Clinical Characteristics of External Hemorrhoids

Written by Deng Heng
Colorectal Surgery
Updated on January 02, 2025
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External hemorrhoids refer to hemorrhoids located below the dentate line, which are classified into four main types, each with distinct clinical manifestations. Connective tissue external hemorrhoids and varicose vein-type external hemorrhoids primarily present with a mild sensation of a foreign body in the anus. Inflammatory external hemorrhoids are characterized by redness, swelling, protrusion, burning, or itching of the anal skin or skin tags. Thrombosed external hemorrhoids often occur after intense exercise or straining during bowel movements, suddenly presenting as a round or oval lump under the skin at the edge of the anus. This lump contains a venous thrombus and is accompanied by anal pain.

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Written by Chen Tian Jing
Colorectal Surgery
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How to quickly eliminate the flesh masses of external hemorrhoids?

If a patient has an external hemorrhoid that has enlarged and they want to quickly or completely eliminate it, it is recommended to directly perform surgical removal. External hemorrhoids generally include thrombotic external hemorrhoids, varicose cluster external hemorrhoids, and inflammatory edematous external hemorrhoids. There are also some skin tag-like or connective tissue external hemorrhoids that do not exhibit clinical symptoms, and do not require excessive intervention in treatment. However, during an acute attack of thrombotic or inflammatory edematous external hemorrhoids, due to congestion or increased pressure in the local hemorrhoidal nucleus, severe pain can occur. You can choose to press with dilute salt water to promote the dissipation of edema. Complete removal requires surgical excision to avoid recurrent flare-ups of the condition.

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Written by Chen Tian Jing
Colorectal Surgery
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The difference between mixed hemorrhoids and external hemorrhoids

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 heal by themselves?

External hemorrhoids can be classified into cutaneous flap hemorrhoids, varicose vein hemorrhoids, thrombotic hemorrhoids, and inflammatory hemorrhoids. These are mostly caused by poor defecation habits of the patient, such as prolonged defecation time or excessive straining during bowel movements, which then lead to the growth of excess skin flaps, varicose veins, or rupture of venous blood vessels, resulting in various types of external hemorrhoids. Therefore, these types of hemorrhoids cannot heal on their own and require treatment with medication or surgery. For cutaneous flap hemorrhoids, if the patient does not experience significant discomfort, specific treatment is generally not necessary, just attention to hygiene around the anal area is needed. However, for inflammatory or thrombotic hemorrhoids, since they can cause anal pain and a feeling of prolapse, it is advisable to opt for surgical stripping of the hemorrhoids as soon as possible. Post-surgery, treatments such as anal washes, red oil gauze strips, and golden ointment should be used for dressing changes, while also maintaining cleanliness of the anal region.

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Written by Chen Tian Jing
Colorectal Surgery
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How to relieve pain from thrombosed external hemorrhoids?

The main cause of pain in thrombotic external hemorrhoids is the thrombus within the local hemorrhoid nucleus, which increases the congestion pressure and leads to discomfort and pain. During the acute phase of thrombotic external hemorrhoids, there is generally pain or bloating in the local area, along with difficulty in defecation. To quickly alleviate the pain, one can manually break the local thrombus or use traditional Chinese medicine washes for hot compresses to promote the absorption of the thrombus. If the thrombus is large or the condition is severe, surgery can also be performed to peel and remove the local thrombus, which is the most effective method for pain relief. After the surgery for peeling off thrombotic external hemorrhoids, it is necessary to disinfect the local wound surface to avoid infection.

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Written by Chen Tian Jing
Colorectal Surgery
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Is a mixed hemorrhoidal thrombosis external hemorrhoid serious?

When thrombotic external hemorrhoids are combined with mixed hemorrhoids, the situation is generally not severe. However, if it is in the acute phase, it needs to be dealt with as soon as possible. During the acute phase of thrombotic external hemorrhoids, there is severe pain in the local area of the anus, accompanied by swelling. The patient feels restless and the pain is unbearable, and thrombectomy surgery needs to be performed as soon as possible. If mixed hemorrhoids with thrombosis do not affect the patient's life, methods such as using anal plugs, hemorrhoid suppositories, or applying hemorrhoid cream to the anus can be used. Additionally, attention should be paid to not strain too much during bowel movements, as excessive straining can cause more severe congestion and swelling in the hemorrhoidal nucleus in the local area of the anus, thereby aggravating the condition of thrombotic external hemorrhoids.