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Treatment Options for External Hemorrhoids

written by: AngelicaMD • edited by: BStone • updated: 4/15/2011

Swollen veins near the opening of the anus can cause extreme pain and discomfort. Learn more about your options for external hemorrhoids treatment and how to prevent them from getting worse.

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    What Are Hemorrhoids?

    Hemorrhoids are swollen veins found in and around the anal canal. When they occur inside the anal canal they are referred to as internal hemorrhoids and when they are found near the opening of the anus they are called external hemorrhoids. Many people get one or both types of hemorrhoids, especially those over the age of 50, those who are overweight and many pregnant women.

    Although they may cause severe pain and discomfort, these swollen anal veins are benign or not serious. They are often caused by frequent straining, especially in those suffering from constipation because the pressure against the walls of the rectum and anus leads to stretching and swelling of the tissues in the area. In pregnant women, an increase in pressure in the pelvic area during the last six months of pregnancy can lead to the development of hemorrhoids. These usually become worse when they strain to push the baby during normal labor and delivery.

    External hemorrhoids can bleed and when blood pools within the vessels they are said to be thrombosed. These cause itchiness, pain and bleeding which is seen as bright red streaks of blood during defecation and when cleaning the anal area. Diagnosis consists of visual examination of the anus showing the presence of swollen and often thrombosed veins.

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    External Hemorrhoids Treatment

    In most cases of external hemorrhoids, home remedies may suffice to relieve pain and itchiness. Treatment for hemorrhoids may consist of:

    • Prevention of constipation by increasing fluid intake and adding more fiber to the diet – fiber from fruits, vegetables and whole grain foods are helpful
    • Taking stool softeners
    • Regular exercise helps in decreasing weight which puts pressure in the pelvic area
    • Non prescription oral pain relievers like nonsteroidal anti-inflammatory drugs (ibuprofen, acetaminophen, and naproxen
    • OTC ointments to be applied in the anal area to protect the skin and reduce itchiness - zinc oxide or petroleum jelly
    • Prescription ointments with steroids or local anesthetics to reduce swelling and pain – may be used for a limited time only
    • Suppositories like Preparation H to help lubricate the anal canal during bowel movements and decrease irritation
    • Application of ice on the area for ten minutes several times a day, followed by warm compress applied ten to twenty minutes.
    • Use a sitz bath, consisting of a warm water tub or basin to soak the anal area for around fifteen minutes especially after a bowel movement. This may be done several times a day to relieve pain.
    • One must avoid sitting or standing for long periods of time to prevent an increase in pressure in the pelvic area.
    • Avoid lifting heavy objects.
    • Bed rest can soothe the pain. One may lie down sideways, especially the pregnant woman, or with a pillow under the hips to reduce swelling of the veins in the anal area.
    • Wear loose clothing and cotton underwear to reduce irritation and discomfort in the pelvic area.
    • To prevent hemorrhoids from getting worse one must avoid rubbing the anal area with toilet paper or using harsh soaps. Instead, wash with water from a bidet, blot or wipe gently using baby wipes or soft toilet paper.

    Surgery is often unnecessary. However, removal of blood clots and hemorrhoidectomy may be done:

    • when the pain is severe and chronic
    • when bleeding is uncontrolled
    • one’s lifestyle is affected
    • blood and pus are coming out
    • hemorrhoids are very large and uncomfortable

    Non-surgical fixative procedures may also be done on small hemorrhoids to control symptoms.

    Medical advice is best sought for when considering these options and especially when confirming the diagnosis in older people, where rectal bleeding may be a sign of more serious disease.

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    References

    WebMD, “Hemorrhoids”, http://www.webmd.com/a-to-z-guides/hemorrhoids-topic-overview

    Mayo Clinic, “Hemorrhoids”, http://www.mayoclinic.org/hemorrhoids/treatment.html