Thrombosed External Hemorrhoids

aka thrombosed external hemroids

Introduction to Thrombosed External Hemorrhoids

A thrombosed external hemorrhoid is one of the most painful experiences outside of childbirth and kidney stones anyone can ever suffer through. Some medical texts describe the pain as "exquisite," if that gives you any idea. Of course, if you've already suffered through a thrombosed external hemorrhoid, you don't need me to tell you that.

A thrombosed external hemorrhoid is a hemorrhoid originating from external skin that has developed a blood clot. This blood clot blocks free blood flow from the external hemorrhoid and surrounding tissues. Hemorrhoids develop from veins, so this isn't as bad as it could be.

If external hemorrhoids developed in arteries, the surrounding tissue would be deprived of oxygen and quickly die. Instead, when an external hemorrhoid develops a clot, cell toxins aren't carried away as they would if the vein were flowing normally. These cell toxins seep into the area of and surrounding the thrombosed external hemorrhoid, causing massive inflammation and pain.

Causes of Thrombosed External Hemorrhoids

Quite a few different conditions can contribute to thrombosed external hemorrhoids. At the most basic, a thrombosed external hemorrhoid is an external hemorrhoid with a blood clot in it. So, how do you get a blood clot inside your skin?

It's more common than you might think. Blood carries multiple kinds of cells. Red blood cells, white blood cells and platelets are the three categories of blood cells. Red blood cells carry oxygen around, white blood cells form part of the immune system and platelets coagulate blood.

Under normal circumstances, platelets only do this when the body is cut, thus forming scabs. Hemophiliacs possess platelets that don't work well or at all, which is why they must worry about bleeding to death from a cut. However, platelets don't require a break in the skin to clot blood.

Any time blood sits around, unmoving, for too long it will start to clot. If blood didn't work like this, bruises would be fatal as well. Blood would just keep oozing through the damaged tissue and fill up under the skin.

Blood moves swiftly through arteries because of driving pressure from the heart. Blood in veins above the heart drain quickly back down towards the heart due to gravity. Blood in veins below the heart, on the other hand, can sit there for quite some time. Venal blood in the lower part of the body gets back up to the heart through a combination of muscle action and one-way valves within the vein canal.

If you don't move around enough, that blood can just sit there for hours or even days. If it sits for too long, it will start to clot. Hemorrhoids are especially prone to this because they're sort of a "backwater" in the circulatory system. Even if venous blood is flowing well in the main part of the vein, the hemorrhoid can catch and retain blood just off the main canal.

Pregnant women and young adults are statistically the most likely to suffer from thrombosed external hemorrhoids. However, any hemorrhoid can develop a blood clot at any point in life. The biggest causative factors at this point seem to be lots of straining and poor circulation.

Symptoms of Thrombosed External Hemorrhoids

If an external hemorrhoid develops a thrombosis (fancy term for blood clot), you'll usually know about it. The pain is quite insistent. You may also experience itching, burning, swelling or inflammation. The most definitive sign of a thrombosed external hemorrhoid is the color. Thrombosed external hemorrhoids develop a deep red, deep purple, blue or black tint, often appearing just underneath the skin. This tint, of course, comes from the blood clot.

Bruises are commonly identified as "black and blue." Take all of the colors you've ever seen in a bruise, concentrate them into one painful spot and you get the idea.

Treatment of Thrombosed External Hemorrhoids

Some thrombosed external hemorrhoids will get better on their own. Your body reabsorbs the clotted blood from a bruise, after all, and your body will sometimes reabsorb this. However, that can be dangerous. If you get a thrombosed external hemorrhoid, it's best to take it to a doctor.

Quite a few home remedies exist to relieve the symptoms of a thrombosed external hemorrhoid. You'll need them if you have to wait any length of time before seeing a doctor.

The first is a sitz bath. Draw one to two inches of water as hot as you can comfortably stand in the bathtub. Sit in it for about twenty minutes at a time, three to four times per day. For maximum relief, follow up by sitting on a towel-wrapped ice pack. The alternation of heat and cold both helps with inflammation and gets the blood moving, taking away some of the cell toxins causing the problem.

Take ibuprofen if you can. Acetaminophen is also acceptable, though it doesn't offer the anti-inflammatory action of ibuprofen. Narcotic painkillers, such as hydrocodone (Vicodan) are not usually recommended because they can contribute to constipation. You really, truly want to avoid constipation right about now.

If your doctor recommends home treatment, the regimen will be pretty much the same as outlined above. Your doctor will also probably have recommendations on lifestyle changes that can help, such as getting enough fiber in your diet, drinking enough water and getting light exercise. Not only are these good for your thrombosed external hemorrhoid, they're good for your health.

If, on the other hand, your doctor recommends surgery, there are two different types of surgery that may occur. The first is simple incision and removal of the clot itself. The doctor makes an eye-shaped cut in the top of the hemorrhoid to remove the blood clot and the skin over it. The wound may be left open to heal or may get stitched shut.

This procedure does not remove the whole hemorrhoid, just the clot. You still need to deal with the external hemorrhoid at home. However, this procedure also doesn't entail cutting into the muscle tissue of the anal sphincter, either.

The second option is to perform a complete hemorrhoidectomy, with either scalpels or lasers, in a full operating theater. Obviously, this is the most extreme response. If your doctor recommends it, schedule the time to sit down with him or her for an in-depth discussion about the benefits and risks.

Complications of Thrombosed External Hemorrhoids

No matter how you do it, you must deal with thrombosed external hemorrhoids effectively. If you don't, they can be dangerous. In the event that the clot just sits there instead of getting reabsorbed or removed, that clot starts causing serious problems. Cell toxins continue to build up in the surrounding area, bleeding and infection are more likely and even gangrene is a remote possibility. Do not ignore thrombosed external hemorrhoids.

Prevention of Thrombosed External Hemorrhoids

The best way to avoid thrombosed external hemorrhoids is to prevent hemorrhoids from forming. If you're pregnant, suffer from Crohn's disease, inflammatory bowel disorder or any other condition that contributes to hemorrhoids, this may not always be easy. However, it's always better to control as many factors as you can.

The first step is a healthy lifestyle with a balanced diet, enough water intake and a reasonable exercise program for your health conditions.

Second, don't sit on the toilet for too long, and get a footstool to raise your feet and give more support to your pelvic muscles.

Third, don't strain to defecate. If you can't go right then, get up off the toilet and try later. Even if you have to hit the bathroom every ten minutes while sorting out constipation, it's better than just sitting there.

Fourth, eliminate irritants. That means to stay away from harsh dyes and perfumes in soap, laundry detergent or toilet paper. Don't wipe too hard with toilet paper, either. Wear loose fitting clothing and cotton underwear that lets your skin breathe instead of tight clothing or synthetic material.

Thrombosed External Hemorrhoids in Conclusion

Thrombosed external hemorrhoids make life miserable in a very short period of time. They interfere with your work, your social life, your activities and your ability to concentrate. They're also embarrassing and can fill you with anxiety. If you're prone to hemorrhoids, you'll probably suffer through at least one in your lifetime.

However, no matter how prone you are to them, you can control them. By understanding the causes of and treatments for thrombosed external hemorrhoids, you've taken an important step in eliminating them from your life.

References used for Thrombosed External Hemorrhoids

Thomas J. Zuber, E. J. Mayeaux, Atlas of Primary Care Procedures, Lippincott Williams & Wilkins, 2003

Kevin J. Knoop, Lawrence B. Stack, Alan B. Storrow, Atlas of Emergency Medicine, McGraw-Hill Professional, 2002

Robert B. Taylor, Alan K. David, S. A. Fields, Family Medicine: Principles and Practice, Springer, 2002

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