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Thrombosed Haemorrhoids

Haemorrhoids are swollen veins in the anus (the entrance to your bottom) or rectum (the lower part of the large intestine).

Also known as piles, they are a common medical condition that many people will develop at some point in their life. It’s possible to have an external haemorrhoid or internal haemorrhoid, both of which can develop into a thrombosed haemorrhoid. 

Thrombosed piles are where a blood clot develops inside the haemorrhoid. It gets its name from the word ‘thrombosis’, which means clotting of the blood.

It’s much more common for this to happen with an external haemorrhoid than an internal one. Although not a dangerous condition, it can be painful.

This page goes into more detail about having a thrombosed external haemorrhoid, including the symptoms to look out for and possible causes of the condition. It also covers some of the most effective treatment options open to you, from at-home remedies to surgical internal and external haemorrhoids treatment.

Causes – Thrombosed Haemorrhoids

Haemorrhoids of all kinds are caused by increased pressure on the veins in your anus and rectum. This can happen for a variety of reasons, such as:

  • Constipation
  • Diarrhoea
  • Straining too hard during bowel movements
  • Not going to the toilet when you feel the urge to defecate
  • Sitting down for prolonged periods of time
  • Pregnancy (both internal and external haemorrhoids in pregnancy can develop due to the extra weight of the baby)
  • Childbirth (the strain of labour can cause piles to develop either during childbirth or shortly afterwards)
  • Weakening of the muscles in the anal canal due to ageing
  • Repeated heavy lifting (like weights or large objects)
  • Obesity

It’s not yet clear why some haemorrhoids develop blood clots and become thrombosed whereas others don’t. However, it’s much more common to have thrombosed external piles compared to internal ones.

Symptoms – Thrombosed Haemorrhoids

Haemorrhoids can present with a number of different symptoms. Depending on the severity of yours, you may experience some, none, or all of the following internal and external haemorrhoids symptoms:

  • Bright red blood during bowel movements (either on the toilet paper, in your stool, or in the toilet itself)
  • Itching around the anus
  • Pain around the anus, for example, when sitting, walking, or defecating
  • Swelling and/or lumps around the anus
  • Feeling as though you still need to have a poo after defecating
  • Slimy mucus on the toilet paper or in your underwear

Burst haemorrhoids

Thrombosed haemorrhoids may sometimes burst as a result of the buildup of pressure and blood inside them. If this happens, you may experience higher levels of pain and bleeding that lasts between a few seconds and several minutes.

This is usually nothing to worry about. However, if the bleeding is very heavy or lasts longer than ten minutes, you should seek medical assistance immediately.

How can you tell if an external haemorrhoid is thrombosed?

Thrombosed external piles are often especially painful because when they fill up with blood, they can become more tender than a regular external haemorrhoid. In addition, thrombosed piles will normally be visible as small lumps just outside the anus.

The blood clot inside usually gives them a dark blue or purple colour, a little bit like a bruise. This is one way in which you can distinguish them from standard external piles. 

Another clue that your piles are thrombosed is if they don’t respond to an over-the-counter topical external haemorrhoids cream. This is because the pain is not simply on the surface of the skin but comes from pressure and swelling deeper within the tissue as well. 

Rather than self-diagnose, it’s best to see a doctor if you suspect you have thrombosed external piles. This will enable you to get a more accurate diagnosis and rule out the possibility of more serious conditions.

Diagnosis with a GP

If you suspect that you have an external haemorrhoid and your symptoms don’t clear up within a couple of days, it’s wise to book an appointment with your GP. They will ask you questions about your symptoms and then likely request to do a visual examination of the affected area.

In many cases, a visual check will be sufficient to confirm you have piles; however, the doctor might also want to do a physical exam.

This will probably be a digital rectal examination, where they use a lubricated, gloved finger to see if there are any abnormalities (such as growths or lumps) inside the anus. This might sound intimidating, but it will be relatively painless and over quickly.

The GP will then be able to make a more precise diagnosis of your condition and advise you on options for external piles treatment. 

Treatments for thrombosed external haemorrhoid

If you’re curious to know, “do external haemorrhoids go away?”, the answer (in most instances) is yes. It’s normal for the condition to clear up on its own or with the help of at-home external piles treatment and remedies to soothe external haemorrhoid pain.

Having said that, in some cases, it may be necessary to seek medical intervention. This is particularly true for thrombosed external piles, which sometimes need to be drained in a procedure called a thrombectomy. Occasionally it may be necessary to have external haemorrhoid removal surgery.

The best course of action is to book an appointment with your GP, so they can advise you on the most appropriate treatment methods for you.

Over-the-counter treatments 

If necessary, you can speak to a pharmacist about over-the-counter treatments. These include an external haemorrhoids cream or suppositories to heal and provide pain relief. Sometimes it can be necessary with laxatives to help alleviate constipation and make bowel movements easier.

Home remedies

If you’re currently suffering from thrombosed external piles, the main question on your mind is probably how to get rid of them. The good news is that there are lots of simple at-home remedies you can try that will help to both speed up your recovery and reduce external haemorrhoid pain. 

They include easily implementable actions such as:

  • Sitting in a warm bath a few times a day to soothe any itchiness or pain
  • Applying an ice pack wrapped in a clean towel or a cloth wrung out in ice water to the affected area to reduce external haemorrhoid pain and swelling
  • Using wet wipes or damp toilet paper instead of dry when wiping your bottom. This will reduce the irritation of your piles
  • Avoiding using products with scent, perfume, or chemicals, as these may also irritate your haemorrhoids
  • Wearing loose clothing (cotton is a good choice of fabric)

Medical treatment

If an external haemorrhoid or thrombosed haemorrhoid doesn’t improve with some remedies, you might need medical intervention. There are a few different options when it comes to external piles treatment, but the main procedure for a thrombosed haemorrhoid is a thrombectomy.

This involves making a small cut in the clot to allow it to be drained. You will be given anaesthesia, so it won’t be painful.

Other surgical and non-surgical options include:

  • Infrared coagulation – Uses infrared light to shrink piles by cutting off the blood supply
  • Rubber band ligation – Shrinks piles by placing a small band around them 
  • Electrotherapy – Applies a gentle electric current to haemorrhoids in order to shrink them
  • Sclerotherapy – A liquid is injected into haemorrhoids to shrink them
  • Haemorrhoidectomy – A form of external haemorrhoid removal where your piles are cut out
  • Stapled haemorrhoidopexy – Involves stapling piles back inside the rectum to cut the blood supply and shrink them
  • Haemorrhoidal artery ligation – Uses stitches to shrink piles by cutting off the blood supply to them

The correct treatment for you will depend on a variety of factors, including the location, type, and severity of your haemorrhoids. A medical professional will be able to assess your situation and provide the best advice.

How can you prevent external haemorrhoids from returning? 

These are certain diet and lifestyle changes you can put into practice to prevent an external haemorrhoid from returning:

  • Avoid spending too long on the toilet or straining when defecating.
  • Eat a diet that’s high in fibre to avoid constipation.
  • Stay hydrated by drinking six to eight glasses of water a day.
  • When lifting heavy objects, use good technique, and don’t forget to breathe steadily throughout.
  • Keep your anal area clean and dry.
  • Lead an active lifestyle to reduce the chances of getting constipated

Thrombosed Haemorrhoids FAQs

Do external hamorrhoids go away? 

Yes, the swelling and pain should disappear after a few days or a few weeks, depending on the severity of the haemorrhoid.

How long does it take for a large external haemorrhoid to go away?

While it may not always be possible to get rid of external haemorrhoids in 48 hours, in the majority of cases, they will get better in a few days. For thrombosed external piles, the recovery period is likely to be a bit longer.

It may take a couple of weeks for the condition to disappear completely – especially if the haemorrhoids are particularly large or severe.

Should I be worried about a thrombosed external haemorrhoid?

In the majority of instances, a thrombosed external haemorrhoid is nothing to worry about. Although they can be painful and uncomfortable, piles usually go away on their own in a week or two. It’s rare for there to be complications, although they can occur. These include skin tags and infection.

When should I see a doctor for a thrombosed external haemorrhoid?

Unless your symptoms clear up in a few days, it’s almost always a good idea to see a doctor for a thrombosed external haemorrhoid. That’s because they can check to make sure that you’re definitely suffering from piles and not a more serious health condition with similar symptoms. 

Likewise, if you’re experiencing external haemorrhoid pain, they will be able to prescribe any necessary painkillers, laxatives, or an external haemorrhoids cream or ointment.

If you have an external haemorrhoid and any of the following apply, you should see a doctor immediately:

  • You have a very high temperature and/or feel hot and shivery
  • Pus is leaking from your piles
  • You are in severe pain
  • Your symptoms are worsening
  • You are suffering from heavy or non-stop bleeding

How do you get rid of external haemorrhoids?

In most cases, you will be able to recover from external piles simply by following at-home remedies such as eating high fibre foods, staying hydrated, avoiding straining on the toilet, and keeping your anal area clean and dry.

Warm baths, cold compresses, painkillers, and an external haemorrhoids cream can help to speed up healing and relieve soreness and itching.

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