External rectal venous plexus masses refer to swellings or lumps caused by the enlargement of the veins around the anus. These masses are commonly known as external hemorrhoids, which can be uncomfortable and painful. These can be caused by several factors, and while they are common, many people experience them at some point in their lives.

In this article, we will break down the anatomy, causes, symptoms, diagnostic tests, treatments, medications, and prevention strategies for external rectal venous plexus masses in easy-to-understand language.

---

Anatomy of External Rectal Venous Plexus

The rectal venous plexus is a network of veins found around the anus and lower rectum. This network consists of two main parts:

1. Internal Venous Plexus: Inside the rectum and can cause internal hemorrhoids.
2. External Venous Plexus: Outside the anus, which when swollen leads to external hemorrhoids.

Structure of External Rectal Venous Plexus

• The external rectal venous plexus is located just beneath the skin around the anus.
• The veins in this area are responsible for carrying blood away from the lower rectum and anus.
• When these veins swell or become enlarged due to pressure, it leads to the formation of external hemorrhoids.

Blood Supply

• The blood supply to the external rectal venous plexus comes from the inferior rectal artery, which is a branch of the internal pudendal artery.
• The veins drain into the inferior rectal veins.

Nerve Supply

• The external venous plexus is richly supplied by nerves. These are branches of the pudendal nerve, which is why external hemorrhoids are painful since the nerves in this region can sense touch, pain, and temperature.

---

Types of External Rectal Venous Plexus Masses

There are two main types of hemorrhoids related to the rectal venous plexus:

1. External Hemorrhoids:
   • Form under the skin around the anus.
   • Visible and can feel like hard lumps.
   • Usually more painful due to the nerve supply.
2. Thrombosed Hemorrhoids:
   • A more severe form of external hemorrhoids where a blood clot forms inside the swollen vein.
   • Often more painful and causes significant discomfort.

---

Common Causes of External Rectal Venous Plexus Masses

1. Chronic constipation
2. Straining during bowel movements
3. Sitting for long periods on the toilet
4. Obesity
5. Pregnancy
6. Heavy lifting
7. Diarrhea
8. Low-fiber diet
9. Aging
10. Genetics
11. Prolonged sitting or standing
12. Lack of exercise
13. Anal intercourse
14. Chronic coughing
15. Heavy alcohol consumption
16. Dehydration
17. Liver disease
18. Pelvic tumors or growths
19. Rectal or anal surgery
20. Trauma or injury to the rectal area

---

Symptoms of External Rectal Venous Plexus Masses

1. Painful lumps near the anus
2. Swelling around the anus
3. Itching in the anal area
4. Bleeding during bowel movements
5. Discomfort while sitting
6. Tenderness near the anus
7. Visible bulges or lumps near the anus
8. Hard lump due to clot formation (thrombosis)
9. Pain while passing stool
10. Leakage of stool (minor)
11. Mucus discharge
12. Feeling of incomplete bowel movement
13. Redness around the anus
14. Skin irritation around the anus
15. Anal burning sensation
16. Difficulty cleaning the anus after bowel movement
17. Inability to sit comfortably
18. Pain when walking
19. Infection (in rare cases)
20. Frequent need to scratch the affected area

---

Diagnostic Tests for External Rectal Venous Plexus Masses

1. Visual examination (doctor inspects the anus)
2. Digital rectal exam (finger inserted into the rectum)
3. Anoscopy (small tube with light used to look inside the rectum)
4. Proctoscopy (similar to anoscopy but looks deeper)
5. Colonoscopy (examines the entire colon)
6. Flexible sigmoidoscopy (examines lower part of the colon)
7. Doppler ultrasound (to check blood flow in the area)
8. MRI (for detailed imaging in complex cases)
9. CT scan (if there’s suspicion of other issues)
10. Fecal occult blood test (checks for hidden blood in stool)
11. Complete blood count (CBC) (to check for infection or anemia)
12. Rectal biopsy (in case of suspicious lumps or tumors)
13. Liver function test (if liver issues are suspected)
14. Urinalysis (to rule out urinary issues contributing to swelling)
15. Stool analysis (to check for infections or parasites)
16. Manometry (to test anal muscle function)
17. Pelvic ultrasound (if pelvic tumors are suspected)
18. Venogram (dye injected to view veins more clearly)
19. Endoanal ultrasound (imaging for deeper rectal problems)
20. Pap smear (for women) (to rule out gynecological issues)

---

Non-Pharmacological Treatments for External Rectal Venous Plexus Masses

1. Sitz baths (sitting in warm water several times a day)
2. Ice packs (reduce swelling and pain)
3. Warm compresses (relieves discomfort)
4. Increased fiber intake (helps soften stools)
5. Staying hydrated (prevents constipation)
6. Avoiding straining during bowel movements
7. Using moist wipes instead of dry toilet paper
8. Avoiding sitting for long periods
9. Using a cushion while sitting
10. Wearing loose cotton underwear
11. Regular physical activity (improves blood flow)
12. Pelvic floor exercises (Kegels) (strengthens anal muscles)
13. Elevating legs while sitting
14. Using a squatty potty or similar device to improve bowel posture
15. Eating probiotics (promotes healthy digestion)
16. Yoga (improves circulation and reduces pressure on veins)
17. Avoiding lifting heavy objects
18. Sleeping on your side (to relieve anal pressure)
19. Breathing exercises (relaxation techniques to reduce strain)
20. Avoiding spicy or fatty foods (prevents digestive irritation)
21. Walking after meals (to aid digestion)
22. Wearing loose clothing (prevents friction and irritation)
23. Using Epsom salt in sitz baths (to reduce swelling)
24. Applying aloe vera gel (soothes the area)
25. Applying witch hazel (reduces itching and swelling)
26. Using coconut oil (natural moisturizer and anti-inflammatory)
27. Maintaining a healthy weight (reduces anal pressure)
28. Avoiding caffeine and alcohol (to reduce dehydration)
29. Applying petroleum jelly (helps ease bowel movements)
30. Engaging in stress management techniques (to reduce bowel strain)

---

Medications (Drugs) for External Rectal Venous Plexus Masses

1. Topical hydrocortisone cream (reduces itching and swelling)
2. Topical lidocaine (numbs the area to relieve pain)
3. Over-the-counter hemorrhoid creams (reduce symptoms)
4. Witch hazel pads (soothes and reduces inflammation)
5. Stool softeners (to ease bowel movements)
6. Laxatives (for temporary relief from constipation)
7. Anti-inflammatory suppositories (for internal swelling relief)
8. Oral pain relievers (ibuprofen, acetaminophen) (reduce pain)
9. Oral anti-inflammatories (to reduce swelling)
10. Phlebotonic drugs (diosmin, hesperidin) (improve venous tone)
11. Topical zinc oxide (creates a protective barrier)
12. Oral steroids (for severe inflammation)
13. Glycerin-based suppositories (ease passage of stools)
14. Topical nitroglycerin (relieves pain)
15. Oral flavonoid supplements (to improve blood vessel health)
16. Topical astringents (to shrink tissues)
17. Benzocaine ointments (for numbing the area)
18. Antibiotic ointments (in case of infections)
19. Oral bioflavonoids (improve venous blood flow)
20. Lidocaine gel (provides immediate pain relief)

---

Surgical Options for External Rectal Venous Plexus Masses

1. Hemorrhoidectomy (surgical removal of hemorrhoids)
2. Rubber band ligation (cutting off blood supply to hemorrhoids)
3. Sclerotherapy (injecting a chemical solution to shrink hemorrhoids)
4. Laser treatment (removal of hemorrhoids using lasers)
5. Cryotherapy (freezing hemorrhoids to reduce swelling)
6. Stapled hemorrhoidopexy (stapling hemorrhoids back into place)
7. Infrared coagulation (using infrared light to shrink hemorrhoids)
8. Doppler-guided hemorrhoid artery ligation (tying off hemorrhoid blood vessels)
9. Radiofrequency ablation (using radio waves to shrink hemorrhoids)
10. Anal dilatation (stretching the anal canal to relieve pressure)

---

Prevention Tips for External Rectal Venous Plexus Masses

1. Eat a high-fiber diet (to prevent constipation)
2. Stay well-hydrated (drink plenty of water)
3. Avoid straining during bowel movements
4. Exercise regularly (promotes good digestion)
5. Avoid sitting for long periods
6. Don’t ignore the urge to pass stool (prevents hard stools)
7. Maintain a healthy weight
8. Avoid lifting heavy objects
9. Use the restroom as soon as you feel the need
10. Avoid prolonged sitting on the toilet

---

When to See a Doctor

You should see a doctor if:

• You experience persistent pain or bleeding.
• Your hemorrhoids don’t improve with home treatment.
• You have blood clots in the hemorrhoid.
• The hemorrhoids are affecting your daily life.
• You have significant bleeding during bowel movements.

---

Frequently Asked Questions (FAQs)

1. What causes external rectal venous plexus masses?
   • Common causes include straining during bowel movements, chronic constipation, and prolonged sitting.
2. Can external hemorrhoids go away on their own?
   • Yes, mild hemorrhoids may go away with home treatment, but severe cases may require medical intervention.
3. Are external hemorrhoids dangerous?
   • External hemorrhoids are generally not dangerous but can be uncomfortable. If left untreated, they may lead to complications like thrombosis.
4. What is the best way to prevent external hemorrhoids?
   • Maintaining a high-fiber diet, staying hydrated, and avoiding prolonged sitting can help prevent hemorrhoids.
5. How long does it take for external hemorrhoids to heal?
   • They may take a few days to a couple of weeks to heal, depending on severity and treatment.
6. Can I treat hemorrhoids at home?
   • Yes, using sitz baths, ice packs, and over-the-counter creams can help relieve symptoms.
7. What foods should I avoid if I have hemorrhoids?
   • Avoid spicy foods, processed foods, and alcohol, as they can irritate the digestive system.
8. Are hemorrhoids more common with age?
   • Yes, hemorrhoids are more common as you age due to weakened tissues in the rectal area.
9. Can external hemorrhoids cause cancer?
   • No, hemorrhoids do not cause cancer, but you should consult a doctor if you have rectal bleeding to rule out other conditions.
10. Can pregnancy cause hemorrhoids?
    • Yes, the increased pressure on the veins during pregnancy can lead to hemorrhoids.
11. Do external hemorrhoids always need surgery?
    • No, surgery is typically only needed if other treatments fail or if complications arise.
12. Can exercise worsen hemorrhoids?
    • Some exercises, like heavy lifting, can worsen hemorrhoids, but light exercise can help.
13. Can stress cause hemorrhoids?
    • While stress itself doesn’t cause hemorrhoids, it can lead to behaviors like poor diet or constipation, which contribute to hemorrhoids.
14. Can I use laxatives to treat hemorrhoids?
    • Laxatives can help ease bowel movements temporarily but shouldn’t be a long-term solution.
15. Can external hemorrhoids recur?
    • Yes, without proper lifestyle changes, external hemorrhoids can recur.

---

This guide covers the essential details of external rectal venous plexus masses, also known as external hemorrhoids, providing a detailed but easy-to-understand explanation of the condition, its causes, symptoms, treatment options, and prevention methods.

 

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.

 

References