In order to properly understand the problem of recurring perianal hematoma (a type of hematoma),it is important to understand why it occurs. Reasons for a perianal hematoma could be anything from straining too much to coughing excessively hard, lifting more weight than one should and in rare cases, even hardened stools. What typically happens is that a nerve which ends at the opening of the anus then gets ruptures and bleeds. Once a wound has formed, a small globule like structure forms there, and this is what is called a hematoma. If your son is 21 years old, he should be able to isolate what is causing this problem to occur repeatedly. On the other hand, you should make him go for a medical examination which will determine that he is indeed suffering from a hematoma and not a hemorrhoid, as this confusion is quite common.
For relief, you can ask him to begin with stopping the use of toilet paper immediately, as this will only serve to aggravate his condition further. It is always advisable to use water to wash his anus after a motion has been passed. This is the safest way to ensure that the condition is not being aggravated. Further more, if possible, a warm sitz bath should be used to provide relief and reduce swelling. If you do not have access to a sitz bath, then your son can soak in a hot tub to which a few drops of hydrogen peroxide have been added. This will serve to sanitize his wounds as well. It is also important to take care that he does not have hard stools, otherwise this rupture will keep on repeating itself. He can have milk of magnesia every night before going to bed. This is an excellent and perfectly harmless remedy to take care of softening stools.
answered by G M