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My 96 year old mom broke her hip in April. She is still in a SNF getting rehab, but is doing fantastic and hopefully will be coming home in less than a month. She has an external hemorrhoid, increasing in pain from sitting more. The staff has been a bit lax on treating this so I am encouraging them to use more often the hemorrhoid cream. Does anyone have some suggestions that have worked for them or a patient? Need advice on maybe a donut pillow and I even wonder about surgery. I am not crazy about the idea of surgery for her, but I really don't know, maybe it would be the best thing. I saw one Dr with her in Florida and he was no help at all. I do plan on taking her to her own Dr ASAP when she comes home. Thank you and looking forward to getting great advice from this post.

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My 91 year old mother had four or five hemorrhoid's banded and all but one fell off in a day or so. The surgeon did it in his office and did a great job. My mom was so relieved after suffering with them for so long. The one that didn't fall off was to large for banding and she would have had to have surgery.
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Msbarbie Jul 2021
Thank you for your post concerning the banding of external hemorrhoids. My mom is 96, but she is miserable with her hemorrhoids. She is home now from rehab and is doing well, except her bottom gets sore. I use all kind of creams and keep her clean. I am thinking about calling our local surgeon's office and ask if she would be a candidate for banding. Is the procedure very painful? My mom is a strong women, but she hates any discomfort, lol. I know she is up there in years, but she is fairly healthy and I hate to see her have such pain.
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Banding of the hemorrhoid by a doctor will result in it falling off. Getting rid of the darn thing will also help with hygiene issues that external rhoids can cause.
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If mom is able to drink plenty of fluids Miralax might be a good option. Speak with the dietician there to increase the fruits, vegetables, & fiber in her diet. If she's walking that would also help. Make the doctor & nurse aware as they may need to change some of her meds. Hopefully she's off of the most common pain meds as they do cause constipation.
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The only thing I have to add, if your mom has allergies, check the ingredients before using Preparation H. My poor ex was allergic to the yeast they used in Preparation H and he was worse off even after he washed it off his bottom.
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Imho, this issue should be addressed by the SNF staff members via a donut pillow and more hemorrhoid cream.
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Ask PT in the SNF for a donut pillow. They should have no problem getting one for her.
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Make sure she gets plenty of fiber and water daily. Most hemorrhoids are worsened by straining to have a bm. Keeping her bottom clean and off of the hemorrhoid will help until you can have her doctor remove it. Witch hazel pads (Tucks) can help as well as hemorrhoid cream until she can have it removed.
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One of my client had the same problem. Her doctor had her on the table, bottom up with me at the head end, holding her hands and talking to her. Doc tied a surgical rubber band around the hemorrhoid, resulting in it falling off after a few days. It was so simple logical, and quick - no medications.
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I know there are different strength creams which are cold and cause them to shrink for while. Also sitting on an open pillow will help. And soft toilet paper is good too. Some doctors can do in the office what they call a "freezing" procedure - it works. I had it done many years ago. Look into non-surgical options. Good luck.
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Hemorrhoids can be treated in an outpatient setting with lasers. Look into it.
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Really soft toilet paper helped my husband and mom, in addition to all the great replies. Now I use it too. No more sandpaper!

(After movement , hemorrhoid cream or wipes We would reapply).

If I remember correctly, congested hemorrhoids sometimes need a docs exam and especially if bleeding is involved. Not sure if all medical creams are ok with bleeding. Bleeding is a concern, especially when on blood thinners. A good diet and even stool softeners can help a lot (preventatively).

Hope mom feels better real soon.
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Dout pillow and more Cream.
PUT up a sign in her room Apply Butt Cream 3 Times A Day. Get the Dr at the Place she's recouping at to sign orders to Apply 3 times a day . Use a donut pillow. My 97 yr old Dad stays in his recliner most the day, even chooses to sleep in it and he's never had a bed sore in 2 yrs because less pressure is on his butt when he is reclining and it keeps his feet raised so no swelling.
Donto let her get an Operation, she is too old.
I'd be very surprised if you found a Dr to say otherwise and if you did find a Dr to say surgery, I'd run the other direction like a Bat Out Of Hell
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cwillie Jun 2021
IMO signs posted in the room are useless, any medication (including topical creams and ointments) must be included in the care plan and scheduled on the medication chart.
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Id definitely take her to her dr.
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In addition to the prunes and other fruit mentioned here...
My Husband had problems with constipation and I was giving him prunes and prune juice and all the other things suggested. ( I was mixing in Mirilax, but later that was a problem as it could not be mixed with his drinks since I was using a thickener and Mirilax would thin out and make the thickener useless)
I did a bit of "research" and found a herbal tea called Smooth Move and that worked. I also found that a lot of the OTC products intended for a "cleanse" had 2 primary ingredients. Pineapple and papaya. I bought a pineapple and a papaya and I put both in a blender and portioned it into 1/2 Cup portions and stuck them in the freezer. He would get a serving every other day as a fruit with a meal or a snack. (that worked for quite a while then had to go the RX Lactulose route.)
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My 98 yo Mom has an ongoing problem with external hemorrhoids.
I have the aides have her sit on a portable sitz bath that sits on the toilet bowl ( warm water and epsom salts.) A surgical supply store would have it. Use Preparatin- H on a clean bottom as well. we also use Tucks pads that prove to be soothing. Keep the Tucks pads in the refrigerator. Make sure she is hydrating enough and has enough roughage in her diet.
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i developed one while throwing up sitting on toilet, didn't want to take a chance of other stuff happening..........anyhow...........wash gently in that area.......maybe put on a cold wet compress for about 10 minutes......then dry and put on some Tucks cream that has some lidocaine in it or try Prep H which can be used up to 6 times a day. The Tucks cream came (at least where I live) in with a small container of Tucks pads (sterile pads) to also help in cleansing that area. You can get a small donut pillow for her to sit on, make sure she drinks plenty of water and eats fruit to help her go without straining. And never let her sit on toilet too long IF she hasn't gone. IF she can take tylenol, she can also take that. I wish her luck..............i know her pain. Not sure about the surgery, they only would do that IF seriously bad and sometimes I think they can do a "band type" thing, but it would have to be really bad. I sure wish her luck and you.
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OTC cream nupercainal is far better than Preparation H for discomfort. But getting the fiber (prunes was an excellent suggestion but plums are good too) is essential
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I'd think many times before surgery - surgery for hemorrhoids is hell, they haven't
really improved it much, according to my doctor. If you get her on probiotics (check with her MD), it not only makes you regular, it softens stool and eases the problem.
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gaknitter Jun 2021
No surgery for hemorrhoids is not the only solution. I very strongly encourage anyone having the problem to look for rubber ligation. I accidentally found out about this procedure sitting in gastroenterologist's office. I discussed that with him in my appointment and presto.... Got an appointment to get started. I had 4 visits to get rid of the pesky things. In office procedure, all of minutes in there, and one can go back to normal activity immediately. Not all hemorrhoids are candidates for this but most are. Please look this up, much information on variety of websites, YouTube etc. I am so glad I got that done!!
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There’s a prescription strength that’s much better. Do not use it every day or it will make things worse, according to the gastroenterologist.
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There is an rx a doctor can prescribe which does work better than over the counter. A bidet toilet seat is helpful, as is a “sitz bath” which is recommended for women post partem. At the very least, use a wet wipe, not toilet tissue in the area.
Ice packs are a nice relief too. Constipation and sitting on the toilet for long periods of time are bad.
Definitely more fiber (Metamucil)
and liquids! to keep stool soft.
PRUNES!! Kiwi.to stay regular. Miralax works for us if no bm for 3 days. Sadly, lack of movement thwarts a body’s functions.
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The only thing with surgery is that eventually the hemorrhoid's do come back.(at your moms age you won't have to worry about that, but surgery at her age can be tricky) My husband who suffered with hemorrhoid's as long as I knew him, had surgery twice to remove them, and both times they returned.
The best bet to keep them at bay is to make sure mom is eating things with lots of fiber, and drinking lots of fluids to keep her regular.
Other than that, I would use the hemorrhoid cream regularly(as would the hospice aides later on) on my husband to keep them at in check.
Good luck.
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Msbarbie Jun 2021
Thanks for your advice, yes thats what I will do. I have even seen preparation H with lidocaine which might be good for that pain.
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