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External Hemorrhoids

What are external hemorrhoids?

Hemorrhoids occur when the veins of the rectum or anus become dilated or enlarged. Depending on where your hemorrhoids are located, they are considered “internal” or “external.” External hemorrhoids are usually found beneath the skin that surrounds the anus.

Recognizing the symptoms of external hemorrhoids

Symptoms

There is a range of symptoms that can affect a person with hemorrhoids. Symptoms tend to vary depending on the severity of your hemorrhoids. Some of the symptoms that you may have include the following:

  • itching around the anus or rectal area
  • pain around the anus
  • lumps near or around the anus
  • blood in the stool

You may notice bleeding when using the bathroom. This includes seeing blood on toilet paper or in the toilet. Lumps around the anus may feel as if they are swollen.

These symptoms may also occur because of other conditions. But if you experience these symptoms, you should schedule an exam with your doctor.

What are the causes of external hemorrhoids?

Causes

The most common cause of hemmorhoids 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.

Who is at risk for external hemorrhoids?

Risk Factors

If your parents have had hemorrhoids, you may be more likely to have them as well. Hemorrhoids may also be caused by pregnancy.

As we age, hemorrhoids can occur due to increased pressure caused by sitting a lot. And anything that causes you to strain during bowel movements can lead to external hemorrhoids.

If you’re not sure what the cause of your hemorrhoids may be, your doctor might be able to determine why.

How are external hemorrhoids diagnosed?

Diagnosis

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:

  • proctoscopy
  • digital rectum exam
  • colonoscopy
  • sigmoidoscopy
  • anoscopy

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.

Find an internist or a general surgeon near you.

Treating external hemorrhoids

Treatment

Hemorrhoids can be treated a few ways depending on severity. Your doctor may ask if you have any preference for certain types of medications or treatments.

Some general treatments that your doctor might suggest include ice packs to reduce swelling, suppositories, or hemorrhoid creams.

These options can offer relief to individuals who have a milder case of hemorrhoids. If you have a more severe case, your doctor may suggest treatment with a surgical procedure.

Surgical treatments include:

  • removal of hemorrhoids, known as hemorrhoidectomy
  • burning of hemorrhoid tissue with infrared photo, laser, or electrical coagulation
  • sclerotherapy or rubber band ligation to reduce the hemorrhoids

How can I prevent external hemorrhoids from developing?

Prevention

The main factor for preventing external hemorrhoids is to avoid straining during bowel movements. If you have severe constipation, you may want to try using aids such as laxatives or including more fiber in your diet.

Stool softeners are another popular over-the-counter option that can help you with temporary constipation due to pregnancy or other factors. If these options don’t help, you may want to talk with your doctor about other options to reduce strain.

What is the long-term outlook for external hemorrhoids?

Outlook

Hemorrhoids are a fairly common condition. Many people recover with proper treatment. In severe cases of external hemorrhoids, surgical methods may be necessary for treatment. People who have severe external hemorrhoids may only notice a reduction as a result of these types of treatment.

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