Definition
A thrombosed external hemorrhoid is an external hemorrhoid that develops a blood clot in it. It can be moderately to extremely painful.
Causes
Hemorrhoids are a small bulge that forms in an anal vein, basically what happens is that the hemroid creates a sort of “harbor” where blood flow isn’t smooth and constant, the blood may begin to pool and slowly clot. This bad blood flow can be the result of poor circulation, extended periods of sitting or medical conditions. Here’s some more information about what causes hemroids.
Symptoms
In addition to the pain which in some cases can be excruciating, there may also be burning, itching and swelling in the impacted area. Perhaps the most frightening thing about the thrombosed external hemorrhoid is how it looks, the hemorrhoid may appear bruised turning purple and black and blue, the bruise like appearance is the blood clot under the skin.
Diagnosing
I have no doubt that most people, when they’re in enough pain, will see a doctor, but when it comes to colon health proper diagnosing is always important. With hemorrhoids it can be tempting to self diagnose just to avoid the embarrassment of seeing a doctor, but getting a properly diagnosing hemroids is an important part of the process. Some potentially deadly colorectal diseases like colon cancer can have the same symptoms of much less serious conditions such as hemorrhoids so these conditions need to be ruled out as a health risk. External hemorrhoids can be diagnosed with a simple visual exam as the hemorrhoids can be easily seen, but your doctor may still choose to do a more thorough exam like a colonoscopy or a sigmoidoscopy in order to get a better view of your colon. With internal hemorrhoids, one of these more compressive exams will most likely need to be done as these hemorrhoids can’t always be seen visually. Check out hemroid picture for a quick visual.
Treatment
Ideally you want to catch the thrombosed external hemorrhoid before it gets to the extreme pain stage, but once the pain set in, no doubt you will go running to your doctor. Sometimes thrombosed external hemorrhoids may clear up without any treatment, but usually they will need a little bit of care and treatment to reduce swelling and control pain. Depending on the severity of the clot, your doctor may recommend some home treatment options such as soaking in a sitz bath for 15 minutes about 2-3 times a day to help with swelling. An ice pack applied after the sitz bath or done separately can also help some patients with symptoms. Your doctor can also tell you which over the counter pain relievers are the best choice for this condition, ideally you want something that helps control pain as well as reduce swelling and promote better blood flow, both ibuprofen and acetaminophen are good choices.
If your thrombosed external hemorrhoid is serious enough, these home hemorrhoid treatment options may not be enough. At his point your doctor may choose one of the following options, simply removing the blood clot or removing the entire hemorrhoid. The benefits of just removing the clot are that it is an easier procedure, the clot is simply removed with a small incision in the hemorrhoid, this allows for less potential side effects. The down side of this option is that the hemorrhoid is still there. Totally removing the thrombosed external hemorrhoid calls for a hemorrhoidectomy which is the most serious of all the hemorrhoid procedures and surgical options. In the hemorrhoidectomy, the hemorrhoid is removed with a scalpel. The main benefit of the hemorrhoidectomy is that the whole hemorrhoid is removed, clot and all. Down sides include a slow recovery, more potential pain, an increased risk of short term or long term incontinence if the anal muscle tissues are damaged during the procedure. Whether you are able to use home remedies to treat your hemorrhoid or need surgery, either way your doctor is going to recommend an improved diet with more fiber. This is a standard recommendation for all hemorrhoids not just the thrombosed external hemorrhoids. More fiber helps to reduce straining and makes going to the bathroom easier, this is the single best thing you can do in the long term to help manage your hemorrhoids.
After Treatment
If your home treatment option isn’t working or you experience any of the following symptoms after surgery you should contact your doctor:
- Difficulty urinating
- Intense pain
- Fever or chills
- Diarrhea or constipation
- Vomiting or nausea
- Excessive bleeding
