External hemorrhoids – causes, symptoms. Treatment of external hemorrhoids

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Hemorrhoids are a very embarrassing topic for many people, but they are a physiological part of our excretory system. Problems related to them concern more and more people around the world. External hemorrhoids are one of two types of hemorrhoids and are located below the anal sphincter. In the case of problems with external hemorrhoids, these appear as red, hard to the touch nodules. Hard and bleeding lumps can make everyday life difficult, but fortunately they can be treated.

External hemorrhoids – what is it?

In its simplest form, external hemorrhoids are lumps or bulges under the skin around the anus. These lumps and bulges form when too much pressure is applied to the rectal veins, causing the tissue around the anus to swell. Over time, external hemorrhoids can become more and more irritating, causing frequent itching, pain, and swelling.

Since external hemorrhoids develop outside the anus, they are often easier to identify than internal hemorrhoids that lie inside the anus. Although internal hemorrhoids can protrude and extend beyond the anus, they can return inside by themselves. For this reason, many people who have a problem with internal hemorrhoids think they have a problem with external hemorrhoids.

It is best to consult a doctor in this situation to find out what we are experiencing and what treatment option may be appropriate for our hemorrhoids. While external hemorrhoids can be very uncomfortable, there are many ways to relieve symptoms, including home solutions and medical procedures.

External hemorrhoids – causes and risk factors

The most common cause of problems with external hemorrhoids is repeated stress during bowel movements, leading to dilatation or enlargement of the anus or rectal veins. Since problems with external hemorrhoids are caused by excessive pressure in the veins in the rectum, certain factors may increase the risk of external hemorrhoids.

Some of the most common causes of external hemorrhoids problems include:

1. pregnancy;
2. constipation or diarrhea;
3. Weightlifting;
4. obesity;
5. genes;
6. age.

Each of the above places additional pressure on the rectal veins, which can eventually cause increased swelling of the external hemorrhoids. For example, in pregnant women, the uterus puts extra pressure on these veins and may cause them to enlarge. To reduce the likelihood of external hemorrhoids or prevent your symptoms from worsening, it is recommended that you limit your toilet time to two minutes and make sure you always exercise with proper lifting technique.

If in our family there have already been cases of problems with hemorrhoids, it also increases the risk of such problems in us. Doctors often ask if family members have hemorrhoids to identify a genetic tendency. In addition, the risk of developing hemorrhoids increases with age. While children and young adults also experience problems with hemorrhoids, it is most common in adults aged 45 to 65.

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External hemorrhoids – symptoms

Unlike internal hemorrhoids, external hemorrhoids are located in an area with nerve endings, which can make them easier to identify but also make symptoms much more unpleasant. Patients with external hemorrhoids usually report severe pain or discomfort, especially during bowel movements. However, these symptoms may only appear occasionally, making it difficult to tell if the discomfort is actually related to the hemorrhoids.

Many people with external hemorrhoids also have symptoms of internal hemorrhoids. While your doctor is the only one who can make a reliable diagnosis, here are some symptoms that usually indicate a problem with external hemorrhoids:

1. mild but constant itching in the anal area;
2. pain in the anal area, from mild to severe;
3. swelling around the anus.

You may also notice that external hemorrhoids swell especially during a bowel movement. Remember to limit the time you spend on the toilet to two minutes, as extra stress can worsen the condition of external hemorrhoids. If we find that we often have to strain ourselves to defecate, try increasing our fiber and water intake.

Eating foods that contain fiber is the most beneficial way to get carbohydrates, but you can also take fiber supplements. The recommended intake is 20 to 30 grams per day.

Many people with external diseases also have symptoms related to problems with internal hemorrhoids. Internal hemorrhoids are located in the rectum. While they don’t usually cause pain, they can also cause discomfort. Painless bleeding during bowel movements is a basic sign that we have a problem with internal hemorrhoids. However, if we do experience rectal bleeding, it may not only be caused by internal hemorrhoids, but also by an anal tear or other condition.

Another symptom of internal hemorrhoids to keep in mind is prolapse – when tissue in the anal canal temporarily bulges outside the rectum. Loss of tissue is usually caused by effort to move the stools and may be treated by one of the procedures discussed in later sections.

Since people who have problems with external hemorrhoids may also have trouble with internal hemorrhoids, we should speak to a doctor if we suspect we may have a problem with hemorrhoids. Although external hemorrhoids are rarely a serious health risk, proper treatment can prevent painful relapses in the future.

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Possible Complications

The most dangerous complication of external hemorrhoids is the formation of a blood clot. But even in the absence of an acute form of pathology, the disease affects the patient’s life and causes serious physical and psychological discomfort. A person has difficulty with bowel movements, it is often difficult for him to sit or walk for a long time. Unpleasant sensations are observed with minor physical exertion.

If left untreated, inflammation of the cavernous bodies may occur, which proceeds in several stages:

• At first, the patient complains of increased pain, itching and burning, more often this occurs after a bowel movement or as a result of eating spicy food. When examined by a doctor, a dense and edematous node is revealed.
• Gradually, the symptoms intensify, reddening of the skin around the anus occurs, swelling of the tissues increases. Palpation is not possible due to severe pain.
• After that, the inflammatory process covers neighboring tissues and subcutaneous tissue. As a result, the skin in the anal area acquires a burgundy or cyanotic hue. Often an infiltrate is felt, inside which a dense formation is found. In the later stages, necrotic areas are determined.

In men, one of the complications of external hemorrhoids can be prostatitis . With large hemorrhoids, there is a risk of impaired blood flow in the pelvic area, which leads to atrophy of the prostate tissue. Many experts note the relationship of the two diseases, since only a small septum of connective tissue separates the prostate and rectum. Therefore, even in the presence of external “bumps” the risk of prostatitis is quite high.

Untreated external hemorrhoids

A few initial symptoms that indicate we may have a problem with external hemorrhoids include itching, a nagging feeling around the anus, as well as swelling and pain. If left untreated, the condition can worsen and develop into a thrombosis of the external hemorrhoids, which is a large and extremely painful bulge containing blood clots.

In some cases, an external hemorrhoid can become thrombosed, which is when a blood clot blocks blood flow to the hemorrhoid and causes an acutely painful hard bulge or lump around the anus. Although thrombosis is not a dangerous condition, it can cause excessive swelling around the anus and severe pain. Although external hemorrhoid thrombosis can cause inflammation, it does not cause fever. If we have a fever along with pain and swelling in the anus, we are more likely to have a perianal abscess.

If external hemorrhoid thrombosis is detected early enough, your doctor may be able to prick the nodules and dry them to relieve pain. Otherwise, the clot usually breaks up within a week or two and symptoms resolve without further intervention. Over-the-counter medications can help you manage your pain while you wait for the thrombosis of external hemorrhoids to improve.

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External hemorrhoids – diagnosis

Common symptoms of external hemorrhoids include itching, pain, a feeling of swelling or lump in the rectum, and bleeding. Diagnosis is made on the basis of an interview and physical examination. Your history may focus on related symptoms including constipation, hard bowel movements, and straining to go to the toilet. Other questions may be about other causes of rectal bleeding, including tumors, inflammatory bowel disease, and gastrointestinal bleeding.

A physical examination is performed to confirm a diagnosis and includes a rectal examination (digital rectal examination), where your finger is for any abnormal lumps or lumps. Interestingly, internal hemorrhoids are usually not palpable. Rectal examination may be postponed in the event of severe pain or swelling. In addition, hemorrhoids and constipation can be associated with anal fissures or cracks in the skin surrounding the anus. The associated pain and spasm make rectal examination very uncomfortable.

If a healthcare professional is concerned that symptoms, especially rectal bleeding, cannot be explained by hemorrhoids, an anoscopy may be considered. Anoscopy is an in-office procedure that uses a short, stiff speculum that allows you to look at the anus. A sigmoidoscopy or colonoscopy may be ordered if there is concern that the bleeding is coming from other areas of the colon. These treatments are usually performed by a gastroenterologist or surgeon.

Depending on the situation, blood tests may be ordered. In case of excessive bleeding, the level of hemoglobin or red blood cells may be checked. If you are taking warfarin, an INR (international normalized ratio) test or a PT (prothrombin time) test may be ordered to check if your blood is “thinning” properly. Keep in mind that there are many newer anticoagulants that ‘thin’ the blood and their activity cannot be measured by routine blood tests.

External hemorrhoids – treatment

The best way to treat hemorrhoids is to reduce the likelihood of their occurrence in the first place. For example, a healthy diet rich in fiber and drinking plenty of fluids can help. Try to avoid sitting for long periods, taking regular stretching breaks, or include exercise in our daily routine if this is no longer normal activity for us. Exercise reduces the pressure on the veins in the rectum and prevents constipation.

Unfortunately, once an external hemorrhoid has formed, it most likely won’t go away on its own. However, there are still many different treatment options for external hemorrhoids that either ease the symptoms of the hemorrhoids or address the problem entirely.

You can temporarily ease the symptoms of hemorrhoids on your own with over-the-counter topical creams, as well as natural remedies such as apple cider vinegar and witch hazel. Try, for example, HEMOpran – cream for hemorrhoids. Keep in mind that home treatment and positive lifestyle changes can reduce haemorrhoid recurrences, but symptoms are unlikely to completely disappear without professional treatment under the supervision of an experienced physician. Seeing a doctor is essential to either tackle the underlying causes of hemorrhoidal exacerbations or treat advanced tumors such as Stage IV hemorrhoids.

Sitz baths will be effective in relieving the symptoms of hemorrhoids. At Medonet Market, you can buy a special mixture of herbs for hemorrhoids for siphons, thanks to which you will reduce swelling and pain associated with hemorrhoids. Proper hygiene is also important, which can be supported by Anusir rectal cleansing foam.

Here are the three most common but invasive hemorrhoids treatment options:

1. A hemorrhoidectomy is a type of hemorrhoid surgery used to remove hemorrhoids. The procedure usually includes fasting, sedation, and metal clamps to assist with surgical removal of the affected tissue. Since surgery has a high complication rate and long downtime, it is often a last resort reserved for extreme cases of hemorrhoids.
2. Photon Coagulation (IRC) – IRC is the process by which infrared light creates scarring around the nodules to cut off the blood supply and reduce the tissue affected. Patients may experience pain or a burning sensation during surgery, especially when treating larger or more advanced nodules. Overall, IRC therapy requires multiple treatments, with 90 days between visits.
3. sclerotherapy consists in injecting appropriate substances into the affected tissue, which causes its contraction. Because sclerotherapy carries a higher risk of complications than most other treatment options, it is not widely used in the treatment of external hemorrhoids. Sclerotherapy is often followed by ulceration, excessive pain, and bleeding for several days, so it is usually best to consider safer and more comfortable treatments first.

Disease prevention

Pathology prevention is of key importance. With its help, you can avoid relapses and prevent the development of hemorrhoids in the presence of provoking factors. The main recommendations of experts:

• Stick to the right diet. Include fiber in your diet, drink more water, avoid too fatty or spicy foods.
• Give up alcohol. The abuse of alcoholic beverages can lead to disruption of the blood vessels and stagnation of blood in the pelvic area. And this is the main reason for the development of hemorrhoids.
• Lead an active lifestyle. Avoid prolonged sitting at the computer, do morning exercises, include walks or workouts in your daily routine.
• Normalize the routine of going to the toilet. Defecation should occur daily, preferably in the morning. The stool should pass without difficulty, so if you have problems with bowel movements, it is worth consulting with your doctor and learning about possible ways to normalize the stool.
• Follow intimate hygiene. After going to the toilet, clean the anal area with a damp paper or do a hygienic shower.

It is best if you visit a coloproctologist at least once a year. This will allow you to identify external hemorrhoids in the early stages and choose the most gentle treatment. If you are faced with signs of the disease, especially in an acute form, then be sure to make an appointment with a doctor!