How to treat thrombotic external hemorrhoids?

Written by Deng Heng
Colorectal Surgery
Updated on February 22, 2025
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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 Yu Xu Chao
Colorectal Surgery
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Do external hemorrhoids require surgery?

If external hemorrhoids do not cause any discomfort to the patient, then it is possible to delay surgical treatment in this situation. This is because the treatment of external hemorrhoids is primarily based on their clinical symptoms to choose different treatment methods. If it is simply a case of redundant skin hemorrhoids, where the patient only experiences a slight foreign body sensation in the anus, surgical intervention is not necessary. The patient only needs to maintain smooth bowel movements, perform more anal lifting exercises, avoid prolonged sitting and squatting, and take a warm saltwater sitz bath after defecation to prevent exacerbation of the external hemorrhoids. However, if the external hemorrhoid node develops inflammatory edema or thrombosis, causing anal swelling and pain, and the patient is unable to walk normally, it is then recommended to promptly visit the proctology department of a hospital to undergo external hemorrhoidectomy, to prevent worsening of the inflammatory edema or thrombosis, leading to significant anal swelling and pain.

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Written by Deng Heng
Colorectal Surgery
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Do external hemorrhoids always require surgery?

Simple external hemorrhoids do not necessarily require surgery. External hemorrhoids are mainly those that grow below the dentate line, and their main clinical manifestation is a foreign body sensation in the anus, which does not pose a significant risk to the body. Only thrombosed external hemorrhoids with obvious anal pain may not require surgery if the lump is small, as the thrombus can be absorbed on its own. Only those with large lumps need to have the thrombus removed to alleviate pain.

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Written by Chen Tian Jing
Colorectal Surgery
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How are thrombosed external hemorrhoids formed?

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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Written by Chen Tian Jing
Colorectal Surgery
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What are the effects of external hemorrhoid fumigation and washing liquid?

Shrink hemorrhoids, eliminate swelling. For the treatment of external hemorrhoids, one can choose Chinese herbal washes to fumigate the affected area, apply hot compresses, or take sitz baths. Their primary efficacy is to shrink the local external hemorrhoidal nodules and reduce swelling through the effects of the medication, or to enable the self-absorption of thrombosis and varicose veins within the local nodules. Beyond local fumigation agents, the treatment of external hemorrhoids can also include applying ointments or using suppositories. It is also necessary to maintain good bowel habits to avoid further irritation and enlargement from stool. If repeated treatment for external hemorrhoids is ineffective, or if the local symptoms are severe, surgery may be considered to remove the external hemorrhoids completely.

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Written by Yu Xu Chao
Colorectal Surgery
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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.