The difference between mixed hemorrhoids and external hemorrhoids

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 16, 2024
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Both mixed hemorrhoids and external hemorrhoids fall within the clinical scope of hemorrhoids. However, mixed hemorrhoids generally include external hemorrhoids, whereas external hemorrhoids consist simply of local skin tags or connective tissue-based external hemorrhoids near the anal region. In addition to the local external hemorrhoids, mixed hemorrhoids also have local mucosal protrusions around the dentate line inside the anal canal, which connect with the external hemorrhoids to form mixed hemorrhoids. Both mixed and external hemorrhoids are very common. Treatment options include conservative medication or surgical removal. The primary surgical method for mixed hemorrhoids is excision and ligation, while for external hemorrhoids, the primary method is excision. Post-surgery, it is necessary to disinfect and change dressings on the local wounds to promote further growth and healing.

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Written by Yu Xu Chao
Colorectal Surgery
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Can external hemorrhoids be eliminated?

External hemorrhoids can certainly be removed. Clinically, surgical treatment can be used to remove external hemorrhoidal masses. Hemorrhoidectomy is a common surgical option and can be performed under local infiltration anesthesia, spinal anesthesia, or general anesthesia. After surgery, it is crucial for patients to adhere to changing dressings to avoid infections, inflammation, or edema at the wound site. Dietary precautions should be taken as well; spicy, irritating, and dry foods should be avoided as much as possible. If patients prefer not to undergo surgery, medications can be considered for treating external hemorrhoids, though they can only reduce the size of the hemorrhoidal masses, not eliminate them entirely. Common treatments include anal washes and sitz baths, topical application of golden ointment, and when necessary, oral administration of Diosmin can help reduce swelling. Additionally, patients should regularly perform pelvic floor exercises and avoid prolonged or excessive straining during bowel movements.

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Written by Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids exercise?

During the acute flare-up of thrombotic external hemorrhoids, there is congestion and edema of the local anal cushion, and thrombosis forms within the local hemorrhoidal nucleus and mucosa. It is not advisable for patients to engage in excessive exercise, as this may aggravate the congestion of the local hemorrhoidal nucleus and worsen the condition of thrombotic hemorrhoids. Excessive exercise and friction may also lead to rupture of the thrombus, resulting in pain or infection. During an acute episode of thrombotic external hemorrhoids, patients may choose to use hemorrhoid wash solution for hot compresses to alleviate local symptoms. If the symptoms are severe or the thrombus is large, surgical removal may also be an option. Patients with thrombotic external hemorrhoids need to pay attention to the duration of defecation, mainly keeping it under ten minutes, because prolonged defecation or excessive straining during bowel movements can increase vascular pressure in the local hemorrhoidal nucleus, leading to thrombus formation.

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Written by Yu Xu Chao
Colorectal Surgery
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How to eliminate the flesh lump of external hemorrhoids

External hemorrhoids mainly consist of varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombotic external hemorrhoids. If the patient wants to completely remove them, in such cases, only external hemorrhoidectomy or external hemorrhoid stripping surgery can be performed. After the surgery, anal cleansers, red oil gauze strips, and golden ointment are used for dressing changes to promote wound healing. If the patient is unwilling to undergo surgery and opts for conservative treatment with medications alone, the external hemorrhoidal mass will not be completely eliminated but will only shrink slightly and improve clinical symptoms. To completely eliminate the external hemorrhoidal mass, surgical treatment is necessary. Moreover, after surgery, patients should develop good defecation habits, such as not spending too much time on defecation, not straining excessively, and performing more pelvic floor exercises after defecation to strengthen the anal sphincter muscles to help prevent recurrence of external hemorrhoids.

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Written by Yu Xu Chao
Colorectal Surgery
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How to eliminate external hemorrhoids with a fleshy lump?

External hemorrhoids involving a flesh mass are considered organic lesions. Complete removal typically requires hemorrhoid surgery, such as excision of external hemorrhoids or debridement surgery. Postoperative care includes changing dressings using products like anal washes, red oil gauze strips, and golden ointment. It is also important for patients to develop good bowel habits post-surgery, maintain smooth bowel movements, and avoid prolonged or excessive straining to facilitate recovery and prevent recurrence of external hemorrhoids. If treated solely with conservative medication, the flesh mass of external hemorrhoids can only be reduced, not completely eliminated. Inappropriate diet or abnormal bowel movements can lead to an increase in the size of external hemorrhoids, potentially causing inflammatory edema or thrombosis, which can result in significant anal discomfort and severely impact the patient’s normal life. Therefore, the treatment approach for external hemorrhoid flesh mass should be based on the severity of the condition.

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Written by Deng Heng
Colorectal Surgery
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What does an external hemorrhoid look like?

External hemorrhoids are hypertrophic protrusions of the skin around the anal margin, forming skin tags, or expansions of the subcutaneous venous plexus, where blood flow stagnates and thromboses form, or other raised lesion-like abnormalities appear. Based on histopathological characteristics, external hemorrhoids can be categorized into four main types: connective tissue-type, thrombotic-type, varicose-type, and inflammatory external hemorrhoids. Connective tissue-type external hemorrhoids primarily consist of hypertrophic protrusions of the anal margin skin tags, also known as skin tag external hemorrhoids. Varicose-type external hemorrhoids, also known as venous cluster-type external hemorrhoids, occur when the venous plexus below the dentate line expands and twists, forming venous clusters. Inflammatory external hemorrhoids are a condition where pre-existing skin tag external hemorrhoids develop inflammatory changes. Thrombotic-type external hemorrhoids are a type of anal disease that occurs due to bleeding from the hemorrhoidal veins or the formation of thromboses in the skin around the anus.