Hemorrhoids: Symptoms, Treatments, and Surgical Options

Q: Hemorrhoids: Symptoms, Treatments, and Surgical Options

Hello： It is not possible to determine whether it is hemorrhoids based on photos alone. <br>Please consult a surgeon for a physical examination and assessment. <br>Ointments can only relieve symptoms of redness, swelling, and heat. <br>If the hemorrhoids are not severe, you may u

Hemorrhoid issues

Hello Dr.
Li, I discovered I had hemorrhoids since high school.
At that time, due to long periods of sitting on those wooden school chairs, I would sometimes develop a sizable hemorrhoid that would be painful.
However, there was one occasion when I went to the bathroom and suddenly experienced extreme pain with a lot of bleeding.
After that, I noticed something that looked like skin around the anus.
I apologize for not being able to share the photos directly with you.

Is this skin a remnant from a ruptured hemorrhoid? If I want it to go away, is surgery the only option? I feel a bit uneasy about it.
Even now, whenever I maintain a position that stretches the anus (like squatting or sitting for long periods), external hemorrhoids still appear, sometimes causing pain, but they disappear after a while.
Can this be treated with medication or topical ointments?
Additionally, I would like to ask if this is related to the hemorrhoids: sometimes I experience itching in the area connecting the anus to the scrotum, and there is a raised line, as shown in the photo.
What could be causing this?
Thank you for taking the time to respond.

K, 20~29 year old female. Ask Date: 2024/03/13

Dr. Li Qinglong reply Surgery

Hello: It is not possible to determine whether it is hemorrhoids based on photos alone.
Please consult a surgeon for a physical examination and assessment.
Ointments can only relieve symptoms of redness, swelling, and heat.
If the hemorrhoids are not severe, you may use the ointment initially to observe its effectiveness.
If the results are unsatisfactory, surgical treatment should be considered.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2024/03/13

More Info

Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two main types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Your description suggests that you have been experiencing symptoms consistent with external hemorrhoids, especially given the pain and bleeding you mentioned.

Symptoms of Hemorrhoids
The symptoms of hemorrhoids can vary depending on their type and severity. Common symptoms include:
- Bleeding: Bright red blood during bowel movements is a classic sign of hemorrhoids.

- Pain or Discomfort: This is particularly common with external hemorrhoids, especially when sitting or during bowel movements.

- Itching or Irritation: The area around the anus may become itchy or irritated.

- Swelling: You may notice a lump near the anus, which can be painful.

Treatment Options
Treatment for hemorrhoids can range from conservative measures to surgical interventions, depending on the severity of the condition.

1. Conservative Treatments:
- Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, and whole grains.

- Hydration: Drinking plenty of water can help prevent constipation.

- Topical Treatments: Over-the-counter creams or ointments can relieve itching and discomfort.

- Sitz Baths: Soaking the affected area in warm water can provide relief from pain and irritation.

2. Minimally Invasive Procedures:
- Rubber Band Ligation: This involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: A chemical solution is injected into the hemorrhoid to shrink it.

- Infrared Coagulation: This technique uses infrared light to cut off blood supply to the hemorrhoid.

3. Surgical Options:
- If conservative and minimally invasive treatments fail, surgical options may be considered. Hemorrhoidectomy, the surgical removal of hemorrhoids, is often recommended for severe cases or when there are complications, such as thrombosis or persistent bleeding.

Your Specific Concerns
Regarding the skin-like growth you mentioned after a painful bowel movement, it is possible that this is a skin tag or a thrombosed hemorrhoid that has healed improperly. Skin tags are common after hemorrhoids and can be removed surgically if they cause discomfort or cosmetic concerns.

As for the itching and the raised area extending from the anus to the groin, this could be related to several factors, including irritation from hemorrhoids, skin conditions, or even infections. It is essential to consult a healthcare provider for a thorough examination to determine the exact cause and appropriate treatment.

Conclusion
In summary, while hemorrhoids can often be managed with conservative treatments, surgical options are available for more severe cases. It is advisable to consult a healthcare professional for a proper diagnosis and tailored treatment plan, especially considering your ongoing symptoms and concerns. Regular follow-ups and monitoring can help manage your condition effectively and improve your quality of life.

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