Can external hemorrhoids be treated without surgery?

Written by Deng Heng
Colorectal Surgery
Updated on October 27, 2024
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Some external hemorrhoids do not require surgical treatment, as they come in three types. The first type, connective tissue external hemorrhoids, mainly presents as a mild foreign body sensation, generally painless, thus surgery is not necessary. Varicose vein type external hemorrhoids typically cause a feeling of heaviness and discomfort around the anus, and if symptoms are not severe, surgery is not required either. Only thrombosed external hemorrhoids, which usually involve severe pain, may resolve significantly on their own within two to three days if the lump is not large. Surgery is only needed for large, thrombosed external hemorrhoids.

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Written by Deng Heng
Colorectal Surgery
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Will external hemorrhoids affect sexual life?

External hemorrhoids generally do not affect sexual life. External hemorrhoids mainly refer to hemorrhoids that grow below the dentate line, primarily divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombosed external hemorrhoids. The main clinical manifestations of the first three types of external hemorrhoids are a foreign body sensation in the anus and moisture at the anus, so they do not affect sexual life. Only thrombosed external hemorrhoids can cause anal pain, which might affect sexual life if the pain is very severe.

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Written by Chen Tian Jing
Colorectal Surgery
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How to treat thrombosed external hemorrhoids

The treatment of thrombosed external hemorrhoids generally includes conservative medication or surgical treatment. Thrombosed external hemorrhoids are a clinical type of external hemorrhoids. They usually present in the acute phase with significant local pain and thrombus encapsulation within the hemorrhoid. Due to congestion and edema in the hemorrhoid, excessive pressure builds up inside, causing severe pain for the patient. Conservative medication treatment primarily involves sitz baths with hemorrhoidal wash solutions and hot compresses to promote thrombus absorption, as well as applying hemorrhoidal creams, or orally taking anti-swelling, pain-relieving, and thrombus-absorbing medications. If these methods repeatedly fail, surgery can be opted to strip and remove the local thrombus.

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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 Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids be ruptured?

If a patient experiences an acute episode of thrombosed external hemorrhoids, the local pressure on the external hemorrhoids is generally high, and there are thromboses wrapped in the hemorrhoid nucleus. However, it is not advisable for patients to burst it on their own, as under unhygienic conditions, doing so could easily lead to local infection of the hemorrhoids, further exacerbating the condition. The treatment of thrombosed external hemorrhoids requires the professional management of a proctologist. Generally speaking, for mild symptoms, local use of Chinese herbal wash solutions or hemorrhoid creams can be chosen to press on the area, which helps promote the absorption of local thromboses. Alternatively, a professional proctologist can use specialized techniques to crush and press the local thromboses. If the thromboses are large or the local symptoms are severe, causing significant pain and severely affecting normal life, surgical excision might also be considered.

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Written by Chen Tian Jing
Colorectal Surgery
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How to reduce swelling of thrombosed external hemorrhoids

During the acute flare of thrombotic external hemorrhoids, the primary issue is the filling of the hemorrhoidal nucleus with blood clots, leading to congestion and swelling of the hemorrhoids. Due to edema or excessive pressure inside the hemorrhoidal nucleus, the patient may experience local discomfort or even severe pain. Therefore, the treatment of thrombotic external hemorrhoids first needs to reduce swelling. The methods mainly include local hot compresses, along with the oral administration of medicines that cool the blood, reduce swelling, and relieve pain. However, in some cases of thrombotic external hemorrhoids, where the blood clots are large or cannot be absorbed on their own after repeated attacks, surgery to excise the clots may be necessary to achieve the purpose of reducing swelling. During the acute flare of thrombotic external hemorrhoids, it is recommended that the patient seek medical attention as soon as possible to avoid complications such as repeated attacks or local blood supply disturbances, which could lead to necrosis of the external hemorrhoids.