The difference between mixed hemorrhoids and external hemorrhoids

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 16, 2024
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Both mixed hemorrhoids and external hemorrhoids fall within the clinical scope of hemorrhoids. However, mixed hemorrhoids generally include external hemorrhoids, whereas external hemorrhoids consist simply of local skin tags or connective tissue-based external hemorrhoids near the anal region. In addition to the local external hemorrhoids, mixed hemorrhoids also have local mucosal protrusions around the dentate line inside the anal canal, which connect with the external hemorrhoids to form mixed hemorrhoids. Both mixed and external hemorrhoids are very common. Treatment options include conservative medication or surgical removal. The primary surgical method for mixed hemorrhoids is excision and ligation, while for external hemorrhoids, the primary method is excision. Post-surgery, it is necessary to disinfect and change dressings on the local wounds to promote further growth and healing.

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Written by Chen Tian Jing
Colorectal Surgery
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How are thrombosed external hemorrhoids formed?

The formation of thrombosed external hemorrhoids is mainly related to local congestion pressure in the anal area and excessive filling of submucosal blood vessels, especially after the patient abstains from spicy and irritating food, excessive defecation, and excessive fatigue. This condition becomes more prominent. Once thrombosed external hemorrhoids form, they are generally accompanied by the formation of skin tags and internal hemorrhoids in the anal area, and the external hemorrhoids enclose a blood clot. When the blood clot becomes congested or swollen, the patient will experience significant pain or distension. Once thrombosed external hemorrhoids have formed, it is crucial to treat them early to avoid necrosis caused by prolonged and repeated congestion and edema. Treatment options include using local medications for hot compresses or application to alleviate symptoms, or performing surgery to excise and remove the blood clots.

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Written by Chen Tian Jing
Colorectal Surgery
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How to treat thrombosed external hemorrhoids

The treatment of thrombosed external hemorrhoids generally includes conservative medication or surgical treatment. Thrombosed external hemorrhoids are a clinical type of external hemorrhoids. They usually present in the acute phase with significant local pain and thrombus encapsulation within the hemorrhoid. Due to congestion and edema in the hemorrhoid, excessive pressure builds up inside, causing severe pain for the patient. Conservative medication treatment primarily involves sitz baths with hemorrhoidal wash solutions and hot compresses to promote thrombus absorption, as well as applying hemorrhoidal creams, or orally taking anti-swelling, pain-relieving, and thrombus-absorbing medications. If these methods repeatedly fail, surgery can be opted to strip and remove the local thrombus.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Deng Heng
Colorectal Surgery
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What foods to eat for thrombotic external hemorrhoids?

Thrombotic external hemorrhoids are primarily caused by inflammation of the anal veins, or by the rupture and thrombus formation of the anal venous plexus due to excessive straining. The main symptoms are a sudden bluish-purple swelling at the edge of the anus or severe pain. The primary cause is usually due to constipation. Therefore, it's important to maintain smooth bowel movements when eating. Increasing the intake of vegetables and fruits and reducing the consumption of meat, while ensuring regular bowel movements, is most crucial.