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External hemorrhoids
How to treat thrombotic external hemorrhoids?
The treatment of thrombosed external hemorrhoids generally falls into two categories: first, conservative treatment; second, surgical treatment. Small lumps can be treated conservatively, and after 2-3 days, the thrombus can be absorbed, the pain can be significantly reduced, and self-healing is possible. However, larger lumps may erode on the surface, causing bleeding and severe pain that can impede walking and cause discomfort while sitting or lying down. In such cases, thrombectomy may be necessary.
What does an external hemorrhoid look like?
External hemorrhoids are hypertrophic protrusions of the skin around the anal margin, forming skin tags, or expansions of the subcutaneous venous plexus, where blood flow stagnates and thromboses form, or other raised lesion-like abnormalities appear. Based on histopathological characteristics, external hemorrhoids can be categorized into four main types: connective tissue-type, thrombotic-type, varicose-type, and inflammatory external hemorrhoids. Connective tissue-type external hemorrhoids primarily consist of hypertrophic protrusions of the anal margin skin tags, also known as skin tag external hemorrhoids. Varicose-type external hemorrhoids, also known as venous cluster-type external hemorrhoids, occur when the venous plexus below the dentate line expands and twists, forming venous clusters. Inflammatory external hemorrhoids are a condition where pre-existing skin tag external hemorrhoids develop inflammatory changes. Thrombotic-type external hemorrhoids are a type of anal disease that occurs due to bleeding from the hemorrhoidal veins or the formation of thromboses in the skin around the anus.
Can external hemorrhoids be eliminated?
External hemorrhoids are generally divided into skin tag-type external hemorrhoids, thrombotic external hemorrhoids, and inflammatory edematous external hemorrhoids; each type presents different clinical symptoms. If the condition is skin tag-type external hemorrhoids or connective tissue-type external hemorrhoids, the patient generally does not feel obvious symptoms, but these will not resolve on their own and require surgical removal. If skin tag-type or connective tissue-type external hemorrhoids do not affect the patient's normal life, it is possible to avoid excessive intervention and treatment. However, if it is thrombotic external hemorrhoids or inflammatory edematous external hemorrhoids, since there is significant pain during flare-ups that affects the patient’s normal life, surgical removal and treatment should be performed as soon as possible.
Can external hemorrhoids be treated with anti-inflammatory drugs?
Some types of external hemorrhoids can be treated with anti-inflammatory drugs. External hemorrhoids refer to hemorrhoids that are located below the dentate line. They can be divided into four categories: connective tissue external hemorrhoids, varicose vein type external hemorrhoids, thrombotic external hemorrhoids, and inflammatory external hemorrhoids. The first three types of external hemorrhoids do not require anti-inflammatory drugs. Only inflammatory external hemorrhoids, which are caused by inflammatory hyperplasia around the anus, can be treated with anti-inflammatory drugs during inflammation to reduce the size of the pathological tissues. (Please use medication under the guidance of a doctor.)
How long does it take to recover after external hemorrhoidectomy?
External hemorrhoids are mainly classified into inflammatory external hemorrhoids, thrombotic external hemorrhoids, connective tissue external hemorrhoids, and varicose vein external hemorrhoids. Regardless of the type, the primary treatment method is surgical removal. After the hemorrhoids are excised, the perianal area generally does not bleed when passing stools for the first two to three days, and the patient can usually go home in about 7 days. For complete recovery to the pre-condition state, it is estimated to take between 20 days to a month.
Can external hemorrhoids be cured completely?
External hemorrhoids are a common clinical type of hemorrhoids, and the main method for radical treatment is primarily surgical removal. The sole use of topical medications or oral medications can only alleviate the congestion, swelling, and pain caused by external hemorrhoids, but cannot completely remove them. The surgical methods for external hemorrhoids primarily include external hemorrhoidectomy or the combined internal ligation and external excision surgery. If internal hemorrhoids are also removed during the surgery, there will be sutures present, and it is recommended that patients be hospitalized and observed until the sutures fall out before being discharged. This is to avoid complications such as major bleeding from premature suture loss due to early discharge or exertion.
Clinical Characteristics of External Hemorrhoids
External hemorrhoids refer to hemorrhoids located below the dentate line, which are classified into four main types, each with distinct clinical manifestations. Connective tissue external hemorrhoids and varicose vein-type external hemorrhoids primarily present with a mild sensation of a foreign body in the anus. Inflammatory external hemorrhoids are characterized by redness, swelling, protrusion, burning, or itching of the anal skin or skin tags. Thrombosed external hemorrhoids often occur after intense exercise or straining during bowel movements, suddenly presenting as a round or oval lump under the skin at the edge of the anus. This lump contains a venous thrombus and is accompanied by anal pain.
Can external hemorrhoids use hemorrhoid suppositories?
In clinical practice, hemorrhoidal suppositories can also be used for external hemorrhoids. Since hemorrhoidal suppositories are mainly administered through the rectum to act locally, they have a certain therapeutic effect on external hemorrhoids, especially for varicose external hemorrhoids and inflammatory external hemorrhoids, helping to alleviate local swelling and pain. Additionally, for external hemorrhoids, it is often recommended to use anal cleansers, or to sit in baths with potassium permanganate or other medicated solutions, combined with the external application of hemorrhoidal cream or golden ointment. If symptoms do not show significant improvement after four to five days of medication treatment, it is advisable to visit a hospital's proctology department for external hemorrhoid surgery as soon as possible, to prevent potential thrombosis or necrosis of the external hemorrhoids. Moreover, patients should develop good bowel habits, avoiding prolonged sitting or excessive straining during bowel movements to prevent worsening of external hemorrhoids. (Medication should be used under the guidance of a doctor)
Do external hemorrhoids always require surgery?
Simple external hemorrhoids do not necessarily require surgery. External hemorrhoids are mainly those that grow below the dentate line, and their main clinical manifestation is a foreign body sensation in the anus, which does not pose a significant risk to the body. Only thrombosed external hemorrhoids with obvious anal pain may not require surgery if the lump is small, as the thrombus can be absorbed on its own. Only those with large lumps need to have the thrombus removed to alleviate pain.
Can external hemorrhoids heal by themselves?
External hemorrhoids can be classified into cutaneous flap hemorrhoids, varicose vein hemorrhoids, thrombotic hemorrhoids, and inflammatory hemorrhoids. These are mostly caused by poor defecation habits of the patient, such as prolonged defecation time or excessive straining during bowel movements, which then lead to the growth of excess skin flaps, varicose veins, or rupture of venous blood vessels, resulting in various types of external hemorrhoids. Therefore, these types of hemorrhoids cannot heal on their own and require treatment with medication or surgery. For cutaneous flap hemorrhoids, if the patient does not experience significant discomfort, specific treatment is generally not necessary, just attention to hygiene around the anal area is needed. However, for inflammatory or thrombotic hemorrhoids, since they can cause anal pain and a feeling of prolapse, it is advisable to opt for surgical stripping of the hemorrhoids as soon as possible. Post-surgery, treatments such as anal washes, red oil gauze strips, and golden ointment should be used for dressing changes, while also maintaining cleanliness of the anal region.