Managing Discomfort from Hemorrhoids: Effective Treatment Options

The sensation of a foreign body caused by hemorrhoids can lead to discomfort, and you may be seeking solutions to address this issue?

Hello, Dr.
Ke.
Let me explain my situation.
I have mixed hemorrhoids, and I treated three internal hemorrhoids using the ligation method in mid-July to August of this year.
One of them seemed to have a failed ligation, so I went for another ligation at the end of October.
Currently, when I go to the bathroom, the external hemorrhoids protrude.
I can feel one that is larger and another that is smaller; I assume the smaller one is an internal hemorrhoid.
After bowel movements, they retract on their own, but I often feel a sensation of foreign body presence, which is uncomfortable.
I might be more sensitive personally, and sometimes I feel quite irritated and want a definitive solution.
Additionally, I currently have bowel movements almost every day and try to avoid excessive straining and prolonged sitting.
I have a few questions, and I hope Dr.
Ke can answer them.
Thank you!
Q1: If I go for an outpatient procedure to treat the external hemorrhoids using "electrocautery," are there any potential side effects?
Q2: If I decide to undergo traditional surgical intervention, are there any potential side effects? I am very concerned about the risks of anal stenosis and incontinence.
Q3: Given my current symptoms, are there any other recommended treatment options?

Kuaizhe, 20~29 year old female. Ask Date: 2016/11/22

Dr. Ke Fangxu reply Surgery

1.
External hemorrhoids are defined as hemorrhoidal tissue located outside the dentate line, meaning that external hemorrhoids do not retract into the anal canal.
Therefore, what you perceive as external hemorrhoids may not actually be external hemorrhoids, and it cannot be treated solely with electrocautery.

2.
The likelihood of developing anal stenosis or incontinence as a complication from traditional surgery is very low.
These complications typically arise from complex fistula surgeries or inexperienced surgeons.
Generally, after surgery, patients may only experience pain and bleeding for one to two weeks.
3.
Based on your description, the symptoms do not appear to be severe.
I personally recommend conservative treatment.

Reply Date: 2016/11/22

More Info

Managing discomfort from hemorrhoids, especially when dealing with mixed hemorrhoids, can be challenging. Your situation, involving both internal and external hemorrhoids, is not uncommon, and it's understandable that you're seeking effective treatment options. Let's address your questions and provide some insights into managing your condition.

Q1: If I opt for outpatient surgery to treat the external hemorrhoid using "electrocautery," are there any potential side effects?
Electrocautery is a common method for treating external hemorrhoids. While it can be effective, there are potential side effects to consider. Common side effects include:
1. Pain and Discomfort: Post-procedure pain is common, but it usually subsides within a few days. Over-the-counter pain relief can help manage this.

2. Bleeding: Some bleeding is expected, especially in the first few days after the procedure. However, if bleeding is excessive or persistent, you should contact your healthcare provider.

3. Infection: As with any surgical procedure, there is a risk of infection. Keeping the area clean and following your doctor's post-operative care instructions can help minimize this risk.

4. Skin Changes: The area treated may experience changes in pigmentation or texture, which can be temporary or, in rare cases, permanent.

5. Recurrence: While electrocautery can provide relief, it does not guarantee that hemorrhoids will not return. Lifestyle changes and ongoing management may be necessary.

Q2: If I consider traditional surgical options, are there any potential side effects?
Traditional surgical options for hemorrhoids, such as hemorrhoidectomy, can be more invasive than electrocautery. Potential side effects include:
1. Pain: This is often more significant than with less invasive procedures and may require stronger pain management.

2. Bleeding: Similar to electrocautery, there is a risk of bleeding, particularly in the first few days post-surgery.

3. Infection: The risk of infection is present, and proper wound care is essential.

4. Anal Stenosis: This is a concern with any surgical intervention in the anal area. It occurs when scar tissue forms and narrows the anal canal, potentially leading to difficulties with bowel movements.

5. Incontinence: While rare, there is a risk of nerve damage during surgery that could lead to fecal incontinence. Discussing this risk with your surgeon is crucial.

6. Recurrence: As with electrocautery, there is a possibility that hemorrhoids may recur after surgery.

Q3: Given my current symptoms, what other treatment options do you recommend?
In addition to surgical options, there are several non-surgical treatments that may help manage your symptoms:
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Consider incorporating more fruits, vegetables, and whole grains into your diet.

2. Hydration: Drinking plenty of water can help prevent constipation and promote regular bowel movements.

3. Topical Treatments: Over-the-counter creams and ointments can provide temporary relief from itching and discomfort. Look for products containing hydrocortisone or witch hazel.

4. Warm Baths: Soaking in a warm bath (sitz bath) can help relieve discomfort and promote healing.

5. Lifestyle Modifications: Avoid prolonged sitting on the toilet, and try to establish a regular bowel routine. If you feel the urge to go, do so promptly to avoid straining.

6. Medications: If you're experiencing significant pain or discomfort, your doctor may recommend medications to help manage your symptoms.

7. Consultation with a Specialist: If your symptoms persist or worsen, consider seeking a consultation with a colorectal specialist who can provide tailored advice and treatment options based on your specific situation.

In conclusion, managing hemorrhoids effectively often requires a combination of lifestyle changes, non-surgical treatments, and, if necessary, surgical interventions. It's essential to have an open discussion with your healthcare provider about the risks and benefits of each treatment option to determine the best course of action for your individual needs.

Similar Q&A

Effective Treatments for Prolapsed Hemorrhoids: A Guide

Hello doctor, I have a history of hemorrhoids. In the past, I only used topical medications and warm sitz baths, and I didn't have any major issues. However, recently, due to work, I have to stand for over ten hours a day, and I have been experiencing diarrhea for the past t...

Dr. Ke Fangxu reply Surgery
For hemorrhoids that are prolapsed and cannot be pushed back in, the most effective treatment is surgical removal. While conservative treatments can alleviate discomfort and bleeding symptoms, surgery is the only option if improvement of the prolapse is desired.

Managing Hemorrhoids: Symptoms, Treatments, and Lifestyle Factors

Hello, doctor. Recently, after using the restroom, my hemorrhoids have been protruding and are difficult to push back in. I also experience pain during bowel movements and have noticed external hemorrhoids (which I didn't have before). Will applying ointment and taking warm ...

Dr. Ke Fangxu reply Surgery
Topical ointments combined with warm sitz baths can provide some improvement; however, it is still important to avoid constipation and prolonged straining during bowel movements. If there is no improvement or if symptoms worsen, medical consultation should be sought to consider s...

Understanding Post-Anal Intercourse Discomfort: Hemorrhoids or Tears?

After anal intercourse, if you are experiencing persistent swelling and warmth in the anus, along with a constant urge to have a bowel movement but only producing white mucous discharge, this could be indicative of either hemorrhoids or a tear. The discomfort you are feeling, mak...

Dr. Xu Kaixi reply Surgery
The normal function of the anal mucosa is to serve as the surface for the transportation and storage of feces in the colon. When substances other than feces come into contact with this mucosa, it may lead to mucosal damage, triggering an inflammatory response that results in swel...

Understanding Anal Pain: Treatment Options for Hemorrhoids and Relief

Hello, doctor. In the past, after having a bowel movement, I would notice several soft lumps that I could push back in. Recently, these lumps have become hard and swollen, causing pain that prevents me from sleeping well at night. Could you please advise how many days of sitz bat...

Dr. Ke Fangxu reply Surgery
Based on your description, it seems you may have acute thrombosed hemorrhoids. Using topical ointments and warm sitz baths should gradually alleviate your symptoms. If the affected area is small, you should start to feel better within 1-2 weeks. However, if the thrombosed hemorrh...