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Assessing External Hemorrhoids: When to Consider Surgery

6/23/2025, 5:20:20 AMMale25-34

I'm a 33-year-old woman weighing 110 pounds and currently dealing with two minor external hemorrhoids, each about 2mm wide. These have been present since last year. There are good days and bad days with them; some days they seem more pronounced, but they’ve never completely gone away. Their appearance bothers me quite a bit, and I find wiping uncomfortable. During my last colonoscopy, my surgeon mentioned that a hemorrhoidectomy could be a viable option. However, I’ve heard the recovery from such a procedure can be quite difficult. She also indicated that the banding technique isn't effective for external hemorrhoids. I'm seeking a second opinion to determine whether I should endure surgery or if it might resolve on its own.

Crohn's DiseaseInternal MedicineRheumatology

Answers (1)

Cony

6/23/2025, 5:20:37 AM

OpenHealth AI

It's understandable to feel concerned about your external hemorrhoids, especially when they affect your comfort and well-being. Given that you've had them for some time, and you've noted discomfort with wiping, it’s important to weigh your options mindful of your lifestyle and preferences.

Overview:

External hemorrhoids can often cause discomfort and dissatisfaction with their appearance. As they can vary in symptoms, some people find relief through conservative measures, while others consider surgery if symptoms are persistent or bothersome.

Explanation:

External hemorrhoids are swollen blood vessels in the anal area. They can cause discomfort, itching, and sensitivity, especially during bowel movements or when wiping. Since you mentioned that you’ve had them for a while and they are not going away, it's worth considering your management options. Non-surgical treatments typically focus on alleviating discomfort and may include dietary adjustments, topical treatments, and improved hygiene practices.

Next Steps:

  1. Lifestyle Modifications:

    • Increase Fiber Intake: Aim for 20-35 grams of fiber daily through fruits, vegetables, whole grains, and legumes. This can help soften stools and reduce straining.
    • Stay Hydrated: Drinking plenty of water can also prevent constipation.
    • Warm Baths: Soaking in a warm bath several times a week can soothe discomfort.
  2. Topical Treatments:

    • Over-the-counter creams or ointments that contain hydrocortisone can relieve discomfort and inflammation. Witch hazel pads may also help.
  3. Monitor Symptoms:

    • Keep a diary of your symptoms, noting any changes and triggers (like diet or activities). This can help gauge their variability and determine how much they impact your daily life.
  4. Evaluate Surgical Options:

    • If your symptoms persist and significantly affect your quality of life, and conservative measures do not help, a frank discussion about a hemorrhoidectomy may be necessary. Keep in mind that recovery can vary; some individuals experience significant relief post-surgery, while others find recovery challenging.
  5. Communicate with Your Surgeon:

    • If surgery is still on the table, discuss your concerns regarding recovery and the surgical process. There may be other techniques or advice specific to your case that can be beneficial.

Feel free to revisit these steps over the next few weeks and note any changes in your symptoms. It's important to find a balance that maintains your quality of life while managing your concerns about your hemorrhoids. Let me know if you have any further questions or needs!

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