how to treat external hemorrhoids

Hemorrhoids, a common condition affecting millions of people worldwide, can be painful, uncomfortable, and disruptive to daily life. Among the different types, external hemorrhoids occur outside the anal opening and can cause itching, swelling, and sometimes bleeding.

In this article, we will provide a comprehensive guide on how to treat external hemorrhoids effectively. We will discuss various treatment options, lifestyle modifications, and preventive measures to alleviate symptoms and promote healing. Read on to discover important information and find answers to frequently asked questions regarding this condition.

What Are External Hemorrhoids?

External hemorrhoids are swollen veins that develop around the anus and lower rectum. They occur when excessive pressure is exerted on the veins, causing them to stretch and bulge. These swollen veins can be found under the skin around the anus, leading to symptoms such as discomfort, pain, itching, and sometimes bleeding.

Causes and Risk Factors

Several factors can contribute to the development of external hemorrhoids

1. Chronic constipation or diarrhea
2. Straining during bowel movements
3. Sitting or standing for prolonged periods
4. Pregnancy and childbirth
5. Obesity
6. Aging
7. Poor dietary habits, low fiber intake
8. Family history of hemorrhoids

Symptoms of External Hemorrhoids

External hemorrhoids may manifest through various signs and symptoms. These include:
1. External lumps or bulges around the anus
2. Pain or discomfort, especially during bowel movements or sitting
3. Itching and irritation in the anal area
4. Bleeding, usually during bowel movements
5. Swelling and inflammation

How to Diagnose External Hemorrhoids

To diagnose external hemorrhoids, a healthcare professional will usually perform a physical examination of the anal area. They may inspect the external lumps, check for signs of inflammation, and examine for any bleeding. In some cases, a sigmoidoscopy or colonoscopy may be recommended to rule out other possible conditions.

Conservative Management and Home Remedies

In many cases, home remedies and lifestyle modifications can provide relief from external hemorrhoid symptoms. The following measures may help alleviate discomfort:
A. Sitz Bath:
– Fill a bathtub or basin with warm water.
– Sit in the water for 10 to 15 minutes, two to three times a day.
– It helps reduce inflammation and relieve itching or pain.
B. Topical Creams and Ointments:
– Over-the-counter creams containing hydrocortisone may provide relief from itching and inflammation.
– Witch hazel-based products can soothe the affected area.
C. Over-the-counter Pain Relievers:
– Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help reduce pain and inflammation.
– It is important to follow the recommended dosage and consult a healthcare professional if needed.
D. Proper Hygiene:
– Clean the anal area gently with mild soap and water after each bowel movement.
– Avoid using harsh or scented toilet paper and instead opt for soft, fragrance-free options.
E. Dietary Modifications:
– Include high-fiber foods in your diet, such as fruits, vegetables, and whole grains.
– Increase water intake to soften stools and prevent constipation.
– Avoid spicy foods, alcohol, caffeine, and processed foods that can exacerbate symptoms.

Medical Treatments

If conservative management fails to provide relief, medical interventions may be necessary. These treatments are typically performed in a healthcare professional’s office or a hospital setting and include

Rubber Band Ligation

– A small rubber band is placed around the base of the hemorrhoid, cutting off its blood supply.
– The hemorrhoid then shrinks and typically falls off within a week.
B. Sclerotherapy:
– A sclerosing agent is injected into the hemorrhoid, causing it to shrink and wither away.
– Usually used in smaller hemorrhoids or as a follow-up to rubber band ligation.
C. Infrared Coagulation:
– Infrared light is applied to the hemorrhoid, causing it to scar and shrink.
– It is relatively painless and can be performed in an outpatient setting.
D. Doppler-Guided Hemorrhoidal Artery Ligation:
– A Doppler ultrasound device is used to locate and tie off the blood vessels supplying the hemorrhoids.
– This procedure is reserved for severe cases and is usually performed under general anesthesia.
E. Hemorrhoidectomy:
– Surgical removal of the hemorrhoid under general or local anesthesia.
– Used for larger hemorrhoids or when other treatments fail.

Minimally Invasive Procedures

In addition to traditional surgical techniques, several minimally invasive procedures may be employed to treat external hemorrhoids effectively:
A. Stapled Hemorrhoidopexy:
– The stapling method is used to remove excess tissue and reposition the remaining hemorrhoidal tissue.
– It is less painful than traditional surgery and allows for faster recovery.

Laser and Bipolar Coagulation:

– A laser beam or an electric current is used to seal off the blood vessels supplying the hemorrhoid.
– This causes the hemorrhoid to shrink and eventually disappear.

VIII. Precautions and Preventive Measures:
To prevent and manage external hemorrhoids effectively, it is important to adopt certain precautions and make lifestyle changes:
A. Maintain Good Bowel Habits:
– Avoid straining during bowel movements.
– Establish a regular bowel movement routine to prevent constipation.
B. Avoid Straining during Bowel Movements:
– Use proper technique, sitting posture, and avoid sitting for extended periods on the toilet.
– Do not push excessively or strain while passing stools.
C. Adequate Hydration and Fiber Intake:
– Drink plenty of water throughout the day to prevent dehydration and promote soft stools.
– Include fiber-rich foods like fruits, vegetables, and whole grains in your diet.
– Consider taking fiber supplements if necessary.
D. Regular Exercise Routine:
– Engage in regular physical activity to improve bowel movements and prevent constipation.
– Walking, swimming, and cycling are excellent options for maintaining overall colon health.

Frequently Asked Questions (FAQs):

1. Can external hemorrhoids be cured without surgery?
– Yes, in most cases, external hemorrhoids can be managed and resolved using non-surgical treatments and lifestyle modifications.

2. How long do external hemorrhoids last?
– The duration of external hemorrhoids can vary depending on the severity and individual healing abilities. Mild cases may resolve within a week, while chronic ones may require medical intervention for complete resolution.

3. Are external hemorrhoids contagious?
– No, external hemorrhoids are not contagious. They are a result of increased pressure and vascular changes in the anal area, not a result of an infection or transmission.

4. Do external hemorrhoids go away on their own?
– External hemorrhoids can go away on their own, particularly if appropriate measures such as dietary changes and conservative management are employed. However, severe cases may require medical intervention for quicker healing.

5. Can external hemorrhoids cause cancer?
– External hemorrhoids do not lead to cancer. However, it is important to consult a healthcare professional to rule out any other underlying conditions, especially if there are abnormal symptoms.

6. Can exercise worsen external hemorrhoids?
– In general, exercise does not worsen external hemorrhoids. Regular physical activity can promote healthy bowel movements and prevent constipation, which is beneficial for hemorrhoid management.

7. Is it safe to have sexual intercourse with external hemorrhoids?
– Engaging in sexual intercourse with external hemorrhoids may cause discomfort and pain. It is advisable to avoid any activities that may aggravate the condition until the hemorrhoids have healed.

8. Are there any medications specifically for external hemorrhoids?
– Over-the-counter creams and ointments containing ingredients like hydrocortisone, witch hazel, or lidocaine can provide temporary relief for external hemorrhoid symptoms. Prescription medications may be recommended in severe cases.

9. Can sitting on hard surfaces cause external hemorrhoids?
– Prolonged sitting on hard surfaces can increase pressure on the anal area, potentially exacerbating external hemorrhoid symptoms. It is advisable to use cushioned seats or take breaks to relieve pressure regularly.

10. Can obesity cause external hemorrhoids?
– Obesity is considered a risk factor for the development of external hemorrhoids. Excess weight can put increased pressure on the anal and rectal veins, leading to their swelling and protrusion.

11. Are there any dietary restrictions for external hemorrhoids?
– While there are no specific dietary restrictions, it is advisable to avoid spicy foods, alcohol, caffeine, and processed foods that can irritate the digestive tract and worsen hemorrhoid symptoms.

12. Is it common to experience bleeding from external hemorrhoids?
– Bleeding is one of the symptoms commonly associated with external hemorrhoids. However, it is essential to consult a healthcare professional to rule out other potential causes of rectal bleeding.

13. Can stress worsen external hemorrhoids?
– Persistent stress can contribute to various health problems, including digestive issues. While stress alone may not cause external hemorrhoids, it can indirectly worsen symptoms by exacerbating constipation or diarrheal conditions.

14. Can pregnancy cause external hemorrhoids?
– Pregnancy increases the risk of developing external hemorrhoids due to hormonal changes, increased pressure on blood vessels, and excessive straining during childbirth. The condition often resolves after delivery.

15. Can external hemorrhoids lead to rectal prolapse?
– External hemorrhoids do not typically cause rectal prolapse. However, severe or chronic cases, if left untreated, may contribute to rectal wall laxity, potentially increasing the risk of prolapse.

16. Can I use ice packs to relieve external hemorrhoid discomfort?
– Applying ice packs for short durations can help reduce swelling and alleviate discomfort associated with external hemorrhoids. However, avoid direct contact with the skin and limit application to 10-15 minutes at a time.

17. Can external hemorrhoids recur after treatment?
– External hemorrhoids can recur after treatment, especially if proper preventive measures are not followed. Adopting a healthy lifestyle, including a high-fiber diet, regular exercise, and good bowel habits, can help prevent recurrence.

18. Can external hemorrhoids be prevented?
– While it may not always be possible to prevent external hemorrhoids entirely, maintaining a high-fiber diet, staying hydrated, avoiding excessive straining during bowel movements, and adopting a physically active lifestyle can reduce the risk of developing hemorrhoids.

19. Can external hemorrhoids cause sexual dysfunction?
– External hemorrhoids themselves do not directly cause sexual dysfunction. However, the discomfort, pain, and psychological impact associated with the condition can potentially affect sexual performance and enjoyment. Addressing the hemorrhoids and seeking treatment can alleviate this factor.

20. When should I seek medical help for external hemorrhoids?
– If home remedies and lifestyle changes do not provide significant relief or if symptoms worsen, it is advisable to consult a healthcare professional. Additionally, if there is excessive bleeding, persistent pain, or a change in bowel movements, seeking prompt medical attention is crucial.


Knowing how to effectively treat external hemorrhoids is essential for managing symptoms and promoting healing. By adopting a combination of conservative management, medical treatments, lifestyle modifications, and preventive measures, individuals dealing with external hemorrhoids can find relief and regain their quality of life. Remember to consult a healthcare professional for an accurate diagnosis and personalized treatment plan tailored to your specific needs. Don’t let external hemorrhoids hinder your daily life; take proactive steps towards recovery.

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