A thrombosed hemorrhoid is painful and uncomfortable but rarely serious. Around 4.4%¹ of American adults face thrombosed hemorrhoids. They account for around 3 million emergency room visits every year.
Many thrombosed hemorrhoids go away without treatment. Others may require surgery. If you have a thrombosed hemorrhoid, you don't have to live with pain and hope for it to disappear. Contact your doctor for available treatment options.
Let's take a closer look at thrombosed hemorrhoids and their possible complications.
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Hemorrhoids are a swelling of the normal collection of blood vessel tissues located along the anal canal. When the anus experiences too much pressure, the surrounding blood vessels enlarge, and hemorrhoids can become painful and swollen.
This usually happens when a person is sitting too much (especially on the toilet), gains too much weight, or pushes too hard during a bowel movement in case of constipation.
Due to this pressure, swollen blood vessels stretch, can develop blood clots, and become thrombosed hemorrhoids. The word thrombosis means clotting. The condition is somewhat similar to varicose veins.
There can be two types of thrombosed hemorrhoids:
External hemorrhoids occur when blood-filled veins bulge out at the edge of the anal canal. They look like bluish lumps.
Internal hemorrhoids occur when the thrombosed vein sacks stay inside the canal. They may not always be visible from the outside.
External hemorrhoids are much more common than internal thrombosed hemorrhoids.
When you develop thrombosed hemorrhoids, one of the first symptoms is usually pain. Other symptoms include:
Itching in the anus and around it
Bluish lumps around the anus
Hard lumps near the anus that feel sore to the touch
Thrombosed hemorrhoids can cause significant discomfort, especially when you need to sit or go to the bathroom. If not treated properly, some thrombosed hemorrhoids can become infected and cause an abscess.
You must see a doctor if you think you have a thrombosed hemorrhoid. While some blood-clotted veins can resolve on their own, others may lead to complications.
When you visit a doctor, they will run some tests to diagnose your condition. These tests may include the following:
A doctor will insert a gloved finger into the anus to feel the veins. This procedure isn't painful since the doctor lubricates the finger and touches the hemorrhoids lightly.
A doctor can insert a tiny tube with a light on the end into the anus to get a good picture of the lining of your anus and rectum.
A doctor inserts a tiny tube with a camera to get a better look at the colon and rectum.
In most cases, a visual or rectal exam may be sufficient to diagnose the condition and determine the best course of treatment.
When your hemorrhoids are thrombosed, they contain trapped blood that causes pain and other symptoms.
One of the ways to treat hemorrhoids is to drain that blood. The procedure is called external thrombectomy. It requires a local anesthetic. Blood draining works best within 72 hours of the clot's formation.
A doctor creates a small incision in swollen hemorrhoid and drains the blood. Sometimes, the clots may reform. In severe cases, a doctor may suggest removing hemorrhoids surgically through a hemorrhoidectomy.
Only a small percentage of people with thrombosed hemorrhoids require surgical treatment. In most cases, thrombosed hemorrhoids can be treated with creams, diet adjustments (adding more fiber), and other pain-relief tactics (hot baths, oral pain-relievers, suppositories).
If your thrombosed hemorrhoid starts bleeding, talk to your doctor about other treatment options. It's important to avoid an infection that may cause an abscess.
Some hemorrhoids go away on their own within four to five days². Others may stay for weeks. If you are trying to self-treat a thrombosed hemorrhoid at home, and it remains painful after five days, contact a doctor.
If you don't treat a thrombosed hemorrhoid, it may result in complications. While rare, they can be uncomfortable and sometimes dangerous.
Increased pressure inside the thrombosed hemorrhoid can lead to necrosis (death of tissue) and ulceration (open sore) on the skin. This could cause rectal bleeding and additional pain.
If your thrombosed hemorrhoids get worse and begin to bleed, contact a doctor as soon as possible.
Some people are more likely to develop thrombosed hemorrhoids than others. The common risk factors include:
Hemorrhoid problems usually occur in people between 45 and 65 years of age³. However, younger people can develop the condition as well.
People with a history of constipation are more likely to face thrombosed hemorrhoids because these vessels are under constant pressure.
Powerlifting done wrong or lifting heavy objects regularly for work could cause pressure to build up and veins to hemorrhage.
People who lead a sedentary way of life could develop hemorrhoids more often than people who exercise regularly.
People with excess weight usually don't consume sufficient fiber, exercise regularly, or lead an active life. That's why they are generally more prone to developing thrombosed hemorrhoids.
In the third trimester of pregnancy, women may develop hemorrhoids. The excess weight and the stretching uterus put additional pressure on the pelvic veins.
To prevent thrombosed hemorrhoids, it's important to watch your diet (adding plenty of fiber, drinking plenty of water), exercise regularly, and avoid putting on excess weight.
Thrombosed hemorrhoids are rarely serious or dangerous. According to studies, only around 4% of all thrombosed hemorrhoid cases are complicated. Around 40% don't produce any symptoms.
However, in some cases, complications may occur. If you are experiencing symptoms, contact your doctor as soon as possible. They can run simple tests and recommend the appropriate treatment.
Hemorrhoid blood clots can resolve themselves within four to five days. If this doesn't happen, it's important to contact a doctor.
Only a small percentage of thrombosed hemorrhoids require surgery. The majority goes away after conservative treatment. However, you still need to consult a doctor to avoid complications.
No. Draining a thrombosed hemorrhoid is a serious procedure that must be done in a medical setting. Otherwise, you risk getting an infection, an abscess, and other complications. Draining of a thrombosed hemorrhoid is most effective within the first 72 hours from the time the clot appears.
Hemorrhoids: Expanded information | American Society of Colon & Rectal Surgeons