Alternative Treatments for External Hemorrhoids: Beyond Surgery Options - Surgery

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Treatment of External Hemorrhoids


I would like to ask if there are any treatment options for external hemorrhoids besides surgery.
I have visited a hospital, and the doctor mentioned that I can leave it alone since the external hemorrhoid has been present for a long time, is not painful, and does not bleed, but it is always visible and not aesthetically pleasing.
This causes me psychological stress regarding sexual activity.
The doctor said that it is at its smallest size and will not shrink further.
I asked if a rubber band ligation could be used, but he said it is not suitable for external hemorrhoids.
I do not want surgery because it requires hospitalization.
Are there any other methods to address this issue? Thank you.

kai, 20~29 year old female. Ask Date: 2013/06/11

Dr. Ke Fangxu reply Surgery


Hello: In response to your question, the treatment options for external hemorrhoids are quite limited.
Generally, if there is no pain or bleeding, surgery is not recommended.
However, aside from surgery, there may not be any effective solutions to address the appearance of external hemorrhoids.
Due to their location, which is innervated by superficial nerves, rubber band ligation is not applicable.
To my knowledge, some clinics perform ligation or partial excision of external hemorrhoids under local anesthesia, but I personally do not recommend this due to the risk of pain or incomplete removal.
Please consider your options carefully before making a decision to avoid any regrets.

Reply Date: 2013/06/11

More Info


External hemorrhoids, while often uncomfortable and sometimes aesthetically displeasing, can be managed through various non-surgical methods, especially if they are not causing significant pain or bleeding. Here are some alternative treatments and management strategies that you might consider:
1. Dietary Changes: One of the most effective ways to manage hemorrhoids is through dietary modifications. Increasing fiber intake can help soften stools and reduce straining during bowel movements, which is a common cause of hemorrhoids. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can also aid in digestion and stool formation.

2. Topical Treatments: Over-the-counter creams and ointments can provide temporary relief from discomfort associated with external hemorrhoids. Products containing hydrocortisone can reduce inflammation and itching. Witch hazel is another natural remedy that can soothe the area. Always ensure that any topical treatment is safe for your specific condition and consult with a healthcare provider if unsure.

3. Warm Sitz Baths: Soaking the affected area in warm water for 10 to 15 minutes several times a day can help alleviate discomfort and promote healing. This method can also help relax the muscles around the anus, which may reduce pain and swelling.

4. Cold Compresses: Applying a cold compress or ice pack to the area can help reduce swelling and numb the pain. This can be particularly helpful after bowel movements or prolonged sitting.

5. Lifestyle Modifications: Avoiding prolonged sitting or standing can help reduce pressure on the hemorrhoidal veins. If your job requires long periods of sitting, consider taking short breaks to walk around. Regular exercise can also improve circulation and help prevent constipation.

6. Medications: If you experience discomfort, over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain. However, always consult with a healthcare provider before starting any new medication.

7. Non-Surgical Procedures: While your doctor mentioned that rubber band ligation is not suitable for external hemorrhoids, there are other minimally invasive procedures that can be considered, such as sclerotherapy or infrared coagulation, which are typically used for internal hemorrhoids but may be discussed with a specialist for external cases.

8. Psychological Support: If the appearance of the hemorrhoid is causing you psychological distress, consider speaking with a counselor or therapist. They can help you work through feelings of anxiety or embarrassment related to your condition.

9. Monitoring: Since your doctor indicated that the external hemorrhoid is stable and not causing significant issues, regular monitoring may be a reasonable approach. If you notice any changes, such as increased pain, bleeding, or changes in size, it is essential to follow up with your healthcare provider.

In conclusion, while surgery is often considered the definitive treatment for external hemorrhoids, many non-surgical options can help manage symptoms and improve quality of life. It is crucial to maintain open communication with your healthcare provider about your concerns and preferences, as they can guide you in choosing the best approach tailored to your situation. If your symptoms change or worsen, do not hesitate to seek further medical advice.

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