Can external hemorrhoids be pushed back in by hand?

Written by He Cai Dong
Colorectal Surgery Department
Updated on May 04, 2025
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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.

Other Voices

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Written by Yu Xu Chao
Colorectal Surgery
1min 4sec home-news-image

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.

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Written by Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids go away?

Thrombotic external hemorrhoids mainly refer to the formation of blood clots within the external hemorrhoids located around the anus. During the acute phase of thrombotic external hemorrhoids, there is generally severe pain and a feeling of distension in the anal region. If not treated with medication, thrombotic external hemorrhoids are difficult to resolve on their own. Options include applying hemorrhoid cream or using traditional Chinese medicine solutions for fumigation and hot compresses to promote the absorption and dissipation of the blood clots in the external hemorrhoids. If conservative medication does not yield good results, surgery can be considered to strip and remove the blood clots from the external hemorrhoids. Failure to use medications can potentially lead to a worsening of the thrombotic external hemorrhoids, or an increase in blood clots leading to necrosis and delaying treatment of the disease.

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Written by Chen Tian Jing
Colorectal Surgery
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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.)

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Written by Chen Tian Jing
Colorectal Surgery
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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.

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Written by Yu Xu Chao
Colorectal Surgery
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How to eliminate external hemorrhoids without a core?

Conservative medication treatment for external hemorrhoidal nodules can only reduce their size, but cannot completely eliminate them. For instance, if an external hemorrhoidal nodule develops inflammatory edema, one can take oral Diltiazem tablets, combined with anal wash or potassium permanganate solution for local sitz baths, and apply Golden Ointment externally, which can achieve good anti-swelling effects. However, if the external hemorrhoidal nodule is significantly enlarged, or even forms a thrombus causing pain and swelling in the anus, simply using medication cannot effectively improve the symptoms. In such cases, surgical intervention is required to eliminate the nodule, such as external hemorrhoidectomy. Post-surgery, dressing changes such as Mupirocin ointment, red oil gauze strips, Golden Ointment, and other medications are recommended. Furthermore, the patient should maintain good bowel habits, avoiding prolonged toilet time or excessive straining.