How to treat thrombosed external hemorrhoids

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 15, 2024
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The treatment of thrombosed external hemorrhoids generally includes conservative medication or surgical treatment. Thrombosed external hemorrhoids are a clinical type of external hemorrhoids. They usually present in the acute phase with significant local pain and thrombus encapsulation within the hemorrhoid. Due to congestion and edema in the hemorrhoid, excessive pressure builds up inside, causing severe pain for the patient. Conservative medication treatment primarily involves sitz baths with hemorrhoidal wash solutions and hot compresses to promote thrombus absorption, as well as applying hemorrhoidal creams, or orally taking anti-swelling, pain-relieving, and thrombus-absorbing medications. If these methods repeatedly fail, surgery can be opted to strip and remove the local thrombus.

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Written by Chen Tian Jing
Colorectal Surgery
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Can external hemorrhoids be cured completely?

External hemorrhoids are a common clinical type of hemorrhoids, and the main method for radical treatment is primarily surgical removal. The sole use of topical medications or oral medications can only alleviate the congestion, swelling, and pain caused by external hemorrhoids, but cannot completely remove them. The surgical methods for external hemorrhoids primarily include external hemorrhoidectomy or the combined internal ligation and external excision surgery. If internal hemorrhoids are also removed during the surgery, there will be sutures present, and it is recommended that patients be hospitalized and observed until the sutures fall out before being discharged. This is to avoid complications such as major bleeding from premature suture loss due to early discharge or exertion.

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Written by Chen Tian Jing
Colorectal Surgery
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Thrombosed external hemorrhoid characteristics

Thrombosed external hemorrhoids are a clinical type of external hemorrhoids. The main characteristics of the hemorrhoid nucleus in thrombosed external hemorrhoids are that the hemorrhoid nucleus is stuck at the anus and cannot retract, accompanied by swelling and enlargement. As the hemorrhoid nucleus contains thrombosis, its color is mostly purplish red or dark red, and patients will experience severe local pain and a sensation of distension. Thrombosed external hemorrhoids generally belong to the acute phase of external hemorrhoids, often occurring when the stool is dry or the intestinal heat is severe. For the treatment of thrombosed external hemorrhoids, one can choose Chinese herbal solution for hot compresses to promote the absorption of the thrombus, or directly perform a surgical excision. (This answer is for reference only. For medication, please consult a professional physician and do not medicate blindly.)

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Written by Yu Xu Chao
Colorectal Surgery
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Can external hemorrhoids be punctured?

External hemorrhoids should not be punctured because they are located at the anus, which is at the end of the digestive tract and often contaminated by feces and excretions. If punctured, it can easily lead to local infection, causing pain and increased secretion, and worsening necrosis of the external hemorrhoids. Therefore, external hemorrhoids should be treated as soon as possible with hemorrhoidectomy, rather than being punctured by oneself. After surgical treatment, it is also necessary to use anal cleansers, red oil gauze, and golden ointment for dressing changes to promote the healing of the wound. Moreover, patients should maintain smooth bowel movements to avoid hard and dry stools or frequent diarrhea. In terms of diet, it is advisable to consume foods rich in roughage to ensure smooth bowel movements and to avoid fishy seafood and similar foods.

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Written by Deng Heng
Colorectal Surgery
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What does an external hemorrhoid look like?

External hemorrhoids are hypertrophic protrusions of the skin around the anal margin, forming skin tags, or expansions of the subcutaneous venous plexus, where blood flow stagnates and thromboses form, or other raised lesion-like abnormalities appear. Based on histopathological characteristics, external hemorrhoids can be categorized into four main types: connective tissue-type, thrombotic-type, varicose-type, and inflammatory external hemorrhoids. Connective tissue-type external hemorrhoids primarily consist of hypertrophic protrusions of the anal margin skin tags, also known as skin tag external hemorrhoids. Varicose-type external hemorrhoids, also known as venous cluster-type external hemorrhoids, occur when the venous plexus below the dentate line expands and twists, forming venous clusters. Inflammatory external hemorrhoids are a condition where pre-existing skin tag external hemorrhoids develop inflammatory changes. Thrombotic-type external hemorrhoids are a type of anal disease that occurs due to bleeding from the hemorrhoidal veins or the formation of thromboses in the skin around the anus.

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Written by Yu Xu Chao
Colorectal Surgery
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Can external hemorrhoids use hemorrhoid suppositories?

In clinical practice, hemorrhoidal suppositories can also be used for external hemorrhoids. Since hemorrhoidal suppositories are mainly administered through the rectum to act locally, they have a certain therapeutic effect on external hemorrhoids, especially for varicose external hemorrhoids and inflammatory external hemorrhoids, helping to alleviate local swelling and pain. Additionally, for external hemorrhoids, it is often recommended to use anal cleansers, or to sit in baths with potassium permanganate or other medicated solutions, combined with the external application of hemorrhoidal cream or golden ointment. If symptoms do not show significant improvement after four to five days of medication treatment, it is advisable to visit a hospital's proctology department for external hemorrhoid surgery as soon as possible, to prevent potential thrombosis or necrosis of the external hemorrhoids. Moreover, patients should develop good bowel habits, avoiding prolonged sitting or excessive straining during bowel movements to prevent worsening of external hemorrhoids. (Medication should be used under the guidance of a doctor)