Spotting and Treating the
Thrombosed External Hemorrhoid




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What is a thrombosed external hemorrhoid? And how can you tell if you have one? If you do, how do you treat it? What kinds of results can you expect? These are some of the most common questions associated with this painful topic. This article looks briefly at the answers.

What Is a Thrombosed External Hemorrhoid?

An external hemorrhoid becomes thrombosed when a blood clot forms within it. Doctors aren't quite sure why this happens, but they believe it results from a specific experience or change. This may come from

One study found that traumatic delivery appears to be associated with thrombosed external hemorrhoids. The hemorrhoid becomes stressed, with the surrounding veins overextended and nerve endings inflamed. Too much blood settles in these weakened and expanding pockets. The more you strain, the longer you sit, the more stress you place on the hemorrhoid. The result is a hemorrhoid that swells into a hard, painful lump around your anus.

In the worst cases, the external hemorrhoid protrudes through the skin that covers it and bleeds, compounding the pain you're already feeling from the overstressed nerves in the hemorrhoid. This intense pain can last one to two weeks. The inflamed nerve endings can also lead to itching. So you have a bleeding hemorrhoid that's painful to touch but itches. Misery.

How Can You Tell If You Have One?

thrombosed external hemorrhoidThe hard lump that forms in a thrombosed external hemorrhoid leaves you constantly aware of this new intruder. Suddenly, it's painful to sit, stand, walk, or move your bowels.

How can you tell if you have one? Check out the color. The gathering of engorged blood from the blood clot gives the lump and surrounding area a distinctive purple, blue, or blood red color. Definitely not a pretty sight.

How Do You Make It Go Away?

Home treatments
Home treatments or surgery?
Surgical options

Thrombosed External Hemorrhoids Home Treatments

By the time a hemorrhoid is thrombosed, often your best solution is surgery. Still, as with any type of hemorrhoid, it's usually best to try a hemorrhoids home treatment regimen first. A persistent combination of sitz baths, creams, anti-inflammatory pain relief, such as ibuprofen, and heat and ice compresses may do the trick.

In time, your body may reabsorb the hemorrhoid. However, if you're experiencing intense pain or severe bleeding, time may not be on your side. Home treatments, generally, need time to take effect. Because a blood clot is behind the problems a thrombosed external hemorrhoid causes, relieving the pressure on the clot is critical to relieving your discomfort. Also, if you're bleeding profusely, you need to be concerned with the potential for anemia.

If you're going to need surgery, it's best performed within the first 72 hours of the thrombosis setting in. During this period, the pain experienced from the surgery will be significantly less than if you wait.

Home Treatment or Surgery?

So, what's best? Remove the blood clot surgically immediately or wait for the home treatments to work? No studies have been conducted to answer this question. The best judgment is to give the home treatment up to 48 hours to demonstrate some significant improvement. If there is none, it's time to call the doctor.

Surgical Options for Thrombosed External Hemorrhoids

Doctors usually recommend a hemorrhoidectomy if home treatments fail. In this surgery, doctors remove both the blood clot and the blood vessels in the hemorrhoid. After numbing the area, the doctor makes an incision over the thrombosis. He or she doesn't want to cut too deeply. It's important to protect muscles beneath the hemorrhoid. This type of damage would extend the patient's recuperation time significantly.

A less extensive surgery is an excision, in which the doctor makes an incision around the hemorrhoid and removes the blood clot but not the blood vessels. The problem is this procedure has only about a 50 percent success rate, compared with a 95 percent success rate for the hemorrhoidectomy. Recurrence seems to be connected to the fact that the blood vessel is left intact and can, therefore, support new outbreaks of inflammation.

Care After Surgery to Remove a Thrombosed External Hemorrhoid


Once the surgery is over, you'll focus again on home treatments. These will include:

You may see some bleeding and experience some itching as a normal part of your recuperation. What's not normal?


Expect to be off work at least two to three weeks after a hemorrhoidectomy.

A hemorrhoidectomy results in full hemorrhoid removal. However, this doesn't mean that new hemorrhoids can't develop if the behaviors that led you to the surgeon's table don't change. For long-lasting results, change your diet; change your life.


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Carex Sitz Bath, 6/Pack

Carex Sitz Bath, 6/Pack

The Carex Sitz Bath is ideal for use in the treatment of hemorrhoids and other conditions in the anal and genital areas, and especially after an episiotomy. It has wide contoured edes for comfort and comes with a covenient on/off flow control clip. Designed to fit standard toilets. Product Size: 60" (152.4 cm) no-kink tubing. Capacity: Bag = 2 U.S. qts (1.9 L), Basin = 2.1 U.S. qts (2 L).

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