Thrombosed Hemorrhoids – Symptoms, Causes, Complications, Treatment

What Is a Thrombosed Hemorrhoid?

The most common form of hemorrhoidal disease is thrombosed hemorrhoids. It’s caused by abnormal distension of hemorrhoidal veins below the mucosa and anus of the lower rectum.

While hemorrhoids are often used to describe hemorrhoidal diseases, hemorrhoids are normal clusters made up of smooth muscle, highly vascular structures, and elastic connective tissues that make up the anal cushions. They protect the anal and prevent incontinence from rising abdominal pressure, such as during coughing or sneezing.

These anal cushions can become swollen and protrude into the anal canal. This is known as hemorrhoids, or piles. A hemorrhoid thrombosis is a condition in which a blood clot builds up inside a hemorrhoidal vein. This can block blood flow and cause painful swelling of the anal tissues. Although they are not dangerous, thrombosed hemorrhoids can cause severe pain and even ulceration.

Two types of hemorrhoids exist: internal hemorrhoids that develop in the lower part of the rectum, just above the dentate, and external hemorrhoids that develop at the edge of the anal channel, just below the dentate. Although most thrombosed hemorrhoids are caused by external factors, it is possible to have internal hemorrhoids.

How Does a Thrombosed Hemorrhoid Look?

Acutely thrombosed hemorrhoids are characterized by a painful, dark-bluish lump near the anal canal. Sometimes, increased pressure in the hemorrhoid can cause necrosis or ulceration of the skin, leading to rectal bleeding.

However, thrombosed hemorrhoids may be less common and not visible from the outside unless protruding from the anal channel.

What Are The Signs?

A thrombosed hemorrhoid is usually a small lump on the outside of your anus. It will appear darkened and bluish due to the blood clot.

An external hemorrhoid with thrombosis will look different from other hemorrhoids. External hemorrhoids that are not thrombosed look more like a rubbery lump without the blue color.

The following symptoms are indicative of thrombosed hemorhoids:3

• Pain when sitting, walking, or having a bowel movement
• Bleeding during bowel movements
• You are aching for the anus.
• Anus swellings or lumps

For the first 24 to 48 hours, the pain will be most severe. The blood clot will slowly be absorbed after that. The pain will begin to disappear once this happens.

If you are experiencing pain after taking over-the-counter hemorrhoid medication, it is possible that your body has thrombosed hemorrhoids. The pain is not localized to the skin. It is caused by pressure and swelling in the tissue.

A healthcare provider should be consulted if you have a fever and a thrombosed hemorrhoid. A hemorrhoid infection may occur, which could lead to perianal engorgement. This is the painful pouch of pus that forms around your anus.

You should look for a lump-like appearance that is reddish and feels warm. If you suspect that there is a perianal abscess, consult a healthcare provider. It should be removed as soon as possible.

An untreated perianal abscess may lead to an anal fistula. This refers to an abnormal connection between the skin and the anus. To correct a fistula, it may be necessary to have surgery.

Rectal bleeding should not be ignored or interpreted as hemorrhoids. This could indicate a more serious condition, such as anal cancer or colorectal carcinoma. Rectal bleeding should be reported to your healthcare provider.

What Causes Thrombosed Hemorrhoids?

Hemorrhoids occur when blood vessels in your anal canal become swollen. Hemorrhoids usually do not cause pain. They can become painful if they become thrombosed.

Hemorrhoids occur when there is an increase in pressure on your rectum’s veins. Possible triggers are:

• Pregnancy due to the pressure of the baby
• Childbirth, starting with pushing during delivery,
• Physical exertion, particularly repeated heavy lifting,
• Long-term sitting
• Constipation can cause straining while using the toilet.
• Diarrhea or loose stool.
• Obesity, or having a large amount of body fat,
• Intercourse anal
• To not use the toilet frequently

It is possible for a hemorrhoid to thrombose once it has formed. Healthcare providers aren’t sure why certain people get blood clots in their hemorrhoids while others don’t.

How Can It Be Diagnosed?

About one-third of the approximately 10 million Americans with hemorrhoids seek treatment.

It’s something that most people don’t want to talk about, so they suffer silently. Many hemorrhoids patients only seek medical attention when they are tired of managing them, “states Sarah B. Umar, M.D., a gastroenterologist at Mayo Clinic’s Arizona campus who specializes in anorectal disorders.”

She states that hemorrhoids are a common cause of anorectal pain. However, it is important that other causes be considered. Evidence suggests that hemorrhoids can be caused by other conditions.

In a prospective study, published in Diseases of the Colon and Rectum in 2010, a review looked at the diagnostic accuracy of doctors regarding seven common anorectal conditions: prolapsed intra hemorrhoid (thrombosed), thrombosed, abscess and fissure, condyloma acuminata, and full-thickness rectal prolapse. Even though hemorrhoidal diseases were difficult to diagnose, doctors were less likely than others to identify them.

Home Remedies to Ease Discomfort

Hemorrhoids can be relieved with these home remedies.

• Hemorrhoid cream: An over-the-counter cream for hemorrhoids can be used to relieve symptoms.
• Pain relief: You can take over-the-counter painkillers to relieve your pain.
• Warm water: Take a soak in warm water and pat dry the area.
• Cold compress: A cold compress or icepack may be applied to the affected area to reduce pain and inflammation.
• Witch Hazel: This can reduce the itching and pain in the area.
• Wet wipes: Use wet wipes instead of toilet paper to reduce friction and irritation.
• Aloe Vera: Aloe vera is well-known for its anti-inflammatory properties. Pure aloe vera can be applied to the affected area to reduce inflammation.
• Stool softeners: To treat hemorrhoids at home, the National Institute of Diabetes and Digestive and Kidney Diseases recommends using stool softeners or fiber supplements. This makes it easier to move a stool, reducing irritation.
• Loose cotton clothing: It is best to avoid tight clothes made from artificial fabrics. Loose cotton clothing is a good choice to reduce irritation and dry the skin.

What Are The Complications?

These are possible complications of thrombosed hemorrhoid excision.

• Bleeding is the most common problem with this procedure. It can usually be controlled with direct pressure. If hemostasis cannot be achieved with direct pressure, you can use either silver nitrate cauterization or a figure-8 stitch with an absorbable staple.
• Infection: Although the infection rate is unknown, it is thought to be less than 5%. Prophylactic antibiotics are not recommended routinely.
• Perianal skin tag: This is a benign condition that can occur after the incised region has healed.
• Stricture: This is a rare complication that can be avoided by working with the external anal sphincter muscles.
• Incontinence: This is a rare complication that can be avoided by working with the external anal sphincter muscles.
• Pain: This is an avoidable but common complication and can be prevented with any combination of parenteral or local anesthesia with or without procedural sedation.

How Can Hemorrhoids Be Prevented?

Keep your stool soft to prevent hemorrhoids. This will allow them to pass more easily. These tips will help you prevent hemorrhoids.

• Eat high-fiber foods. Consume more fruits, vegetables, and whole grains. This will soften your stool and increase its bulk. It can also help to avoid straining, which can lead to hemorrhoids. Increase your fiber intake gradually to avoid gas problems.
• Get plenty of fluids. To keep your stool soft, drink six to eight glasses of water or other liquids (not liquor) every day.
• Consider fiber supplements. Fiber supplements are a good option. Most people don’t consume the recommended daily intake of fiber (20–30 grams per day). Research has shown that taking over-the-counter supplements like psyllium (Metamucil) or methylcellulose can improve hemorrhoid symptoms and reduce bleeding. Fiber supplements should be taken with at least eight glasses of water each day. Supplements can worsen or cause constipation.
  Do not strain. When you are trying to pass a stool, straining and holding your breath can cause more pressure in the lower rectum.
• You should go as soon as you feel the need. You could have difficulty passing your stool if you wait for a bowel movement to occur.
• Exercise Keep moving to prevent constipation. You can lose weight and prevent hemorrhoids by exercising.
• Avoid sitting for long periods. Avoid sitting too long, especially on the toilet. This can increase pressure on the anus.

What Are The Prospects For Thrombosed Hemorrhoids?

Most likely, thrombosed hemorrhoids will improve within a few days and then disappear on their own. There are many treatment options available to relieve the pain and get you back to living your life. It is very painful but not serious.

The condition can be treated with standard treatment in a few days or two. There is no need for any further treatment or evaluation. If the hemorrhoid is extremely large, the doctor might perform local anesthesia to remove the clot. There is no cure for hemorrhoids forever. However, there are many treatments that can be used to manage them.

Sources:

• Perianal Skin Tag: What They Are, How To Identify Them, And How To Treat Them. (2021, November 27). WebMD. https://www.webmd.com/skin-problems-and-treatments/what-is-a-perianal-skin-tag.
• The Prevalence Of Hemorrhoids And Chronic Constipation. An Epidemiologic Study – PubMed. (1990, February 1). PubMed. https://pubmed.ncbi.nlm.nih.gov/2295392/.
• A. (2020, February 21). Perianal Abscess Vs. Anal Hemorrhoid: What’s The Difference? — Colorectal Clinic Of Tampa Bay. Colorectal Clinic of Tampa Bay. https://www.tampacolorectal.com/blog/perianal-abscess-vs-anal-hemorrhoid-whats-the-difference.
• Thrombosed Hemorrhoids | Saint Luke’s Health System. (n.d.). Saint Luke’s Health System. https://www.saintlukeskc.org/health-library/thrombosed-hemorrhoids.
• Internal And External Hemorrhoids: Symptoms, Treatment, Pictures & Causes. (n.d.). MedicineNet. https://www.medicinenet.com/hemorrhoids_piles/article.htm.
• The Anal Cushions–a Fresh Concept In Diagnosis.. (1979, June 1). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2425593/.
• Hemorrhoidal Disease: Diagnosis And Management – Mayo Clinic. (n.d.). Hemorrhoidal disease: Diagnosis and management – Mayo Clinic. https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/hemorrhoidal-disease-diagnosis-and-management/mac-20430067.