Hemorrhoids are swollen veins in the rectum and anus. The event typically involves a thrombosed external hemorrhoid, where a blood clot has formed inside the vein, causing acute pain and pressure. When this pressure becomes too great, the overlying skin can tear, leading to a rupture. Although the experience is alarming due to the sudden presence of blood, a burst hemorrhoid is rarely life-threatening for an otherwise healthy individual. The rupture represents the body’s natural release of the clot and pressure, which initiates the healing process.
What Happens When a Hemorrhoid Bursts
The moment a thrombosed hemorrhoid ruptures, the immediate physical experience can be intense and contradictory. The rupture often causes a sudden, forceful release of built-up pressure, which can result in an unexpected and welcome wave of pain relief. This sensation of decompression replaces the severe throbbing pain that characterized the thrombosed state preceding the event.
The most noticeable consequence is the bleeding, which can be surprisingly significant in volume, often appearing as bright red blood or dark, clotted blood that may turn the toilet water red. This bleeding is usually brief, lasting anywhere from a few seconds to several minutes, as the body’s natural clotting mechanisms begin to work. Once the pressure is released, the once-hard, purplish lump deflates, leaving an open, shallow wound and potentially a small, soft flap of skin. This rupture site requires careful attention to prevent secondary infection.
Immediate Home Care Following the Event
The primary focus immediately after a hemorrhoid bursts is to manage the bleeding, ensure cleanliness, and provide pain relief. For the first few hours, applying gentle, continuous pressure with a clean piece of gauze or a sanitary napkin can help encourage clotting and absorb the initial drainage. It is important to keep the open wound site meticulously clean, particularly after a bowel movement, to prevent bacteria from the stool from causing an infection.
Cleaning should be done with extreme gentleness, avoiding abrasive dry toilet paper or harsh, scented soaps that can irritate the raw tissue. Instead, use a peri bottle or a handheld shower sprayer to wash the area with plain warm water, followed by gently patting the area completely dry with a soft cloth. Soaking the affected area in a warm sitz bath is recommended, as the warm water relaxes the anal sphincter muscles and promotes blood flow to aid healing. Soaking for 10 to 20 minutes, two to three times a day, is often sufficient for soothing the area and maintaining hygiene.
Pain management typically involves over-the-counter options, such as acetaminophen or ibuprofen, to manage discomfort and inflammation. For localized relief, a thin layer of a topical hemorrhoid cream containing lidocaine or witch hazel can be applied to the surrounding skin for temporary numbing and soothing. Avoid inserting suppositories or using topical creams that contain irritating ingredients directly into the open wound unless specifically advised by a healthcare provider.
Navigating the Recovery and Healing Process
After the initial event, the healing process for a ruptured thrombosed hemorrhoid typically spans several weeks, though acute discomfort often resolves quickly. The wound created by the rupture is a shallow tear that will usually close and heal within four to seven days, though residual swelling and tenderness may persist longer. During this phase, it is common to notice a small amount of yellowish discharge or drainage as the body cleanses the wound site.
A common occurrence after the swelling resolves is the formation of a residual anal skin tag, which is excess skin that was stretched by the thrombosed hemorrhoid. These tags are usually painless and are simply a cosmetic or hygiene nuisance, not a persistent hemorrhoid. They do not require medical intervention unless they cause difficulty with cleaning or chronic irritation.
Preventing recurrence during recovery is paramount, which involves managing the consistency of bowel movements. This is best achieved by gently increasing daily fiber intake to between 25 and 35 grams and ensuring adequate hydration by drinking plenty of water throughout the day. Fiber adds bulk to the stool, and water softens it, reducing the need to strain during defecation. Stool softeners like docusate sodium can be used temporarily to ensure soft passage, preventing further trauma to the healing tissue.
Critical Signs Requiring Medical Attention
While a burst hemorrhoid usually resolves without serious complication, certain symptoms necessitate immediate medical evaluation to rule out a more serious issue. Any instance of persistent, heavy bleeding where you are soaking through a sanitary napkin within a short period, or if the bleeding lasts continuously for longer than ten minutes, warrants urgent care.
Systemic symptoms related to blood loss, such as feeling dizzy, lightheaded, or faint, indicate a potentially dangerous drop in blood pressure and require emergency attention. Signs of a developing infection should also be treated seriously, including a fever higher than 100.4 degrees Fahrenheit, the presence of thick, yellow or green pus draining from the wound, or severe, escalating pain that is not managed by over-the-counter medication.
If you are currently taking blood-thinning medication, any hemorrhoidal bleeding should be discussed with a doctor immediately. All rectal bleeding should ultimately be evaluated by a healthcare professional to confirm the source and exclude other conditions.