External hemorrhoids are a type of anorectal condition caused by the enlargement of subcutaneous veins around the anus, often presenting with symptoms such as pain, itching, or swelling. Bowel habits, lifestyle, and genetic factors play a significant role in the development of this condition.
Symptoms of External Hemorrhoids
Unlike internal hemorrhoids, external hemorrhoids form beneath the skin surrounding the anus and can therefore be seen with the naked eye or felt by touch. Symptoms vary depending on the size of the hemorrhoid, whether or not it contains a clot, and if inflammation is present.
- Swelling in the Anal Area
The most noticeable symptom of external hemorrhoids is a lump around the anus that can be felt or seen. This swelling becomes more apparent especially after defecation. If a clot has formed inside the vein, the lump tends to be harder and more painful. - Pain and Tenderness
Pain is the most common symptom and often prompts patients to consult a doctor. In cases of thrombosed external hemorrhoids, sudden and severe pain may occur, making it difficult to sit. - Itching and Irritation
Hemorrhoids may cause moisture around the anus, which leads to chronic itching and skin irritation. Frequent scratching can trigger eczema-like skin problems. - Bleeding
Bleeding from external hemorrhoids is usually due to superficial tears. In open, non-thrombosed external hemorrhoids, mild bleeding may occur following straining during bowel movements. - Clot Formation (Thrombosis)
A thrombosed hemorrhoid develops due to clot accumulation in the vein. A hard, purple-colored, and very painful lump appears. This condition may require urgent medical intervention.
Table of External Hemorrhoid Symptoms
| Symptom | Prevalence | Description |
|---|---|---|
| Swelling around the anus | Very common | Can be felt by hand, sometimes visible |
| Severe pain | Especially with thrombosis | May cause difficulty in sitting and walking |
| Itching and irritation | Frequent | Increases with skin moisture and irritation |
| Surface bleeding | Moderate | Usually occurs after bowel movements |
| Hard, purplish lump | Sign of thrombosis | May require emergency treatment |
Treatment of External Hemorrhoids
The treatment method for external hemorrhoids depends on the stage of the condition, the severity of symptoms, and whether complications are present. In general, treatment includes lifestyle modifications, medical approaches, and surgical interventions.
- Lifestyle and Dietary Adjustments
- Increase intake of high-fiber foods (vegetables, fruits, oats)
- Ensure adequate daily water intake
- Support circulation with regular exercise
- Avoid prolonged sitting
- Avoid straining and spending too much time on the toilet
These simple changes can help reduce symptoms in mild cases.
- Medications and Supportive Treatments
- Pain relievers (paracetamol, ibuprofen)
- Topical creams and ointments (hydrocortisone, lidocaine, witch hazel-based products)
- Cold compresses: May reduce swelling and pain
- Sitz baths: Done with warm water, relieves irritation and itching
- Treatment of Thrombosed External Hemorrhoids
Thrombosed external hemorrhoids usually subside with conservative treatment. However, if the pain is severe, surgical drainage (thrombectomy) may be required. This procedure is done under local anesthesia and provides relief.
- Surgical Treatment (Hemorrhoidectomy)
In cases of frequent recurrence, large, bleeding, or thrombosed hemorrhoids, surgical intervention may be necessary. The hemorrhoidal tissues are completely removed by surgery. Postoperative recovery varies from person to person but typically takes 2–3 weeks.
Which Department to Consult for External Hemorrhoids?
People experiencing external hemorrhoid symptoms should consult the General Surgery department. Surgeons specialized in anorectal conditions have experience in examination and treatment approaches for the rectal area.
Examination Process
- Visual and manual examination
- Anoscopy: May be needed to rule out internal hemorrhoids
- Blood tests and differential diagnosis of other anorectal diseases when necessary
When Do External Hemorrhoids Become Serious?
Although external hemorrhoids are generally benign, the risk of complications increases under certain conditions:
- Thrombosis: Severe pain due to clot formation may require urgent intervention.
- Persistent bleeding: Increases the risk of anemia.
- Infection: Can occur in severely swollen and inflamed hemorrhoids.
- Symptoms that impair quality of life: Persistent discomfort during sitting, walking, or bowel movements may occur.
These situations should be taken seriously and medical attention should not be delayed.
External hemorrhoids are a significant health issue that can cause severe discomfort, pain, and bleeding around the anus. If detected early, they can be controlled with appropriate lifestyle changes. However, in severe cases, medical or surgical treatment may be unavoidable. Therefore, if symptoms of external hemorrhoids are observed, consulting a General Surgery specialist without delay is crucial for accurate diagnosis and effective treatment.
All content on this site is for informational purposes only and is based on scientific sources valid as of the date of preparation. For any symptoms, diagnosis, or treatment requiring medical attention, please consult your doctor or a licensed healthcare provider directly.
