Thrombosed Hemorrhoid

What is a thrombosed hemorrhoid?

A thrombosed hemorrhoid is when a blood clot forms inside a hemorrhoid. A hemorrhoid is a swollen vein in your rectum or anus. Sometimes, the swelling makes blood inside of the vein clot. This causes symptoms like pain, itching and rectal bleeding. Thrombosed hemorrhoids appear as a purple-blue lump, usually around your anus (butthole).

Thrombosed hemorrhoids can be external or internal:

• An external thrombosed hemorrhoid forms around your anus (or butthole). You may see a dark blue or purple lump. It can cause severe pain when sitting or walking. This type is more common.
• An internal thrombosed hemorrhoid forms inside your rectum. You usually can’t see an internal thrombosed hemorrhoid unless it bulges outside of your anus.

Most thrombosed hemorrhoids get better with at-home treatments. If these don’t help, your healthcare provider may need to remove the clot in the office.

What are the symptoms of a thrombosed hemorrhoid?

The biggest sign is a blueish-purple lump on or around your butthole. You can often see it or feel it. It can be extremely painful and tender.

Other symptoms include:

• Pain, especially when sitting, walking or pooping
• Bleeding from your anus (especially if it ruptures or bursts)
• Itching

What causes a thrombosed hemorrhoid?

They occur when a blood clot develops inside a hemorrhoid. Hemorrhoids occur due to increased pressure in your rectum. This can happen when you perform activities that involve straining. (The clot is just in your anus and doesn’t travel to other parts of your body.)

Hemorrhoids are also more common as you age because the tissues and veins in your rectum weaken. This makes them even more likely to swell under pressure.

Any hemorrhoid has the possibility of becoming thrombosed. Activities or conditions that put you at risk for hemorrhoids are:

• Frequent constipation
• Straining to poop
• Sitting on the toilet for long periods of time
• Weightlifting or lifting heavy objects
• Obesity
• Pregnancy or vaginal delivery (from pushing)
• Not using the bathroom as soon as you get the urge to poop
• Anal intercourse
• Being inactive or spending most of your day sitting

What are the complications of a thrombosed hemorrhoid?

Thrombosed hemorrhoids aren’t life-threatening, but they can be very painful. Other than severe pain, other possible complications include:

• Infection, which can cause a perianal abscess
• Bleeding that can be alarming if the hemorrhoid bursts

You should contact your healthcare provider if you notice signs of infection, like a fever or chills.

How is a thrombosed hemorrhoid diagnosed?

A healthcare provider diagnoses thrombosed hemorrhoids based on your symptoms and a rectal exam. Often, you’ll have intense and sudden pain and a visible lump at your anus. This is usually all a provider needs to diagnose a thrombosed hemorrhoid. They may also ask you if you have frequent constipation.

How is a thrombosed hemorrhoid treated?

Treatment often depends on the severity of the hemorrhoid. Most people feel the pain is most intense in the first 48 hours. You’ll usually find relief from at-home treatments like:

• Taking sitz baths
• Eating a lot of fiber-rich foods and drinking lots of water to soften your stool
• Using topical pain relievers or hemorrhoid creams containing hydrocortisone, witch hazel or lidocaine
• Taking pain relievers like ibuprofen
• Using stool softeners or laxatives to make pooping less painful

Often, at-home and over-the-counter treatments are enough to make a thrombosed hemorrhoid go away. Your body will eventually reabsorb the blood clot, and the pain will improve a little each day.

Draining the clot is an option if your pain is severe or you still feel a lot of pain after a few days of at-home treatment. Your healthcare provider may suggest a hemorrhoidectomy to remove the hemorrhoid.

Do thrombosed hemorrhoids go away on their own?

Yes, most of them will go away within a few weeks.

How do they drain a thrombosed hemorrhoid?

You should never attempt to drain a hemorrhoid on your own. Only healthcare providers should remove or drain a thrombosed hemorrhoid.

How do I prevent a thrombosed hemorrhoid?

Any hemorrhoid can become thrombosed. So, the best prevention strategy is to reduce the risk of hemorrhoids altogether. Avoiding constipation is key.

Other tips are:

• Make sure you eat enough fiber. You can also take fiber supplements.
• Drink plenty of water.
• Don’t strain to have a bowel movement.
• Avoid sitting on the toilet too long.
• Get regular exercise.

What can I expect if I have a thrombosed hemorrhoid?

No one wants to have hemorrhoids. They can be disruptive and uncomfortable. If a hemorrhoid causes intense pain and you notice a lump around your anus, it’s likely thrombosed. Most thrombosed hemorrhoids go away with at-home treatments like sitz baths and softening your stool. If you’re still in a lot of pain after a few days, contact a healthcare provider. They can take a look and recommend another way to treat a thrombosed hemorrhoid.

When should I see my healthcare provider?

Contact your provider if you have a thrombosed hemorrhoid that causes you pain. While most get better in a few days on their own, you may need your healthcare provider’s help. A thrombosed hemorrhoid can become infected or rupture.