A “burst” or ruptured hemorrhoid is a thrombosed external hemorrhoid that has broken open. This event often results in sudden, intense pain relief followed by noticeable bleeding. It occurs when the pressure from a blood clot causes the overlying skin to tear, leaving an open wound in a sensitive area. Immediate and meticulous care is necessary to manage symptoms, promote healing, and prevent infection.
Immediate Cleaning and Initial Management
Gentle, thorough cleaning is the first step in managing a burst hemorrhoid to remove residual blood and prevent bacterial contamination. The area should be cleaned using warm water instead of dry, rough toilet paper, which can cause irritation. A bidet, handheld shower sprayer, or a squeeze bottle filled with warm water can be used for rinsing after a bowel movement or for general cleaning.
Avoid using harsh soaps, as these can dry out the delicate skin and prolong healing. After cleaning, gently pat the area dry with a soft, clean towel or a gauze pad, taking care not to rub the wound. To manage minor bleeding, apply a cold compress, such as an ice pack wrapped in a soft cloth, for a few minutes. This helps constrict blood vessels and reduce swelling.
Specific Topical Medications for Relief
Topical products should focus on active ingredients that offer protection, pain relief, and astringent action. Protectants form a physical barrier over the open wound, shielding it from friction and contact with stool. Common protectant ingredients in over-the-counter products include petrolatum, mineral oil, and zinc oxide.
Local anesthetics provide temporary relief from the sharp pain and burning sensation. Ingredients like lidocaine or pramoxine work by temporarily blocking nerve signals in the area, reducing discomfort. Applying an anesthetic cream or ointment can make sitting and moving more tolerable during the initial healing phase.
Astringents, such as witch hazel, provide relief by causing a temporary tightening of the tissues. This action helps reduce swelling and offers a cooling sensation that alleviates burning and itching. Use products specifically formulated for hemorrhoids. Avoid applying creams containing hydrocortisone or other steroid ingredients to the open wound, as these can slow down the natural healing process unless directed by a healthcare professional.
Comfort Measures and Healing Environment
Creating a supportive environment is important for promoting recovery. The warm, shallow soak of a sitz bath is a highly effective comfort measure that should be performed multiple times a day, especially after bowel movements. The warm water increases blood flow to the anal area, which helps relax the anal sphincter muscle and promotes healing.
To perform a sitz bath, fill a basin or bathtub with enough warm water to cover the hips and buttocks, ensuring the temperature is comfortable. Soaking for 10 to 15 minutes, three to four times daily, can significantly reduce inflammation and keep the area clean. Use plain warm water and avoid adding salts, oils, or scented soaps, as these additives can cause further irritation.
Preventing constipation and straining during bowel movements is essential to prevent re-injuring the healing site. Increase dietary fiber intake through foods or supplements, along with drinking plenty of water, to keep stools soft and easy to pass. Additionally, avoiding prolonged sitting, especially on the toilet, and refraining from heavy lifting reduces pressure on the pelvic floor, allowing the ruptured hemorrhoid to mend quickly.
Recognizing When to Seek Professional Care
While most burst hemorrhoids can be managed successfully with at-home care, certain signs indicate the need for professional medical attention. Immediate medical evaluation is required for significant blood loss, such as continuous heavy bleeding, the passage of large blood clots, or feeling dizzy or faint. Although bleeding is common with a burst hemorrhoid, a doctor must always check rectal bleeding to rule out other serious underlying conditions.
Signs of a possible infection also necessitate a prompt visit to a healthcare provider. These signs include a fever, spreading redness around the anus, increasing pain disproportionate to the injury, or the presence of pus or foul-smelling discharge. If severe pain is unmanageable with over-the-counter treatments after 48 hours, consult a physician for stronger prescription options or further evaluation.