EXTERNAL HEMORROIDS: causes, symptoms, main remedies and treatments


We talk about external hemorrhoids when hemorrhoids protrude from the anal canal and are visible to the naked eye. There are many people between 45 and 65 years of age living in developed countries who suffer, at some point in their lives, from hemorrhoids. The general percentage, in fact, varies between 50% and 66% of the population, both male and female, while a percentage equal to 30% specifically concerns pregnant women; however, despite being such a frequent and widespread problem, a certain modesty prompts you to talk about it with your doctor only in extreme cases. It seems that the first testimony that has come to us of this disease dates back, even, to an Egyptian papyrus of 1700 BC

What are hemorrhoids

The hemorrhoids they are structures placed in the anal orifice where numerous blood vessels intertwine which can be subject to inflammation. In their normal state, these vascular structures are pads that aid in stool control, but they become pathological when they become inflamed and swollen. Internal hemorrhoids usually present with bright red bleeding and are painless during defecation. The external ones, bluish-red, flow at the height of the sphincters and cause bowel movements with pain, swelling, burning, itching and discomfort in the anus area and, sometimes, blood loss. Although the precise causes of hemorrhoids are uncertain, it is believed to be due to some factors that increase abdominal pressure, including constipation, diarrhea, straining to defecate, and pregnancy.

Although they share intense pain, bleeding and itching, hemorrhoids should not be confused with anal fissures, skin lacerations that form in the anal canal or on the mouth of the anus. Their formation is due to an excessive dilation of the anus during defecation, which causes a break in the skin. Generally, this laceration resolves itself in a few days, but, when it occurs repeatedly, always in the same spot, it no longer heals and then we speak of a fissure.

Hemorrhoids are diagnosed by visual examination of the area. Numerous people use the term "hemorrhoids" inappropriately to describe any symptoms that occur around the anal area, thus ruling out possible more serious causes of the symptoms. Colonoscopy can reasonably be used to confirm the diagnosis or rule out more serious causes.

External hemorrhoids

External hemorrhoids: notice the difference between a real external hemorrhoid and a prolapsed internal hemorrhoid


Why do hemorrhoids come out? The causes why are formed hemorrhoids are linked to a number of factors including irregular bowel habits, such as chronic constipation or diarrhea, poor physical activity and sedentary lifestyle, low-fiber diet, abuse of laxatives, alcohol, caffeine and nicotine, increased abdominal pressure due to strain prolonged and excessive or to pregnancy, genetic factors, obesity, cough and aging. Unfortunately, hemorrhoids can also be a symptom of cancer or cardiovascular disease.

Recent studies show that patients with hemorrhoidal pathology they tend to have narrower than average smooth muscle in the anal canal, even when not under strain. Constipation adds to these problems because they strain during the defecation increases the pressure of the anal canal and pushes the hemorrhoids against the sphincter muscle. Finally, the connective tissues that support and keep the hemorrhoids in place can weaken with age, causing prolapse and swelling.


The migration of hemorrhoids outwards, that is, outside the anus, can occur permanently or only during defecation; the most common symptoms of external hemorrhoids are:
- sensation of rectal weight;
- anal itching, discomfort and burning;
- bright red blood loss, not only associated with defecation, and possible anemia caused by bleeding;
- pains, even excruciating ones, during evacuation or when sitting down, with the probable presence of hemorrhoidal thrombophlebitis;
- swelling and sensation of a lump in the anus, which, in particular, are symptoms associated with inflamed hemorrhoids;
- prolapse of the rectal mucosa.

External hemorrhoids can also cause excess skin growths at the anal edge, causing problems with cleaning after a bowel movement that leads to secondary skin infections.
A vascular thrombosis of external hemorrhoids occurs when an underlying vein closes, preventing blood circulation. It is a condition that causes very intense pain. In the case of thrombosed hemorrhoids, an incision is generally used which, by releasing the clot, temporarily removes the pain. The pathology is not eliminated, however, and can, unfortunately, reappear. In addition, even after the thrombosis has recovered, a protrusion of skin may remain.


But how to cure, deflate and return hemorrhoids? Well, the hemorrhoid therapy, which varies according to the severity of the problem, may include the use of pharmacological remedies, natural remedies and, finally, also surgical therapy. The initial measures to treat bothersome but not too painful hemorrhoids are behavioral, that is, they consist in modifying daily actions, for example by increasing the intake of fiber, drinking more fluids to stay hydrated and also doing more physical movement for the purpose. to favor intestinal evacuation and blood circulation, to de-inflammation the venous walls and make them more elastic.

If, on the other hand, you suffer a lot and the problem has become chronic, you must resort to pharmacological remedies, taking, for example, the NSAID drugs prescribed by the doctor, to control the pain, while remaining at rest. Even a good ointment for hemorrhoids, in gel or cream, disinfectant and decongestant, based on cortisone and anesthetic substances, can be applied to the affected area, to soothe the pain while trying to bring the hemorrhoid back into the anus with the hand. If the symptoms, however, do not improve with conservative therapy, surgical removal can be used, with hemorridectomy, often resolving, or with a less invasive operation (Thd method) that causes the hemorrhoids to deflate, blocking their blood supply, but without removing them, or with the repositioning of prolapsed hemorrhoids.

Natural remedies are effective, but more in the long term, and are, above all, soothing and preventive of the problem, however they do not have the side effects of synthetic drugs. You can, for example, eat berries, in particular blueberries, and use extracts of witch hazel, rusco, centella asiatica and horse chestnut, rich in flavonoids useful for strengthening, protecting and healing the veins, and also treating anal hygiene by doing the bidet with the concentrated infusion of chamomile, warm or cold, but not icy, and also add the extract of propolis, natural antibiotic and antiviral.


During the period of pregnancy, hormonal changes, with an increase in progesterone and estrogen, the volumetric development of the uterus, which, pressing on the veins of the anus, favors constipation, increased abdominal pressure, stagnation of blood and a decrease physical activity, represent factors that predispose to dilate and weaken the veins, causing the prolapse of hemorrhoids, anal swelling and the development of varicose veins. Furthermore, neglecting the problem and not treating it favors the worsening of the pathology, even with the appearance of anal fissures and anemia.

Therefore, in addition to going to the doctor, you need to opt for dietary and behavioral precautions to treat constipation and free the intestine, eating more fiber from fruit and vegetables and drinking more water to soften the stool, and decrease inflammation and vascular weakness , increasing physical movement, perhaps walking every day. It is also very important to take care of anal hygiene to prevent infections and worsening of the problem. But how to relieve the pain?

Well you can use suppositories or ointments based on anesthetic and cortisone drugs to relieve symptoms, but in pregnancy it is better to prefer natural treatments such as phytotherapy, which is less risky than drugs. You can decrease inflammation, for example, with concentrated infusions of mallow and chamomile to be used for anal hygiene, and replace the ointment with aloe gel or olive oil, which are also beneficial in case of fissures. Among others precautions Some foods, such as chocolate, coffee, alcohol, sausages, hot spices, and junk foods, should be avoided as they increase inflammation. Also, if you have to sit for many hours, you should sit on a pillow.


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