External hemorrhoids are small lumps just outside the anus that can cause discomfort, itching, and sometimes bleeding. Home remedies for relief include warm baths, applying cool compresses, and using topical treatments like witch hazel.
Hemorrhoids, also known as piles, often result from straining during bowel movements. Factors such as pushing too hard, sitting for long periods on the toilet, or dealing with hard stools can contribute to their development.
Most external hemorrhoids are harmless and resolve on their own. However, they can become painful if a clot forms, known as a thrombus. In such cases, a doctor may suggest surgical removal to alleviate severe pain.
This article discusses what external hemorrhoids are, their common causes, and available treatments.
What are the treatment options?
External hemorrhoids usually don’t need specific treatment unless they develop a clot and become painful.
Most will disappear on their own within a few days. However, those that persist may lead to discomfort, itching, and some pain. Various home remedies can help relieve these symptoms.
Some home remedies people can try include:
- Taking warm baths
- Using over-the-counter (OTC) pain relievers like ibuprofen or acetaminophen to reduce pain and discomfort
- Applying ointments with ingredients such as witch hazel or hydrocortisone to ease itching
- Gently cleaning the anus after bowel movements, using moistened wipes or cotton pads
- Applying ice packs covered with cloth to reduce swelling
For external hemorrhoids that have developed a clot, surgical intervention may be required.
Surgical Removal
There are two main surgical options for external hemorrhoids:
- A small incision can be made in a thrombosed hemorrhoid to drain the blood clot. This procedure can be done under local anesthesia, offering quicker relief if performed within 48 hours of the clot’s formation. However, it doesn’t remove the hemorrhoid itself.If performed within the 48-hour window, this surgery can bring rapid pain relief. After this time, the surgery may not be as helpful, and the symptoms usually improve on their own.
- Hemorrhoidectomy, a procedure that involves completely removing the hemorrhoid, is another option. This surgery requires general anesthesia.
Treatments During Pregnancy
Many home remedies mentioned are safe to use during pregnancy to relieve the discomfort caused by external hemorrhoids.
However, pregnant individuals should always consult a doctor before using any topical treatment to ensure it won’t interfere with the pregnancy.
Symptoms of External Hemorrhoids
External hemorrhoids can cause itching and irritation, and they may also lead to pain. However, not everyone with external hemorrhoids experiences symptoms.
According to a study from 2012, more than half of those with hemorrhoids did not report any symptoms.
People with external hemorrhoids may feel a tender lump around the anus.
Blood in the Stool
Individuals with external hemorrhoids might notice blood on the surface of their stool, which is usually bright red, as it comes directly from the hemorrhoid.
The bleeding is typically minimal, but if a significant amount of blood is noticed, a doctor should be consulted.
Thrombosed Hemorrhoids
Thrombosed external hemorrhoids can be particularly painful. They may appear purple on lighter skin and grey, black, or dark brown on darker skin.
A thrombosed hemorrhoid occurs when the veins inside the hemorrhoid develop a clot, restricting blood flow and causing severe pain. Over time, the body may absorb the clot, easing symptoms and reducing pain.
Once the clot resolves, an external hemorrhoid may leave behind a perianal skin tag. If the tag consistently traps stool and is difficult to keep clean, a doctor may recommend surgical removal.
Causes and Risk Factors
In addition to straining, other factors that can lead to hemorrhoids include:
- Lifting heavy objects or weights
- A low-fiber diet
- Obesity
- Prolonged sitting or standing
- Pregnancy
- Ascites (fluid buildup in the abdomen)
Hemorrhoids are one of the most common medical conditions, and the risk of developing them increases with age.
This happens because the tissues lining the anus become thinner and less capable of withstanding pressure from straining.
External hemorrhoids differ from other types because of their location. Internal hemorrhoids, which develop inside the rectum, are usually painless but may cause bleeding.
Prolapsed hemorrhoids are internal hemorrhoids that bulge outside the anus but can often be pushed back inside.
Diagnosis
A doctor can diagnose external hemorrhoids by assessing the person’s symptoms and performing a physical exam.
Anyone who suspects they have external hemorrhoids should seek medical advice. Some symptoms, such as rectal bleeding, can also be associated with more serious conditions like:
- Anal cancer
- Anal fissures
- Colorectal cancer
- Inflammatory bowel disease
- Perianal abscesses
- Skin tags
Prevention Methods
The best way to prevent external hemorrhoids is to avoid constipation and hard stools. Some prevention tips include:
- Increasing dietary fiber intake to 25–30 grams per day by eating more fruits, vegetables, whole grains, and cereals
- Drinking enough water so that urine is pale yellow every time you urinate
- Engaging in regular physical activity to help the bowels move naturally
- Using the bathroom when needed and avoiding delays
- Minimizing the time spent sitting on the toilet
People who experience chronic constipation and hemorrhoids should consult a doctor to discuss treatment options.
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Frequently Asked Questions
Are external hemorrhoids painful?
Yes, external hemorrhoids can be painful, especially after bowel movements or when lifting heavy objects.
Thrombosed hemorrhoids are particularly painful but tend to improve once the clot is treated or dissolves.
Are external hemorrhoids dangerous?
External hemorrhoids are rarely dangerous. They may develop a clot that can burst, causing several minutes of bleeding. However, the bleeding usually stops on its own.
If it doesn’t, medical attention is needed. Regular rectal bleeding should always be discussed with a doctor.
Do external hemorrhoids go away on their own?
Yes, most external hemorrhoids will resolve on their own, even without treatment. However, they can recur, so preventive measures should be taken to avoid future occurrences.
Can you push an external hemorrhoid back in?
No, external hemorrhoids cannot be pushed back inside since they form outside the anus.
Is there a difference between male and female hemorrhoids?
Both men and women can develop hemorrhoids. Studies suggest that women are more likely to report them, but more research is needed on this topic.
Summary
External hemorrhoids usually resolve on their own. Preventing constipation and avoiding straining during bowel movements can reduce the risk of developing them.
If they cause significant pain or discomfort, consult a doctor for appropriate treatment options.