Recurring Acute External Hemorrhoids: Causes and Solutions

Acute external hemorrhoids

Dear Director Ke,
A few months ago, I discovered a lump in my anal area (flesh-colored, slightly painful).
After examination, the doctor diagnosed it as acute external hemorrhoids and prescribed me a topical medication, suggesting that it would resolve in a few days (that it would heal on its own without the ointment).
The lump did indeed disappear afterward, but it has been recurring, which is quite bothersome.
Here are a few points regarding my situation:
1.
After bowel movements, I often notice that the external hemorrhoid has swollen again, but it reduces in size after a while.
2.
If I experience diarrhea, the swelling lasts for 1 to 2 days (I apply the prescribed ointment when I feel discomfort), and then it resolves on its own.
3.
Currently, aside from the lump, there are no other abnormal symptoms.
Therefore, I would like to ask the following questions:
1.
What could be the reasons for the recurring episodes (could it be related to my regular jogging)?
2.
Is there a way to completely cure my condition? Would surgical removal be recommended?
3.
What methods do you suggest for alleviating the symptoms?
Thank you very much for your response, Director Ke.

Mr. Chen, 40~49 year old female. Ask Date: 2020/07/19

Dr. Ke Fangxu reply Surgery

1.
It is not related to jogging but is related to diarrhea.

2.
To address the swelling of hemorrhoids, one should first improve the issue of diarrhea while also shortening the time spent on bowel movements.
If there is still no improvement, then consider surgery.

3.
Based on your description, it seems more like irritable bowel syndrome leading to hemorrhoid swelling.
It is recommended to maintain a light diet and a good lifestyle routine.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be helpful.
If symptoms persist without improvement, you may consult a physician for medication or undergo a colonoscopy.

Reply Date: 2020/07/19

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding recurring acute external hemorrhoids. I understand how frustrating and uncomfortable this condition can be, and I’m here to provide you with some insights and recommendations based on your situation.

Understanding Acute External Hemorrhoids
Acute external hemorrhoids are swollen veins located around the anus that can become inflamed and painful. They often occur due to increased pressure in the lower rectum, which can be caused by various factors, including straining during bowel movements, prolonged sitting, and even physical activities like running. The symptoms you describe, such as the appearance of a lump after bowel movements and the swelling associated with diarrhea, are common in cases of external hemorrhoids.

Possible Causes of Recurrence
1. Straining During Bowel Movements: This is one of the most common causes of hemorrhoids. If you experience constipation or have to strain to pass stools, this can lead to increased pressure on the veins in the anal area, causing them to swell.

2. Diarrhea: As you noted, episodes of diarrhea can also contribute to the irritation and swelling of hemorrhoids. Frequent bowel movements can lead to inflammation and discomfort.

3. Physical Activity: While regular exercise, such as jogging, is generally beneficial for overall health and can help prevent constipation, excessive or improper exercise can sometimes exacerbate hemorrhoidal symptoms, especially if it involves heavy lifting or straining.

4. Dietary Factors: A diet low in fiber can lead to constipation, which in turn can cause hemorrhoids. Ensuring adequate fiber intake can help maintain regular bowel movements and reduce straining.

Treatment Options
1. Conservative Management: Since your symptoms seem to resolve with the use of topical treatments like the ointment prescribed, continuing with conservative management is advisable. Over-the-counter creams and ointments can provide relief from pain and swelling.

2. Dietary Changes: Increasing your fiber intake through fruits, vegetables, and whole grains can help prevent constipation and reduce the likelihood of straining during bowel movements. Staying well-hydrated is also crucial.

3. Sitz Baths: Taking warm sitz baths can help soothe the area and reduce discomfort. This can be done several times a day, especially after bowel movements.

4. Avoiding Strain: When you feel the urge to have a bowel movement, try not to delay it. Also, avoid straining during bowel movements. If you are constipated, consider using a stool softener or a mild laxative after consulting with your healthcare provider.

Surgical Options
If your symptoms persist despite conservative measures, or if you experience significant pain or complications, surgical options may be considered. Procedures such as rubber band ligation, sclerotherapy, or even hemorrhoidectomy may be recommended based on the severity and frequency of your symptoms. A thorough evaluation by a colorectal specialist can help determine the best course of action.

Conclusion
In summary, recurring acute external hemorrhoids can be managed effectively with lifestyle modifications, dietary changes, and topical treatments. If your symptoms continue or worsen, I recommend consulting with a healthcare provider who specializes in gastrointestinal health for a more comprehensive evaluation and potential treatment options.

Please feel free to reach out if you have any further questions or concerns. Your health and comfort are important, and I wish you the best in managing your condition.

Best regards,
Doctor Q&A Teams

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