Hemorrhoids occur as a result of a disease of dilatation and distortion of the external and internal hemorrhoidal plexuses. There are two types of hemorrhoids: internal hemorrhoids that are related to disease of the anal cushions. These are found inside the anus, and in the early stages can be seen only with an anoscope. External hemorrhoids are caused by a disease of the external hemorrhoidal plexus. Some of these venous blood vessels may break causing a hematoma inside the external hemorrhoid called perianal venous hematoma. This is extremely painful and requires urgent medical attention.
Chronic constipation, diarrhea, a diet poor in fibers, prolonged sitting and lack of exercise can lead to dilation and engorgement of blood vessels in the anus.
Diagnosis of external hemorrhoids
External hemorrhoids are usually seen at the edge of the anus. They may only be engorged and will feel painful but soft on palpation. When a hematoma happens inside them, the external hemorrhoids become hard and extremely painful.
Medical Treatment of complicated external hemorrhoids
When external hemorrhoids swell up and cause pain, some basic treatment can be followed:
- Keep stool soft and avoid straining on defecation
- Use of topical creams and ointments that reduce symptoms. These include:
- Natural hemorrhoid cream containing natural substances including mint and cactus.
- Ointments containing effective anti-inflammatory, antibacterial and analgesic substances to reduce swelling and relieve pain.
- Steroid-based cream may be used for a short period of time to reduce swelling as they have anti-inflammatory effects.
To summarize: How do external hemorrhoids disappear?
Simple remedies to resolve external hemorrhoids include:
- Increase water amount to help keeping the stool soft.
- Exercise and avoid sitting for long periods on the toilet.
- Clean the anus thoroughly and gently.
- Take a warm water bath or sitz-baths to reduce swelling.
- Avoid certain foods that in some people may exacerbate symptoms (e.g. spicy food, etc.).
- Use hemorrhoid cream to reduce symptoms.
Signs of healing of external hemorrhoids
External hemorrhoids usually disappear a week after onset with conservative management including the avoidance of constipation, straining and the use of topical ointments or creams containing steroids and local anesthetics.
The swelling and pain slowly disappear over a week after being treated with the use of ointments and custom creams. In case symptoms persist, a proctologist will indicate the best way forward.
Surgical Treatment of External Hemorrhoids
Surgical intervention should be considered to solve the problem of external hemorrhoids once and for all, especially if the condition does not respond to pharmacological or behavioral treatment. Surgery may include deroofing the external hemorrhoid in the acute setting when a hematoma has formed. Another option is the complete excision of the hemorrhoid.
The removal of external hemorrhoid may be performed with scalpel, cautery or using energy devices, such as laser.
Laser excision of external hemorrhoids is one of the best ways as it is usually associated with less pain and fast healing.
Dr. Antonio Privitera and laser treatment for hemorrhoids in Dubai
With the development of modern medicine and the introduction of innovative techniques in surgery to reduce the complications and risks of traditional treatment, Dr. Antonio Privitera advises the use of laser as a final treatment to remove external hemorrhoids, in case surgery is indicated. This may occur is in case the external hemorrhoids are persistent, recurrent, severely painful, and not responding to conservative management.
It is worth mentioning that one of the advantages of laser is the precision of surgery and less pain related to the procedure.