Thrombosed Hemorrhoid Symptoms and Treatment

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A hemorrhoid is a swollen vein in the anus or rectum, the last part of the large intestine. Thrombosed hemorrhoids happen when a blood clot forms inside a hemorrhoid. The blood clot blocks blood flow, causing painful symptoms.

Most thrombosed hemorrhoids are external, but they can also be internal. External hemorrhoids form in the tissue outside the anus, while internal hemorrhoids are inside.

Thrombosed hemorrhoids are also known as acute hemorrhoidal disease or perianal thrombosis. Perianal is a general term for the area around the anus.

Thrombosed hemorrhoids may appear as a single lump or a circle of lumps. In most cases, the blood clot is reabsorbed by the body and the symptoms go away.

Thrombosed hemorrhoids are not considered dangerous, but they can be very painful. If symptoms do not go away, there are multiple treatment options ranging from topical creams to surgery.

This article discusses the causes, symptoms, and treatment for thrombosed hemorrhoids.

Symptoms of a Thrombosed Hemorrhoid
Verywell / Brooke Pelczynski

Hemorrhoid Causes

Hemorrhoids form when the blood vessels that line your anal canal become swollen. Most of the time, hemorrhoids are painless. When they become thrombosed, though, they can be painful.

A hemorrhoid is caused by increased pressure on the veins in your rectum. Some possible triggers include:

  • Pregnancy, from pressure caused by the baby
  • Childbirth, from pushing during delivery
  • Physical exertion, especially repeated heavy lifting
  • Prolonged sitting
  • Constipation, which can lead to straining on the toilet
  • Diarrhea, or loose stools
  • Obesity, or having an excessive amount of body fat
  • Anal intercourse
  • Not using the toilet regularly

Once you have a hemorrhoid, it is possible for it to become thrombosed. Healthcare providers don't know why some people develop blood clots in their hemorrhoids and others don't.

Thrombosed Hemorrhoid Symptoms

A thrombosed hemorrhoid usually appears as a small lump on the outside of your anus. The blood clot inside will make it appear dark and bluish in color.

A thrombosed hemorrhoid looks different than other hemorrhoids. An external hemorrhoid that is not thrombosed will just look like a rubbery lump without the blue color.

Symptoms of thrombosed hemorrhoids include:

  • Pain when sitting, walking, or having a bowel movement
  • Bleeding with a bowel movement
  • Itching around the anus
  • Swelling or lumps around the anus

The pain will be at its worst for the first 24 to 48 hours. After that time, the blood clot will be slowly reabsorbed. When this happens, the pain will start to go away.

If over-the-counter topical hemorrhoid medications don't relieve your pain, you may have a thrombosed hemorrhoid. This is because the pain is not on the surface. Instead, it comes from pressure and swelling within the tissue.

If you have a fever with a thrombosed hemorrhoid, see a healthcare provider. The hemorrhoid may be infected, which can cause a perianal abscess. This is a painful pocket of pus that forms in the top tissue layer around your anus.

Look for a boil-like lump that may be red and feel warm. See a healthcare provider if you suspect a perianal abscess. It should be drained as soon as possible.

An untreated perianal abscess can lead to an anal fistula. This is an abnormal connection between the skin and the anus. A fistula may require surgery to correct.

Never ignore rectal bleeding or assume that it is related to hemorrhoids. It could be a sign of something serious, like anal cancer or colorectal cancer. See your healthcare provider if you have rectal bleeding.

Treatment for Thrombosed Hemorrhoids

Most thrombosed hemorrhoids will get better on their own. It may take two to three weeks for them to disappear completely. In the meantime, there are options for self-care. In extreme cases, you may want to consider surgery.

Self-Care

You can do a few things at home to improve your symptoms, including:

  • Sitz baths, shallow, warm baths to clean the area around the anus.
  • Dietary changes to keep your stool soft. Eating a lot of fiber and drinking plenty of fluids can help.
  • Avoiding straining during bowel movements. Try to lean forward, relax, and breathe slowly. Let the stool come out in its own time.

If these things do not make you feel better, see your healthcare provider. Topical treatments like ointments and creams could help. AneCream (lidocaine) ointment is an over-the-counter treatment commonly used for hemorrhoids.

Newer drugs such as topical Adalat CC (nifedipine) may be more effective treatments. Some studies suggest that nifedipine may help symptoms resolve faster than lidocaine.

Surgery

If treatments don't help, your healthcare provider may suggest surgery. A simple procedure can remove the blood clot. This is a good option if you are in a lot of pain.

Surgery for a thrombosed hemorrhoid can usually be done in a healthcare provider's office. It is considered safe and doesn't usually lead to complications, or new problems caused by the surgery.

Surgery may also keep the thrombosed hemorrhoid from coming back. Patients are typically satisfied with the results.

Recap

Most of the time, thrombosed hemorrhoids go away on their own. You can treat the symptoms with self care. Sitz baths, a high-fiber diet, and topical ointments can help. Avoid straining when using the toilet. A simple surgical procedure may be needed if pain is severe or other treatments don't work.

Summary

Hemorrhoids are caused by increased pressure on the veins in your rectum. They can become thrombosed if a blood clot forms inside.

Thrombosed hemorrhoids can be painful. They may also bleed and itch.

Most of the time, thrombosed hemorrhoids go away on their own. You should start to feel better in a couple of days.

In the meantime, you can treat your symptoms with sitz baths, a high fiber diet, and topical ointments. If your thrombosed hemorrhoid does not seem to be improving, see your healthcare provider. A healthcare provider can help you find a successful treatment.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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