A 45-year-old male presents with severe rectal pain, especially during bowel movements. On examination, a painful, swollen mass is visible on the anal verge. What is the potential diagnosis and what would be the treatment?
This patient's symptoms suggest the presence of an external thrombosed hemorrhoid, which occurs when a blood clot forms in an external hemorrhoid, leading to severe pain and swelling. Immediate treatment options include conservative measures like sitz baths, topical analgesics, and oral pain relievers. If the patient presents within the first 48-72 hours of symptom onset, excision of the thrombosed hemorrhoid can be considered for faster relief.