely constipated for at least 6 days. If I make efforts to evacuate my bowels, going from the level of pain and exertion I’ve had over the past week, do I have cause to be afraid that I might get a heart attack or arrythmia or something? (I recently read that Elvis Presley, who died while on the toilet, had his official cause of death listed as a cardiac arrythmia and that it was speculated to have caused by having trouble evacuating his bowels due to a colon problem or something, although that is only one explanation)?

What should I do? Should I keep trying to evacuate what I can and wait until the proctologist’s verdict on Thursday, or should there be more of a sense of urgency - should I go to the hospital tomorrow and ask if, based on the facts so far, surgery or other more radical treatment than the drugs I’ve been taking so far aren’t a pressing need?

Were I not to go to the hospital, I am committed to attending an event in another town to which I would travel tomorrow in late afternoon/evening, sleep over in a tent, and come back on Sunday afternoon/evening. Would this be risky in my condition?

Sounds like a thrombosed hemorrhoid to me (and I am a doctor who has treated such issues often in the past, though I’m retired now).

I’d advise a visit to an urgent care center for evaluation. When these things initially occur, they can often be relieved with a little anesthetic gel in the area and a quick slash with a scalpel, to get the thrombosis out, which typically relieves the pain promptly. Otherwise it’s days of misery as it slowly resolves on its own.

Nothing you mention really suggests an urgent threat to life or health, but I have NOT examined you directly nor taken additional history, so if you want answers that can be applied to you (and to be sure something worse is not going on like a perirectal abscess which is unlikely by your description), get yourself to a competent practitioner soon.

There are some tips in that link about thrombosed hemorrhoids that you may want to try in the meantime, if you haven’t already.

Thank you very much for your assessment, Qadgop_the_Mercotan. I’ll see about the next steps to take.

I once went to the ER for a hemorrhoid. The doctor cut it with a scalpel as Qadgop describes (or did something with a scalpel; I wasn’t really in a position to examine her actions in detail). She gave me demerol before the procedure, which was nice, and dropped a lamp on me during the procedure, which was not so nice, although with the demerol in me I didn’t really care that much. In any case, the procedure cleared it up.

Medical advise has been given.
But, Dude, don’t go camping.
It doesn’t seem like bathroom facilities will be great at a camp out type place.

Good luck. Sounds just miserable.

OK, it’s decided. I’m going to the hospital with this. Have excused myself from the event I was supposed to attend.

Thank you for your observations, guys.

Well, the doctor at the hospital examined it and didn’t want to immediately proceed to any kind of surgery. He advised me to continue with the drugs I’m taking now, to eat more fiber, to keep hydrated, and to use an oak bark solution on the piles as well.

I did manage to have two bowel movements today. Not pleasant, but I got out a lot that I couldn’t the last two days.

I guess I’ll just stay in town and rest over the weekend, continue with this treatment, and hope things will improve a bit, and keep my proctologist’s appointment on Thursday and ask for a final opinion as to whether I should have any kind of surgery or not.

Sounds like a winner. By the time you see the procto doc, the thrombosis may well be resolved enough that surgery for it doesn’t get recommended. Good luck and feel better!

Or it will cure itself by exploding. I’ve heard it’s like getting shot in the ass with a .45.
I had one a couple month ago and used an ass-load of Prep H and witch hazel and by day 3 I was waiting for it to explode. It eventually went away but until then it was a pain in the butt to deal with.