About External Hemorrhoids
The causes of external hemorrhoids include:
- Dilated blood vessels beneath the skin surrounding the anus.
- Enlarged blood vessels that protrude and may form a hard lump.
- Blood clotting inside the protruding blood vessel, leading to pain.
Non-modifiable risk factors for external hemorrhoids cannot be changed or controlled. These include:
- Aging, which weakens the support tissues around the anus and rectum
- Pregnancy, due to increased pressure on the veins in the abdomen
Modifiable risk factors for external hemorrhoids can be influenced or changed. These include:
- Repeated straining while having a bowel movement, often caused by severe constipation or diarrhea
- Prolonged sitting on the toilet, which puts pressure on the tissues around the rectum and anus
- Obesity, as excess weight has been associated with an increased risk of hemorrhoids
- Frequent heavy lifting, which can raise the risk of hemorrhoids
- Inadequate fiber intake in the diet
It's important to note that these risk factors can be addressed through lifestyle changes. However, it's always advisable to consult with a healthcare professional for personalized advice and guidance.
Common symptoms of external hemorrhoids include:
- Anal itching: Itching around the anus is a common symptom of external hemorrhoids. This itching can be bothersome and may worsen with straining, rubbing, or cleaning around the anus.
- Tender lumps near the anus: External hemorrhoids can cause the formation of one or more hard, tender lumps near the anus. These lumps may be sensitive to touch and can cause discomfort.
As external hemorrhoids progress or become more severe, additional symptoms may occur, such as:
- Anal ache or pain: Pain or discomfort in the anal area, especially when sitting, can be experienced with more advanced external hemorrhoids.
- Bleeding: External hemorrhoids may cause bleeding from the rectum. This can manifest as bright red blood on the stool, on toilet paper, or in the toilet bowl after a bowel movement.
- Prolapse: In some cases, external hemorrhoids can prolapse or fall through the anal opening. This can lead to a visible lump outside the anus and may cause pain and discomfort.
It's important to note that not all individuals will experience all of these symptoms, and some people with external hemorrhoids may have no symptoms at all. If you suspect you have external hemorrhoids or are experiencing any concerning symptoms, it is advisable to consult with a healthcare professional for an accurate diagnosis and appropriate management.
To diagnose external hemorrhoids, doctors commonly perform the following examinations, tests, and procedures:
- History and Physical Exam: The doctor will ask about any symptoms or factors that could be contributing to your condition. They will visually examine the area around your anus to look for external hemorrhoids.
- Digital Rectal Exam: During this exam, the doctor will insert a lubricated, gloved finger into your anus to feel for any abnormalities.
- Anoscopy: This procedure involves inserting a device called an anoscope into your rectum to get a closer look at the anal canal and rectum. It helps in identifying any internal hemorrhoids that may be present alongside external ones.
Additional examinations or tests may include:
- Sigmoidoscopy or Colonoscopy: If you have rectal bleeding, your doctor may recommend these procedures to rule out colorectal cancer and assess the extent of the hemorrhoids.
It's important to note that these are general guidelines, and the specific diagnostic approach may vary depending on individual circumstances. It is also very important to know that anyone with undiagnosed rectal bleeding or pain should be evaluated to make sure there is not a more serious cause of these symptoms. Always consult with your healthcare professional for personalized advice and recommendations.
The goals of treatment for external hemorrhoids are to alleviate symptoms, reduce inflammation and swelling, and promote healing. Here are the different treatment options and how they work to achieve these goals:
Medications:
- Over-the-counter (OTC) pain relievers (ibuprofen or acetaminophen): These help to relieve pain and discomfort associated with hemorrhoids.
- Ointments with witch hazel or hydrocortisone: These creams help to reduce itching and inflammation.
Therapies:
- Warm baths: Soaking in warm water can provide relief by reducing swelling and soothing the area.
- Cloth-covered ice packs: Applying cold packs can help to reduce swelling and provide temporary pain relief.
- Infrared photocoagulation: Using infrared light, this therapy blocks blood supply to the hemorrhoids, causing them to shrink.
Therapeutic Procedures:
- Injection therapy: Injections such as Shaobei injection, a traditional Chinese medicine extract, can reduce local tissue inflammation and promote mucosal repair and regeneration.
- Sclerotherapy: This procedure involves injecting a solution into the hemorrhoids to block blood supply, leading to shrinkage.
- Rubber band ligation: A rubber band is placed near the base of the hemorrhoids to cut off blood supply, causing them to shrink and fall off.
- Hemorrhoidectomy: Surgical removal of the hemorrhoids using a scalpel.
Self-care and Health behavior changes:
- Increasing dietary fiber intake: Consuming more fruits, vegetables, whole grains, and cereals can prevent constipation and promote regular bowel movements.
- Drinking enough water: Staying hydrated helps soften stools and makes them easier to pass.
- Regular physical activity: Engaging in exercise promotes natural bowel movements.
It's important to note that while these treatments can provide relief, it's always best to consult with a healthcare professional for proper diagnosis and individualized treatment recommendations.