Hemorrhoids are swollen veins that form in the lower rectum or around the anus. An external thrombosed hemorrhoid is a common type, characterized by a blood clot in a vein under the skin outside the anus. This condition can cause sudden, intense discomfort, but it is generally treatable.
Understanding External Thrombosed Hemorrhoids
An external thrombosed hemorrhoid forms when a blood clot develops in a vein just outside the anal opening. This differs from internal hemorrhoids, which are usually inside the rectum and often painless. The clot causes pronounced swelling and severe, sudden pain. The affected area appears as a firm, tender lump near the anus, often purple, blue, or dark brown due to clotted blood. Increased pressure on anal veins contributes to their development. This pressure results from straining during bowel movements, prolonged sitting, chronic constipation or diarrhea, or heavy lifting.
Immediate At-Home Relief
Several at-home strategies can provide immediate relief. Soaking the affected area in warm water through sitz baths can relax anal sphincter muscles, promote blood flow, and provide comfort. Do this for 10 to 15 minutes, two or three times daily, using plain warm water without additives.
Applying an ice pack wrapped in cloth reduces swelling and numbs pain. Apply ice for 15 to 20 minutes, ensuring a barrier like a towel between the ice and skin.
Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage the pain. Topical creams containing hydrocortisone or witch hazel may offer some relief from itching and discomfort.
Stool softeners ease bowel movements, reducing straining and irritation. After a bowel movement, gently clean the area with moist wipes instead of dry toilet paper to prevent irritation.
When to Seek Professional Medical Care
While many external thrombosed hemorrhoids improve with home care, certain signs indicate the need for professional medical evaluation. Seek medical care for persistent or severe pain that does not subside with at-home treatments.
Excessive or prolonged rectal bleeding also requires medical attention, as it can indicate more serious underlying conditions. Signs of infection, such as fever, increasing redness, pus, or unusual discharge, require immediate medical assessment.
Consult a doctor if symptoms worsen despite consistent home care, or if they do not improve within a few days to a week. A healthcare professional can diagnose the condition and recommend treatment.
Medical Procedures and Recovery
When home treatments are insufficient or pain is severe, medical intervention often involves an incision and drainage procedure, known as a thrombectomy. This procedure is typically performed in a doctor’s office under local anesthetic, which numbs the affected area. A small incision is made in the skin over the hemorrhoid to remove the blood clot.
It provides immediate pain relief and is most effective within 48 to 72 hours of clot formation. If more time passes, the body may naturally reabsorb the clot, and home treatments might be recommended.
After the procedure, patients should take daily sitz baths and keep the area clean. Minor bleeding or discharge is expected as the wound heals, typically within a week. Avoid strenuous activity for at least a day.
Strategies for Prevention
Lifestyle and dietary adjustments can help prevent the recurrence of external thrombosed hemorrhoids. A fiber-rich diet, aiming for 25 to 38 grams daily, softens stools and increases their bulk, reducing straining. Good sources include fruits, vegetables, and whole grains.
Adequate hydration, drinking six to eight glasses of water or other fluids daily, helps the fiber function effectively and keeps stools soft.
Avoid prolonged sitting, especially on the toilet, and respond promptly to bowel movement urges to minimize anal vein pressure. Regular physical activity promotes consistent bowel movements and reduces hemorrhoid risk.