Who Removes External Hemorrhoids
In many cases of mild external hemorrhoids, a general practitioner or your family doctor can treat you.
For hemorrhoid removal, however, your regular doctor may refer you to a specialized physician such as a gastroenterologist or a proctologist.
A gastroenterologist has received training in diagnosing and treating intestinal and rectal conditions while a proctologist specializes in surgical procedures for intestinal and rectal disorders.
If you are suffering from severe or chronic external hemorrhoids, ask your doctor about treatment methods best for your condition.
Surgery is often the last tried method in serious cases of hemorrhoids, and there are plenty of treatments that are non-operative.
What Treatments Are Available For Thrombosed External Hemorrhoids
The treatments for external hemorrhoids are different from those for internal hemorrhoids. One treatment option is to allow clots in the external hemorrhoids to be slowly absorbed by the body over several weeks. You can try hot baths, ointments or creams for the discomfort. Most experts recommend that the blood clots be surgically removed.
How Big Can External Hemorrhoids Become
External hemorrhoids can become quite large and inhibit daily life and activities. The size of external hemorrhoids varies, ranging anywhere from grape-sized to the size of a golf ball.
Typically, the more enlarged the hemorrhoid becomes, the more challenging and severe the symptoms are.
Symptoms of enlarged hemorrhoids consist of itching, burning, severe pain, and the discharge of stool or mucus. If you notice that your hemorrhoids do not go away by themselves after a few days or so, you will want to talk to your doctor.
Getting on track for the right treatment for your external hemorrhoids can help curb the risk of the hemorrhoids becoming enlarged.
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Types Of External Hemorrhoids
Hemorrhoids are classified as either internal or external. While most hemorrhoids fall under one of these two categories, prolapsed or thrombosed hemorrhoids can have qualities of both.
A prolapsed hemorrhoid is an internal hemorrhoid that can protrude out of the anus, appearing to be an external hemorrhoid.
A thrombosed hemorrhoid is an external hemorrhoid that has prolapsed and formed a blood clot. This is the most painful type of hemorrhoid.
Hemorrhoids also fall into four different stages based on size, severity of symptoms, and required treatments.
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Blood Clots In The Hemorrhoid
External hemorrhoids can be very painful if they become thrombosed. Thrombosed hemorrhoids are usually purple-blue.
A thrombosed hemorrhoid occurs when the veins that cause the bulge in the hemorrhoid develop a blood clot. As a result, blood is unable to flow to the hemorrhoid, and the effect can be extremely painful.
The body will often absorb the blood clot, therefore reducing the symptoms and easing the pain.
When the blood clot passes or the body reabsorbs it, an external hemorrhoid may sometimes leave behind a perianal skin tag. A doctor may recommend surgical removal if this skin tag regularly catches stool and is difficult to keep clean.
Treatments include home remedies and surgery.
Examples of home remedies people can use to treat hemorrhoids include:
- taking warm baths
- gently cleaning the anus after a bowel movement, often by using moistened wipes or cotton pads
- applying cloth-covered ice packs to reduce swelling
- taking over-the-counter pain relievers, such as ibuprofen or acetaminophen, to relieve pain and discomfort
- applying ointments, such as creams with witch hazel or hydrocortisone- that relieve itching
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When you go to see a doctor, you will probably first be asked about your symptoms and whether you have other medical conditions. The doctor will then look at your anus to see whether it is inflamed, and whether enlarged hemorrhoids come out of it when you push, or whether they are already outside.
Depending on your symptoms, various examinations might be done. If theres blood in your stool, the doctor may suggest a colonoscopy . Some people are afraid of having physical examinations and the possible associated pain. But most of these examinations don’t hurt, even if theyre sometimes considered to be unpleasant or embarrassing. Theyre a normal part of everyday life for medical professionals.
Doctors typically first feel for anything unusual. Known as a digital rectal examination, this involves gently inserting a finger into the anus, with gloves and a little lubricant. The doctor feels the inside of the anal canal using circular movements. This allows him or her to examine the sphincter muscles and the texture of the membranes lining the anus. Grade 1 hemorrhoids generally cant be felt in this way. But digital rectal examinations can help rule out other medical conditions. The procedure is usually not painful.
Who Removes Hemorrhoids Treatment
Treating enlarged hemorrhoids is important, because they tend to get worse over time. Hemorrhoids are treated with a variety of measures including diet, over-the-counter medicine like
- anti-inflammatory pain killers,
and various treatment options are available, like
Who Removes Hemorrhoids?
Most hemorrhoid complaints begin with a trip to a family doctor. Your doctor will then refer you to a specialist: either a gastroenterologist or a proctologist . Proctologists specialize in surgical treatments, while gastroenterologists are experts in digestive diseases.
Why Do External Hemorrhoids Itch
External hemorrhoids often cause moderate to severe itching around the anus. The itching comes from the inflammation of your anal area.
As inflammation increases due to external hemorrhoids, the intensity of your itching will increase as well.
For a list of products that can help, take a look at our guides below.
Symptoms Of Prolapsed Internal Hemorrhoids
Hemorrhoids prolapse when their blood vessels swell and extend from their location in the rectum through the anus. In the anal canal, the hemorrhoid is exposed to the trauma of passing stool, particularly hard stools associated with constipation. The trauma can cause bleeding and sometimes pain when stool passes.
The presence of
- inflammation, and
- constant moisture
can lead to anal itchiness , and occasionally the constant feeling of needing to have a bowel movement. The prolapsing hemorrhoid usually returns into the anal canal or rectum on its own or can be pushed back inside with a finger, but falls out again with the next bowel movement.
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What Are The Causes Of External Hemorrhoids
The most common cause of hemorrhoids is repeated straining while having a bowel movement. This is often caused by severe cases of constipation or diarrhea. Straining gets in the way of blood flow into and out of the area. This results in the pooling of blood and enlargement of the vessels in that area.
Pregnant women may also be at an increased risk of hemorrhoids because of the pressure that the uterus places on these veins.
Hemorrhoid Medication: When Why And Which Ones To Use
A number of OTC creams, ointments, and pads that contain hydrocortisone or witch hazel are available to help relieve pain, swelling, and itching caused by hemorrhoids. According to the National Institute of Diabetes and Digestive and Kidney Diseases, doctors recommend using over-the-counter products for a week. If symptoms persist beyond a week, follow up with your doctor.
Creams and suppositories containing hydrocortisone can cause the skin to weaken and thin, so they should not be used for more than a week. If any of these creams cause a rash or dry skin around the area, contact your healthcare provider.
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Gradually Increase Your Fiber Intake
Most of us dont get in enough fiber everyday, but adding more high-fiber foods like beans, broccoli, whole grains, and fresh fruit to your diet can help you avoid constipation and stay regular. This in turn reduces the chances that youll find yourself straining and further irritating your hemorrhoids, says Dr. Thomas. Aim for 20 to 30 grams of fiber a day, and consider taking a fiber supplement that contains psyllium or methylcellulose to help you hit your daily goal. If youre typically low on fiber-rich foods, though, take your timesuddenly upping your intake may make you gassy.
Treatment Of External Hemorrhoids
The best treatment for hemorrhoids is reducing the likelihood of them in the first place. For example, eating a healthy, fiber-rich diet and drinking plenty of liquids. Try to avoid sitting for long periods by taking regular stretch breaks, or incorporate exercise into your routine if it isnt already a normal activity for you. Physical activity reduces pressure on the veins in the rectum and prevents constipation.
Unfortunately, once an external hemorrhoid has formed, it most likely will not go away on its own. However, there is still a wide variety of external hemorrhoid treatment options to alleviate hemorrhoid symptoms or take care of the problem altogether.
You can temporarily relieve hemorrhoid symptoms on your own by using over-the-counter topical creams as well as natural remedies, such as apple cider vinegar and witch hazel. Keep in mind that at-home treatments and positive lifestyle changes may reduce hemorrhoid flare-ups, but the symptoms likely wont completely go away without professional treatment under the supervision of an experienced physician. Seeing a physician is essential for combating the underlying causes of hemorrhoid flare-ups or treating advanced piles, such as grade IV hemorrhoids.
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When To Seek Medical Help
When To See A Doctor About Hemorrhoids
You should see a doctor if you notice bleeding during a bowel movement, or if you produce stool thats red or black. If you know you have a hemorrhoid, you should also see a doctor if the discomfort doesnt go away after a week with the help of at-home remedies.
Many patients find it to be difficult or embarrassing to talk to their doctor about gastrointestinal issuesbut you should know that your doctor is there to help you find solutions to your medical concerns, and you are certainly not the first patient theyve seen with this problem! Talking openly with your doctor is the best way for you to find long-lasting relief.
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Apple Cider Vinegar On External Hemorrhoids Does It Work
Apple Cider Vinegar has been known to relieve the symptoms of external hemorrhoids. A topical solution of apple cider vinegar can reduce the symptoms in a few weeks. When applied to the affected area two or three times a day, it can temporarily reduce the symptoms of swelling and irritation.
It should be noted apple cider vinegar is not a solution and will only provide temporary relief. Be careful as well! Apple cider vinegar can burn very bad and be harmful if too much is applied or it is ingested. Do not use if you haven’t spoken with your doctor.
How Are External Hemorrhoids Diagnosed
Because many of the symptoms of external hemorrhoids can also be caused by other conditions, it is necessary to have an in-depth exam. Your doctor may use a series of tests to confirm the presence of external hemorrhoids near the anus. These tests may include:
Your doctor may begin with a physical exam. In cases of external hemorrhoids, they may be able to see the hemorrhoids.
If your doctor suspects that you have internal hemorrhoids instead of external hemorrhoids, they may use an anoscopy to examine the inside of the anus. Internal hemorrhoids can also be seen with colonoscopy, sigmoidoscopy, or proctoscopy.
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What Causes Hemorrhoids
Traditionally, hemorrhoids are associated with chronic constipation, straining during bowel movements, and prolonged sitting on the toilet all of which interfere with blood flow to and from the area, causing it to pool and enlarge the vessels. This also explains why hemorrhoids are common during pregnancy, when the enlarging uterus presses on the veins.
More recent studies show that patients with hemorrhoids tend to have a higher resting anal canal tone that is, the smooth muscle of the anal canal tends to be tighter than average . Constipation adds to these troubles, because straining during a bowel movement increases pressure in the anal canal and pushes the hemorrhoids against the sphincter muscle. Finally, the connective tissues that support and hold hemorrhoids in place can weaken with age, causing hemorrhoids to bulge and prolapse.
When To Call A Doctor
Common symptoms of hemorrhoids may be a sign of other serious health problems. Colon or rectal cancer and other conditions have many of the same symptoms as hemorrhoids. Call your doctor if you have symptoms like these:
- Stools are black or tarry or change size and shape.
- A lump or bulge that isn’t tender and that doesn’t go away forms at the anal opening.
- Rectal bleeding becomes heavy or changes color .
If you have hemorrhoids, call your doctor if:
- Moderate rectal pain lasts longer than 1 week after home treatment.
- Pain or swelling is severe.
- Tissue from inside the body bulges from the anus and does not return to normal after 3 to 7 days of home treatment.
- A lump inside the anus gets bigger or more painful.
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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.
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 don’t bother with at-home remedies for your external hemorrhoids, don’t worry, but do consider adding more fiber to your diet.
While this won’t immediately affect your external hemorrhoids, it can help prevent them from occurring so often in the future.
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What Gets Rid Of External Hemorrhoids
Sometimes, getting rid of external hemorrhoids is as simple as increasing your water intake and adding fiber to your diet.
If you experience constipation, a stool softener can help rid the occurrence of external hemorrhoids.
Other things you can do to get rid of them is limit the amount of time you sit on the toilet and refrained from holding in bowel movements.
Practice good hygiene and be sure to keep the area around your anus clean.
If you are prone to get external hemorrhoids, try using moist hemorrhoid wipes to clean your anus after you pass a bowel movement.
Using a sitz bath or sitting in a warm tub can help alleviate irritation from external hemorrhoids.
You may also use over-the-counter medications to ease discomfort and reduce swelling.
If you are prone to external hemorrhoids and they become increasingly painful or uncomfortable, or you notice continuous bleeding, you may want to talk to a doctor about more advanced treatment options.
What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- Why did I get hemorrhoids?
- What is the best treatment for me?
- What lifestyle changes can I make to keep from getting hemorrhoids again?
- When will symptoms improve?
- Should I look out for signs of complications?
A note from Cleveland Clinic
An estimated 15 million Americans have sought treatments for hemorrhoids at some point in their lives. But many more suffer needlessly. Dont be too embarrassed to talk to your healthcare provider about your symptoms. If hemorrhoids cause pain or discomfort, your provider has treatments that can help. You can also take steps to keep hemorrhoids from coming back.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
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