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External Hemorrhoids (Piles) Treatment

External piles develop under the skin around the anus, where there are more pain-sensing nerves. At Pristyn Care, we offer advanced and minimally invasive surgical treatments at cost-effective rates to make treatment for external piles accessible for all. Book your appointment now with Pristyn Care for safe and effective external piles surgery.

External piles develop under the skin around the anus, where there are more ... Read More

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What Are External Hemorrhoids?

Piles (hemorrhoids) are swellings that develop inside and around the back passage (anal canal). There is a network of small veins known as blood vessels inside the lining of the anal canal. These blood vessels can sometimes become more expansive and engorged with more blood. As a result, the swollen vessels and overlying tissue can form into one or more swellings called piles. 

Piles can be divided into either internal piles or external piles. External piles are usually the first thing people think of when they hear the word piles. These piles impact veins outside the anus and lead to bleeding, cracking, and itching. Most external piles will not cause other problems, but they can become more painful and discomforting if they form a clot, known as a thrombus. If a person is in extreme pain, a doctor may suggest the surgical removal of external piles.

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Symptoms of External Piles

Symptoms of external piles differ depending on their severity. Some of the symptoms that you may experience include:

  • one or more blue-colored lumps near the opening of the anus
  • itching around the rectal or anal area
  • pain around the anus, especially when you’re sitting down

You may see bleeding when you are using the toilet. It includes noticing blood in the toilet or on the toilet paper. In addition, lumps around the anus may feel as if they are inflamed. Large external piles may make it challenging to keep the anal area clean.

If you experience any of these symptoms, you should immediately consult with your doctor. 

Experiencing Any Of These Piles Symptoms?

What Causes External Hemorrhoids?

External piles happen when one or more tender blue-colored lump forms beneath the skin covering the anus. These are basically the dilated blood vessels that have become so enlarged that they protrude. You may be more likely to get external piles if other family members like your parents had them.

Some of the causes of external piles include:

  • Straining during bowel movements
  • Straining when you do something that is physically demanding, like lifting heavy objects
  • Obesity
  • Pregnancy, when the growing uterus adds pressure on the veins
  • A diet low in fiber
  • Anal sex

People who sit or stand for extended periods are also at greater risk for external piles. In addition, you may get them when you have constipation or diarrhea that does not clear up. Coughing, sneezing, and vomiting can make them worse.

Diagnosis and Treatment Of External Piles

External Piles Diagnosis

A doctor will ask your health history and symptoms to diagnose external piles. They will also likely do a physical exam. In the case of external piles, they can see the piles by examining the area around the anus. 

Your doctor may also perform an anoscopy and digital rectal exam to check for problems inside the anal canal and rectum, including internal hemorrhoids.

During a digital rectal exam, the doctor inserts a gloved, lubricated finger into the anus to feel abnormalities. During the exam, the patient may experience some discomfort and some bleeding from the rectum. 

During an anoscopy, the doctor will insert an anoscope into the rectum that allows them to see abnormalities. The patient will be asked to be in the fetal position on the table and bend forward. The anoscope will then be inserted by lubricating with a gel into the lower gastrointestinal tract through the anus. The scope used here is made of plastic or stainless steel. 

If you also have rectal bleeding, the doctor will ask you to get a sigmoidoscopy or colonoscopy to rule out colorectal cancer. These methods will also detect any internal hemorrhoids.

External Piles Treatment

If you are experiencing pain and discomfort around your anal region, your doctor may advise using over-the-counter pain relief medicines, such as ibuprofen, acetylsalicylic acid, or acetaminophen.

Other ways to treat external piles include:

Home remedies

You can use various home remedies to help with external piles. Here are some safe and successful at-home remedies for external piles:

  • Cold compress. Wrap ice in a cloth and apply it to your piles for not more than 15 minutes at a time. It can significantly decrease inflammation and pain.
  • Sitz bath. A sitz bath is done by soaking the bottom in warm water. Patients use a small tub made to fit over the toilet, which you can fill with warm water and sit in several times a day to help soothe external piles. Some doctors also advise adding unscented Epsom salts to the water.
  • Topical ointments or wipes. Some patients use ointments or wipes made with naturally derived ingredients, like witch hazel and aloe vera, to help relieve external piles, inflammation, and pain. 
  • OTC creams. OTC topical medications are also very effective in reducing pain and swelling. 

However, home remedies cannot treat piles effectively. To treat piles effectively and safely, one needs to undergo surgery. Contact your doctor if you are experiencing severe pain, if symptoms have not gone away after 1 week of treatment at home, or if you are experiencing bleeding from the rectum.

Surgical treatment

Laser and stapler surgery are the two most effective surgical treatment options for external piles. 

  • Laser surgery for piles (laser hemorrhoidectomy)- This surgery uses high-energy light to cut or burn the expanded pile’s tissue. Laser surgery is an advanced and safe surgical procedure because it is less painful and has fewer complications.
  • Stapler Surgery (stapled hemorrhoidectomy)- Stapler surgery for piles is a relatively new and increasingly popular surgical procedure. This surgery does not remove piles but treats them by inhibiting blood flow to the tissue. In this procedure, the doctor removes enlarged piles and then staples the remaining tissues to the lining of the anus again.

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List of Top Health Insurance Provider for Piles Surgery
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Aditya Birla Health Insurance Co. Ltd. Aditya Birla Health Insurance Co. Ltd.
National Insurance Co. Ltd. National Insurance Co. Ltd.
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Bharti AXA General Insurance Co. Ltd. Bharti AXA General Insurance Co. Ltd.
Future General India Insurance Co. Ltd. Future General India Insurance Co. Ltd.
HDFC ERGO General Insurance Co. Ltd. HDFC ERGO General Insurance Co. Ltd.

How to Prevent External Hemorrhoids?

The best way to prevent external piles from forming is to avoid constipation and the development of dry and hard stools that are difficult to release.

Some of the tips to prevent external piles include:

  • Boosting the amount of dietary fiber in your diet to 25–35 grams by consuming plenty of fruits, vegetables, whole grain bread, and cereals. 
  • Drinking enough water each day to keep the stools soft
  • Engaging in regular physical activity, which stimulates the natural movement of the bowels
  • Using the restroom when required and not delaying for an unnecessary amount of time
  • Spending the shortest possible time sitting on the toilet

What are the Risks of External Piles Surgery?

After your external piles are removed, your anal region might hurt or ache for two to four weeks. And you could need painkillers to soothe this pain. In addition, it is normal to experience little bleeding and yellow fluid from the anus after your surgery. 

Some of the complications and risks of external piles surgery are:

  • Slow wound recovery
  • Minor surgical cuts that could be a little painful
  • Scar tissue damage to the sphincter muscles forces the anus to narrow down (stenosis), which can lead to incontinence or urine retention

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    Dr . Sathish Kumar Bagepally (nXnm39njYk)

    Dr . Sathish Kumar Bagep...

    MBBS, MS-General Surgery, FAIS
    25 Yrs.Exp.

    4.7/5

    28 Years Experience

    location icon Maruthi School bus stop Banaswadi main road, HRBR 1 Block,, next to fire station, Banaswadi, Bengaluru, Karnataka 560043
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    6366-528-013
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    Dr. Milind Joshi (g3GJCwdAAB)

    Dr. Milind Joshi

    MBBS, MS - General Surgery
    25 Yrs.Exp.

    4.9/5

    25 Years Experience

    location icon SN 61/1/1, 61/1/3, Wanowrie, Nr, Salunke Vihar Rd, Oxford Village, Pune, Maharashtra 411040
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    6366-528-292
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    Dr. Amol Gosavi (Y3amsNWUyD)

    Dr. Amol Gosavi

    MBBS, MS - General Surgery
    25 Yrs.Exp.

    4.7/5

    25 Years Experience

    location icon 1st floor, GM House, next to hotel Lerida, Majiwada, Thane, Maharashtra 400601
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    6366-528-316
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    Dr. Naveed Pasha Sattar (mO01xEE36l)

    Dr. Naveed Pasha Sattar

    MBBS, MS, DNB- General Surgery
    24 Yrs.Exp.

    4.7/5

    24 Years Experience

    location icon 266/C, 80 Feet Rd, near C.M.H HOSPITAL, HAL 3rd Stage, Indiranagar, Bengaluru, Karnataka 560038
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    6366-528-013

Common FAQs Around External Piles

Is it possible to get hemorrhoids treatment in 48 hours?

Actually, the answer is YES, it requires surgery which is a minimally invasive treatment with laser therapy. Most who fear surgery end-up following western medicine as symptoms are not easy to bear.

Are external piles painful?

External piles can be painful. They are generally most painful immediately following a bowel movement or after lifting or straining. They may be extremely painful if they form a blood clot known as a thrombosed pile. If healthcare professionals can lance and drain the clot within 2 to 3 days of its development, the pain will reduce immediately. If not, the clot will not dissolve independently, and the pain will reduce in time.

Do external piles get bigger?

External piles might get worse and cause more severe symptoms. But they might not get bigger.

Are external piles dangerous?

External piles are rarely dangerous and life-threatening. However, they can form a blood clot that can burst. Bursting of the clot can cause several minutes of bleeding, but it usually ends independently. If it does not, a person should seek immediate medical treatment.

Do external piles go away on their own?

Yes, most external piles can go away on their own, even without treatment. However, external piles can recur, indicating that a person may deal with them frequently if they do not prevent them. Therefore, undergoing surgery is the best way to prevent recurring of external piles. 

What do external piles feel like when you touch them?

You may feel a tender lump on the edge of the anus if you have an external pile. You may also notice blood on the toilet paper after wiping or in the toilet after a bowel movement.

What to eat after external piles surgery?

After external piles surgery, it is advised to start with a liquid and fiber-rich diet, including sprouts, whole grains, buttermilk or curd, green leafy vegetables, fresh fruits, etc.

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Medically Reviewed By
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Dr . Sathish Kumar Bagepally
25 Years Experience Overall
Last Updated : December 20, 2024

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