Can thrombotic external hemorrhoids be lanced?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 03, 2024
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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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
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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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Colorectal Surgery
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How to quickly eliminate the flesh masses of external hemorrhoids?

If a patient has an external hemorrhoid that has enlarged and they want to quickly or completely eliminate it, it is recommended to directly perform surgical removal. External hemorrhoids generally include thrombotic external hemorrhoids, varicose cluster external hemorrhoids, and inflammatory edematous external hemorrhoids. There are also some skin tag-like or connective tissue external hemorrhoids that do not exhibit clinical symptoms, and do not require excessive intervention in treatment. However, during an acute attack of thrombotic or inflammatory edematous external hemorrhoids, due to congestion or increased pressure in the local hemorrhoidal nucleus, severe pain can occur. You can choose to press with dilute salt water to promote the dissipation of edema. Complete removal requires surgical excision to avoid recurrent flare-ups of the condition.

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Colorectal Surgery
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What are the effects of external hemorrhoid fumigation and washing liquid?

Shrink hemorrhoids, eliminate swelling. For the treatment of external hemorrhoids, one can choose Chinese herbal washes to fumigate the affected area, apply hot compresses, or take sitz baths. Their primary efficacy is to shrink the local external hemorrhoidal nodules and reduce swelling through the effects of the medication, or to enable the self-absorption of thrombosis and varicose veins within the local nodules. Beyond local fumigation agents, the treatment of external hemorrhoids can also include applying ointments or using suppositories. It is also necessary to maintain good bowel habits to avoid further irritation and enlargement from stool. If repeated treatment for external hemorrhoids is ineffective, or if the local symptoms are severe, surgery may be considered to remove the external hemorrhoids completely.

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Can thrombotic external hemorrhoids be ruptured?

If a patient experiences an acute episode of thrombosed external hemorrhoids, the local pressure on the external hemorrhoids is generally high, and there are thromboses wrapped in the hemorrhoid nucleus. However, it is not advisable for patients to burst it on their own, as under unhygienic conditions, doing so could easily lead to local infection of the hemorrhoids, further exacerbating the condition. The treatment of thrombosed external hemorrhoids requires the professional management of a proctologist. Generally speaking, for mild symptoms, local use of Chinese herbal wash solutions or hemorrhoid creams can be chosen to press on the area, which helps promote the absorption of local thromboses. Alternatively, a professional proctologist can use specialized techniques to crush and press the local thromboses. If the thromboses are large or the local symptoms are severe, causing significant pain and severely affecting normal life, surgical excision might also be considered.