External Hemorrhoids: Symptoms, Causes, Risk Factors, Diagnosis and Treatment

Origin of external hemorrhoids

The most common cause of external hemorrhoids occurs when the effort is repeated in a bowel movement. In this sense, hemorrhoids develop when the veins of the rectum or anus dilate or enlarge.

These dilatations can be “internal” or “external”. External hemorrhoids are usually found under the skin surrounding the anus.


Recognizing the symptoms of external hemorrhoids

There are a number of symptoms that can affect a person with hemorrhoids. The symptoms tend to vary depending on the severity of your hemorrhoids. Some of the symptoms that a person can have are the following:

  • Pruritus around the anus or rectal area
  • Pain around the anus
  • Lumps near or around the anus
  • Blood in the stool

You may notice bleeding when you need to use the bathroom. For example, find blood on toilet paper or in the toilet.

Also, the bumps around the anus may feel as if they are swollen.

These symptoms can also occur due to other conditions. But if you experience these symptoms, you should schedule an exam with your doctor.


Usually, external hemorrhoids could occur in those cases where evacuation involves a lot of effort or vigor on the part of the person.

This is often caused by severe cases of constipation or diarrhea. The effort gets in the way of blood flow in and out of the area. This results in the accumulation of blood and enlargement of the vessels in that area.

However, it must be said that pregnant women may also be at an increased risk of hemorrhoids due to the pressure that the uterus puts on these veins.

Risk factor’s

Who is at risk for external hemorrhoids?

If your parents have had external hemorrhoids at some time, you may be more likely to have them too; that is, if there are precedents in your family, you may be exposed to it.

However, hemorrhoids can also be caused by pregnancy, in the case, obviously, of women.

Now, another factor to take into account is the age. Well, as we get older, hemorrhoids can occur due to the increased pressure caused by sitting a lot.

But also, everything that causes tension during bowel movements can lead to external hemorrhoids.

If you are not sure what could be the cause of your hemorrhoids, your doctor may be able to determine why you are being affected by this bothersome condition.


Because many of the symptoms of external hemorrhoids can be caused by other conditions not mentioned here, an in-depth examination is necessary.

Therefore, your doctor may use a series of tests to confirm the presence of external hemorrhoids near the anus.

These tests may include:

  • Proctoscopia
  • Examination of the digital rectum
  • Colonoscopy
  • Sigmoidoscopia
  • Anoscopia

Your doctor can start with a physical exam. In cases of external hemorrhoids, they may be able to see hemorrhoids.

If your doctor suspects you have internal hemorrhoids instead of external hemorrhoids, you can use an anoscopy to examine the inside of the anus.

Internal hemorrhoids can also be seen with colonoscopy, sigmoidoscopy or proctoscopy.

Treatment of external hemorrhoids

External hemorrhoids can be treated in several ways depending on the severity. Your doctor may ask if you have a preference for certain types of medications or treatments.

Some general treatments that your doctor might suggest include ice packs to reduce swelling, suppositories or hemorrhoid creams.

These options can offer relief to people who have a milder case of hemorrhoids. If you have a severe case, your doctor may suggest treatment with a surgical procedure.

Surgical treatments include:

  • Hemorrhoid removal, known as hemorrhoidectomy
  • Burning of hemorrhoid tissue with infrared photo, laser or electric coagulation
  • Sclerotherapy or rubber ligation to reduce hemorrhoids


How can the development of hemorrhoids be prevented?

The main factor to prevent external hemorrhoids is to avoid tensions during bowel movements.

If you have severe constipation, you can try using aids such as laxatives and add more fiber to your diet.

Stool softeners are another popular over-the-counter option that can help with temporary constipation due to pregnancy or other factors.

If these options do not help, you may want to talk with your doctor about other options to reduce stress.

What is the long-term perspective of external hemorrhoids?

Hemorrhoids are a fairly common condition. Many people recover with the proper treatment. In severe cases of external hemorrhoids, surgical methods may be necessary for treatment.

People who have severe external hemorrhoids can only notice a reduction in symptoms as a result of these types of treatment.

External and Internal Hemorrhoids

Internal hemorrhoids are far enough inside the rectum that you can not normally see or feel them. Generally they do not hurt because you have few nerves sensitive to pain. Bleeding may be the only sign of them.

External hemorrhoids are under the skin around the anus, where there is much more sensitivity to nerve pain, so they tend to hurt as well as bleed.

Sometimes prolapsed hemorrhoids can be bigger and protruding from the anal sphincter, which makes you sick. You may be able to see them as wet protuberances that are more pink than the surrounding area.

And they are more likely to hurt, at the time of excretion. Prolonged hemorrhoids usually come back on their own. Even if they do not, you can often push them gently back into place.

A blood clot can form in an external hemorrhoid, turning it purple or blue. This is called a thrombosis.

It can hurt, itch a lot and it could bleed. When the clot dissolves, you may still have some excess skin, which could be irritated.

How to prevent external hemorrhoids

  • A good measure to prevent external hemorrhoids is to eat enough fiber. A good way to obtain it is from vegetable foods: vegetables, fruits, whole grains, nuts, seeds, beans and legumes.
  • Drinking water. This will help you avoid hard stools and constipation, so they stretch less during bowel movements. Fruits and vegetables, which have fiber, also have water in them.
  • Exercise. Physical activity, like walking half an hour every day, is another way to keep blood and bowels moving.
  • You should go to the bathroom as soon as you feel the impulse, because prolonging the wait will not help you much, but rather could be harmful.