External hemorrhoids – Types, causes, diagnosis, treatment

What are  external hemorrhoids?

Everyone has hemorrhoidal tissue within their anal canal, which consists of blood vessels, some muscles, and connective tissue. It’s a regular part of the human anatomy that helps control stool. At the baseline level, they are harmless. But there can be a pain, discomfort, and mental distress when hemorrhoids become inflamed or swollen. You may or may not have heard or known of people who have experienced this condition. 

There are the following types of hemorrhoids:

Internal: They can happen when swollen veins develop inside the anus and rectum. Although they are not visible or sensitive to touch or painful, there can be some bleeding in the stool when pressure is put on the anus. Despite the lack of pain, mental distress at seeing blood in one’s stool can be understandably unsettling.

External: Also known as external piles, they can happen around the skin of the anus. They can be itchy and painful and can also bleed. The patient may develop a clot in the external hemorrhoids, which is not dangerous but can cause discomfort.

Prolapsed: When internal or external hemorrhoids protrude out of the rectum, they are identified as prolapsed. The patient may experience lumps on the anus, itching, irritation, bleeding, inability to have a satisfying stool, faecal leakage, and/or mucus discharge with a foul odour.

Learning about external hemorrhoids can be alarming because it can be a setback in day-to-day functioning, but with immediate and adequate medical intervention, one can reach a point of resolution.

External hemorrhoids cause

This article focuses on external hemorrhoids; let us explore their causation here. In general, hemorrhoids form when a person strains their anus while passing stool, spends too much time in the toilet, and often experiences hard stool, constipation, and even diarrhea.

A 2016 paper by the Association of Colon & Rectal Surgeons of India says that about 50% of the Indian population would have experienced hemorrhoids at least once in their lifetime. The susceptibility to developing hemorrhoids also increases with age.
Some common reasons why external hemorrhoids may occur:

• Consuming a diet lacking fiber which makes the stool hard and difficult to pass
• Sitting or standing for prolonged stretches
• Lifting heavy weights and objects
• Pregnancy can increase strain on the anal and rectal veins due to the enlargement of the uterus
• Ageing can cause hemorrhoids because support tissues around the anus and rectum weaken as you grow older

Diagnosing external hemorrhoids

External hemorrhoids are visible and quite apparent to the naked eye, especially if clot formation occurs. So, a physical exam and assessment of symptoms will confirm your suspicion. They appear as a bluish lump outside the anus and can be itchy and ache, especially sitting down. If you are experiencing any of the problems and suspect that they could be caused by external hemorrhoids, you should see a doctor.

Prevention of external hemorrhoids

The best way to avoid the formation or return of external hemorrhoids is to ensure that the stool is semi-solid and soft enough to pass through the anal tract. A diet high in fiber (about 25-30 grams) is essential to avoid constipation. Other lifestyle changes like using a squat potty stool so defecation is easier and increasing water and activity intake can also prove helpful. Going to the bathroom without any delays and spending a short time only on the pot are also helpful in avoiding external hemorrhoids.

External hemorrhoids treatment

External hemorrhoids may go away on their own after a week or so. There are times when this condition does not even require any medical intervention. But chances of recurrence are possible if one does not take the correct steps mentioned above.

Neither internal nor external hemorrhoids are dangerous to your health, and they can be easily managed with home remedies like:

Sitz bath: One sits in a small tub with warm water to relieve pain from external hemorrhoids. This can be done several times daily with or without adding Epsom salt.
Over-the-counter pain meds and ointments: The doctor can prescribe you OTC painkillers and topical creams to reduce inflammation and relieve itching. 
Fiber: Besides upping fiber intake, taking a psyllium husk supplement or other similar supplements is recommended.
Then there are other methods for removal of external hemorrhoids like:

Hemorrhoidectomy: When external hemorrhoids are severe, there is no option but to remove them using a laser or a scalpel. General anesthesia is used here, and this surgery has low complications.
Rubber band ligation: A small band is placed around the base of hemorrhoid to cut blood flow and shrink the protrusion.

Meril Life offers the best products for resolving external hemorrhoids

MIRUSTM HEMORRHOIDS STAPLER: This stapler is used during the surgical intervention (hemorrhoidectomy) for both internal and external hemorrhoids. It also becomes useful during Minimally Invasive Procedure for Hemorrhoids (MIPH) and Stapled Transanal Resection of Rectum (STARR). This device gives security, superior haemostasis, and ease of use. It also has an optimised staple formation with adjustable height staples.

Final note
Experiencing external hemorrhoids, or hemorrhoids of any kind for that matter, can cause not just physical distress but also mental distress. While external hemorrhoids are common in adults, they are also easily controllable and preventable. There are both surgical and non-surgical routes that can be taken depending on the severity of the condition. The recurrence of this condition after surgical excision, however, can be much lower as opposed to home remedies.

References

https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids
https://www.healthline.com/health/external-hemorrhoids
https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
https://www.merillife.com/medical-devices/endosurgery/endo-mechancial-staplers/open-surgery/mirus-hemorrhoids-stapler
https://www.verywellhealth.com/prolapsed-hemorrhoid-1945065
https://www.merillife.com/medical-devices/endosurgery/endo-mechancial-staplers/open-surgery/mirus-circular-stapler