Management of External Hemorrhoids

Patients who present with acutely thrombosed external hemorrhoids will typically complain of an intensely painful anal mass. Inspection of the perianal skin reveals the diagnosis with a swollen, tense external hemorrhoid. If such a lesion is not present, anal fissure or perianal abscess must be ruled out.

Excision is recommended for a thrombosed hemorrhoid manifested with intense pain if duration is within 48 hours of onset, or if ulceration or rupture occurs. If pain is improving, symptomatic therapy with sitz baths, bulking agents, and analgesics is preferred. Excision may be performed in the office using local anesthetic. The wound is left open to heal by secondary intention. Larger, more broadly based thromboses may be managed by incision and evacuation of the clot to avoid creation of a large skin defect.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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