Anorectal Care

Thrombosed External Hemorrhoids

 

What are thrombosed external hemorrhoids?
Everyone has blood-filled sacs with veins complexes that cushion the anal canal. Chronic trauma and straining during bowel movements can damage the internal tissue support of these sacs, causing them to swell and further fill with blood. When the sacs get bigger and protrude from the anal canal, they become hemorrhoids. External hemorrhoids occur outside of the anal canal and are very painful, and internal hemorrhoids occur inside the anal canal and can stick out and bleed. External hemorrhoids can develop blood clots inside and become very sensitive. Large blood clots can cause pain while walking, sitting, or passage of stool.

What treatments are available for thrombosed external hemorrhoids?
One method is to allow the clots to be absorbed by the body over several weeks. Hot baths, ointments or creams can be used for discomfort. However, it's recommended that the blood clots be surgically removed.

What happens during surgical removal of the thrombosed hemorrhoid?
One procedure creates an incision over the clot and allows the clot to be squeezed out. It sounds simple and easy, but blood clots usually reform and become very painful. A more extensive procedure, called a full hemorrhoidectomy, removes the clot and the blood vessels in the hemorrhoid. This takes longer and may require stitches, but will most likely provide better results.

Does it matter how long my hemorrhoids have hurt?
It's best to do the surgery within three days after symptoms start. Significant symptom relief can be achieved with early surgery. After three days, the pain relief from the surgery may not be greater than the discomfort from the surgery itself.

How should I prepare for the procedure?
Immediately after you start feeling pain, go visit your doctor. No enemas or colon preparation is required, but you may want to take three or four 200-mg ibuprofen tablets like Advil or Motrin to lessen discomfort.