A thrombosed hemorrhoid happens when an internal or external hemorrhoid ruptures or gets compressed. This can trap blood in the anus and form a clot, leading to swelling and intense anal pain.
It tends to be more common in people with constipation and during pregnancy. It can also happen in situations that raise abdominal pressure, such as heavy straining during workouts.
Treatment depends on the cause and severity of the thrombosis. A gastroenterologist or colorectal surgeon may recommend medications, or in some cases a minimally invasive procedure or surgery.
Common symptoms
The main symptoms of a thrombosed hemorrhoid are:
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Severe anal pain;
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Bleeding, especially during bowel movements or when straining;
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Swelling or a lump at the site.
In these cases, the lump may look purple or black, which can be a sign of thrombosis. If you notice this, you should see a colorectal surgeon as soon as possible.
Confirming a diagnosis
A colorectal surgeon can diagnose a thrombosed hemorrhoid by reviewing your symptoms and examining the area. They will look closely at the hemorrhoid, especially if it is external, to check its appearance and look for signs of a blood clot.
Possible causes
A thrombosed hemorrhoid usually happens as a result of an external hemorrhoid. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), hemorrhoids can be caused by straining during bowel movements, chronic constipation, and pregnancy, which are also risk factors for thrombosis.
Treatment options
Treatment for a thrombosed hemorrhoid should follow your healthcare provider's recommendations, and may include:
1. Taking medications or applying ointments
To treat a thrombosed hemorrhoid, the doctor may recommend:
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Pain relievers, such as acetaminophen, or anti-inflammatory medications, such as ibuprofen, to help relieve pain;
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Hemorrhoid ointments, such as over-the-counter products containing hydrocortisone or lidocaine, which can help reduce local pain and other symptoms;
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Laxatives, such as lactulose, to help soften stool and make it easier to pass;
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Fiber supplements, which help add bulk to stool and may reduce the risk of bleeding. According to the NIDDK, eating high-fiber foods can make stools softer and easier to pass and can help treat and prevent hemorrhoids.
Additionally, your healthcare provider may recommend medications like diosmin combined with hesperidin (available over-the-counter as a dietary supplement), which help improve blood flow in the anal veins and reduce symptoms like itching and bleeding from hemorrhoids.
2. Rubber band ligation of the hemorrhoid
In some cases, the doctor may recommend placing a rubber band around the hemorrhoid. This is used to reduce blood flow so the hemorrhoid falls off in about 7 to 10 days.
3. Injection of a sclerosing solution into the hemorrhoid
A doctor can inject a sclerosing solution into the hemorrhoid, which makes it harden and shrink. The hemorrhoid typically falls off after about 7 days, and this treatment may be used for internal or external thrombosed hemorrhoids.
4. Surgery to remove hemorrhoids
In more severe cases, such as when thrombosis is associated with tissue necrosis, surgery may be recommended. This procedure involves removing the hemorrhoid with a scalpel, and the patient may need to stay in the hospital.
Natural options
A natural option for symptom relief is a sitz bath for hemorrhoids using witch hazel, cypress, or lavender, for example. However, this does not treat the thrombosis permanently and is mainly a way to help ease pain.
If you suspect a thrombosed hemorrhoid, it’s important to see a healthcare provider to evaluate whether you need one of the treatments above.
To support treatment, it can also help to drink about 2 liters (around 8 cups) of water per day and get regular physical activity. These habits can improve bowel function and reduce pressure on the hemorrhoid.
Also recommended: Home Remedies for Hemorrhoids: 7 Natural Options tuasaude.com/en/home-remedies-for-hemorrhoids