How are thrombosed external hemorrhoids formed?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 19, 2024
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The formation of thrombosed external hemorrhoids is mainly related to local congestion pressure in the anal area and excessive filling of submucosal blood vessels, especially after the patient abstains from spicy and irritating food, excessive defecation, and excessive fatigue. This condition becomes more prominent. Once thrombosed external hemorrhoids form, they are generally accompanied by the formation of skin tags and internal hemorrhoids in the anal area, and the external hemorrhoids enclose a blood clot. When the blood clot becomes congested or swollen, the patient will experience significant pain or distension. Once thrombosed external hemorrhoids have formed, it is crucial to treat them early to avoid necrosis caused by prolonged and repeated congestion and edema. Treatment options include using local medications for hot compresses or application to alleviate symptoms, or performing surgery to excise and remove the blood clots.

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How to eliminate the flesh lump of external hemorrhoids

External hemorrhoids mainly consist of varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombotic external hemorrhoids. If the patient wants to completely remove them, in such cases, only external hemorrhoidectomy or external hemorrhoid stripping surgery can be performed. After the surgery, anal cleansers, red oil gauze strips, and golden ointment are used for dressing changes to promote wound healing. If the patient is unwilling to undergo surgery and opts for conservative treatment with medications alone, the external hemorrhoidal mass will not be completely eliminated but will only shrink slightly and improve clinical symptoms. To completely eliminate the external hemorrhoidal mass, surgical treatment is necessary. Moreover, after surgery, patients should develop good defecation habits, such as not spending too much time on defecation, not straining excessively, and performing more pelvic floor exercises after defecation to strengthen the anal sphincter muscles to help prevent recurrence of external hemorrhoids.

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The difference between rectal prolapse and external hemorrhoids.

Rectal prolapse is the protrusion of the rectal mucosa, which manifests as an eversion of the mucosa presenting as pink-colored, cylindrical protrusions. These can usually be manually repositioned back into the anus, appearing smooth once repositioned. In contrast, external hemorrhoids are mostly caused by varicosities and are the same color as the skin. They cannot be completely repositioned manually, which distinguishes them from rectal prolapse.

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Written by Chen Tian Jing
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How to relieve pain from thrombosed external hemorrhoids?

The main cause of pain in thrombotic external hemorrhoids is the thrombus within the local hemorrhoid nucleus, which increases the congestion pressure and leads to discomfort and pain. During the acute phase of thrombotic external hemorrhoids, there is generally pain or bloating in the local area, along with difficulty in defecation. To quickly alleviate the pain, one can manually break the local thrombus or use traditional Chinese medicine washes for hot compresses to promote the absorption of the thrombus. If the thrombus is large or the condition is severe, surgery can also be performed to peel and remove the local thrombus, which is the most effective method for pain relief. After the surgery for peeling off thrombotic external hemorrhoids, it is necessary to disinfect the local wound surface to avoid infection.

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Written by Deng Heng
Colorectal Surgery
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How long does it take for a thrombosed external hemorrhoid to subside?

Thrombotic external hemorrhoids are a type of external hemorrhoids. Generally, after 2-3 days, the thrombus begins to be absorbed and the pain significantly reduces and can be healed. However, in cases with a large thrombotic lump, significant pain can occur and in severe cases, it can hinder walking. The patient may be restless whether sitting or lying down, the surface may re-ulcerate, causing bleeding, and the thrombus can naturally expel itself. At this time, the lump will be eliminated.

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Can external hemorrhoids be treated without surgery?

Some external hemorrhoids do not require surgical treatment, as they come in three types. The first type, connective tissue external hemorrhoids, mainly presents as a mild foreign body sensation, generally painless, thus surgery is not necessary. Varicose vein type external hemorrhoids typically cause a feeling of heaviness and discomfort around the anus, and if symptoms are not severe, surgery is not required either. Only thrombosed external hemorrhoids, which usually involve severe pain, may resolve significantly on their own within two to three days if the lump is not large. Surgery is only needed for large, thrombosed external hemorrhoids.