How long does it take for a thrombosed external hemorrhoid to subside?

Written by Deng Heng
Colorectal Surgery
Updated on November 21, 2024
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Thrombotic external hemorrhoids are a type of external hemorrhoids. Generally, after 2-3 days, the thrombus begins to be absorbed and the pain significantly reduces and can be healed. However, in cases with a large thrombotic lump, significant pain can occur and in severe cases, it can hinder walking. The patient may be restless whether sitting or lying down, the surface may re-ulcerate, causing bleeding, and the thrombus can naturally expel itself. At this time, the lump will be eliminated.

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Written by Deng Heng
Colorectal Surgery
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External hemorrhoids are located.

External hemorrhoids are formed by the inferior rectal venous plexus, located below the dentate line, and are covered by the skin of the anal canal. The most common type is thrombosed external hemorrhoids, which form when a blood clot develops in the subcutaneous venous plexus of the anal canal. Connective tissue external hemorrhoids and inflammatory external hemorrhoids are also relatively common, both located below the dentate line, around the anal margin and inside the anal canal. Generally speaking, hemorrhoids below the dentate line are called external hemorrhoids, and those above the dentate line are called internal hemorrhoids.

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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 Yu Xu Chao
Colorectal Surgery
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How to relieve the pain of external hemorrhoids?

When there is pain in an external hemorrhoidal tag, it is often due to inflammatory edema or the formation of a thrombus, leading to pain. In such cases, it is advisable to first use an anal cleansing agent or a potassium permanganate solution for a sitz bath after defecation. The duration of the sitz bath should be controlled between five to ten minutes, which can effectively reduce swelling and relieve pain. After the sitz bath, applying external remedies such as Yellow Ointment or Musk Hemorrhoids Cream can also help reduce swelling and alleviate pain. For particularly severe pain, directly using diclofenac sodium suppositories inserted into the anus can provide anti-inflammatory and analgesic effects. Additionally, for external hemorrhoids with inflammatory edema, it is also necessary to combine this with oral diosmin tablets to relieve discomfort. However, if the external hemorrhoidal tag remains swollen for a long period or if the thrombus does not resolve, it is advisable to consider early surgical excision of the external hemorrhoids, followed by diligent postoperative dressing changes.

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Written by Yu Xu Chao
Colorectal Surgery
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Hemorrhoids are divided into several degrees.

In clinical practice, external hemorrhoids are not classified by degrees but mainly into skin tag hemorrhoids, varicose vein hemorrhoids, inflammatory hemorrhoids, and thrombosed hemorrhoids. Skin tag hemorrhoids and varicose vein hemorrhoids typically cause sensations of foreign bodies in the anus and feelings of anal prolapse, etc., and conservative medication treatment is generally chosen for these. However, thrombosed hemorrhoids or inflammatory hemorrhoids can cause significant anal swelling and pain, severely impacting the patient's normal life. For these two types of external hemorrhoids, it is recommended to promptly undergo hemorrhoidectomy, followed by medication treatment to promote healing of the surgical site. Because the surgical site for hemorrhoid operations is located at the anus, it is susceptible to contamination from feces and other secretions, which can easily lead to local infections, bleeding, and swelling. Therefore, it is essential to persist in changing dressings and to maintain smooth bowel movements.

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Written by Yu Xu Chao
Colorectal Surgery
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How to deal with occasional bleeding from external hemorrhoids?

Occasional bleeding from external hemorrhoids is mainly due to damage to the hemorrhoids, which leads to bleeding, usually accompanied by pain and a foreign body sensation in the anus. In such cases, if the bleeding is not severe and the pain is mild, it means the damage to the external hemorrhoids is not serious. For these cases, one can choose to use an anal cleansing agent for sitz baths to achieve anti-inflammatory and antibacterial effects, and then apply hemorrhoid cream and other medications externally to promote healing of the sores. At the same time, patients should wear loose, breathable cotton underwear to avoid frequent friction on the external hemorrhoids, which can worsen the damage. If the damage to the external hemorrhoids is severe, or if there is swelling or thrombosis, it is advised to go to the hospital's anorectal surgery department as soon as possible to undergo a hemorrhoidectomy. After the surgery, patients must persist in changing dressings to promote wound healing.