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 Yu Xu Chao
Colorectal Surgery
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Can external hemorrhoids be washed with hot water?

External hemorrhoids can be washed with warm water, but the temperature should not be too high, generally controlled below 40 degrees Celsius. Washing external hemorrhoids with warm water can promote local blood circulation and relieve the anal swelling caused by external hemorrhoids. At the same time, it can also remove secretions on the surface of the hemorrhoids, which helps to avoid inflammatory edema in external hemorrhoids. However, the water temperature must not be too high as it could scald the skin around the anus or cause dehydration of the perianal skin, leading to discomfort. Clinically, external hemorrhoids are mainly classified into four types: excess skin hemorrhoids, varicose vein hemorrhoids, thrombotic hemorrhoids, and inflammatory hemorrhoids. Depending on the type, the treatment methods differ. For inflammatory and thrombotic hemorrhoids, it is generally recommended to undergo early hemorrhoidectomy to prevent severe anal pain and serious impact on the patient's life.

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Written by Deng Heng
Colorectal Surgery
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What causes external hemorrhoids to itch?

External hemorrhoids are hypertrophic skin tags at the anal margin and surrounding skin, or dilation of the subcutaneous venous plexus leading to blood stasis and thrombus formation, resulting in protruding lesions. According to their characteristics, they can be divided into connective tissue external hemorrhoids, thrombotic external hemorrhoids, varicose external hemorrhoids, and inflammatory external hemorrhoids. In particular, inflammatory external hemorrhoids can cause the surrounding skin to become moist. This moisture can lead to the formation of eczema and pruritic diseases in the surrounding skin, causing skin lesions. One of the main features after skin lesions is itching around the skin surrounding the external hemorrhoids.

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Written by Chen Tian Jing
Colorectal Surgery
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How long does surgery for thrombotic external hemorrhoids take?

Thrombotic external hemorrhoid surgery primarily involves the excision of thrombotic external hemorrhoids. If it's simply an excision of external hemorrhoids, the surgery generally takes about half an hour. The recovery time post-surgery requires two to three weeks, mainly depending on the severity of the patient's condition and individual tissue healing rates, which can vary. After the excision surgery for thrombotic external hemorrhoids, a local wound is left, necessitating daily disinfection and dressing changes. When necessary, hemorrhoid ointment or muscle-generating Yuhong ointment may also be applied to promote healing and treatment.

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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.