Symptoms of thrombosed external hemorrhoids

Written by Yang Dong

Colorectal Surgery Department

Updated on September 18, 2024

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Thrombotic external hemorrhoids are a type of external hemorrhoids. They are caused by the rupture of blood vessels in external hemorrhoids, leading to blood spillage, which in turn causes pain and inflammation. The symptoms manifest as a sudden hard lump near the anus. If visible, subcutaneous purple bruises can be seen, and pressing on it causes pain. Generally, surgical treatment is required.

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Written by Chen Tian Jing

Colorectal Surgery

1min 5sec

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How are thrombosed external hemorrhoids formed?

The formation of thrombosed external hemorrhoids is mainly related to local congestion pressure in the anal area and excessive filling of submucosal blood vessels, especially after the patient abstains from spicy and irritating food, excessive defecation, and excessive fatigue. This condition becomes more prominent. Once thrombosed external hemorrhoids form, they are generally accompanied by the formation of skin tags and internal hemorrhoids in the anal area, and the external hemorrhoids enclose a blood clot. When the blood clot becomes congested or swollen, the patient will experience significant pain or distension. Once thrombosed external hemorrhoids have formed, it is crucial to treat them early to avoid necrosis caused by prolonged and repeated congestion and edema. Treatment options include using local medications for hot compresses or application to alleviate symptoms, or performing surgery to excise and remove the blood clots.

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Colorectal Surgery

1min 9sec

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Does the surgical removal of external hemorrhoids hurt?

Surgical removal of external hemorrhoids generally does not cause significant pain because anesthesia is required for the procedure. There are options for anesthesia, including local infiltration anesthesia, spinal anesthesia, or general anesthesia via intravenous injection, ensuring the patient does not experience notable pain during the surgery. However, post-surgery sensitivity is higher because the external hemorrhoids are innervated by perineal nerves. Therefore, it is crucial to use pain relief medication appropriately when changing dressings to alleviate discomfort. Additionally, it is essential to prevent infection, inflammation, or swelling of the wound to reduce postoperative pain. Patients should also manage their bowel movements to avoid dry, hard stools; smooth bowel movements can somewhat relieve postoperative pain. If the pain is particularly severe, the use of diclofenac sodium suppositories for anal insertion can help reduce inflammation and pain. (Please follow medical advice regarding medication use.)

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Written by Chen Tian Jing

Colorectal Surgery

1min 1sec

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How to deal with external hemorrhoids bleeding?

If external hemorrhoids bleed without apparent reason, it may be due to the rupture of thrombosed external hemorrhoids, leading to bleeding. Firstly, it is necessary to disinfect and clean the local wound to avoid accumulation of blood or contaminants and feces, which may cause infection of the wound. If the bleeding does not stop, topical hemostatic drugs or oral hemostatic drugs should be used for symptomatic treatment. If external hemorrhoids bleed and are accompanied by severe prolapse of internal hemorrhoids, it is recommended that the patient undergo surgical treatment to remove and ligate both external and internal hemorrhoids at the same time. This can further prevent exacerbation of bleeding and fundamentally treat hemorrhoids. Patients with bleeding external hemorrhoids must have a light diet and avoid irritating foods such as chili peppers and seafood. (The use of medications should be under the guidance of a doctor.)

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Written by Chen Tian Jing

Colorectal Surgery

1min 3sec

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Is a mixed hemorrhoidal thrombosis external hemorrhoid serious?

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 Chen Tian Jing

Colorectal Surgery

56sec

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Can thrombotic external hemorrhoids be lanced?

Thrombosed external hemorrhoids, as the most common clinical symptom of external hemorrhoids, exhibit significant local pain during acute attacks and are accompanied by a feeling of constriction. If during an acute attack, dark red hemorrhoidal prolapse occurs around the anal area and cannot be absorbed or retracted, a professional doctor can use specialized techniques to crush the local hemorrhoid node or surgically excise it. However, it is not advisable for patients to burst it themselves because if done without proper sterilization and hygiene, it can easily lead to local infection, thereby exacerbating the condition or complicating future surgical treatments. Therefore, if thrombosed external hemorrhoids are detected, it is crucial to seek prompt and active treatment at a hospital.