External and Prolapsed Hemorrhoids
External and Prolapsed Hemorrhoids - We all have two kinds of hemorrhoidal veins: internal, inside the anal passage, and external, on and around the anus. When inflamed internal hemorrhoids end up protruding outside the anal opening, usually because they are pushed out by passing stool, during a bowel movement, they are called prolapsed hemorrhoids. These cause even more discomfort than external hemorrhoids, unlike internal hemorrhoids, which are painless because there are no pain receptors inside the anal passage.
External hemorrhoids are the ones which are right at the anal opening or around the anus, on the outside. When these veins swell, there are actual lumps you can feel. Prolapsed hemorrhoids dangle out of the anus. Both can easily bleed.
Prolapsed hemorrhoids are categorized in 4 degrees. A second degree prolapsed hemorrhoid protrudes only temporarily, retracting by itself. A third degree prolapsed hemorrhoid does not withdraw by itself, but with manipulation, it can be reinserted. The worst case, at the fourth degree, is when the hemorrhoid is impossible to reinsert. To further complicate matters, a fourth-degree prolapsed hemorrhoid can be worsened by spasms of the sphincter muscle. When this happens, hemorrhoid may become strangulated or thrombosed. In these cases, even when the prolapsed hemorrhoid can be reinserted, it will reemerge by itself.
All irritated and swollen hemorrhoids can eventually bleed, but it is the external and the prolapsed hemorrhoids which can be damaged, willingly or unwillingly, by scratching and by contact with toilet paper or clothing. Many products are available in pharmacies to help with the itching sensation and to help heal hemorrhoids. Medicated pads and wipes are very convenient for the gentle cleansing of the anal area, after each bowel movement, if bathing is not an option.
External hemorrhoids can be relieved by soaking in cold water, either in the bathtub or using a sitz bath set, designed primarily to fit over a toilet bowl. The cold water will help reduce the swelling and will cool and lessen the itching sensation. For internal and external hemorrhoids, some people prefer warm water sitz baths, because these relax the sphincter muscle and reducing the pressure on the hemorrhoidal veins.
Topical ointments can be applied to external and prolapsed hemorrhoids to promote healing, reduce swelling, and control the irritation and itching. Some home recipes for topical creams prove very useful, as are over the counter medicated balms, many of which have witch hazel as the active ingredient. They successfully treat the problem in only a few days.
At the first sign of irritation of the anal area, take immediate action and precautions to mitigate what can become an excruciating condition.