Is a mixed hemorrhoidal thrombosis external hemorrhoid serious?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 03, 2024
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When thrombotic external hemorrhoids are combined with mixed hemorrhoids, the situation is generally not severe. However, if it is in the acute phase, it needs to be dealt with as soon as possible. During the acute phase of thrombotic external hemorrhoids, there is severe pain in the local area of the anus, accompanied by swelling. The patient feels restless and the pain is unbearable, and thrombectomy surgery needs to be performed as soon as possible. If mixed hemorrhoids with thrombosis do not affect the patient's life, methods such as using anal plugs, hemorrhoid suppositories, or applying hemorrhoid cream to the anus can be used. Additionally, attention should be paid to not strain too much during bowel movements, as excessive straining can cause more severe congestion and swelling in the hemorrhoidal nucleus in the local area of the anus, thereby aggravating the condition of thrombotic external hemorrhoids.

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Written by Yu Xu Chao
Colorectal Surgery
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Do external hemorrhoids without any symptoms need treatment?

External hemorrhoids can be categorized into skin tag-like external hemorrhoids, varicose vein-like external hemorrhoids, and thrombosed external hemorrhoids. Most patients with skin tag-like external hemorrhoids do not have any sensations, and in such cases, treatment is not necessary. Patients only need to pay attention to the hygiene around the anal area. After each bowel movement, they should wash the anal area with clean water. They should also frequently change their underwear, and their diet should be light and easily digestible to avoid diarrhea or constipation. During bowel movements, it's important to ensure the process is smooth to avoid lengthy bathroom visits or excessive straining, which can prevent the exacerbation of skin tag-like external hemorrhoids, hence no treatment would be needed. However, for varicose vein-like external hemorrhoids or thrombosed external hemorrhoids, patients may experience a foreign body sensation or pain around the anus. In such cases, conservative treatment with medications can be considered initially. If conservative treatment is ineffective, surgical intervention may be required.

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Written by Chen Tian Jing
Colorectal Surgery
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Thrombotic external hemorrhoid compression treatment

Treatment options for thrombosed external hemorrhoids include topical medications, compression therapy, or direct surgical excision. The choice of treatment depends on the severity of the clinical condition. For mild thrombosis, a traditional Chinese medicine wash with blood-activating and stasis-dissolving effects can be used for local hot compresses to promote the absorption and reduction of the thrombus. If the thrombus enlarges, professional proctological techniques can also be used to crush the thrombus locally, but it is important to maintain cleanliness and hygiene of the local mucosa to avoid infection. If the condition of thrombosed external hemorrhoids worsens, or if the patient experiences severe pain, surgical excision treatment can also be directly performed.

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Written by Yu Xu Chao
Colorectal Surgery
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Is the pain and swelling of hemorrhoids external or internal?

This situation might involve both internal and external hemorrhoids, which is referred to as mixed hemorrhoids. Internal hemorrhoids might also prolapse, leading to inflammatory edema and causing anal swelling and pain. External hemorrhoids can also present with inflammatory edema and thrombosis, leading to anal swelling and pain. Hence, in clinical practice, this situation is often considered as mixed hemorrhoids. Mixed hemorrhoids mainly occur at the same point in the anal canal, both above and below the dentate line, and symptoms of both internal and external hemorrhoids are present. Clinically, if the patient is unwilling to undergo surgery, conservative treatment with medication can be considered initially, such as oral administration of Diosmin tablets, followed by the use of an anal wash or a sitz bath with potassium permanganate solution after defecation, and then application of Dihuang ointment externally to alleviate discomfort. However, if the inflammatory edema does not subside and anal swelling and pain are significant, it is advised to consider surgical intervention early to prevent necrosis due to prolapsed hemorrhoids. (Please follow medical advice when using medications.)

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Written by Chen Tian Jing
Colorectal Surgery
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What is inside a thrombotic external hemorrhoid?

Thrombotic external hemorrhoids are a common clinical presentation of external hemorrhoids. During an episode, blood clots generally form within the hemorrhoidal nucleus, which means that thrombotic external hemorrhoids mainly consist of blood clot particles. Because the blood clots are wrapped inside the hemorrhoidal nucleus, the pressure inside the nucleus increases, leading to congestion and edema. Patients experience significant pain and a feeling of fullness. Severe symptoms may also affect the patient's ability to sit or walk normally. Therefore, it is crucial to treat thrombotic external hemorrhoids early in their development. For early-stage mild thrombotic external hemorrhoids, local treatments such as hot compresses with hemorrhoidal medication or manual pressure can be employed to promote the absorption of the blood clots. Oral medications that reduce swelling, relieve pain, and stop bleeding can also be used for symptomatic relief. If thrombotic external hemorrhoids recur frequently or if conservative medication fails, surgical excision and stripping of the thrombotic external hemorrhoids can also be considered.

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Written by Chen Tian Jing
Colorectal Surgery
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What medicine is used for thrombotic external hemorrhoids?

Thrombosed external hemorrhoids generally result from the formation of blood clots inside the local external hemorrhoids, causing acute symptoms. During an episode of thrombosed external hemorrhoids, patients experience localized pain or a feeling of constriction, and the formation of dark red or purplish external hemorrhoids can be visibly seen at the anus, which are very painful to the touch. Treatment for thrombosed external hemorrhoids primarily involves topical medications or surgery. If the symptoms are mild, one may choose to apply hemorrhoid cream or use diluted saline solution to compress and reduce swelling. Surgery can also be opted to excise and remove the affected external hemorrhoids. Thrombosed external hemorrhoids generally occur in individuals who strain excessively during defecation or after extreme fatigue. Therefore, if accompanied by dry stools, it is necessary to use stool softeners to help lubricate and ease bowel movements for treatment.