Managing External Hemorrhoids: Symptoms, Treatment, and Recovery Tips

External hemorrhoidal bleeding

Hello Doctor, I have been aware of my external hemorrhoids for several years without any issues.
Recently, I started experiencing swelling and pain, which is tolerable.
After about three days of exercise, I noticed a small amount of bleeding.
The pain significantly decreased after the bleeding occurred.
Since then, my bowel movements have not had blood in the stool, but when I apply pressure to the external hemorrhoid with toilet paper, there is still a small amount of bright red blood.
What should I do about this? How long might the bleeding last? I usually cycle and do weight training; should I pause these activities for now? (The appearance seems to be connective tissue external hemorrhoids.) Thank you.

Nìngmíng, 30~39 year old female. Ask Date: 2019/04/17

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths should help alleviate symptoms, and you can purchase hemorrhoid suppositories at the pharmacy for use.
Most symptoms should resolve within a week.
It is best to avoid using stool softeners indiscriminately.
It is advisable to stop heavy lifting to prevent increased pressure on the anal area, which could worsen swelling and pain.
If you are cycling and not sitting for long periods, it should be fine.
However, if bleeding persists, it is best to consult a physician for evaluation.

Reply Date: 2019/04/17

More Info

Managing external hemorrhoids can be a challenging yet manageable condition. External hemorrhoids are swollen veins located around the anus, and they can cause discomfort, pain, and bleeding, especially during bowel movements. Given your description of symptoms, it’s essential to understand the nature of your condition and the appropriate steps for treatment and recovery.

Symptoms of External Hemorrhoids
The symptoms you are experiencing, such as swelling, pain, and occasional bleeding, are common with external hemorrhoids. The pain often decreases after a bowel movement, especially if there is a small amount of bleeding, as you noted. The presence of fresh blood on toilet paper can be alarming, but it is typically a sign of irritation or minor trauma to the hemorrhoid rather than a severe condition.

Treatment Options
1. Home Care:
- Warm Baths: Soaking in warm water for 10-15 minutes several times a day can help reduce swelling and relieve pain.

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

- Cold Compresses: Applying a cold pack to the affected area can help reduce swelling and numb the pain.

2. Dietary Changes:
- Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements, which is crucial for preventing further irritation of the hemorrhoids.

- Staying hydrated is equally important, as it helps maintain soft stools.

3. Avoid Straining:
- It’s vital to avoid straining during bowel movements, as this can exacerbate the condition. If you feel the urge to go, try not to delay it.

4. Activity Modifications:
- Given your regular activities like cycling and weight training, you may want to temporarily reduce or modify these exercises. Activities that put pressure on the pelvic area can aggravate hemorrhoids. Consider low-impact exercises like walking or swimming during recovery.

Recovery Tips
- Monitor Symptoms: Keep an eye on your symptoms. If the bleeding continues for more than a few days, or if you experience severe pain, it’s essential to consult a healthcare professional.

- Avoid Prolonged Sitting: If your job or activities require long periods of sitting, take breaks to stand and move around to relieve pressure on the affected area.

- Use Soft Toilet Paper: Gentle wiping can prevent further irritation. Consider using moist wipes designed for sensitive skin.

When to Seek Medical Attention
If you notice any of the following, it’s crucial to seek medical advice:
- Persistent bleeding that does not resolve after a few days.

- Severe pain that does not improve with home treatments.

- Signs of infection, such as increased redness, swelling, or discharge.

Conclusion
While external hemorrhoids can be uncomfortable and sometimes painful, they are generally manageable with proper care and lifestyle adjustments. Your symptoms suggest a mild case, especially since the bleeding is minimal and has decreased. However, if symptoms persist or worsen, do not hesitate to consult a healthcare provider for further evaluation and treatment options. They may recommend additional treatments, such as rubber band ligation or other procedures, if necessary. Remember, maintaining a healthy lifestyle and being proactive about your symptoms can significantly aid in recovery and prevent future occurrences.

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