Can external hemorrhoids be cured completely?

Written by Chen Tian Jing
Colorectal Surgery
Updated on January 06, 2025
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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.

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Written by Deng Heng
Colorectal Surgery
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External hemorrhoids are divided into several types.

External hemorrhoids refer to hemorrhoids below the dentate line and are divided into four types. The first type is the connective tissue type of external hemorrhoids, which are formed by the proliferation and bulging of excess skin at the anal margin. The second type is the varicose vein type of external hemorrhoids, formed by the dilation and bending of the venous plexus below the dentate line. The third type is inflammatory external hemorrhoids, which is a state where external hemorrhoids become inflamed. The fourth type is the thrombosed external hemorrhoid, which is formed by bleeding due to the rupture of the subcutaneous veins at the anal margin, resulting in a blood clot.

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Written by Chen Tian Jing
Colorectal Surgery
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How to relieve pain from thrombosed external hemorrhoids?

The main cause of pain in thrombotic external hemorrhoids is the thrombus within the local hemorrhoid nucleus, which increases the congestion pressure and leads to discomfort and pain. During the acute phase of thrombotic external hemorrhoids, there is generally pain or bloating in the local area, along with difficulty in defecation. To quickly alleviate the pain, one can manually break the local thrombus or use traditional Chinese medicine washes for hot compresses to promote the absorption of the thrombus. If the thrombus is large or the condition is severe, surgery can also be performed to peel and remove the local thrombus, which is the most effective method for pain relief. After the surgery for peeling off thrombotic external hemorrhoids, it is necessary to disinfect the local wound surface to avoid infection.

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Written by Yu Xu Chao
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How to deal with external hemorrhoids bleeding?

If external hemorrhoids bleed without apparent reason, it may be due to the rupture of thrombosed external hemorrhoids, leading to bleeding. Firstly, it is necessary to disinfect and clean the local wound to avoid accumulation of blood or contaminants and feces, which may cause infection of the wound. If the bleeding does not stop, topical hemostatic drugs or oral hemostatic drugs should be used for symptomatic treatment. If external hemorrhoids bleed and are accompanied by severe prolapse of internal hemorrhoids, it is recommended that the patient undergo surgical treatment to remove and ligate both external and internal hemorrhoids at the same time. This can further prevent exacerbation of bleeding and fundamentally treat hemorrhoids. Patients with bleeding external hemorrhoids must have a light diet and avoid irritating foods such as chili peppers and seafood. (The use of medications should be under the guidance of a doctor.)

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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.