External Hemorrhoids: Symptoms, Treatment, and Causes

Inquiry about external hemorrhoids?

Hello, Dr.
Ko: Recently, I have been experiencing significant pain in my anus, and I can feel a lump near the anal opening.
After visiting a colorectal surgeon, I was diagnosed with an external hemorrhoid and advised to use topical medication and suppositories without surgery, with an expectation of improvement in about one to two weeks.
After two days of treatment, the pain has decreased, but since this is my first experience with external hemorrhoids, I still have some questions.

1.
Will the lump near my anus (external hemorrhoid?) go down? Although the pain has eased somewhat, I can still feel the external hemorrhoid when applying the medication.

2.
In the days leading up to the flare-up, I experienced diarrhea and had to wipe my anus frequently with toilet paper.
Could this be the reason for my external hemorrhoid flare-up? Thank you!

Xiao Zhi, 40~49 year old female. Ask Date: 2020/02/20

Dr. Ke Fangxu reply Surgery

1.
If it is a thrombosed external hemorrhoid, it will resolve but may leave behind a small tag of excess skin.
2.
The cause of the flare-up is likely diarrhea rather than friction, as frequent bowel movements can lead to thrombosis formation.

Reply Date: 2020/02/20

More Info

External hemorrhoids, commonly referred to as "piles," are swollen veins located around the anus and lower rectum. They can cause significant discomfort and pain, particularly during bowel movements or when sitting. Understanding the symptoms, treatment options, and potential causes of external hemorrhoids can help manage and alleviate the condition effectively.

Symptoms of External Hemorrhoids
The primary symptoms associated with external hemorrhoids include:
1. Pain and Discomfort: This is often the most distressing symptom. The pain can be sharp and is typically exacerbated during bowel movements or prolonged sitting.

2. Swelling: A lump or swelling near the anus may be felt, which is the swollen vein. This lump can be sensitive to touch and may cause discomfort when sitting.

3. Bleeding: Although less common with external hemorrhoids than with internal ones, some individuals may notice blood on the toilet paper or in the toilet bowl after a bowel movement.

4. Itching or Irritation: The area around the anus may become itchy or irritated, which can lead to further discomfort.

Treatment Options
Treatment for external hemorrhoids often begins with conservative measures. Here are some common approaches:
1. Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone or witch hazel can help reduce inflammation and relieve pain. Your doctor may have prescribed a specific topical medication for you.

2. Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help soothe the area and reduce swelling.

3. Pain Relievers: Non-prescription pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort.

4. Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements, which is a common trigger for hemorrhoids.

5. Avoiding Strain: It's important to avoid straining during bowel movements, as this can exacerbate the condition. If you're experiencing constipation, consider using a stool softener.

In more severe cases, if conservative treatments do not provide relief, medical procedures such as rubber band ligation, sclerotherapy, or surgical removal may be considered.

Causes of External Hemorrhoids
Several factors can contribute to the development of external hemorrhoids:
1. Straining During Bowel Movements: This is one of the most common causes. Straining can occur due to constipation or diarrhea, as you mentioned experiencing diarrhea prior to your symptoms.

2. Prolonged Sitting: Sitting for extended periods, especially on the toilet, can increase pressure on the veins in the anal area.

3. Pregnancy: The increased pressure from the growing uterus and hormonal changes can lead to the development of hemorrhoids.

4. Obesity: Excess weight can put additional pressure on the pelvic veins.

5. Heavy Lifting: Regularly lifting heavy objects can increase abdominal pressure, contributing to the formation of hemorrhoids.

Addressing Your Concerns
1. Will the Swelling Go Down?: Yes, with appropriate treatment and lifestyle changes, the swelling associated with external hemorrhoids can decrease over time. It may take a few weeks for the lump to fully resolve, especially if you are following your doctor's recommendations for treatment.

2. Could Wiping Cause the Hemorrhoids?: Yes, excessive wiping, especially after diarrhea, can irritate the anal area and contribute to the development of hemorrhoids. It's essential to be gentle and consider using moist wipes or a bidet to minimize irritation.

In conclusion, while external hemorrhoids can be uncomfortable and painful, they are manageable with proper care and treatment. If symptoms persist or worsen, it is crucial to follow up with your healthcare provider for further evaluation and management.

Similar Q&A

Understanding External Hemorrhoids: Symptoms, Treatment, and Concerns

Hello Doctor, I am 17 years old. Two months ago, due to exam and assignment stress, I was only sleeping one hour a day, which led to constipation and severe rectal bleeding. I subsequently underwent a rectal examination at Wan Fang Hospital, where I was diagnosed with an internal...

Dr. Ke Fangxu reply Surgery
Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding. The common causes are often constipation or diarrhea. Sometimes, polyps may develop at the edges of the fissure, which ...

Understanding External Hemorrhoids: Causes, Symptoms, and Treatment Options

Hello doctor, about a year ago I experienced anal pain and consulted a physician who diagnosed me with external hemorrhoids. After treatment, I was given medication to apply at home. Now, I can feel two small soft lumps at the anal opening that have remained external and do not r...

Dr. Hou Yongji reply Surgery
Hello: 1. Based on your description, it may be an external hemorrhoid, but a diagnosis cannot be made solely from the written description. Please consult a colorectal specialist for an accurate diagnosis. 2. Please refer to our hospital's educational materials, and I wish yo...

Understanding External Hemorrhoids: Treatment Options and Concerns

Hello Dr. Ke: In early June of this year, I discovered a growth near my anus while showering. It is a painless, non-itchy lump that does not bleed. After a few days, it seemed to swell slightly, and I could feel its presence. I then made an appointment at Shihpai Veterans Gener...

Dr. Ke Fangxu reply Surgery
External hemorrhoids are classified into two types. One type is acute thrombosed external hemorrhoids, which occur due to the formation of a blood clot within the hemorrhoidal tissue. If the clot is not too large, this type of external hemorrhoid typically resolves within about a...

Understanding Hemorrhoids: Symptoms, Treatment Options, and Relief

Hello Doctor: I have developed hemorrhoids around my anus, and every time I have a bowel movement, they protrude. At first, I could push them back in with my hand, but recently, they can no longer be fully reinserted, and they seem to be getting larger. To make matters worse, I h...

Dr. Lin Kecheng reply Surgery
Hello, Xiaoyun: Hemorrhoids can generally be classified into three types: internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids. Internal hemorrhoids are painless but may cause bleeding. External hemorrhoids are located outside the anal opening and can cause pain and ...