<s>[INST] Hi. This is so embarrassing.  That's probably why I haven't gone to the Doctor.  I have a pretty large external hemorrhoid. It's painful. For the last couple of days I have tried over the counter medications. It doesn't seem to be shrinking. It's I guess about a inch in diameter and very hard. Should I just wait it out. I am soaking in warm water now. I read online where it could help. I had one similar to this about 6 months or so ago and it went away after over the counter treatment.  This one seems more painful and larger. Is this something you could help me with? [/INST] . I read your question carefully and I understand your concern. First of all you don't have to be embarrassed from this situation, especially in front of healthcare providers, since this condition is something that healthcare providers have a lot of experience and it is not seen as something weird, rare or embarrassing. From what I read in your post, it seems like the symptoms might be a consequence of thrombosed hemorrhoids (hard and painful).The conservative measures that might help you are warm baths; ice can relieve the pain of acute thrombosis; high-fiber diet (methylcelulose); stool softener; topical steroids can alleviate symptoms of itching and inflammation; topical nitroglicerine can also reduce symptoms, but it can have side effects like dizziness and hypotension. I recommend to visit a general surgeon or a proctologist in order to be evaluated more objectively and for a possible surgical treatment. I hope my answer was helpful. Best regards and I wish you a fast recovery. </s>