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
- Pain around the anal area, ranging from mild to severe
- Swelling around the anus
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.
How Do Doctors Treat Hemorrhoids
Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.
Office treatments include the following:
- Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedureyou should never try this treatment yourself.
- Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
- Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
- Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
Outpatient center or hospital treatments include the following:
Sometimes complications of hemorrhoids also require treatment.
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.
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How To Get Rid Of Internal Hemorrhoid Pain
Internal hemorrhoids are located in the lower rectal region where we do not have many nerves that can sense pain.
While internal hemorrhoids are typically not painful, protruding hemorrhoids can be.
These protruding or prolapsed hemorrhoids form when internal hemorrhoids fall through the anal opening.
Prolapsed hemorrhoids can lead to pain, discomfort, and itching.
Another factor of pain associated with protruding hemorrhoids is the occurrence of pruritus ani, or the itching and irritation of the anal opening.
Pruritus ani is when bacteria and mucus collects around the anal opening.
This itching and irritation can also be painful if you are constantly attempting to relieve it by scratching or persistent wiping with toilet paper.
What Are The Symptoms Of Haemorrhoids
If you have haemorrhoids you may notice bright red blood on the toilet paper or in the toilet when you have a bowel motion . There may be some itchiness, discomfort or pain around the anus. Sometimes there can be a noticeable lump that protrudes out of the anus.
Many people experience no symptoms or very mild symptoms that disappear after a couple of days. For other people, haemorrhoids are more painful.
Internal haemorrhoids are classified into 4 different types based on their degree of prolapse .
- First degree haemorrhoids often bleed a little bit when you pass a bowel motion, but stay inside the anus and are not usually very painful.
- Second degree haemorrhoids bleed and protrude out of the anus when you pass a bowel motion. Once the bowel motion is over, they disappear back inside the anus by themselves.
- Third degree haemorrhoids have to be physically pushed back inside the anus after passing a bowel motion. They may be painful if they are large.
- Fourth degree haemorrhoids are larger lumps that protrude out of the anus permanently, and cannot be placed back inside. The blood inside these haemorrhoids may clot and the lumps can become very painful.
External haemorrhoids occur as a lump outside the anus. A thrombosed haemorrhoid occurs when there is a blood clot in the skin overlying the anus this can cause severe and constant pain.
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Final Thoughts On How To Get Rid Of Hemorrhoids
- Hemorrhoids are a very common anorectal condition that affects millions of people around the world.
- Enlarged hemorrhoids are often associated with symptoms such as itching, mucus discharge or bleeding. Bleeding happens when hard stool damages the thin walls of the blood vessels in hemorrhoids.
- Avoidance of constipation is key when trying to get rid of hemorrhoids. Its important that you dont strain while using the bathroom, dont sit for an excessive period of time and clean yourself thoroughly when finished.
- Foods and herbal supplements that help relieve constipation can alleviate the symptoms of hemorrhoids. A high-fiber diet and drinking plenty of fluids are the most helpful dietary changes that you can make when it comes to how to get rid of hemorrhoids.
- If non-medical treatments dont work, there are relatively painless procedures that can be done to treat hemorrhoids. For extreme cases, an outpatient surgery called a hemorrhoidectomy may be required.
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How Are Haemorrhoids Diagnosed
Diagnosis of haemorrhoids usually involves an examination of the anal passage to look for any swollen blood vessels. Your doctor may conduct one of the following tests.
- Digital rectal examination, where your doctor puts on gloves and places a lubricated finger inside the back passage to gently feel for any abnormalities. This is likely to be uncomfortable but will probably not be painful.
- Proctoscopy, where your doctor examines the inside of the rectum using a proctoscope to look for any swelling or other symptoms. Again, this may be uncomfortable but will probably not be painful.
There is no need to feel embarrassed about these tests haemorrhoids are a common problem and your doctor is used to diagnosing and treating them.
In some cases, your doctor may refer you to a surgeon who can assess your haemorrhoids and recommend a treatment.
The Best And Worst Things You Can Do For Hemorrhoids
Sameet Shah, D.O. contributes to topics such as Gastroenterology.
Near the top of the list of health issues people avoid talking about is hemorrhoids, even to doctors. Theyre uncomfortable, theyre unattractive, they bleed, and they make going to the bathroom a challenge. Theyre also very common. In fact, about half of people have had a bout with hemorrhoids by the time they reach 50 years old.
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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.
What Do Hemorrhoid Bands Look Like
Hemorrhoid bands are those that are placed on the base of problematic hemorrhoids, cutting off blood supply and forcing the hemorrhoid to fall off.
The bands themselves are small and are installed on the bottom of a hemorrhoid with a specialized application tool by your doctor.
Hemorrhoid bands are usually black, and available in different sizes and materials, like rubber or silicone.
This technique is non-operative and is successful in relieving chronic internal hemorrhoid conditions.
After rubber band ligation, patients may feel some pain and discomfort, bleeding from the anal opening, and the hemorrhoid will fall off in about seven to ten days.
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Simple Steps To Help Prevent Hemorrhoids16
If you are pregnant or genetically predisposed to developing symptomatic hemorrhoids, they may be impossible to prevent, but the following tips may nonetheless lower your risk of experiencing them:
- Consume well-balanced meals and snacks, ensuring high-fibre content and adequate fluid intake.
- Avoid sitting or standing for long periods. Take short walks whenever you can.
- Do not delay bowel movements when you feel the urge.
Breathe freely and avoid prolonged straining during bowel movements and other activities that could involve straining, such as lifting heavy objects.
Dr. Iain G.M. Cleator, Professor Emeritus of Surgery
First published in the Inside Tract® newsletter issue 183 2012
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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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Why Are Internal Prolapsed Hemorrhoids At A Greater Risk Of Becoming Thrombosed
Whether internal or external, if your hemorrhoid is prolapsed it is at a greater risk of becoming thrombosed. When outside the anus the hemorrhoids blood supply can be cut off or limited by the anal sphincter limiting blood flow.
Since thrombosis occurs as a result of a lack of blood flow, these types of hemorrhoids are particularly susceptible to this painful condition.
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How To Stop Hemorrhoid Pain
There are many different methods that can be used to stop hemorrhoid pain. A few effective methods for pain management and immediate relief are:
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Hemorrhoids By The Numbers
- Around 20 million people in the United States suffer from hemorrhoids .
- In 2004, the National Institutes of Health noted that the diagnosis of hemorrhoids was associated with 3.2 million ambulatory care visits, 306,000 hospitalizations and 2 million prescriptions in the United States.
- The peak incidence of hemorrhoids is between the ages of 4565. Development of hemorrhoids before the age of 20 is unusual.
- The risk of developing hemorrhoids is higher in white adults than in black adults, higher in women than in men and higher for women who are pregnant.
What Natural Home Remedies Soothe Or Cure Hemorrhoids
Hemorrhoid symptoms of pain and itching can be treated at home by doing the following.
Warm Sitz Baths
- Sitting in a few inches of warm water three times a day for 15 to 20 minutes may help decrease the inflammation of the hemorrhoids.
- It is important to dry off the anal area completely after each Sitz bath to minimize irritation of the skin surrounding the anus.
- Increased fluid intake and dietary fiber will decrease the potential for constipation and lessen the pressure on the rectum and anus during a bowel movement, minimizing further swelling, discomfort, and bleeding. Dietary fiber supplements also may help bulk up the stools
- Stool softeners may help. A health-care professional or a pharmacist are good resources to discuss their use.
- Individuals with hemorrhoids should not sit for long periods of time and may benefit from sitting on an air or rubber donut available at most local pharmacies.
- Exercise is helpful in relieving constipation and in decreasing pressure on the hemorrhoidal veins. Individuals should be encouraged to have a bowel movement as soon as possible after the urge arises and not sit on the toilet for long periods of time. Once that urge passes, stools can become constipated and straining with a bowel movement may occur.
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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.
Hemorrhoids: Diagnosis And Treatment Options
TIMOTHY MOTT, MD, Naval Hospital Pensacola, Pensacola, Florida
KELLY LATIMER, MD, MPH, U.S. Naval Hospital Sigonella, Catania, Italy
CHAD EDWARDS, MD, Hamilton Medical Center, Dalton, Georgia
Am Fam Physician. 2018 Feb 1 97:172-179.
Patient information: A handout on hemorrhoids is available.
Hemorrhoids develop when the venous drainage of the anus is altered, causing the venous plexus and connecting tissue to dilate, creating an outgrowth of anal mucosa from the rectal wall. However, the exact pathophysiology is unknown. Hemorrhoids occur above or below the dentate line where the proximal columnar transitions to the distal squamous epithelium . The anus is approximately 4 cm long in adults, with the dentate line located roughly at the midpoint.2 Hemorrhoids developing above the dentate line are internal. They are painless because they are viscerally innervated. External hemorrhoids develop below the dentate line and can become painful when swollen. The extent of prolapse of internal hemorrhoids can be graded on a scale from I to IV, which guides effective treatment . This grading system is incomplete, however, because it focuses exclusively on the extent of prolapse and does not consider other clinical factors, such as size and number of hemorrhoids, amount of pain and bleeding, and patient comorbidities and preferences.3
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Increasing fiber intake is an effective first-line, non-surgical treatment for hemorrhoids.
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