Acute External Hemorrhoids: Symptoms, Treatment, and Concerns - Surgery

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Acute external hemorrhoids, also known as thrombosed hemorrhoids, can be quite uncomfortable and are often a result of increased pressure in the rectal area, commonly due to straining during bowel movements, prolonged sitting, or constipation. Given your history of constipation and recent symptoms, it’s understandable to have concerns about your condition. Let’s address your questions one by one.

1. Can acute external hemorrhoids heal on their own with sitz baths? How long does it take? Will there be scarring?
Yes, acute external hemorrhoids can often heal on their own, especially with supportive care like sitz baths. Sitz baths, which involve sitting in warm water for about 10-15 minutes, can help reduce pain and swelling. Doing this two to three times a day can be beneficial. Typically, you might expect improvement within a few days to a couple of weeks, depending on the severity of the hemorrhoid. As for scarring, while some people may experience minor skin changes, significant scarring is uncommon if the hemorrhoid resolves without surgical intervention.

2. Is the soft, painless growth you previously had also an external hemorrhoid? Does it need treatment?
The soft, painless growth you described could be a skin tag, which is often a remnant of a previous hemorrhoid or a benign growth. Skin tags themselves do not require treatment unless they become bothersome or painful. If they are not causing any issues, it’s generally safe to leave them alone.

3. Is the swelling after straining during bowel movements considered prolapse? Is it normal?
The swelling you experience after straining could indicate a temporary prolapse of the hemorrhoids, which is not uncommon. This condition, often referred to as "prolapsed hemorrhoids," can occur during bowel movements when excessive pressure is applied. If the swelling reduces on its own, it is usually not a cause for concern. However, if it becomes persistent or painful, it would be wise to consult a healthcare professional.

4. Are the symptoms of sticky stools, weakness during bowel movements, and occasional anal itching indicative of internal hemorrhoids?
The symptoms you describe, such as sticky stools and a feeling of weakness during bowel movements, could suggest a few things, including potential internal hemorrhoids or other gastrointestinal issues. Internal hemorrhoids are typically not visible and can cause bleeding or a feeling of fullness. The anal itching you experienced could be due to irritation from stool or hygiene issues. If these symptoms persist, it’s advisable to seek medical evaluation to rule out any underlying conditions.

In summary, while acute external hemorrhoids can often heal with conservative measures like sitz baths, it’s essential to maintain healthy bowel habits to prevent recurrence. This includes staying hydrated, consuming a high-fiber diet, and avoiding prolonged sitting on the toilet. If you notice any worsening of symptoms or new concerns, don’t hesitate to consult a healthcare provider for a thorough evaluation and personalized advice.