Thrombotic external hemorrhoids clinical characteristics

Written by Chen Tian Jing
Colorectal Surgery
Updated on March 14, 2025
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The clinical features of thrombosed external hemorrhoids primarily include acute episodes of localized swelling and pain in the anal area, with thrombosis forming in the local hemorrhoidal tissue. This condition is primarily due to dry stools and excessive straining during bowel movements, leading to congestion and edema in the local hemorrhoidal tissue and subsequent disruption of local blood circulation, resulting in thrombosis. After an attack, the anal hemorrhoidal tissue may display dark red or purplish clots, enclosed by the local skin and mucous membrane. Treatment options include the application of topical medications and hot compresses to promote absorption of the hemorrhoids, as well as local surgical excision. It is important to note that if rupture or bleeding occurs, considering the possibility of local thrombus rupture, it is essential to perform proper local cleaning and disinfection and to promptly proceed with surgical excision to prevent infection.

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Written by Deng Heng
Colorectal Surgery
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How to treat thrombotic external hemorrhoids?

The treatment of thrombosed external hemorrhoids generally falls into two categories: first, conservative treatment; second, surgical treatment. Small lumps can be treated conservatively, and after 2-3 days, the thrombus can be absorbed, the pain can be significantly reduced, and self-healing is possible. However, larger lumps may erode on the surface, causing bleeding and severe pain that can impede walking and cause discomfort while sitting or lying down. In such cases, thrombectomy may be necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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What fruits should be eaten for thrombotic external hemorrhoids?

During the acute phase of thrombosed external hemorrhoids, patients experience varying degrees of pain in the anal region, occasionally accompanied by a feeling of bloating. Therefore, the diet should primarily consist of light, liquid, and easy-to-digest foods. If consuming fruits, it is best to eat soft, cool-natured fruits such as dragon fruit and bananas, avoiding hard or tropical fruits that may cause dry stools, which can exacerbate the symptoms of thrombosed external hemorrhoids. During the acute phase of thrombosed external hemorrhoids, in addition to dietary considerations, it is also necessary to use topical hemorrhoid cream locally or undergo surgery to excise and strip the local thrombosis for significant symptom relief, to prevent the condition from worsening, which could lead to increased thrombosis or necrosis.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Yu Xu Chao
Colorectal Surgery
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How to relieve the pain of external hemorrhoids?

When there is pain in an external hemorrhoidal tag, it is often due to inflammatory edema or the formation of a thrombus, leading to pain. In such cases, it is advisable to first use an anal cleansing agent or a potassium permanganate solution for a sitz bath after defecation. The duration of the sitz bath should be controlled between five to ten minutes, which can effectively reduce swelling and relieve pain. After the sitz bath, applying external remedies such as Yellow Ointment or Musk Hemorrhoids Cream can also help reduce swelling and alleviate pain. For particularly severe pain, directly using diclofenac sodium suppositories inserted into the anus can provide anti-inflammatory and analgesic effects. Additionally, for external hemorrhoids with inflammatory edema, it is also necessary to combine this with oral diosmin tablets to relieve discomfort. However, if the external hemorrhoidal tag remains swollen for a long period or if the thrombus does not resolve, it is advisable to consider early surgical excision of the external hemorrhoids, followed by diligent postoperative dressing changes.

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Written by Deng Heng
Colorectal Surgery
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How long does it take to recover after external hemorrhoidectomy?

External hemorrhoids are mainly classified into inflammatory external hemorrhoids, thrombotic external hemorrhoids, connective tissue external hemorrhoids, and varicose vein external hemorrhoids. Regardless of the type, the primary treatment method is surgical removal. After the hemorrhoids are excised, the perianal area generally does not bleed when passing stools for the first two to three days, and the patient can usually go home in about 7 days. For complete recovery to the pre-condition state, it is estimated to take between 20 days to a month.