To go to A&E with hemerroids

[bumproblems]

I am 37 weeks pregnant and have hemerroids, I can't get a proper look I think there's 3 and they are swollen and angry and agonising. I can barely walk or sit. I phoned GP and got scheriproct ointment and suppositories which I'm using but I have never been in so much pain in my life and nothing is giving me relief. I've been lying in bed with ice on them for an hour just tried to stand up and it's still agony. I'm weeing a million times a day and night and when I sit on the toilet and then stand up they sort of contract every single time and it brings tears to my eyes how much it hurts. The gp never looked just prescribed over the phone. I'm worried something is wrong I've had piles before but this pain is something I've never experienced 😭😭😭

I had the same issue at 39 weeks pregnant after a week of sickness and diarrhea. So so painful. I was bed bound with it. Personally I think the GP is the best option. They should be able to prescribe a something to ease the discomfort. Can't remember what I had, but it was better than I could get at the pharmacy.

I'm fairly certain mine were thrombosed. They're still hanging around 4 years later (literally). But the pain subsided by the time I gave birth at 41 weeks. Post natal pain will be a walk in the park by comparison.

I'm going to get mine removed once I'm done having babies as I fear any benefit of surgery at this point could be undone if I have another baby.

I would hope your GP would get you a same day appointment given your stage in pregnancy. If not, 111.

I couldn't have sat in A&E for hours with mine.

Exactly that, you only know how excruciating the pain is if you suffered from it.

A&E isn’t just for life threatening situations though.
@dampthursday precisely. You don't need to be shot at, stabbed, being involved in an accident or have a ruptured spleen to go to A&E. I was referred to the Consultant from A&E as all my GP did was prescribe different kinds of creams and suppositories over the times. In the meantime I was still bleeding and in pain. I decided one day that enough was enough and had the operation a couple of months later, best decision I've ever made.

Is it an ACCIDENT or an EMERGENCY (where it'll get untreatable if not treated IMMEDIATELY?) If not then it isn't really for A&E.

If you can get an out of hours GP appointment to get some strong pain-killers then do that. Minor injuries and those types of services can also be helpful. 111 may be able to get you an appointment or a script depending on the complexity of the problem.

I say this because 1. A&E are rammed with people who are waiting hours and hours - sitting on your anus for hours is likely to make things feel much worse 2. we really need to avoid clogging up the system with things that can be managed via other avenues.

At the same time it sounds horrifically painful so do get help quickly!

@Mars27 Gastroenterology is a branch of medicine, and Colorectal is a branch of surgery. They are different things and deal with different issues.

I would be truly astonished if the on-call surgical team would see a patient with thrombosed haemorrhoids, especially on a night shift. In nearly a decade of practice, I’ve never seen it happen.

OP, please call 111, this is what they are there for. If you go to A&E, you will most likely have a long wait on a hard chair to be sent home with some painkillers, whereas hopefully 111 can get you into an out of hours service much faster.

A&E is not the place to go for a ‘fast-track’ referral for a non-emergency operation. My trust will only do referrals for genuine emergencies, or for two week waits for suspected cancers. Referrals for haemorrhoids would need to be done via your GP.

I do have sympathy for the pain you’re in, and it must be awful, but I really don’t think sitting in A&E will fix that. If you do go, take a snack, a book, and a phone charger, and prepare for a very long wait.

Thats fine IF the other avenues/systems are functioning. In a lot of places in the UK it is almost impossible to get a GP appointment. Pharmacy advice is generally to see a doctor. 111 is hit and miss for a lot of people.

It's all well and good saying it's not an A+E job, but if there is nowhere else to go, then the problem is never going to go away.

This is neither an accident or an emergency so YABU

Why don’t you call your maternity day assessment unit and explain the issue to them? One of the obstetric doctors may want to examine you and can prescribe strong pain relief

I can assure you colorectal is not part of gastroenterology. You are just wrong there unfortunately. If you got referred to gastroenterology for haemorrhoids they would write to the colorectal team to ask them to review which would increase her waiting time. (colorectal are under the division of surgery, gastroenterology under the division of medicine. )

Assuming a vaginal delivery , any surgical intervention for haemorrhoids is best left for a while after birth and not "as soon as she gives birth". The best way to be referred is via your GP.

Hope that helps

Genuine question - are there strong painkillers they can give in pregnancy?

This is not a bad idea

I'd probably go to bed and speak to midwife in the morning rather than spending 8 plus hours in a &e

I had a thrombosed one at 32 weeks & it was agony. Every time I sneezed I was in excruciating pain. It was unreal.

I called 111 as it was over Xmas & I was seen, sadly nothing was done. The pain did subside after it had stopped bleeding, so a week or so. It then eventually turned in to a skin tag (sexy) which I later on had removed.

You have my utter sympathies OP, I hope it stops hurting for you asap

You will be waiting so long in A&E that it'll be quicker to call your GP tomorrow first thing and request an urgent appointment.

Sitting/standing in A&E all night/day i whilst heavily pregnant is going to exacerbate the issue tbh. You'll be more comfortable at home. Perhaps call 111 and ask for some stronger pain relief to get you through the night.

As I'm sure you know the NHS and most A&E departments are fucked at the moment and personally I'd be avoiding the place unless it was life or death.

I feel your you OP, the pain is like nothing else

I work in maternity.

I would call 111, they can either “book your arrival” at A & E if the triage deems that necessary (your pain sounds severe which would be A & E, where you can be admitted for pain relief and make sure baby is happy) or they can book you an ooh gp appointment who may well send you in anyway.

Hope you get seen and are more comfortable soon.

It may even be worth phoning the maternity unit and asking if someone there could help you will pain relief

OK, we get it, you're a doctor and know how all the different NHS trusts in the UK work, anything we say as patients is not true. Many thanks for explaining it all to us mere mortals🙄

OP, take a big cushion and go to A&E. Painkillers, ice and Anusol will only decrease your pain by a very slim margin.

Agree. Call 111 for advice first though

I had this at about 37 weeks, they were literally sticking out of my bum cheeks. Steroid suppositories and cream helped, was seen at OOH - they won't operate while you are pregnant so just have to manage. I rang maternity and they booked me into maternal medicine clinic so I could beg for my c - section (planned and booked already for 39 weeks) to be moved forward to 38... a firm no and this was from my colleagues! Lots of sympathy from them but a no. Good news was the pain literally stopped as soon as I had given birth, I really feel for you!

1. Not a doctor.
2. You’re giving incorrect information, and that does need challenging. It’s not condescending, and I wouldn’t assume I know more that someone, but in this instance, you are wrong, and I do apparently know more about the referral pathways and different branches of medicine/surgery than you do.
3. I didn’t call you ‘mere mortals’, and I tried to be as polite as possible. I apologise if you feel this came across as condescending, and that wasn’t my intention, but I also think it’s very important to stop people spreading incorrect medical information.

Like you, I’m actually trying to help the OP. I’m trying to save her hours of feeling even more uncomfortable in an Emergency Department, which is incredibly unlikely to be able to help her.

I spoke to my GP (I didn't realise they were open until 6) and he advised they can't do anything more at this point but to keep up with the suppositories and ointment and paracetamol. I cried! I really hoped there would be so magic option to drain it or something. I'm having my baby at 37+5 for unrelated reasons but wanted this dealt with first, perhaps that's not possible hopefully they go away straight after, it's just excruciating I've never had pain like it.

I want pregnant but I had a thrombosed haemorrhoid. I was given oramorph, the A&E doctor conferred with the surgery team at the bigger hospital nearby. They advised him to send me straight in. Instead of waiting for the ambulance unnecessarily my partner took me there, arriving at approximately 10.30/11pm. They kept me in and operated before lunch the next day, which was a Sunday. So it does happen.

*wasn’t pregnant. And this was two years and a week ago.

Oromorph. And I was referred to A&E by emergency doctor.

It's hard to see the light when you're dealing with it, but the pain will subside. Bag of frozen peas wrapped in a towel. Keep doing all the creams, suppositories, pain relief.

Stay in bed til the worst is over.