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External hemorrhoids
Is surgery necessary for thrombosed external hemorrhoids?
Thrombotic external hemorrhoids do not necessarily require surgery during the acute phase of an attack. If the thrombotic external hemorrhoids are mild, Chinese herbal medicine can be used for local topical application to relieve symptoms. Early-stage or mild thrombotic external hemorrhoids may only form small thrombi, and the pain experienced by the patient is not very intense. Therefore, one can opt to use Chinese herbal washes for hot compresses and fumigation, along with the application of hemorrhoid cream to alleviate symptoms. However, it is only recommended to perform excision surgery for thrombotic external hemorrhoids if they are acutely recurring over a long period or repeatedly, severely affecting the patient's life. (Please use medication under the guidance of a professional physician and avoid self-medication.)
How to deal with occasional bleeding from external hemorrhoids?
Occasional bleeding from external hemorrhoids is mainly due to damage to the hemorrhoids, which leads to bleeding, usually accompanied by pain and a foreign body sensation in the anus. In such cases, if the bleeding is not severe and the pain is mild, it means the damage to the external hemorrhoids is not serious. For these cases, one can choose to use an anal cleansing agent for sitz baths to achieve anti-inflammatory and antibacterial effects, and then apply hemorrhoid cream and other medications externally to promote healing of the sores. At the same time, patients should wear loose, breathable cotton underwear to avoid frequent friction on the external hemorrhoids, which can worsen the damage. If the damage to the external hemorrhoids is severe, or if there is swelling or thrombosis, it is advised to go to the hospital's anorectal surgery department as soon as possible to undergo a hemorrhoidectomy. After the surgery, patients must persist in changing dressings to promote wound healing.
How to eliminate a two-centimeter external hemorrhoid?
The external hemorrhoid is about two centimeters in size, which indicates that it's relatively large. This condition can cause feelings of a foreign object in the anus, itching, and even moisture around the anal area, leading to anal eczema. If one wishes to completely eliminate it, it is advisable to go to the hospital's proctology department as soon as possible to have a hemorrhoidectomy. Post-surgery, one should choose anal cleaning solutions or potassium permanganate solution for sitz baths, complemented by external applications of medicines such as Jing Huang Gao or hemorrhoid creams. At the same time, the patient's diet should consist of light and easily digestible food to prevent dry and hard stools, which will aid in the healing of the surgical site. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid sitting or squatting for long periods. Regularly performing anal lifting exercises can prevent the recurrence of external hemorrhoids. If patients prefer not to undergo surgery, conservative medical treatment can be used to reduce the size of the external hemorrhoids, but it cannot completely eliminate them.
Can anal dilation treat external hemorrhoids?
Anal dilation cannot treat external hemorrhoids. Anal dilation, also known as anal canal dilation surgery, is a common surgical treatment method in proctology. It primarily involves using external force to increase the diameter of the anal canal in order to achieve the purpose of dilation. It is mainly used for patients with early-stage anal fissures and anal stenosis. External hemorrhoids, which grow below the dentate line of the anal canal skin, are not affected by anal dilation treatments.
Do external hemorrhoids require surgery?
If external hemorrhoids do not cause any discomfort to the patient, then it is possible to delay surgical treatment in this situation. This is because the treatment of external hemorrhoids is primarily based on their clinical symptoms to choose different treatment methods. If it is simply a case of redundant skin hemorrhoids, where the patient only experiences a slight foreign body sensation in the anus, surgical intervention is not necessary. The patient only needs to maintain smooth bowel movements, perform more anal lifting exercises, avoid prolonged sitting and squatting, and take a warm saltwater sitz bath after defecation to prevent exacerbation of the external hemorrhoids. However, if the external hemorrhoid node develops inflammatory edema or thrombosis, causing anal swelling and pain, and the patient is unable to walk normally, it is then recommended to promptly visit the proctology department of a hospital to undergo external hemorrhoidectomy, to prevent worsening of the inflammatory edema or thrombosis, leading to significant anal swelling and pain.
Do external hemorrhoids without any symptoms need treatment?
External hemorrhoids can be categorized into skin tag-like external hemorrhoids, varicose vein-like external hemorrhoids, and thrombosed external hemorrhoids. Most patients with skin tag-like external hemorrhoids do not have any sensations, and in such cases, treatment is not necessary. Patients only need to pay attention to the hygiene around the anal area. After each bowel movement, they should wash the anal area with clean water. They should also frequently change their underwear, and their diet should be light and easily digestible to avoid diarrhea or constipation. During bowel movements, it's important to ensure the process is smooth to avoid lengthy bathroom visits or excessive straining, which can prevent the exacerbation of skin tag-like external hemorrhoids, hence no treatment would be needed. However, for varicose vein-like external hemorrhoids or thrombosed external hemorrhoids, patients may experience a foreign body sensation or pain around the anus. In such cases, conservative treatment with medications can be considered initially. If conservative treatment is ineffective, surgical intervention may be required.
What causes external hemorrhoids to itch?
External hemorrhoids are hypertrophic skin tags at the anal margin and surrounding skin, or dilation of the subcutaneous venous plexus leading to blood stasis and thrombus formation, resulting in protruding lesions. According to their characteristics, they can be divided into connective tissue external hemorrhoids, thrombotic external hemorrhoids, varicose external hemorrhoids, and inflammatory external hemorrhoids. In particular, inflammatory external hemorrhoids can cause the surrounding skin to become moist. This moisture can lead to the formation of eczema and pruritic diseases in the surrounding skin, causing skin lesions. One of the main features after skin lesions is itching around the skin surrounding the external hemorrhoids.
Thrombotic external hemorrhoids clinical characteristics
The clinical features of thrombosed external hemorrhoids primarily include acute episodes of localized swelling and pain in the anal area, with thrombosis forming in the local hemorrhoidal tissue. This condition is primarily due to dry stools and excessive straining during bowel movements, leading to congestion and edema in the local hemorrhoidal tissue and subsequent disruption of local blood circulation, resulting in thrombosis. After an attack, the anal hemorrhoidal tissue may display dark red or purplish clots, enclosed by the local skin and mucous membrane. Treatment options include the application of topical medications and hot compresses to promote absorption of the hemorrhoids, as well as local surgical excision. It is important to note that if rupture or bleeding occurs, considering the possibility of local thrombus rupture, it is essential to perform proper local cleaning and disinfection and to promptly proceed with surgical excision to prevent infection.
Does the surgical removal of external hemorrhoids hurt?
Surgical removal of external hemorrhoids generally does not cause significant pain because anesthesia is required for the procedure. There are options for anesthesia, including local infiltration anesthesia, spinal anesthesia, or general anesthesia via intravenous injection, ensuring the patient does not experience notable pain during the surgery. However, post-surgery sensitivity is higher because the external hemorrhoids are innervated by perineal nerves. Therefore, it is crucial to use pain relief medication appropriately when changing dressings to alleviate discomfort. Additionally, it is essential to prevent infection, inflammation, or swelling of the wound to reduce postoperative pain. Patients should also manage their bowel movements to avoid dry, hard stools; smooth bowel movements can somewhat relieve postoperative pain. If the pain is particularly severe, the use of diclofenac sodium suppositories for anal insertion can help reduce inflammation and pain. (Please follow medical advice regarding medication use.)
Can external hemorrhoids be eliminated?
External hemorrhoids can certainly be removed. Clinically, surgical treatment can be used to remove external hemorrhoidal masses. Hemorrhoidectomy is a common surgical option and can be performed under local infiltration anesthesia, spinal anesthesia, or general anesthesia. After surgery, it is crucial for patients to adhere to changing dressings to avoid infections, inflammation, or edema at the wound site. Dietary precautions should be taken as well; spicy, irritating, and dry foods should be avoided as much as possible. If patients prefer not to undergo surgery, medications can be considered for treating external hemorrhoids, though they can only reduce the size of the hemorrhoidal masses, not eliminate them entirely. Common treatments include anal washes and sitz baths, topical application of golden ointment, and when necessary, oral administration of Diosmin can help reduce swelling. Additionally, patients should regularly perform pelvic floor exercises and avoid prolonged or excessive straining during bowel movements.