Hemorrhoids: Causes, Treatments, and Recovery Time

Hemorrhoid issues

Hello, Doctor.
Three years ago, I had a colonoscopy due to blood in my stool, and the doctor diagnosed me with hemorrhoids.
Later, I experienced blood in my stool again, and the doctor performed a digital examination, confirming the presence of internal hemorrhoids.
Recently, I noticed a lump at the anal opening (which has swollen before but resolved on its own).
This time, it has been swollen for over a week and hasn't gone down.
I remembered that the doctor had prescribed a topical ointment for hemorrhoids, which I hadn't finished using.
After applying it for three days, the pain has significantly decreased, but I don't feel any reduction in swelling.
I would like to ask the doctor a few questions and seek treatment recommendations:
1.
How can internal hemorrhoids cause swelling at the anal opening?
2.
Is there a recommended duration for using the hemorrhoid ointment?
3.
How long does it typically take for hemorrhoids to resolve, and could they lead to other anal conditions?

W, 20~29 year old female. Ask Date: 2019/04/09

Dr. Ke Fangxu reply Surgery

1.
This phenomenon is more akin to thrombosed external hemorrhoids, but severe swelling may also lead to prolapse outside the anus.

2.
There are no specific contraindications, but it is generally advised not to use it long-term.

3.
In cases of acute hemorrhoidal swelling, it typically resolves within 2 to 4 weeks.
However, internal hemorrhoids or rectal mucosal prolapse may not necessarily shrink or disappear.
Chronic hemorrhoidal prolapse can potentially damage the function of the sphincter muscle, affecting anal contraction.

Reply Date: 2019/04/09

More Info

Hemorrhoids, commonly known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two main types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Understanding the causes, treatments, and recovery time associated with hemorrhoids is essential for effective management and prevention of complications.

Causes of Hemorrhoids
Hemorrhoids can develop due to increased pressure in the lower rectum, which can be caused by several factors, including:
1. Straining during bowel movements: This is often due to constipation or diarrhea, leading to increased pressure on the veins in the rectal area.

2. Pregnancy: The weight of the fetus can put pressure on the pelvic blood vessels, leading to hemorrhoids.

3. Obesity: Excess weight can increase pressure on the pelvic veins.

4. Sedentary lifestyle: Prolonged sitting can contribute to the development of hemorrhoids.

5. Aging: As people age, the tissues supporting the veins in the rectum and anus can weaken.

Symptoms
Common symptoms of hemorrhoids include:
- Pain or discomfort, especially during bowel movements.

- Bleeding during bowel movements, which may appear as bright red blood on toilet paper or in the toilet bowl.

- Swelling or a lump near the anus.

- Itching or irritation in the anal region.

Treatment Options
Treatment for hemorrhoids can vary based on the severity of the condition:
1. Conservative Measures:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining.

- Hydration: Drinking plenty of water can aid in digestion and prevent constipation.

- Over-the-Counter Medications: Creams and ointments, such as those containing hydrocortisone or witch hazel, can relieve itching and discomfort.

2. Medical Treatments:
- Rubber Band Ligation: A procedure where a rubber band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: An injection of a solution into the hemorrhoid to shrink it.

- Infrared Coagulation: A procedure that uses infrared light to cut off blood supply to the hemorrhoid.

3. Surgical Options: In severe cases, surgical procedures such as hemorrhoidectomy (removal of hemorrhoids) may be necessary.

Recovery Time
The recovery time for hemorrhoids can vary based on the treatment method used. For conservative treatments, symptoms may improve within a few days to weeks. Surgical recovery can take longer, typically a few weeks, and may involve some discomfort during the healing process.

Addressing Your Concerns
1. Why Internal Hemorrhoids Might Swell: Internal hemorrhoids can protrude through the anal opening, especially if they become thrombosed (a blood clot forms inside them) or if there is significant straining. This can lead to swelling and discomfort.

2. Duration of Use for Medications: While topical treatments like the ointment you mentioned can be effective, they should be used as directed by your physician. Prolonged use without medical supervision may lead to skin irritation or other complications.

3. Duration for Swelling to Resolve: The time it takes for hemorrhoids to shrink can vary. Generally, with appropriate treatment, mild cases may resolve within a week or two. However, if the swelling persists beyond this period or worsens, it is crucial to consult your healthcare provider to rule out other conditions or consider alternative treatments.

Conclusion
In summary, hemorrhoids are a common condition that can cause significant discomfort but are generally manageable with lifestyle changes and medical treatments. If you experience persistent symptoms or complications, it is essential to seek medical advice for a tailored treatment plan. Regular follow-ups with your healthcare provider can help monitor your condition and prevent further issues.

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