Managing External Hemorrhoids: Treatment Options and Recovery Time - Surgery

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External hemorrhoid swelling


Hello doctor, I have been experiencing some swelling and pain from external hemorrhoids.
After an examination by a specialist, I was told that surgery is not necessary and was prescribed an ointment to apply.
Will this be sufficient to reduce the swelling of the external hemorrhoids, and how long might it take?

Niming, 20~29 year old female. Ask Date: 2018/11/01

Dr. Ke Fangxu reply Surgery


If external hemorrhoids are swollen without thrombosis, applying ointment for about 3-5 days will usually lead to healing.
In the case of thrombosed external hemorrhoids, depending on their size, it may take about 2-4 weeks for them to resolve.
Taking warm sitz baths can help accelerate symptom improvement.

Reply Date: 2018/11/01

More Info


Managing external hemorrhoids can be a challenging experience, but with the right treatment and care, most patients can expect significant relief. External hemorrhoids are swollen veins located around the anus, and they can cause discomfort, pain, and sometimes bleeding. The treatment options for external hemorrhoids vary depending on the severity of the condition and the symptoms experienced by the patient.

In your case, since the specialist has recommended a topical ointment rather than surgery, it suggests that your external hemorrhoids are likely not severe enough to warrant surgical intervention. Topical treatments, such as ointments or creams, often contain ingredients like hydrocortisone or witch hazel, which can help reduce inflammation and alleviate pain. These medications work by soothing the affected area, reducing swelling, and providing relief from itching or discomfort.

The effectiveness of the ointment in reducing swelling and pain can vary from person to person. Generally, patients may start to notice improvement within a few days of consistent application. However, complete resolution of symptoms may take one to two weeks, depending on the severity of the hemorrhoids and individual healing responses. It is essential to follow the instructions provided by your healthcare provider regarding the frequency and method of application for optimal results.

In addition to topical treatments, there are several self-care measures that can help manage symptoms and promote healing. These include:
1. Warm Sitz Baths: Soaking in warm water for about 15-20 minutes several times a day can help relieve pain and reduce swelling. This can be particularly soothing after bowel movements.

2. Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements, which can exacerbate hemorrhoids. Staying well-hydrated is also crucial.

3. Avoiding Straining: It is important to avoid prolonged sitting on the toilet and straining during bowel movements, as this can worsen hemorrhoids.

4. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help manage pain and discomfort.

5. Lifestyle Modifications: Regular exercise and avoiding prolonged periods of sitting can help improve circulation and reduce the risk of developing further hemorrhoids.

If you find that your symptoms do not improve with the topical treatment and self-care measures, or if they worsen, it is essential to follow up with your healthcare provider. They may consider other treatment options, such as rubber band ligation or sclerotherapy, which are minimally invasive procedures that can provide relief for more severe cases.

In summary, while the topical ointment prescribed by your specialist can be effective in reducing swelling and discomfort associated with external hemorrhoids, it is essential to combine this treatment with self-care measures for the best results. Typically, you can expect to see improvement within a week or two, but individual experiences may vary. If symptoms persist or worsen, further evaluation and treatment may be necessary.

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