Who Is At Risk Of External Hemorrhoids
If your parents have had hemorrhoids, you may be more likely to have them as well. Hemorrhoids may also be more likely to happen during pregnancy.
As we age, hemorrhoids can occur due to increased pressure caused by sitting a lot. And anything that causes you to strain during bowel movements can lead to external hemorrhoids.
A healthcare professional may be able to help you determine the cause of your hemorrhoids.
What Are The Symptoms Of External Hemorrhoids
Unlike internal hemorrhoids, external hemorrhoids are located in an area with nerve endings, which can make them easier to identify but also significantly more uncomfortable. Patients with external hemorrhoids usually report experiencing acute pain or discomfort, especially during bowel movements. However, these symptoms may flare up only every so often, making it difficult to tell whether the discomfort is actually hemorrhoid-related.
Many of those with external hemorrhoids also have symptoms of internal hemorrhoids. While a licensed physician is the only one who can give you a dependable diagnosis, these are some symptoms that typically indicate an external hemorrhoid problem:
- Mild but consistent itching around the rectal area
You may also notice your external hemorrhoids particularly swell when bearing down during a bowel movement. Be sure to limit your time on the toilet to two minutes as additional straining can worsen your external hemorrhoids. If you find that you frequently have to strain to pass bowel movements, try to increase your fiber and water intake. Eating foods with fiber is the most beneficial way to get this carbohydrate, but you can also take fiber supplements. The recommended intake is 20 to 30 grams per day.
Can Hemorrhoids Be Prevented
You can help prevent hemorrhoids by:
- Eating foods that are high in fiber
- Taking a stool softener or a fiber supplement
- Drinking enough fluids every day
- Not straining during bowel movements
- Not sitting on the toilet for long periods of time
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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What Causes Internal And External Hemorrhoids And Simple Ways To Treat Them
Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, hemorrhoids often become an ongoing complaint. By age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse . Although hemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion. Fortunately, there’s a lot we can do about hemorrhoids.
How To Prevent External Hemorrhoids From Developing
There are some methods that can help in prevention of external hemorrhoids, they are:
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Avoid Straining to Poop – Avoid sitting for long time on toilet for long time.
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Take Measures to Prevent Constipation – Have diet rich in high fiber foods, drink lots of water, take fiber supplements.
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Avoid Lifting Heavy Weights – Do not strain yourself.
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Seek for professional advice if you are at higher risk.
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Hemorrhoids In Patients With Cirrhosis Or Portal Hypertension
A clinician must differentiate bleeding hemorrhoids form bleeding anorectal varices because the latter can be managed by suture ligation along the course of varices, transjugular intrahepatic portosystemic shunt, or pharmacological treatment of portal hypertension. Since a majority of bleeding hemorrhoids in such patients is not life threatening, conservative measure with the correction of any coagulopathy is a preferential initial approach. Of note, rubber band ligation is generally contraindicated in patients with advanced cirrhosis due to the risk of profound secondary bleeding following the procedure. Injection sclerotherapy is an effective and safe procedure for treating bleeding hemorrhoids in this situation. In a refractory case, suture ligation at the bleeder is advised. Hemorrhoidectomy is indicated when bleeding hemorrhoids are refractory to other approaches.
Key Points To Remember
- Home treatments for hemorrhoids work for most people: Eat more fibre, drink more fluids, use a stool softener, and use ointments to help your symptoms.
- When home treatments don’t work on internal hemorrhoids, fixative procedures may help. These are treatments that involve cutting off the blood flow to the hemorrhoids using rubber bands, lasers, heat, or electrical currents. These procedures are usually less painful than surgery.
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What Are Home Treatments For Hemorrhoids
You can try the following home treatments:
- Use hemorrhoid ointments, such as Preparation H.
- Don’t strain while you are having a bowel movement.
- Apply ice several times a day. Also try applying moist heat several times a day, or sit in warm water .
- Eat more fibre, and drink more water.
- Take stool softeners.
You can also take non-prescription pain relievers. Acetaminophen can help with pain. Aspirin and other non-steroidal anti-inflammatory drugs , such as ibuprofen and naproxen , can help with pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
These treatments cure most small and some large internal hemorrhoids. They aren’t used for external hemorrhoids. They work by cutting off the blood supply to the hemorrhoid, which makes the hemorrhoid shrink or go away.
There are different ways to do this:
- Rubber band ligation. This is the most successful non-surgical procedure. It is the one most often used for small and medium hemorrhoids. It involves tying off hemorrhoids with rubber bands.
- Coagulation. This procedure involves using heat, a laser, or an electrical current to create scar tissue around the hemorrhoids. Infrared photocoagulation uses infrared light to do this.
Surgery for hemorrhoids is called hemorrhoidectomy. It is the most successful way to treat large internal hemorrhoids.
Surgery is used for small internal hemorrhoids when:
When To Seek Medical Advice
See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes.
The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription . However, speak to your GP if your symptoms don’t get better or if you experience pain or bleeding.
Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.
Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids.
Read more about diagnosing haemorrhoids.
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How To Treat Bleeding Hemorrhoids
Though its not a very pleasant topic to think about, the fact is that hemorrhoids are one of the most common gastrointestinal problems. The National Institutes of Health estimates that about 1 in 20 Americans will develop hemorrhoids at some point during their life. For most people, though, getting hemorrhoids is a temporary problem that isnt much of a cause for concern. Sometimes the problem is more severe and the hemorrhoids cause rectal bleeding in those cases, a more proactive treatment approach is usually necessary.
How A Doctor Can Help
Doctors can recommend medical treatments and procedures that can reduce or get rid of hemorrhoids. Some of these procedures can be done right in a doctors office and involve very little discomfort.
- Medicated creams/ointments. If an OTC hemorrhoid cream isnt enough, doctors can prescribe stronger creams and ointments.
- Minimally-invasive procedures. There are some minimally-invasive procedures that a doctor can do in their office or in an ambulatory surgery center that typically doesnt require anesthesia or long recovery times. Some of these procedures include rubber band ligation, sclerotherapy injections, and laser/infrared coagulation treatments.
- Thrombectomy. For severe cases that develop blood clots and cause a lot of pain, your doctor can perform an external hemorrhoid thrombectomy to remove the hemorrhoid. Thrombectomies are most effective when performed no more than 72 hours after severe symptoms emerge.
- Surgery. There are several surgical options available when other treatments and procedures havent worked or if you have very large hemorrhoids. If youve struggled to find relief, talk to your doctor to learn if surgery is right for you.
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Medical Procedures For Hemorrhoids
If your symptoms are severe or aren’t getting better after a couple of weeks, your doctor may suggest a procedure to shrink or remove the hemorrhoids. Many can be performed in their office.
Injection. Your doctor can inject an internal hemorrhoid with a solution to create a scar and close off the hemorrhoid. The shot hurts only a little.
Rubber band ligation. This procedure is often done on prolapsed hemorrhoids, internal hemorrhoids that can be seen or felt outside. Using a special tool, the doctor puts a tiny rubber band around the hemorrhoid, which shuts off its blood supply almost instantly. Within a week, the hemorrhoid will dry up, shrink, and fall off.
Coagulation or cauterization. With an electric probe, a laser beam, or an infrared light, your doctor will make a tiny burn to remove tissue and painlessly seal the end of the hemorrhoid, causing it to close off and shrink. This works best for prolapsed hemorrhoids.
Surgery. For large internal hemorrhoids or extremely uncomfortable external hemorrhoids, your doctor may recommend surgery.
- Hemorrhoidectomy. The most effective technique is to completely remove the hemorrhoids. But recovery is painful and can take several weeks.
- Hemorrhoid stapling. This technique cuts blood flow to internal hemorrhoids and moves prolapsed tissue back in place. Recovery is easier, but thereâs a greater chance of the hemorrhoids coming back.
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When To Seek Medical Help
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When Hemorrhoid Surgery May Be Necessary
Very few people fewer than 10 percent of all adults who see a doctor because of symptomatic hemorrhoids will require a surgical operation.
Surgery to remove hemorrhoids is called a hemorrhoidectomy.
Your doctor may recommend a hemorrhoidectomy if:
- You have large external hemorrhoids
- You have both internal and external hemorrhoids
- An internal hemorrhoid has prolapsed
- You have excessive bleeding
In a hemorrhoidectomy, the doctor makes a small incision to remove the hemorrhoid and surrounding tissue before closing the wound with stitches.
A hemorrhoidectomy is performed in an operating room and can be done under general anesthesia, in which you are unconscious and unable to feel pain.
Hemorrhoidectomy is associated with postoperative pain, but the procedure is successful for 95 percent of cases.
More recently, another option aimed at avoiding the postoperative pain of a hemorrhoidectomy has become available, called a stapled hemorrhoidopexy. A circular stapling device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. The staples eventually fall out over time.
According to a study published in the journal Techniques in Coloproctology, in the long term, patient satisfaction, resolution of symptoms, quality of life, and functional outcome appeared similar among patients after stapled hemorrhoidopexy and hemorrhoidectomy. But other sources note that stapling has been associated with a greater risk of recurrence and rectal prolapse.
For Seriously Bad Hemorrhoids Talk To Your Doctor About Surgical Options
If youve tried home remedies and in-office procedures but your hemorrhoids are still making you miserable, it might be time to ask your doctor about surgery. Recovery from the surgical removal of hemorrhoids can be extremely painful, notes Dr. Bernstein, but its one of the most effective ways to get rid of hemorrhoids for good.
Another surgical option is having your hemorrhoids stapled into place. This is a less painful procedure compared to a hemorrhoidectomy, but it does come with a greater risk of relapse and is not recommended if you have , as staples can cause injury, notes Dr. Ky.
When to see a doctor for hemorrhoids
Hemorrhoids can be a massive pain, but thankfully, symptoms typically go away within a week. If you still have symptoms of hemorrhoids after a week of self-care measures or youre experiencing severe pain or bleeding, seek medical attention immediately, says Dr. Thomas.
Its important to note that sometimes what might seem like symptoms of hemorrhoids could indicate something more serious. Less commonly, rectal bleeding can also be a sign of diseases such as colorectal cancer or . Make sure to get checked out if you notice large amounts of bleeding or other changes in your bowel habits like a different stool color or consistency.
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Prognosis For External Hemorrhoids In The Long Run
External hemorrhoids are a prevalent problem. As the bodyreabsorbs the blood clot inside the protruding blood vein, they usually go awayon their own in a couple of days or weeks.
Your doctor may prescribe surgical excision of externalhemorrhoids in severe conditions.
If your external hemorrhoid disappears on its own, a skintag may remain, which you should have removed.
Other Types Of Hemorrhoids
Hemorrhoids can bleed internally or externally, but bleeding from hemorrhoids isnât always a sure sign of what might be causing the problem. Bleeding from internalhemorrhoids can be caused by infections, tumors, inflammation, internal bleeding, or blood clots.
Some of the most common treatments for hemorrhoids are creams and ointments that apply to the affected area, like Preparation H or witch hazel. These treatments arenât always effective, but they are the cheapest way to treat external hemorrhoids. Over-the-counter hemorrhoidcream and ointments can also be very effective.
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What Are The Treatments For Hemorrhoids
If at-home treatments for hemorrhoids donât help you, you may need a medical procedure. There are several different procedures that your provider can do in the office. These procedures use different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply, which usually shrinks the hemorrhoids. In severe cases, you may need surgery.
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How Long Do External Hemorrhoids Last Without Treatment
External hemorrhoids typically last for a few days to a few weeks. Like any condition, this depends on your body and how susceptible you are to experience external hemorrhoid flare-ups.
If you have external hemorrhoids and even if you do not treat them, they will go away on their own.
Severe cases of external hemorrhoids tend to stick around, and you should ask your doctor about treatment methods to help shrink them.
If you dont bother with at-home remedies for your external hemorrhoids, dont worry, but do consider adding more fiber to your diet.
While this wont immediately affect your external hemorrhoids, it can help prevent them from occurring so often in the future.
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How To Treat External Hemorrhoids
In many incidents, individuals usually treat externalhemorrhoids at home and they disappear on their own in most cases.
According to doctors, they usually dont require medicalattention unless theyre causing you a lot of pain or are extremely swollen.
The treatment for external hemorrhoids is usually to relievepain, prevent infection, and treat symptoms such as itching and irritation.Treatments for external hemorrhoids can include over-the-counter creams,ointments, gels, suppositories, topical anesthetics, and other things.
The most common treatment for external hemorrhoids is to removethem surgically. This is known as hemorrhoidectomy and is done by a doctor tocompletely remove the internal hemorrhoids.
Precautions On How To Get Rid Of Hemorrhoids
A common concern is that hemorrhoids increase the risk of colorectal cancer, but thats not true. However, the two conditions do cause similar symptoms. This is why its important to mention your hemorrhoids to your health care provider. Even when a hemorrhoid is healed completely, a colonoscopy may be done to rule out other causes of rectal bleeding. According to the American Society of Colon and Rectal Surgeons , every person age 50 and older should undergo a colonoscopy to screen for colorectal cancer.
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Treating External Hemorrhoids At Home
There are many methods of alleviating external hemorrhoids symptoms at home, such as:
However, should symptoms persist, or if you are unsure if your symptoms result from external hemorrhoids, it is best to contact a physician for diagnosis and treatment. Although these remedies can provide relief, most at-home treatments merely mask the symptoms caused by hemorrhoids instead of getting rid of the underlying issue. For this reason, you will most likely need to see a professional for long-lasting pain relief.
Interestingly, although you may think your symptoms come from your external hemorrhoids, many times it is the internal hemorrhoid disease causing the problems.
How Are Hemorrhoids Treated
Your healthcare provider will create a care plan for you based on:
- Your age, overall health, and past health
- How serious your case is
- Whether you have internal hemorrhoids, external hemorrhoids, or both
- How well you handle certain medicines, treatments, or therapies
- If your condition is expected to get worse
- What you would like to do
The main goal of treatment is to reduce your symptoms. This may be done by:
- Sitting in plain, warm water in a bathtub several times a day
- Using ice packs to reduce swelling
- Using hemorrhoid creams or medicines inserted into your rectum
Your healthcare provider may also suggest that you add more fiber and fluids to your diet to help soften your stools. Having softer stools means you don’t have to strain during bowel movements. This reduces the pressure on your hemorrhoids.
Adding more fiber to your diet means eating more:
Tips to help you get the most from a visit to your healthcare provider:
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