External Hemorrhoids: Symptoms, Treatments, and Surgery Options - Surgery

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External hemorrhoids, commonly referred to as external piles, are swollen veins located around the anus and lower rectum. They can cause discomfort, pain, and bleeding, particularly during bowel movements. The symptoms often include itching, irritation, and the presence of a lump near the anus. In your case, the mention of a "little white spot" on the external hemorrhoid could indicate several possibilities, including a thrombosed hemorrhoid, which occurs when a blood clot forms in the swollen vein, or it could be a sign of skin irritation or a small fissure.

When it comes to treatment, the first line of action usually involves conservative measures. These can include over-the-counter topical treatments, such as creams or ointments that contain hydrocortisone or witch hazel, to reduce inflammation and discomfort. Additionally, lifestyle changes such as increasing fiber intake, staying hydrated, and avoiding straining during bowel movements can help alleviate symptoms and prevent further irritation.

If conservative treatments do not provide relief, or if the hemorrhoid is particularly painful or large, surgical options may be considered. The most common surgical procedures for external hemorrhoids include:
1. Hemorrhoidectomy: This is a surgical procedure where the hemorrhoid is excised. It is typically performed under local or general anesthesia and is considered the most effective treatment for severe cases. Recovery can involve pain management and a temporary change in bowel habits.

2. Rubber Band Ligation: Although more commonly used for internal hemorrhoids, this method involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off. This is less invasive than a hemorrhoidectomy but may not be suitable for external hemorrhoids.

3. Sclerotherapy: This involves injecting a solution into the hemorrhoid to shrink it. This method is less common for external hemorrhoids but can be an option in certain cases.

4. Laser Treatment: This is a newer technique that uses laser energy to remove or shrink the hemorrhoid. It is less painful and has a quicker recovery time compared to traditional surgery.

Regarding the "little white spot," it is essential to have it evaluated by a healthcare professional. It could be a sign of a more serious condition, such as a skin infection or a different type of lesion. If the white spot persists despite treatment, or if it changes in appearance, further investigation may be warranted.

In summary, while external hemorrhoids can often be managed with conservative treatments, surgical options are available for more severe cases. If your doctor has suggested surgery, it is likely because they believe that the hemorrhoid is not responding to other treatments. It is crucial to discuss all your concerns with your healthcare provider, including the nature of the white spot, the recommended surgical procedure, and any potential risks and benefits associated with it. Seeking a second opinion from a colorectal specialist can also provide additional insights and options for your treatment plan.