External and Internal Hemorrhoids: Symptoms and Treatment Options

Mole and skin lesion issues?

Hello, doctor.
In my student days, I experienced severe diarrhea, and after repeated wiping, I developed an external hemorrhoid, but I'm unsure if there are any internal hemorrhoids.
Initially, I took over-the-counter medication, which significantly reduced the external hemorrhoid, but it gradually grew larger again and has persisted until now.
Generally, it doesn't hurt or cause any discomfort, and I don't feel pain when touching it while showering.
However, sometimes after frequent bowel movements or occasional diarrhea, it may become swollen and painful, and I have noticed blood stains on the toilet paper after wiping.
I would like to ask the doctor if this condition can be ignored.
If it continues long-term, is there a possibility of worsening? Is surgery necessary for removal? Is it possible for it to resolve on its own just by taking medication? If surgery is required, how long is the recovery period? Thank you.

kevin, 30~39 year old female. Ask Date: 2016/02/26

Dr. Yu Mingchang reply Surgery

Hello; please take some time to visit the colorectal department to address the issue of external hemorrhoids as soon as possible.
The Ministry of Health and Welfare Changhua Hospital cares about you.

Reply Date: 2016/02/26

More Info

Understanding external and internal hemorrhoids is crucial for managing symptoms and determining appropriate treatment options. Hemorrhoids are swollen veins in the lower rectum and anus, and they can be classified into two types: external and internal.
Symptoms of Hemorrhoids:
1. External Hemorrhoids: These occur under the skin around the anus and can cause symptoms such as:
- Pain or discomfort, especially during bowel movements.

- Swelling or a lump near the anus.

- Itching or irritation in the anal region.

- Bleeding, which may appear as bright red blood on toilet paper or in the toilet bowl.

2. Internal Hemorrhoids: These develop inside the rectum and may not be visible. Symptoms can include:
- Painless bleeding during bowel movements.

- Prolapse, where the hemorrhoid protrudes outside the anus, which can cause discomfort or pain.

In your case, it sounds like you are experiencing symptoms consistent with external hemorrhoids, particularly with the history of severe diarrhea and irritation from wiping. The fact that you have noticed swelling and occasional pain, especially after bowel movements, suggests that your hemorrhoids may be inflamed or aggravated.

Treatment Options:
1. Conservative Management: For mild cases, lifestyle changes can be effective:
- Dietary Adjustments: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements.

- Hydration: Drinking plenty of water can also aid in preventing constipation.

- Over-the-Counter Medications: Topical treatments, such as creams or ointments containing hydrocortisone or witch hazel, can provide relief from itching and discomfort.

2. Medical Treatment: If conservative measures do not alleviate symptoms, or if the hemorrhoids become more severe, medical interventions may be necessary:
- Rubber Band Ligation: This is a common procedure for internal hemorrhoids where a rubber band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: Involves injecting a solution into the hemorrhoid to shrink it.

- Infrared Coagulation: A procedure that uses infrared light to cut off blood supply to the hemorrhoid.

3. Surgical Options: If hemorrhoids are large, persistent, or causing significant discomfort, surgical removal (hemorrhoidectomy) may be recommended. This is typically reserved for severe cases and involves a longer recovery period, usually around 1-2 weeks, depending on the individual’s health and the extent of the surgery.

When to Seek Medical Attention:
Given your symptoms, it is advisable to consult with a healthcare provider. While some hemorrhoids can be managed conservatively, persistent symptoms, especially bleeding, should be evaluated to rule out other conditions. If you notice significant changes in your symptoms, such as increased pain, swelling, or bleeding, it is essential to seek medical advice promptly.

In summary, while you may be able to manage mild symptoms with lifestyle changes and over-the-counter treatments, it is crucial to monitor your condition. If symptoms persist or worsen, a medical evaluation is necessary to determine the best course of action, which may include further treatment or surgical options.

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