External hemorrhoids are prone to intermittent flare-ups and can become large or persistent enough that they require surgical excision (external hemorrhoidectomy). Small and asymptomatic external hemorrhoids, however, don’t usually need any treatment.
Causes of anal tags include:
While anal tags can be very irritating, they can easily be removed with a simple radio frequency device. This 10-minute procedure is performed in an office using local anesthesia and requires zero downtime.
An external hemorrhoid can escalate to a thrombosed external hemorrhoid due to varicose veins rupturing causing blood clots to form in the anal tissue. Thrombosed external hemorrhoids are associated with swelling, a bluish-purplish discoloration, and severe pain.
Treatment Options
For more severe cases, surgical excision is often more effective and efficient, especially for patients with thrombosed external hemorrhoids. Performed under local anesthesia, surgical excision is a safe, office-based procedure with low complication rates and high levels of patient satisfaction.
Surgery Procedure
There are two primary surgical methods that can be used. The first method is quicker and seemingly more efficient. Your doctor will create a small incision over the clot and squeeze out the clot’s contents. However, this method could result in blood clot recurrence and continued pain, which often requires patients to come back to the office for further treatment.
The more extensive procedure, called a full hemorrhoidectomy, your doctor will remove the entire clot and the hemorrhoidal blood vessels. This method takes longer and may require stitches, but it can yield better long-term results.
Both methods are performed under local anesthesia.
Post-Operative Care
Acetaminophen or ibuprofen can be taken for pain. Warm sitz baths should be done three times daily, 15-30 minutes per session, while stool should be kept soft by drinking lots of water and taking stool softeners.
Complications
Common complications associated with thrombosed external hemorrhoid treatment include pain, bleeding, infection and delayed healing. Some patients may also develop an anal skin tag (see above). Extremely rare complications include anal stricture (narrowing of the anal passage) and incontinence (inability to control urination and defecation).