External hemroids are due to increased pressure and swelling of the external hemorrhoidal veins. These swollen veins form a mass under the skin around the anus.

External hemroids are more common in pregnant women, old age, with obesity and with chronic constipation. Genetic factors also play a role in the development of external hemroids.

Symptoms of external hemroids. Rectal pain and discomfort are the main symptoms of external hemroids. This is in contrast to internal hemroids in which pain is usually absent or minimal. This is because of the fact that the skin is sensitive to pain while mucus membranes are not.

Diagnosis of external hemroids is easier than diagnosis of internal hemroids, because in the former,  a fleshy painful mass can be seen and palpated around the anus.

One of the risks associated with untreated external hemroids, is thrombosis which is more common with long lasting untreated hemroids. Blood clots may spread from the thrombosed vessels to various parts of the body causing serious embolic phenomena. Thrombosed external hemroids are associated with severe pain and itching. Rectal bleeding may occur due to itching caused by irritation, or due to rubbing or incresed pressure inside the rectal veins.

Early treatment of external hemroids and early correction of the causes that contribute to them will help to avoid this risk, in addition to other complications associated with untreated hemroids. Treatment will also help to exclude other possible causes of rectal pain or bleeding which may be more serious.

Treatment of external hemroids. Treating external hemroids is easier than internal hemroids, as they are more readily reachable by both medications and surgery. In addition to the general conservative and surgical measures discussed in the treatment section, the following local measures provide temporary relief of pain and discomfort associated with external hemroids.

• Warm baths. The bath continues for about 15 minutes and should be repeated for three times daily.
• Ice packs. They are applied to the affected area for a suitable period of time to relieve pain.
• Soft seats. These are necessary especially if your job requires sitting for long periods of time. This is to decrease pressure on the affected veins which may worsen the symptoms.
• Loose undergarments. The aim is decrease pressure on the affected area which will help to relieve pain and discomfort.