Thrombotic external hemorrhoid compression treatment

Written by Chen Tian Jing
Colorectal Surgery
Updated on May 16, 2025
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Treatment options for thrombosed external hemorrhoids include topical medications, compression therapy, or direct surgical excision. The choice of treatment depends on the severity of the clinical condition. For mild thrombosis, a traditional Chinese medicine wash with blood-activating and stasis-dissolving effects can be used for local hot compresses to promote the absorption and reduction of the thrombus. If the thrombus enlarges, professional proctological techniques can also be used to crush the thrombus locally, but it is important to maintain cleanliness and hygiene of the local mucosa to avoid infection. If the condition of thrombosed external hemorrhoids worsens, or if the patient experiences severe pain, surgical excision treatment can also be directly performed.

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Written by Chen Tian Jing
Colorectal Surgery
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Thrombotic external hemorrhoids clinical characteristics

The clinical features of thrombosed external hemorrhoids primarily include acute episodes of localized swelling and pain in the anal area, with thrombosis forming in the local hemorrhoidal tissue. This condition is primarily due to dry stools and excessive straining during bowel movements, leading to congestion and edema in the local hemorrhoidal tissue and subsequent disruption of local blood circulation, resulting in thrombosis. After an attack, the anal hemorrhoidal tissue may display dark red or purplish clots, enclosed by the local skin and mucous membrane. Treatment options include the application of topical medications and hot compresses to promote absorption of the hemorrhoids, as well as local surgical excision. It is important to note that if rupture or bleeding occurs, considering the possibility of local thrombus rupture, it is essential to perform proper local cleaning and disinfection and to promptly proceed with surgical excision to prevent infection.

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

In clinical practice, external hemorrhoids can be classified into skin tag hemorrhoids, varicose vein hemorrhoids, thrombosed hemorrhoids, and inflammatory hemorrhoids. Among these, skin tag hemorrhoids can be pinched, but do not exert excessive force to avoid skin damage and causing anal pain. On the other hand, varicose vein hemorrhoids, thrombosed hemorrhoids, and inflammatory hemorrhoids should not be pinched, as pinching may easily cause subcutaneous vein damage, exacerbate thrombosis, and lead to anal distension and pain. External hemorrhoids can be gently massaged and rubbed, but should not be pinched forcefully. Moreover, clinically, treatments for external hemorrhoids often involve the use of anal washes or potassium permanganate solution for sits baths, and it is recommended to take a sitz bath for five to ten minutes after defecation to help reduce external hemorrhoids and prevent their enlargement. Maintaining good bowel habits is essential, avoiding prolonged defecation and excessive straining. After defecation, it is advisable to perform more anal lift exercises to strengthen the anal sphincter muscles.

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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 Deng Heng
Colorectal Surgery
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Will external hemorrhoids affect sexual life?

External hemorrhoids generally do not affect sexual life. External hemorrhoids mainly refer to hemorrhoids that grow below the dentate line, primarily divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombosed external hemorrhoids. The main clinical manifestations of the first three types of external hemorrhoids are a foreign body sensation in the anus and moisture at the anus, so they do not affect sexual life. Only thrombosed external hemorrhoids can cause anal pain, which might affect sexual life if the pain is very severe.

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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.)