External Anal Sphincter Piles 

External anal sphincter piles, commonly known as external hemorrhoids, are swollen veins located around the anus and lower rectum. They can cause discomfort, pain, and bleeding, especially during bowel movements. This guide provides detailed information about external anal sphincter piles, including their anatomy, types, causes, symptoms, diagnostic methods, treatments, prevention strategies, and frequently asked questions.

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Anatomy of External Anal Sphincter Piles

Structure

The external anal sphincter is a muscle surrounding the anus. It helps control bowel movements by tightening or relaxing to allow stool to pass. External hemorrhoids are swollen veins located just beneath the skin around the anus. Unlike internal hemorrhoids, which are inside the rectum, external hemorrhoids can be felt and seen outside the anal opening.

Blood Supply

External hemorrhoids receive blood through the superior rectal artery, which branches from the inferior mesenteric artery. Proper blood flow is essential for the health of the anal tissues, but increased pressure can cause the veins to swell.

Nerve Supply

The area around the anus is richly supplied with nerves, making external hemorrhoids particularly sensitive. Pain and discomfort from hemorrhoids are due to the irritation of these nerves.

Types of Hemorrhoids

Hemorrhoids are classified into two main types:

1. Internal Hemorrhoids: Located inside the rectum. Usually painless but may cause bleeding.
2. External Hemorrhoids: Located under the skin around the anus. Can cause pain, itching, and swelling.

Additionally, hemorrhoids can be categorized based on their severity:

• Grade I: Small swelling without prolapse.
• Grade II: Prolapse during bowel movements but return spontaneously.
• Grade III: Prolapse during bowel movements and require manual repositioning.
• Grade IV: Permanently prolapsed and cannot be pushed back.

Causes of External Anal Sphincter Piles

External hemorrhoids result from increased pressure in the lower rectum, leading to swollen veins. Here are 20 common causes:

1. Straining during Bowel Movements
2. Chronic Constipation
3. Diarrhea
4. Sitting for Long Periods
5. Pregnancy
6. Childbirth
7. Obesity
8. Low-Fiber Diet
9. Heavy Lifting
10. Aging
11. Genetic Predisposition
12. Liver Disease
13. Anal Intercourse
14. Inflammatory Intestinal Conditions
15. Prolonged Standing
16. Frequent Coughing or Sneezing
17. Lack of Exercise
18. High-Impact Activities
19. Poor Bathroom Habits
20. Dehydration

Symptoms of External Hemorrhoids

External hemorrhoids can cause a range of 20 symptoms, including:

1. Pain or Discomfort: Especially during bowel movements.
2. Itching: Around the anal area.
3. Swelling: Visible lumps near the anus.
4. Bleeding: Bright red blood on toilet paper or stool.
5. Lump Formation: Hard or soft lumps around the anus.
6. Irritation: Due to excessive wiping.
7. Burning Sensation: Around the anal region.
8. Mucus Discharge: From the anus.
9. Difficulty Cleaning: Due to swelling.
10. Tenderness: To touch around the anus.
11. Throbbing: Persistent discomfort.
12. Prolapse: Veins protruding outside the anus.
13. Cramping: In the anal area.
14. Bleeding During Exercise: Rare but possible.
15. Persistent Discomfort: Even when not using the bathroom.
16. Visible Veins: Enlarged veins around the anus.
17. Numbness: Around the anal area.
18. Soreness: Chronic discomfort.
19. Redness: Around the affected area.
20. Anal Fissures: Small tears due to irritation.

Diagnostic Tests for Hemorrhoids

To diagnose external hemorrhoids, doctors may use various tests. Here are 20 diagnostic methods:

1. Physical Examination: Inspecting the anal area for swelling.
2. Digital Rectal Exam: Inserting a finger to feel for abnormalities.
3. Anoscopy: Using a small tube to view the anal canal.
4. Proctoscopy: Examining the rectum with a proctoscope.
5. Sigmoidoscopy: Viewing the lower colon with a flexible scope.
6. Colonoscopy: Inspecting the entire colon with a colonoscope.
7. Rubber Band Ligation: Placing bands to restrict blood flow.
8. Ultrasound: Using sound waves to view internal structures.
9. CT Scan: Detailed imaging for complex cases.
10. MRI: High-resolution imaging for detailed views.
11. Defecography: Imaging during bowel movements.
12. Anorectal Manometry: Measuring muscle contractions.
13. Biopsy: Taking tissue samples to rule out cancer.
14. Bleeding Tests: To assess the extent of blood loss.
15. Blood Tests: Checking for underlying conditions.
16. Stool Tests: To rule out infections or other issues.
17. Inspection for Skin Tags: Identifying additional signs.
18. Palpation for Thrombosis: Feeling for blood clots.
19. Venography: Imaging of blood vessels.
20. Endoanal Ultrasound: Detailed view of anal structures.

Non-Pharmacological Treatments

Managing external hemorrhoids often involves lifestyle changes and home remedies. Here are 30 non-pharmacological treatments:

1. High-Fiber Diet: Increase intake of fruits, vegetables, and whole grains.
2. Hydration: Drink plenty of water daily.
3. Regular Exercise: Helps prevent constipation.
4. Avoid Straining: During bowel movements.
5. Proper Bathroom Habits: Don’t delay bowel movements.
6. Sitz Baths: Soak the anal area in warm water.
7. Cold Compresses: Reduce swelling with ice packs.
8. Good Hygiene: Gently clean the area after bowel movements.
9. Avoid Prolonged Sitting: Take breaks to move around.
10. Use Soft Toilet Paper: Prevent irritation.
11. Witch Hazel: Natural astringent applied topically.
12. Aloe Vera Gel: Soothes the skin.
13. Over-the-Counter Creams: Provide temporary relief.
14. Kegel Exercises: Strengthen pelvic muscles.
15. Elevate Feet During Bowel Movements: Use a stool to mimic squatting.
16. Avoid Heavy Lifting: Reduce pressure on veins.
17. Maintain a Healthy Weight: Decrease strain on anal veins.
18. Use Moist Wipes: Instead of dry toilet paper.
19. Avoid Spicy Foods: Prevent irritation.
20. Limit Caffeine and Alcohol: Reduce dehydration.
21. Massage the Area: Gently to improve blood flow.
22. Essential Oils: Like tea tree oil for soothing.
23. Wear Loose Clothing: Prevent irritation.
24. Use Hemorrhoid Cushions: For sitting comfort.
25. Avoid Long-Distance Travel: Prevent prolonged sitting.
26. Manage Coughs and Sneezes: Use supports to reduce strain.
27. Practice Relaxation Techniques: Reduce overall stress.
28. Natural Fiber Supplements: Like psyllium husk.
29. Dietary Adjustments: Reduce foods that cause constipation.
30. Stay Active: Regular movement to keep bowels active.

Medications for Hemorrhoids

When home remedies aren’t enough, 20 medications can help manage hemorrhoids:

1. Topical Creams: Hydrocortisone to reduce inflammation.
2. Suppositories: Medicated treatments inserted into the rectum.
3. Pain Relievers: Acetaminophen or ibuprofen for pain.
4. Stool Softeners: Like docusate sodium to ease bowel movements.
5. Fiber Supplements: Psyllium or methylcellulose to prevent constipation.
6. Witch Hazel Pads: For soothing and cooling.
7. Anesthetic Ointments: Numbing agents for pain relief.
8. Vasoconstrictors: Reduce swelling by narrowing blood vessels.
9. Astringent Lotions: Tighten tissues to reduce bleeding.
10. Botanical Extracts: Such as horse chestnut for vein health.
11. Oral Pain Relievers: For systemic pain management.
12. Hemorrhoid Ointments: Combination of ingredients for relief.
13. Antipruritics: To relieve itching.
14. Protective Barriers: Create a shield over hemorrhoids.
15. Mineral Oil: Lubricates the stool.
16. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Reduce inflammation.
17. Topical Nitroglycerin: To increase blood flow and reduce pain.
18. Calamine Lotion: Soothes irritated skin.
19. Capsaicin Cream: Reduces pain by depleting substance P.
20. Oral Flavonoids: Strengthen blood vessels.

Surgical Treatments

For severe or persistent external hemorrhoids, 10 surgical options may be considered:

1. Hemorrhoidectomy: Surgical removal of hemorrhoids.
2. Stapled Hemorrhoidopexy: Removes tissue and staples to reposition remaining hemorrhoidal tissue.
3. Rubber Band Ligation: Ties a band around the base to cut off blood flow.
4. Sclerotherapy: Injection of a solution to shrink hemorrhoids.
5. Infrared Coagulation: Uses infrared light to reduce blood flow.
6. Laser Therapy: Uses laser energy to remove hemorrhoidal tissue.
7. Doppler-Guided Hemorrhoidal Artery Ligation: Uses Doppler to locate arteries and tie them off.
8. Cryotherapy: Freezes hemorrhoidal tissue to cause it to die and shrink.
9. Flebectomy: Removal of blood vessels causing hemorrhoids.
10. Prolapse and Hemorrhoids (PPH) Procedure: Reshapes the anal canal and reduces blood flow.

Prevention of Hemorrhoids

Preventing external hemorrhoids involves lifestyle and dietary changes. Here are 10 prevention strategies:

1. Eat a High-Fiber Diet: Prevents constipation and straining.
2. Stay Hydrated: Drink plenty of water daily.
3. Exercise Regularly: Promotes regular bowel movements.
4. Avoid Straining: During bowel movements.
5. Don’t Delay Bowel Movements: Go when you feel the urge.
6. Use the Bathroom Properly: Avoid prolonged sitting on the toilet.
7. Maintain a Healthy Weight: Reduces pressure on anal veins.
8. Lift Objects Properly: Avoid heavy lifting or do it correctly.
9. Practice Good Hygiene: Keep the anal area clean and dry.
10. Avoid Prolonged Sitting or Standing: Take breaks to move around.

When to See a Doctor

Seek medical attention if you experience:

• Severe Pain: That doesn’t improve with home treatment.
• Excessive Bleeding: Bright red blood during bowel movements.
• Persistent Itching or Discomfort: That doesn’t go away.
• Lumps Near the Anus: That become hard or don’t reduce.
• Difficulty Passing Stool: Or a change in bowel habits.
• Signs of Infection: Such as fever or chills.
• Unusual Symptoms: Like unexpected weight loss or fatigue.

Frequently Asked Questions (FAQs)

1. What are external hemorrhoids?

External hemorrhoids are swollen veins located under the skin around the anus, causing pain, itching, and bleeding.

2. How do hemorrhoids form?

Hemorrhoids form due to increased pressure in the lower rectum, causing veins to swell and become inflamed.

3. What causes external hemorrhoids?

Common causes include straining during bowel movements, chronic constipation, pregnancy, obesity, and a low-fiber diet.

4. Can hemorrhoids be prevented?

Yes, by maintaining a high-fiber diet, staying hydrated, exercising regularly, and avoiding prolonged sitting or straining.

5. What are the symptoms of external hemorrhoids?

Symptoms include pain, itching, swelling, visible lumps, and bleeding during bowel movements.

6. How are hemorrhoids diagnosed?

Through physical examinations, digital rectal exams, anoscopy, and other imaging tests to rule out other conditions.

7. What treatments are available for hemorrhoids?

Treatments range from home remedies and medications to surgical procedures for severe cases.

8. When should I see a doctor for hemorrhoids?

If you experience severe pain, excessive bleeding, persistent symptoms, or signs of infection, seek medical help.

9. Are hemorrhoids a serious health concern?

While uncomfortable, hemorrhoids are usually not serious and can be managed with proper treatment. However, complications can arise if left untreated.

10. Can diet affect hemorrhoids?

Yes, a diet low in fiber can lead to constipation and straining, increasing the risk of hemorrhoids.

11. What home remedies can relieve hemorrhoid symptoms?

Sitz baths, cold compresses, high-fiber diets, and proper hygiene can help alleviate symptoms.

12. Do hemorrhoids go away on their own?

Mild hemorrhoids may resolve with home treatment, but severe cases might require medical intervention.

13. Can hemorrhoids cause complications?

Yes, complications like thrombosis (blood clots), prolapse, and anemia from chronic bleeding can occur.

14. Is surgery the only cure for hemorrhoids?

No, many hemorrhoids can be treated with non-surgical methods. Surgery is reserved for severe or persistent cases.

15. Can lifestyle changes prevent hemorrhoids?

Absolutely. Maintaining a healthy diet, staying active, and avoiding straining can significantly reduce the risk.

Conclusion

External anal sphincter piles, or external hemorrhoids, are a common condition that can cause significant discomfort. Understanding their anatomy, causes, symptoms, and treatment options can help manage and prevent this condition effectively. By adopting healthy lifestyle habits, seeking timely medical advice, and utilizing appropriate treatments, individuals can alleviate symptoms and improve their quality of life.

 

Authors Information

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

 

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