What Is a Thrombosed Hemorrhoid?

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Thrombosed hemorrhoids are typically external hemorrhoids that have no blood flow due to a blood clot in the vein. Thrombosed hemorrhoids are not considered to be dangerous, yet they can be quite painful. In most cases, the blood clot is eventually reabsorbed by the body and the symptoms resolve themselves.

Thrombosed hemorrhoids may present as a single pile or a circle of piles. Thrombosed hemorrhoids are classified as Grade IV hemorrhoids.

Symptoms of a Thrombosed Hemorrhoid

As most hemorrhoids are painless, a possible marker that a hemorrhoid has thrombosed is the experience of acute pain and swelling in the area of the anus. In some cases, there may be some bleeding.

Topical hemorrhoid medications do not typically result in relief from the pain of a thrombosed hemorrhoid as the pain is the result of pressure and swelling within the tissue. The pain will be at its worst for the first 24 to 48 hours. After that time, the blood clot will be slowly reabsorbed and the pain will reduce.

Causes of Thrombosed Hemorrhoids

The causes of thrombosed hemorrhoids are not always identifiable. Some possible triggering events include:

  • Childbirth
  • Physical exertion
  • Prolonged sitting
  • Straining on the toilet to pass hard stool

Treatment of Thrombosed Hemorrhoids

Most thrombosed hemorrhoids will resolve on their own, although it may take two to three weeks for it to be completely gone.

Self-care measures for a thrombosed hemorrhoid include taking sitz baths, working to keep the stool soft, and avoiding straining during bowel movements.

There are some topical preparations that your doctor can prescibe that can be helpful. Surgery is an option for cases in which there is a lot of bleeding and the pain is quite severe.

If surgery is performed, the entire blood clot will be removed.

Also known as:

  • Acute hemorrhoidal disease
  • Anal hematoma
  • Hemorrhoidal thrombosis
  • Perianal hematoma
  • Perianal thrombosis

Interestingly, some researchers would like to rename thrombosed hemorrhoids as "perianal thrombosis" as the tissue involved may not necessarily be that of a hemorrhoid.

Sources:

Gebbensleben, O., Hilger, Y. and Rohde, H. "Aetiology of thrombosed external haemorrhoids: a questionnaire study" BMC Research Notes 2009 2:216.

Gebbensleben, O., Hilger, Y. and Rohde, H. "Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study" Clinical and Experimental Gastroenterology 2009 2:69–74.

Lohsiriwat, V. "Hemorrhoids: From basic pathophysiology to clinical management" World Journal of Gastroenterology 2012 18:2009–2017.

Lohsiriwat, V. "Treatment of hemorrhoids: A coloproctologist’s view" World Journal of Gastroenterology 2015 21:9245–9252.

Sanchez, C. & Chinn, B. "Hemorrhoids" Clinics in Colon and Rectal Surgery 2011 24:5–13.

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