We have mainly been talking about internal hemorrhoids and anal fissure in this book. If, however, you are suffering from painful external hemorrhoids that are large and inflamed, this section is for you. In this case, the source of pain is below the dentate line and can be easily addressed.
Simply take a small, short needle, and pierce the hemorrhoids until it drains the blood and pus that are causing it to inflame. Make sure the area is clean and that you use a sterile needle. You can find a box of lancets that are used for diabetes in your local pharmacy. They should be around 26 gauge, and are sometimes labeled “alternate site.”
Your pain will instantaneously resolve itself. Many people spend inordinate amounts of money in order to have someone more “professional” do this. In fact, you can do a better job with more care and attention to detail by yourself.
I have seen this minor surgery performed “professionally” in videos online, and they always remove more tissue than necessary, which may lengthen the time to recover. It is the equivalent of taking a large, painful blister, and removing the entire surround skin with a scalpel, versus simply piercing it to drain. Whether it is a hemorrhoid or skin surrounding a blister, it is still tissue that is part of your body, and the less you damage it the better off you will be. All that is needed is to drain the hemorrhoid with a small puncture and your body will naturally let any excess tissue dry up and fall away without any pain.
Now, the reason I am going into this is because of my experience with anal fissure and misdiagnosing myself. I had known that I had an anal fissure and that I had internal hemorrhoids that were compounding the problem, but I had also convinced myself that I had external thrombosed hemorrhoids as well since it did feel inflamed and “full” below the dentate line, instead of realizing that they were the internal hemorrhoids that had extended themselves below the anal sphincter. After using a mirror and some mild acrobatic maneuvers, I was able to look below and saw what I believed to be external hemorrhoids. In fact, it was just a very large skin tag that had grown over time. I spent a lot of time trying to pierce this “hemorrhoid” only to realize later that it was a fruitless endeavor. This is all the more reason to make sure you get a proper diagnosis and have all your questions addressed if and when seeing a doctor.