How to eliminate the external hemorrhoids in postpartum women?

Written by Yu Xu Chao
Colorectal Surgery
Updated on June 21, 2025
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The external hemorrhoids in postpartum women are primarily due to the pathology of the anal cushions, which become pathologically hypertrophic and descend due to the compression of the rectum and anal canal during childbirth. This can lead to the enlargement of external hemorrhoidal nodules and even inflammatory edema. For such cases, it is generally recommended to first try conservative treatment with medications. For example, after defecation, a sitz bath using agents like anal washes or potassium permanganate solution can be used to reduce inflammation and swelling. Then, applying ointments like yellow ointment or other hemorrhoid creams can help reduce swelling and relieve pain. Oral medications like Diosmin tablets may also be needed to relieve swelling. At the same time, patients must develop good bowel habits, ensure smooth bowel movements, and avoid prolonged toilet sessions or excessive straining. These measures can significantly reduce the size of external hemorrhoidal nodules and even alleviate them. However, if the external hemorrhoidal nodules persist at the anus, an external hemorrhoidectomy can be directly performed.

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Written by Chen Tian Jing
Colorectal Surgery
1min 2sec home-news-image

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 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.

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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.

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Written by Chen Tian Jing
Colorectal Surgery
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The difference between mixed hemorrhoids and external hemorrhoids

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 Deng Heng
Colorectal Surgery
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Can external hemorrhoids be treated without surgery?

Some external hemorrhoids do not require surgical treatment, as they come in three types. The first type, connective tissue external hemorrhoids, mainly presents as a mild foreign body sensation, generally painless, thus surgery is not necessary. Varicose vein type external hemorrhoids typically cause a feeling of heaviness and discomfort around the anus, and if symptoms are not severe, surgery is not required either. Only thrombosed external hemorrhoids, which usually involve severe pain, may resolve significantly on their own within two to three days if the lump is not large. Surgery is only needed for large, thrombosed external hemorrhoids.