External hemorrhoids

External hemorrhoids (piles) are swollen and prolapsed rectal veins which are seen in the area around the anus. The peri-anal skin covering them has stretched and may form skin tags when the external hemorrhoids resolve.

Symptoms associated with external hemorrhoids:

  1. Sometimes, people have hemorrhoids and are not aware of it (asymptomatic)
  2. Itching
  3. Not usually painful but may be painful if a blood clot forms
  4. Bleeding
  5. It may become ulcerated or infected
  6. Hemorrhoids do NOT cause cancer
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What causes external hemorrhoids?

Anything that exerts pressure on the pelvic floor for long periods of time causes stretching of tissues that support the rectal veins; the veins dilate, become thin, prolapse and may bleed.
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Powerful agent against hemorrhoids and rectal fissures

Causes of external hemorrhoids include:

  1. Old age: the pelvic floor tends to get weaker with age
  2. Constipation or diarrhea that lasts for a long time
  3. Pregnancy can cause hemorrhoids because of the increased pressure on the pelvic floor
  4. Abuse of laxatives: especially when this happens over long periods of time
  5. Spending long periods on the toilet: when you bear down in the toilet for long periods, you risk exerting too much pressure on the pelvic floor. So, avoid reading for long periods while sitting on the toilet seat
  6. It may run in the family (familial tendency)

Treatment of external hemorrhoids

The type of treatment needed for external hemorrhoids depends on how serious the symptoms are.

The following treatments may be used for mild symptoms, you can do these at home:

  • A high fiber diet e.g., fruits and vegetables, brown rice
  • Increase fluid intake (8 to 10 cups water every day)
  • Avoid sitting in the toilet for long periods of time
  • You can do a Sitz bath (sitting on warm water for about 15 minutes)
  • Avoid excessive cleaning with dry tissue paper (which can cause more irritation), use moist toilet paper instead
  • Regular exercise

If your symptoms are serious, you may need surgery.

Surgical treatments for external hemorrhoids include:

Excision: performed within 72 hours of onset, done under local anesthesia.

Incision: to evacuate the blood clot and thereby reduce pain
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The particular type of surgical procedure depends on the size of the external hemorrhoid and its location.


To get medications kit and guideline for treatment of external hemorrhoids, fill in the form below

Feel free to ask an Israeli doctor