Can external hemorrhoids be pinched?

Written by Yu Xu Chao
Colorectal Surgery
Updated on May 22, 2025
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In clinical practice, external hemorrhoids can be classified into skin tag hemorrhoids, varicose vein hemorrhoids, thrombosed hemorrhoids, and inflammatory hemorrhoids. Among these, skin tag hemorrhoids can be pinched, but do not exert excessive force to avoid skin damage and causing anal pain. On the other hand, varicose vein hemorrhoids, thrombosed hemorrhoids, and inflammatory hemorrhoids should not be pinched, as pinching may easily cause subcutaneous vein damage, exacerbate thrombosis, and lead to anal distension and pain. External hemorrhoids can be gently massaged and rubbed, but should not be pinched forcefully. Moreover, clinically, treatments for external hemorrhoids often involve the use of anal washes or potassium permanganate solution for sits baths, and it is recommended to take a sitz bath for five to ten minutes after defecation to help reduce external hemorrhoids and prevent their enlargement. Maintaining good bowel habits is essential, avoiding prolonged defecation and excessive straining. After defecation, it is advisable to perform more anal lift exercises to strengthen the anal sphincter muscles.

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Written by Chen Tian Jing
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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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Is internal hemorrhoids more uncomfortable or external hemorrhoids?

"Whether internal hemorrhoids or external hemorrhoids are more uncomfortable, overall, internal hemorrhoids tend to be more discomforting. This is because internal hemorrhoids have three main clinical manifestations: rectal bleeding, prolapse of the hemorrhoidal nucleus outside the anus, and pain. Rectal bleeding can lead to systemic anemia, prolapse of the hemorrhoidal nucleus can cause anal itching and anal eczema, and the pain is also very distressing. On the other hand, the main clinical manifestations of external hemorrhoids are a foreign body sensation in the anus and moisture in the anus, and only thrombosed external hemorrhoids cause anal pain."

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Written by Yu Xu Chao
Colorectal Surgery
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Does the surgical removal of external hemorrhoids hurt?

Surgical removal of external hemorrhoids generally does not cause significant pain because anesthesia is required for the procedure. There are options for anesthesia, including local infiltration anesthesia, spinal anesthesia, or general anesthesia via intravenous injection, ensuring the patient does not experience notable pain during the surgery. However, post-surgery sensitivity is higher because the external hemorrhoids are innervated by perineal nerves. Therefore, it is crucial to use pain relief medication appropriately when changing dressings to alleviate discomfort. Additionally, it is essential to prevent infection, inflammation, or swelling of the wound to reduce postoperative pain. Patients should also manage their bowel movements to avoid dry, hard stools; smooth bowel movements can somewhat relieve postoperative pain. If the pain is particularly severe, the use of diclofenac sodium suppositories for anal insertion can help reduce inflammation and pain. (Please follow medical advice regarding medication use.)

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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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How long does surgery for thrombotic external hemorrhoids take?

Thrombotic external hemorrhoid surgery primarily involves the excision of thrombotic external hemorrhoids. If it's simply an excision of external hemorrhoids, the surgery generally takes about half an hour. The recovery time post-surgery requires two to three weeks, mainly depending on the severity of the patient's condition and individual tissue healing rates, which can vary. After the excision surgery for thrombotic external hemorrhoids, a local wound is left, necessitating daily disinfection and dressing changes. When necessary, hemorrhoid ointment or muscle-generating Yuhong ointment may also be applied to promote healing and treatment.