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External hemorrhoids
Is internal hemorrhoids more uncomfortable or external hemorrhoids?
"Whether internal hemorrhoids or external hemorrhoids are more uncomfortable, overall, internal hemorrhoids tend to be more discomforting. This is because internal hemorrhoids have three main clinical manifestations: rectal bleeding, prolapse of the hemorrhoidal nucleus outside the anus, and pain. Rectal bleeding can lead to systemic anemia, prolapse of the hemorrhoidal nucleus can cause anal itching and anal eczema, and the pain is also very distressing. On the other hand, the main clinical manifestations of external hemorrhoids are a foreign body sensation in the anus and moisture in the anus, and only thrombosed external hemorrhoids cause anal pain."
Hemorrhoids are divided into several degrees.
In clinical practice, external hemorrhoids are not classified by degrees but mainly into skin tag hemorrhoids, varicose vein hemorrhoids, inflammatory hemorrhoids, and thrombosed hemorrhoids. Skin tag hemorrhoids and varicose vein hemorrhoids typically cause sensations of foreign bodies in the anus and feelings of anal prolapse, etc., and conservative medication treatment is generally chosen for these. However, thrombosed hemorrhoids or inflammatory hemorrhoids can cause significant anal swelling and pain, severely impacting the patient's normal life. For these two types of external hemorrhoids, it is recommended to promptly undergo hemorrhoidectomy, followed by medication treatment to promote healing of the surgical site. Because the surgical site for hemorrhoid operations is located at the anus, it is susceptible to contamination from feces and other secretions, which can easily lead to local infections, bleeding, and swelling. Therefore, it is essential to persist in changing dressings and to maintain smooth bowel movements.
Thrombotic external hemorrhoid compression treatment
Treatment options for thrombosed external hemorrhoids include topical medications, compression therapy, or direct surgical excision. The choice of treatment depends on the severity of the clinical condition. For mild thrombosis, a traditional Chinese medicine wash with blood-activating and stasis-dissolving effects can be used for local hot compresses to promote the absorption and reduction of the thrombus. If the thrombus enlarges, professional proctological techniques can also be used to crush the thrombus locally, but it is important to maintain cleanliness and hygiene of the local mucosa to avoid infection. If the condition of thrombosed external hemorrhoids worsens, or if the patient experiences severe pain, surgical excision treatment can also be directly performed.
What should I do if a thrombosed external hemorrhoid is bleeding?
After the skin of a thrombosed external hemorrhoid ruptures, small blood clots may be exposed, leading to bleeding. Generally, resting, diet adjustment, and maintaining soft and smooth bowel movements can be effective. Additionally, local use of hemorrhoid creams and suppositories can typically help achieve healing and stop the bleeding. Thrombosed external hemorrhoids often occur after intense physical activity or straining during bowel movements due to the sudden rupture of subcutaneous veins around the anal margin, forming an oval lump. (The use of medications should be carried out under the guidance of a professional doctor.)
Can external hemorrhoids be pushed back in by hand?
External hemorrhoids cannot be pushed back in by hand, as they are swollen around the anus, not prolapsed internal hemorrhoids. If they were prolapsed internal hemorrhoids, the lump could be pushed back in. For external hemorrhoids, if it is a short-term flare-up, it is recommended to take a warm saltwater sitz bath. After ten minutes, apply hemorrhoid cream to the affected area once in the morning and evening. Oral medication can also be used in conjunction, and treatment for a week can reduce the swelling. If the external hemorrhoid lump is very large and accompanied by severe pain, thrombosed hemorrhoids should be considered, and it is necessary to visit the hospital's proctology department. Surgery may be required if necessary. Diet should be light; spicy and irritating foods should not be eaten, nor should triggering foods like beef, lamb, and seafood. Alcohol consumption, including beer, should be avoided.
Do minor external hemorrhoids itch?
Mild external hemorrhoids can also cause localized itching in the anal area, but the itching is not pronounced. This is because the external hemorrhoids themselves stimulate the perianal skin, causing mild itching and a sensation of a foreign body in the anus. Moreover, external hemorrhoids can lead to increased secretions around the anus, further irritating the perianal skin and, in severe cases, causing anal eczema. Thus, in most cases, mild external hemorrhoids can cause itching, although it is not intense. For such situations, it is primarily important for patients to keep the perianal area dry and hygienic, wear loose, breathable cotton underwear, and avoid friction against the hemorrhoids. For mild itching, topical treatments such as calamine lotion can be used, along with keeping the perianal area dry. Additionally, a light diet should be maintained.
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.