Seeing blood can be alarming, leading many to wonder about the pain of a ruptured hemorrhoid. A hemorrhoid is a cluster of swollen veins in the anus and lower rectum. The term “burst” typically refers to a thrombosed external hemorrhoid, where a blood clot forms inside the vein, creating a hard, painful lump. When this hemorrhoid ruptures, the pressure is released, which often changes the immediate sensation from severe pain to relief. Understanding this distinction is important for managing the situation effectively.
The Sensation of a Ruptured Hemorrhoid
The pain associated with a thrombosed hemorrhoid is most severe in the 48 hours leading up to the rupture because the blood clot causes intense pressure and swelling beneath the skin. This preceding pain can be constant and severe, making sitting, walking, or having a bowel movement difficult. When the hemorrhoid finally ruptures, the internal pressure is released, often resulting in a sudden reduction in that severe, throbbing pain.
The moment of rupture itself may not be intensely painful, but the shock of seeing bright red blood is often significant. The bleeding can be quite noticeable, appearing in the toilet bowl or on the toilet paper, as the built-up blood clot is expelled. This bleeding is typically brief, lasting up to around 10 minutes. The overall feeling after the event is frequently one of relief rather than sharp pain, followed by minor discomfort, itching, or irritation as the small tear begins to heal.
Understanding Why Hemorrhoids Rupture
Hemorrhoids become swollen due to increased pressure in the veins around the anus and rectum, often caused by chronic constipation, straining during a bowel movement, or prolonged sitting on the toilet. Rupture is almost exclusively associated with external hemorrhoids that have become thrombosed, meaning a blood clot has formed inside the vein. This clot causes the skin covering the hemorrhoid to stretch and thin until the pressure becomes too high and the tissue breaks open.
Internal hemorrhoids, located inside the rectum, usually do not “burst.” Instead, an irritated internal hemorrhoid will simply bleed, producing bright red blood that coats the stool or appears on the toilet paper. The rupture of an external, thrombosed hemorrhoid releases the trapped blood and clot, which is a natural way for the body to relieve the painful pressure.
Immediate Steps for Care at Home
After a hemorrhoid ruptures, the immediate focus should be on gentle hygiene and comfort to prevent infection and promote healing. The affected area should be cleaned gently with warm water, avoiding harsh scrubbing or dry toilet paper. Using a moist wipe or a bidet can help keep the area clean without causing further irritation.
To manage lingering discomfort or swelling, apply a cold compress or an ice pack wrapped in a clean cloth for 5 to 10 minutes several times a day. Soaking the anal area in a sitz bath—a shallow bath of plain warm water—for 10 to 15 minutes two to three times daily can soothe the pain and aid in cleanliness. Over-the-counter pain relievers like acetaminophen can be taken, but avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen if the hemorrhoid is actively bleeding.
Warning Signs Requiring Medical Attention
While a ruptured hemorrhoid is rarely dangerous, certain symptoms indicate that professional medical care is necessary. Seek immediate medical attention if there is excessive or continuous bleeding, such as soaking pads quickly, or if the toilet water turns red and the bleeding does not stop after about 10 minutes. The passage of large blood clots also signals that the bleeding is more significant than a typical rupture.
Systemic signs of volume loss or infection should prompt an immediate visit to an emergency department. These include feeling dizzy, faint, or lightheaded, which may signal excessive blood loss. Signs of a localized infection, such as fever, chills, increasing redness or swelling, pus, or a foul odor around the rupture site, also require prompt professional evaluation. If the pain is severe and does not improve within a few days, or if home treatments fail to provide relief after a week, consult a healthcare provider to rule out other conditions.