External Hemorrhoids: Symptoms, Concerns, and Treatment Options

Thrombosed external hemorrhoid

Hello, doctor.
A week ago, I had diarrhea, and suddenly a lump the size of a peanut appeared at the anal area.
It doesn't look red or swollen.
It was painful for two to three days, but now I don't feel much discomfort, just a sensation of something being stuck at the anal opening.
However, when I touch it, it feels hard and can be a bit painful.
If I don't touch it, I don't feel anything.
Could this be a thrombosed external hemorrhoid? It's been a week, and it doesn't seem to have shrunk at all.
I'm a bit worried that it won't go away.

TT, 40~49 year old female. Ask Date: 2023/02/13

Dr. Ke Fangxu reply Surgery

Thrombotic external hemorrhoids typically take 2 to 4 weeks to completely resolve.
If there is no pain or discomfort, observation is sufficient.
Applying hemorrhoid ointment can help alleviate uncomfortable symptoms, and taking warm sitz baths can also be beneficial.

Reply Date: 2023/02/13

More Info

External hemorrhoids, also known as external piles, are swollen veins located around the anus and lower rectum. They can be quite uncomfortable and may cause a variety of symptoms, especially after events like diarrhea, which can lead to increased pressure in the anal region. Your description of a lump the size of a peanut that is hard and occasionally painful suggests that you may be dealing with a thrombosed external hemorrhoid, which occurs when a blood clot forms in the external hemorrhoid.

Symptoms of External Hemorrhoids
Common symptoms of external hemorrhoids include:
- A lump near the anus, which may be sensitive or painful.

- Itching or irritation in the anal region.

- Pain during bowel movements.

- Bleeding, although this is more common with internal hemorrhoids.

- A feeling of fullness or discomfort around the anus.

In your case, the lump you described, which is hard and causes some pain when touched, aligns with the characteristics of a thrombosed external hemorrhoid. These can occur when the veins in the anal area become engorged with blood and then form a clot, leading to swelling and discomfort.

Concerns
While external hemorrhoids are generally not serious, they can lead to complications if left untreated. These complications may include:
- Thrombosis: The blood clot can cause significant pain and swelling.

- Infection: If the hemorrhoid becomes irritated or ruptures, there is a risk of infection.

- Chronic discomfort: Persistent hemorrhoids can lead to ongoing discomfort and may require medical intervention.

Treatment Options
1. Home Remedies: Many cases of external hemorrhoids can be managed at home. Here are some common approaches:
- Warm Sitz Baths: Soaking in warm water several times a day can help reduce swelling and relieve discomfort.

- Over-the-Counter Treatments: Creams or ointments containing hydrocortisone or witch hazel can provide temporary relief from itching and discomfort.

- Cold Compresses: Applying ice packs to the affected area can help reduce swelling and numb the pain.

- Dietary Changes: Increasing fiber intake and staying hydrated can help prevent constipation, which can exacerbate hemorrhoids.

2. Medical Treatments: If home remedies do not provide relief, or if the hemorrhoid does not improve, it may be necessary to consult a healthcare provider. They may recommend:
- Minimally Invasive Procedures: These can include rubber band ligation, sclerotherapy, or infrared coagulation, which can help reduce the size of the hemorrhoid.

- Surgical Options: In more severe cases, surgical removal of the hemorrhoid (hemorrhoidectomy) may be necessary.

When to Seek Medical Attention
You should consider seeking medical advice if:
- The pain becomes severe or persistent.

- You notice significant bleeding.

- The lump does not decrease in size after a week or two.

- You experience any signs of infection, such as fever or increased redness and swelling.

Conclusion
Based on your description, it is possible that you are experiencing a thrombosed external hemorrhoid. While these can be uncomfortable, they often resolve on their own with conservative treatment. However, if you have concerns about the lump not decreasing in size or if you experience worsening symptoms, it is advisable to consult a healthcare professional for a thorough evaluation and appropriate management.

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