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

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External hemorrhoids, commonly referred to as "外痔" in Chinese, can indeed be a source of discomfort and concern, especially when they become large and protrude. Your mother’s description of her external hemorrhoid being large and unable to be pushed back in suggests that it may be in a more advanced stage, potentially Stage IV. In this stage, the hemorrhoid is often permanently prolapsed and cannot be reduced manually.


Symptoms of External Hemorrhoids
External hemorrhoids can present with various symptoms, including:
- Swelling or a lump near the anus
- Pain or discomfort, especially during bowel movements
- Itching or irritation in the anal region
- In some cases, bleeding, although your mother has not experienced this symptom.


Treatment Options
1. Conservative Management: For smaller external hemorrhoids, conservative treatments may include:
- Dietary changes to increase fiber intake, which can help soften stools and reduce straining during bowel movements.

- Over-the-counter topical treatments to relieve pain and itching.

- Warm sitz baths to soothe the area.

2. Minimally Invasive Procedures: If the hemorrhoid is larger or causing significant discomfort, there are several minimally invasive options:
- Rubber Band Ligation: This procedure involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and eventually fall off. However, this is typically more effective for internal hemorrhoids.

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

3. Surgical Options: If the hemorrhoid is large and causing persistent symptoms, surgical intervention may be necessary. Surgical options include:
- Hemorrhoidectomy: This is the surgical removal of the hemorrhoid and is often recommended for large external hemorrhoids that do not respond to other treatments.

- Stapled Hemorrhoidopexy: This technique involves repositioning the hemorrhoid and cutting off its blood supply, which can be less painful and have a quicker recovery time compared to traditional hemorrhoidectomy.


Considerations for Surgery
Given that your mother’s external hemorrhoid is large and cannot be pushed back, it is advisable to consult a colorectal surgeon. They can assess the situation and recommend the most appropriate treatment. Surgery may be necessary if the hemorrhoid is causing significant discomfort or if there is a risk of complications, such as thrombosis (formation of a blood clot).


Conclusion
While your mother does not currently have bleeding symptoms, the size and inability to reduce the hemorrhoid suggest that a more definitive treatment may be warranted. It is important to seek medical advice to evaluate her condition thoroughly and discuss the best course of action. If surgery is recommended, it can provide relief and prevent further complications associated with large external hemorrhoids.