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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Can thrombotic external hemorrhoids exercise?

During the acute flare-up of thrombotic external hemorrhoids, there is congestion and edema of the local anal cushion, and thrombosis forms within the local hemorrhoidal nucleus and mucosa. It is not advisable for patients to engage in excessive exercise, as this may aggravate the congestion of the local hemorrhoidal nucleus and worsen the condition of thrombotic hemorrhoids. Excessive exercise and friction may also lead to rupture of the thrombus, resulting in pain or infection. During an acute episode of thrombotic external hemorrhoids, patients may choose to use hemorrhoid wash solution for hot compresses to alleviate local symptoms. If the symptoms are severe or the thrombus is large, surgical removal may also be an option. Patients with thrombotic external hemorrhoids need to pay attention to the duration of defecation, mainly keeping it under ten minutes, because prolonged defecation or excessive straining during bowel movements can increase vascular pressure in the local hemorrhoidal nucleus, leading to thrombus formation.

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Written by Yu Xu Chao
Colorectal Surgery
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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 Yu Xu Chao
Colorectal Surgery
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How to eliminate external hemorrhoids with a fleshy lump?

External hemorrhoids involving a flesh mass are considered organic lesions. Complete removal typically requires hemorrhoid surgery, such as excision of external hemorrhoids or debridement surgery. Postoperative care includes changing dressings using products like anal washes, red oil gauze strips, and golden ointment. It is also important for patients to develop good bowel habits post-surgery, maintain smooth bowel movements, and avoid prolonged or excessive straining to facilitate recovery and prevent recurrence of external hemorrhoids. If treated solely with conservative medication, the flesh mass of external hemorrhoids can only be reduced, not completely eliminated. Inappropriate diet or abnormal bowel movements can lead to an increase in the size of external hemorrhoids, potentially causing inflammatory edema or thrombosis, which can result in significant anal discomfort and severely impact the patient’s normal life. Therefore, the treatment approach for external hemorrhoid flesh mass should be based on the severity of the condition.

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Written by Chen Tian Jing
Colorectal Surgery
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Is surgery necessary for thrombosed external hemorrhoids?

Thrombotic external hemorrhoids do not necessarily require surgery during the acute phase of an attack. If the thrombotic external hemorrhoids are mild, Chinese herbal medicine can be used for local topical application to relieve symptoms. Early-stage or mild thrombotic external hemorrhoids may only form small thrombi, and the pain experienced by the patient is not very intense. Therefore, one can opt to use Chinese herbal washes for hot compresses and fumigation, along with the application of hemorrhoid cream to alleviate symptoms. However, it is only recommended to perform excision surgery for thrombotic external hemorrhoids if they are acutely recurring over a long period or repeatedly, severely affecting the patient's life. (Please use medication under the guidance of a professional physician and avoid self-medication.)

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Written by Yang Dong
Colorectal Surgery Department
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Symptoms of thrombosed external hemorrhoids

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.