Boils and Hemorrhoids

Finding a painful lump anywhere on your body is unsettling at best, and finding one around your anal area can be quite frightening. The natural first impulse is to just classify any lump as a hemorrhoid and call it a day, but it’s important to know what you’re looking at so you can get the right treatment for it. Boils are another potential lump that can form anywhere on the body, including in the hemorrhoidal area. Boils can also be difficult to treat for a variety of reasons, not least of which is that they are caused by bacteria that can be hard to treat.

Boils, also known as furuncles, are defined as a deep infection of the hair follicle. This infection is usually, but not always, caused by Staphylococcus aureus bacteria. The infection creates a painful swelling in the skin that’s caused by the accumulation of pus and dead cells. This pus fills the interior of the hair follicle and causes a boil. Several boil can cluster together to create a carbuncle, and there are many hair follicles around the anal opening that can cause problems.

On a side note, the name Staphylococcus roughly translates to “bunch of grapes” because that’s what the bacteria look like under a microscope, and these bacteria are fairly omnipresent throughout the environment and can especially be found in the same neighborhood as hemorrhoids. Keeping them from getting a foothold is far easier than treating them once they’re in. S. aureus can infect any organ or system in the body, and can easily jump from boils to anywhere.

Caused by staph present on the skin. Colonization begins in hair follicles and quickly causes local cellulitis and inflammation, which calls immune cells, which fight and cause pus.

Boil Or Hemorrhoid: Which Have You Got?

Boils can only occur on the outside of the body, because hair follicles are on the outside of the body, so they’re never going to be confused with internal hemorrhoids. However, they hurt about as badly as external hemorrhoids do, so that confusion can come quite naturally. Boils also range from pea sized to golf ball sized, so they are quite similar to hemorrhoids in that respect as well. For those unfamiliar with the symptoms, it can be quite easy to confuse a boil and a hemorrhoid.

Fortunately, there are a few differences that can be used to tell whether you’ve got a boil or a hemorrhoid. The biggest difference is in the appearance of the swelling. Boils get a yellow or white point at the center of the lump when the boil is ready to drain or discharge pus. Boils are also tender and hot to the touch, while hemorrhoids are generally harder and the same temperature as the body. The last and biggest clue is that the boil is entirely contained within the skin, while hemorrhoids actually originate below it. If you take the time to feel the lump thoroughly you can usually tell the difference.

If a boil progresses far enough, you may also suffer from symptoms of fever, swollen lymph nodes, fatigue, chills and nausea. These symptoms mean that the infection has officially gotten severe enough to warrant an immediate visit to the emergency room because the infection has gotten into the rest of your body to some degree.

Preventing and Treating Boils In The Hemorrhoids Area

Preventing boils in the hemorrhoidal area tends to be a lot easier than treating them, at least until you get your first one. Unfortunately, once you’ve gotten your first one these sorts of skin infections tend to be recurrent in many patients. Most people these days never get a boil at all considering the level of hygiene that the post-industrial world often enjoys. People with depressed immune systems, such as people who have leukemia or other forms of cancer, are most prone to them. Diabetes mellitus, obesity, malnutrition and use of immunosuppressant drugs can all also increase the risk of getting the first boil. Naturally, they can occur anywhere on the body that has hair follicles, but around the hemorrhoids area is quite probable given the bacteria present in the intestinal area.

As already stated, boils tend to happen several times in people who get their first one, and the bacteria is often so contagious and in such high quantity that family members also get them. Multiple lesions and associated skin diseases also tend to go along with boils. Therefore, it’s also important to use the maximum hygiene in the hemorrhoids area possible during both prevention and treatment stages. In effect, you’re preventing more from getting started while treating the one you have. Remember to boil all washcloths, towels, sheets, underwear and clothing that may have had a remote possibility of coming in contact with the boil, and never share these things with another person.

S. aureus from a hemorrhoidal area boil can cause some serious complications, considering that it can infect anything anywhere in the body. Scarring is the most common result of a boil in the hemorrhoids area, while infection that travels is the most dangerous. Infection of the spinal cord, brain, kidneys, and other organs can cause abscesses on those organs. If the infection spreads to the bloodstream then you’ve got a life threatening systemic infection that requires immediate emergency attention. Infection can be limited or systemic in any organ that the bacteria gets a toehold in. In addition, just as a bonus, the enzymes and exotoxins secreted by Staphylococcus strains often cause or increase the severity of diseases like food poisoning, septic shock, toxic shock syndrome, and scalded skin syndrome.

The best way to treat the boil itself, once you’ve ascertained that it is a boil and not a hemorrhoid, is to wash it well in an antibacterial soap containing triclosan or the equivalent, cover it in antibiotic cream and bandage it with gauze. When changing the gauze, use latex gloves and seal everything, changed bandage and latex gloves, up in a sealed plastic bag before you throw it in the garbage. Do not, and I really can’t stress this enough, do not try to lance it or squeeze it out yourself at home. Don’t let anyone but a doctor drain it, either. The pus from a boil is only slightly less infectious than a specially cultured sample intended for germ warfare, and it can get everywhere. If it does pop and drain on its own, you’ll have to change the gauze every few hours.

While a boil in the hemorrhoidal area doesn’t necessarily require a doctor’s intervention, if the boils spread to your spine, you get one in the middle of your face, or it doesn’t go away within a week, you really do need to go in for a doctor’s appointment. If there are red streaks around it, if it hurts unbearably, or if you get the signs of systemic infection, go the emergency room immediately.

Antibiotic ointment will doubtless be a part of your treatment plan for boils in the hemorrhoids area, and oral antibiotic therapy may be necessary for large or recurrent boils. If the boils spread to sensitive sites such as genitalia, you may also want to go for powerful oral antibiotics fairly early on.

Boils Vs. Hemorrhoids: Conclusion

Which is worse around the anal area, boils or hemorrhoids? Well, if you’re going for straight severity, boils are. Boils can kill you if you ignore them, while a hemorrhoid usually won’t do any worse than make your life miserable. However, boils are also something that resolves fairly quickly, while hemorrhoids can persist and linger for what seems like half of eternity. In the end, neither are very much fun at all, and both should be banished as quickly as possible. Remember, if you’ve never had a hemorrhoid before, or if you really just cannot figure out what you’re dealing with, save yourself a lot of time and trouble and go see a doctor. Otherwise, treat whatever your painful lump is appropriately, and it should cease troubling you before long.

REFERENCES:

Blume JE, Levine EG, Heymann WR (2003). “Bacterial diseases”. In Bolognia JL, Jorizzo JL, Rapini RP. Dermatology. Mosby. p. 1126

Habif TM. Bacterial infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 9.

AUTHOR: Loni Ice.

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