External Hemorrhoids: What To Expect And What To Do
What To Expect Initially From External Hemorrhoids
External hemorrhoids are annoying, embarrassing and often frightening. Many people react with a combination of terror and disgust when they first see external hemorrhoids, particularly their own. The fear is exasperated with you can't go to anyone aside from a doctor for help with diagnosis or treatment.
While uncomfortable, external hemorrhoids are usually not exceedingly dangerous. They are most often relieved and cured by home treatment regimens. Of course, for any treatment program to be effective, external hemorrhoids must first be correctly diagnosed. Several dangerous anal conditions mimic external hemorrhoids, and these require immediate medical attention.
This explanation of external hemorrhoids was written in part to help you make the best health decisions for your life and circumstances. Before you can decide whether to go to a doctor or to take care of the problem yourself, you must know the pros and cons of each.
We provide a page of clinical hemorrhoid photos so you can compare your suspected external hemorrhoids to confirmed examples. Comparing for yourself may help you with initial self diagnosis. We currently feature three categories of hemorrhoid photos - external, prolapsed internal and thrombosed prolapsed hemorrhoids.
Clinical Photograph of External Hemorrhoids
If you're prepared for the graphic nature of medical-grade hemorrhoid photos, then click --> hemorrhoid pictures.
External Hemorrhoids Defined: What they are and differences from internal and prolapsed hemorrhoids:
External hemorrhoids are swollen masses of tissue originating just outside the anal canal containing enlarged blood vessels. In contrast with internal hemorrhoids, external hemorrhoids always originate below the dentate line, a transition point between internal membrane and external skin. External hemorrhoids are only found in the anal region.
While enlarged blood vessels do occur elsewhere in the body, they are most often referred to as varicose veins. Dependent on specific traits, they may also be called a hematoma, myotoma, or even something else entirely. Hemorrhoids are enlarged veins originating around the anal region, and are so common because anal veins are particularly elastic to assist with sphincter control.
Because internal hemorrhoids occur above the dentate line, they present different symptoms and treatment options than external hemorrhoids. External hemorrhoids usually hurt quite a bit, while internal hemorrhoids may not even be uncomfortable until well advanced. This is due to a change in nerve density right below that dentate line. When an internal hemorrhoid gets large enough to protrude below the detnate line, it's not an external hemorrhoid. Rather, it's classified as a prolapsed internal hemorrhoid, which is not covered in this section.
Symptoms of External Hemorrhoids:
External hemorrhoids are found in an area featuring a dense band of nerves, which can make external hemorrhoids excruciatingly painful.
Of course, many of the symptoms presented by external hemorrhoids are common to any hemorrhoids. When external hemorrhoids are irritated, they cause painful swelling around the anal rim. This swelling is due to the body's natural response to tissue irritation, which involves release of edemic fluid and arrival of immune cells. This enlarged inflammation gives external hemorrhoids quite the unsightly appearance in addition to the massive discomfort they cause. When inflamed, external hemorrhoids can itch, burn, or send lancing pain throughout the region. They're much more uncomfortable than their internal counterparts, which can be seen as a backhanded blessing because you're motivated to do something about them before they get too severe.
While bleeding from external hemorrhoids is much more rare than internal, when it does show up you'll usually find bright red blood on the stool itself, on your toilet paper or in the toilet bowl.
Of course, most of the external hemorrhoid symptoms are also produced by prolapsed internal hemorrhoids, so it's a good idea to know exactly what you're dealing with. External hemorrhoids and prolapsed hemorrhoids are treated quite differently.
To return to the subject of external hemorrhoids, this type can become thrombosed like any other. If an external hemorrhoid is normally inflamed, the swelling should be bright red. If, on the other hand, you notice a dark red, blue, black or purple tint on the hemorrhoid, it means that you've developed a blood clot, or thrombosis, within the hemorrhoid itself. Thrombosis within a hemorrhoid usually produces even more massive pain, burning and itching than usual. Any thrombosed external hemorrhoid should be examined by a doctor immediately, as they can cause dangerous side effects in short order. While the home treatments for your external hemorrhoids aren't going to change, a thrombosis may need to be surgically removed.
External hemorrhoids only occur at or around the anal rim, distinctly originating on the exterior of the body. They never protrude from within the body. If you have a hemorrhoid protruding from inside, it's a prolapsed internal hemorrhoid and needs to be examined by a doctor within a short span of time.
External Hemorrhoids: What To Do When Bleeding
Any bleeding from the rectum needs to be examined by a doctor. There are multiple causes of rectal bleeding, including anal fissures, warts, fistulas, polyps, ulcers and even colorectal cancer. Some can be dealt with at home, but most are dangerous and need a doctor's treatment immediately.
Treating External Hemorrhoids:
Ever wanted to know how to treat and cure hemorrhoids?
Unless an external hemorrhoid is bleeding or thrombosed, they are usually best treated at home. The vast majority of the creams and ointments on the market today are specificially formulated for external hemorrhoid treatment. Those with internal or prolapsed hemorrhoids have far less to choose from.
Don't Create External Hemorrhoids:
"An ounce of prevention is worth a pound of cure." Of course, the best way to avoid suffering from external hemorrhoids is to avoid causing them.
External hemorrhoids are started by excessive pressure on the anal veins. These veins are made to swell and contract within set boundaries in order to help with anal sphincter control, but if they are stretched too far they can't bounce back.
The causal pressure usually comes from abdominal muscle force brought on by constipation or pregnancy.
If pregnancy's the culprit, prevention may not be the way to go for completely different, far more important reasons. The good news is that pregnancy-related hemorrhoids usually vanish within a few months after childbirth with no recurrence.
The basic regimen to relieve and cure constipation-related hemorrhoids helps relieve hemorrhoids related to pregnancy or other health conditions, but may not be enough to cure them without the underlying health problems getting resolution.
Prevention and Cure of External Hemorrhoids:
1...Prevention and cure of external hemorrhoids requires a balanced and healthy lifestyle.
The first step, of course, is to change to a nutritional diet featuring plenty of whole grains and fresh fruits and vegetables.
When adding fiber to the diet, beans are also good sources both of roughage and nutrition. In order to work properly, the intestinal tract needs between 25 to 30 grams of fiber every day. Adding daily fiber too quickly can easily lead to excessive gas, so introduce new, fiber rich food slowly.
Add one new food per week until you reach the proper fiber intake.
Whenever you add fiber to your diet, you must remember to drink enough water as well.
A full grown human requires approximately 64 ounces of water per day in order to stay hydrated. Avoid caffinated drinks like coffee, tea, and soda. Caffeine is a diuretic, a kind of drug that draws water out of the body.
2...In order to attain a healthy, balanced, hemorrhoid free life, you must also get sufficient exercise.
Light and regular exercise serves to "rev up" your body's metabolic engine, which helps you efficiently process food even while resting.
The intestines perform a series of involuntary muscle contractions called "peristaltic motion" in order to push digestive mass through. Peristalsis is aided by normal body movements, such as walking or running.
Adding a program of brisk walking for twenty minutes at a time, three times per week is a wonderful place to start helping your intestines and overall health.
3...It's a good idea to try setting a bowel movement schedule.
One does this by sitting on the toilet at a certain time every day, which eventually trains your colon to empty on a regular basis.
When starting, don't strain or sit for a long time. If nothing happens, just try again the next day. Eventually, your body will take the hint.
4...Resisting the urge to evacuate is never a good idea, as it can cause constipation and fecal impaction problems.
Again, when it comes up, don't strain to hurry the process.
These toileting guidelines don't just help prevent external hemorrhoids, they prevent a whole host of gastrointestinal health problems.
If you're prone to hemorrhoids, any treatment program will ultimately fail unless you include these lifestyle and habit changes. While the hemorrhoid might feel better or even vanish in the short term, the conditions that create hemorrhoids will still plague you.
External Hemorrhoid Treatment Through Fiber and Laxatives:
It can be difficult to get enough fiber to combat hemorrhoids through diet alone.
If this is true in your case, a fiber supplement such as Metamucil may hold the answer. You can't take these supplements too often, and your body doesn't build up a resistance to them. Don't take too much at any one time, though, or you will regret it.
Fiber supplements usually come from flax seed and psyllium seed husks. They don't offer any nutrition, or even chemical action. Rather, they merely add undigestible fiber to your system so you get the roughage you need.
Laxatives, on the other hand, do work through chemical means and can be dangerous.
Never take laxatives on an ongoing basis without a doctor's supervision and care. Overuse or inappropriate use of laxatives can lead to dehydration, intestinal dysfunction and malnutrition.
While a one-time use of a laxative for a specific problem isn't normally a big deal, laxatives are not a maintenance medication for anyone not suffering from specific medical conditions.
External Hemorrhoid Treatment for Itching
Anal itching is clinically referred to as pruritis ani, and doesn't need a hemorrhoid to occur. The most common cause of pruritis ani is external aggravation. This doesn't mean your frustration with your child, but rather irritation caused by tight underwear, harsh soaps, artificial dyes, or vigorous scrubbing.
The idea that we need to clean the anal area excruciatingly well is a myth. While basic hygiene is a necessity, it's important to understand that the anus is designed to be self cleaning and work with it instead of against.
The area of tissue right around the anal sphincter has several oil-producing glands that moisturize while they slough off or kill dirt and bacteria. When we scrub too hard or use the wrong chemicals, we strip the skin of its natural oils. Dry skin naturally itches, and by removing the sterilizing oils we open ourselves up to bacterial infection, which also itches.
When an external hemorrhoid gets particularly aggravated, the itching it causes can start a vicious cycle of itching, scratching, scrubbing and over-cleaning. To avoid this cycle, gentle and immediate relief and treatment are paramount.
To best deal with anal itching, don't clean the area with more vigor than anywhere else, avoid alcohol based wipes, harsh soaps and artificial dyes, and wear clean, loose cotton underwear. If you've got anal itching without a hemorrhoid, make an appointment with your doctor to diagnose the real cause and get back to your natural balance.
Home Remedies for Relief of External Hemorrhoids:
The first line of relief from external hemorrhoid misery can be found as close as your bathroom.
Run one to two inches of water as hot as you can stand in your bathtub, and sit in it for 15 to 20 minutes, up to three times per day. This is called a sitz bath, and if you find it particularly helpful you may want to invest in sitz bath container you might find more convenient. However, it's certainly not necessary for immediate relief.
Never add any chemicals or cleansers to the water, these can make the problem worse instead of better.
Once you get out of the bath, you can alternate the heat of the water with the cool of an icepack. Wrap an icepack or several icecubes up in a towel and sit on it. Never use an icepack on bare skin, always use a towel. These can be used alone or in combination to help with the pain and itching of hemorrhoid inflammation.
External hemorrhoid treatments are reasonably simple:
Use acetaminophen or ibuprofen to get relief from external hemorrhoid discomfort. Ibuprofen is generally better as it is both a painkiller and an anti-inflammatory, while acetaminophen only deals with the pain, but use what you have available.
Even the simplest barrier, such as aloe vera salve, petroleum jelly or cocoa butter can help keep the external hemorrhoid and surrounding skin from drying and itching.
If the irritation goes beyond that, more complex over-the-counter preparations may offer enough help.
The most effective and immediate external hemorrhoid medications are creams, salves and ointments that include lidocaine or hydrocortisone as one of the active ingredients.
Lidocaine is a mild local topical anesthetic related to novocaine. Lidocaine does not actually treat hemorrhoids, but the numbing action will reduce or eliminate pain and discomfort while treatment measures are in progress.
Hydrocortisone is a corticosteroid anti-inflammatory that directly reduces swelling and itching, but this medication isn't recommended for long periods of use without a prescription. Corticosteroids will start to make the muscle walls of the anus thinner over time, which can lead to incontinence and less support for blood vessels, which only increases your likelihood of getting hemorrhoids in the future.
Calamine, zinc oxide, and witch hazel are in a class known as astringents, which perform many of the same functions and are more appropriate for long-term use.
After the birth of each child (I have two), my obstetrician gave me wipes soaked in witch hazel to pat clean with after bowel movements. I found it quite soothing and it helped greatly with many of the problems of pregnancy and childbirth. However, I was warned never to scrub at the area, as scrubbing or harsh cleaning only makes irritation worse. In addition, I was told not to use alcohol based wipes or baby wipes.
If you don't have access to witch hazel, the same effect can be gotten out of a vinegar-soaked sterile cotton swab, but most people find the witch hazel to be best.
Using a sterile cotton swab soaked in vinegar is a quick fix option when you're fresh out of witch hazel. If this works for you, you should still get witch hazel solution as soon as possible, as it's widely acknowledged to be the best.
If home remedies don't start improving external hemorrhoids within seven days, if your symptoms get worse instead of better after you've started a treatment program, or if your symptoms are interfering with your ability to function in daily life, make an appointment with a doctor as soon as possible.
In addition, if any symptom is getting worse, discontinue use of all products and stick with the plain water sitz baths.
Surgical Procedures for External Hemorrhoids:
While there are a number of surgical treatments for hemorrhoids, the only ones for external hemorrhoids are coagulation therapy or full hemorrhoidectomy.
Any surgical procedure for hemorrhoids works by cutting off the lump's blood supply and either shrinking or removing the swollen tissue. The natural strength of scar tissue usually serves to keep the veins around the origin of the hemorrhoid supported.
There's usually a small amount of rectal bleeding for approximately a week after any surgical hemorrhoid procedure except full hemorrhoidectomy. There's usually a lot of bleeding after one of those.
For coagulation therapy, frequent sitz baths after surgery help with both the discomfort and hygiene issues.
In addition, most doctors will give you prescriptions for anti-inflammatories, painkillers and antibiotics to take after surgery in order to reduce both pain and complications.
Any surgical procedure carries risks such as infection, ulceration and wound bursting.
No hemorrhoid surgery is free from these risks or potential side effects, so following pre- and post-surgical instructions is vital to reducing your chances of suffering one of these.
While you may have heard of latex band ligation and sclerotherapy as hemorrhoid treatments, be aware that these are UNSUITABLE for external hemorrhoid treatment. They can only be used on internal hemorrhoids, and then only if the internal hemorrhoids are in the right size range.
Coagulation therapy is a less invasive procedure that is becoming more available as an option.
This surgical procedure relies on lasers, infrared lights, or electricity to cauterize the blood flow to the hemorrhoid and therefore eliminate it.
Coagulation therapy is usually painful but carries less risk of adverse events than hemorrhoidectomy.
The external hemorrhoid and surrounding area will be irritated and inflamed for a number of days, but recovery is generally faster than from full surgery. The equipment to perform coagulation therapy is not universally available yet, so you'll need to research whether it's cost-effective and appropriate to your circumstances. Do your research to make sure that the surgeon you pick has performed this kind of procedure often and is fully certified on the exact method used.
Hemorrhoidectomy is the most invasive surgical procedure possible.
You're placed under full anesthesia in an operating theater and have the hemorrhoid excised.
This surgery cannot take place at a doctor's office, it must be done at a hospital.
While you may go home the same day if everything goes well, they may keep you in the hospital if any difficulties come up.
Either way, you'll probably be spending well over a week on bedrest.
Hemorrhoidectomy is performed either with scalpel or laser, and seems to have equal results and risks with each option.
Scalpel surgery carries more risk of bleeding and infection, while laser surgery can cause deep tissue burns and scarring.
Studies have shown that if both procedures are performed competently, the recovery time and recurrence rate is about equal.
Hemorrhoidectomy is the best option if you have severe external hemorrhoids or if they've come back in the past.
Open and honest communication with your doctor is essential to find the best hemorrhoid procedure for you.
External hemroids are usually a relatively mild health problem, and the home treatments are usually the most effective ones.
Using over the counter creams and salves for external hemroid relief also helps whether you've chosen a doctor-administered procedure or not, but you should stop using them after the treatment.
For any external hemroid medical procedure to be effective, you usually have to make a commitment to practice things like diet change anyway, so it's best to start there. After all, by making a commitment to eating better and exercising more, you're helping more than just your hemroids.
Under normal circumstances, external hemorrhoids are a mild health problem at worst.
Home treatments are the most effective unless complications are already present.
Over the counter creams and ointments are handy for external hemorrhoid relief even if you've chosen to have surgery, but stop using them during recovery.
Diet and lifestyle changes are essential to keep hemorrhoids from coming back no matter what, so those are a good place to start. Making a commitment to eat better and exercise more helps more than just your hemorrhoids.
Research and main write by Loni L. Ice, editing by D. S. Urquhart.
Main book reference "Taber's Cyclopedic Medical Dictionary" F.A. Davis Company, Philadelphia, 1997 + several more modern references.
External Hemorrhoids Spelling:
External hemorrhoids and external hemroids are the two "correct" spellings you'll find. External hemorroids and many other variations are consider technically incorrect, but are fairly common.
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All the best to you in your search for hemorrhoid relief and prevention
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HEMORROIDES el español.