Internal and External Hemorrhoids: Treatment Options - Surgery

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When it comes to understanding hemorrhoids, both internal and external types can cause significant discomfort and may require different treatment approaches. Hemorrhoids are swollen veins in the lower rectum and anus, and they can be classified as either internal (inside the rectum) or external (under the skin around the anus).
In the case of a bedridden patient who has developed a lump near the anus that appears dark, it is essential to first determine whether this is indeed an external hemorrhoid or another condition, such as a thrombosed hemorrhoid or even a more serious issue like a skin infection or malignancy. The dark coloration could indicate a thrombosis (a clot within the hemorrhoid), which can be quite painful and may require specific treatment.

For external hemorrhoids, conservative treatments often include over-the-counter medications such as topical creams or suppositories, like the "宜痔平栓劑" mentioned. These products typically contain ingredients that can help reduce inflammation, relieve pain, and promote healing. However, while these treatments can alleviate symptoms, they may not resolve the underlying issue if the hemorrhoid is thrombosed or significantly enlarged.

If the lump is indeed a thrombosed external hemorrhoid, the patient may experience severe pain and swelling. In such cases, a healthcare provider may recommend a procedure to remove the clot, which can provide immediate relief. This is usually done under local anesthesia and is a relatively simple outpatient procedure.

In more severe cases, or if there is any suspicion of complications (such as infection or malignancy), surgical intervention may be necessary. This could involve a hemorrhoidectomy, where the hemorrhoids are surgically removed. However, this is typically reserved for cases where conservative measures have failed or if the hemorrhoids are particularly large or symptomatic.

Given that the patient has been bedridden for an extended period, it is also important to consider factors such as hygiene and the potential for skin irritation or infection around the anal area. Maintaining cleanliness and using barrier creams can help prevent further complications.

In summary, while the topical treatment may provide some relief for external hemorrhoids, it is crucial to have a healthcare professional evaluate the lump to determine the appropriate course of action. If the condition does not improve or worsens, further medical evaluation and possibly surgical intervention may be warranted. It is always best to consult with a healthcare provider for a proper diagnosis and treatment plan tailored to the patient's specific situation.