The how and why of hemroids thrombosis

The Interactions Between Blood Circulation, Thrombosis and Hemorrhoids

Hemorrhoids are an outgrowth of the circulatory system, and so to gain a comprehensive knowledge of hemorrhoids, and in particular thrombosed hemroids, it helps to understand exactly how the circulatory system works.

Practically everyone knows that as blood is pumped through the body, it brings oxygen to cells and takes waste away, but there are several mechanical factors at work to make this happen efficiently and effectively that are not such common knowledge.

Arteries are, of course, the vessels by which fresh, oxygenated blood goes out from the heart to the rest of the body.

The major arteries are usually found deep within the body, close to bones and far from possible damage. The blood inside of them is bright red and usually moving rather fast and under pressure.

When a doctor measures your blood pressure, he or she is measuring arterial pressure.

You may have noticed that your blood pressure has two numbers. The first, higher number is indicative of your arterial blood pressure when the artery is full of blood right after a heartbeat, and the lower number indicates the hydraulic pressure in the artery during its "lull" period between heartbeats.

When you have a problems like high cholesterol within the arteries, your blood pressure may go up because the same amount of blood is trying to all fit into cholesterol clogged vessels.

Veins carry deoxygenated blood back to the heart, which is blue when in a vacuum and very dark red when exposed to air.

If you have fair skin, you can see your veins at certain places on the body, such as within the crook of the elbow. Veins do not pulse with the heartbeat and are under almost no pressure whatsoever.

In fact, one of the most miraculous features about the circulatory system has to do with the veins in your legs.

There are muscular valves throughout those veins that only allow blood to flow upwards back to the heart.

These muscular valves are worked by a combination of things, including your normal body motion and if they didn't exist, your blood would pool in your feet and stay there due to the effects of gravity.

Even so, the vast majority of your blood just sits there in your legs at any given time, which allows that blood to have plenty of time to develop clots, a condition referred to as thrombosis.

Thrombosis can happen anywhere in the body, and it is always defined as a blood clot developing within the bloodstream.

If the clot is exactly the wrong size, it can travel all the way to the heart and cause a heart attack by blocking the heart's valves.

However, a clot large enough to block proper venous blood flow can be a serious problem anywhere in the body.

Blood clots almost never develop in the arteries because the blood is moving too fast, but a clot blocking a vein can cause old, non-oxygenated blood that is carrying toxins and waste products to back up and sit there behind the clot, irritating and eventually poisoning the surrounding tissue.

So, how does blood get from arteries to veins?

The turn-around point for the circulatory system is the millions of tiny blood vessels called arterioles and capillaries that permeate almost every centimeter of muscle, skin, bone, and nervous tissue of the body.

These miniscule blood vessels have extremely permeable walls that allow oxygen to get to cells and cell waste products to get into the blood for eventual filtration by the kidneys and liver. These tiny vessels can be extremely easy to clog individually, but there are so many of them running so close together that a single small clot usually cannot do irreversible damage before it can be taken care of.

The thrombosis of Hemroids / hemorrhoids

Also known as Thrombosed hemroids / hemorrhoids

Within the anal canal, there are cushions of capillary rich tissues, fed by many arteries and veins, called hemorrhoidal cushions.

These cushions can expand and contract to assist with anal sphincter control.

A hemorrhoid occurs when one of the veins in this area gets weak or damaged and starts to fall out of its rightful place, dragging surrounding tissue with it.

Internal hemroids thrombosis

If it is an internal hemorrhoid, it can grow so large that it starts to prolapse outside of the anal sphincter ( anal / bottom hole).

At first, a prolapsed internal hemorrhoid will only emerge from the anal sphincter during a bowel movement, and retract afterwards, but as gravity and strain work on it it may grow so large and hang down so low that it protrudes from the anal sphincter all the time.

This can lead to strangulation, where the blood has a more difficult time going anywhere, and eventually to thrombosis within the hemorrhoid as the blood has been stuck within the hemorrhoid for so long.

Internal and external hemroids with thrombosis

However, due to the lack of pressure within veins, especially those veins below the heart, thrombosis can happen in any hemorrhoid, internal, external, prolapsed or not, and needs to be dealt with as soon as possible no matter what conditions it occured under.

Thrombosis that is left untreated for too long can eventually lead to gangrene as the surrounding tissue starts to die from oxygen deprivation. Prior to that, the tissue will get massively inflamed and irritated from the build-up of cell waste products, so you'll have plenty of painful warning to take care of the problem prior to actual gangrene.

How come surgeries like rubber banding don't have these devastating side effects of thrombosis?

If a blood clot and blockage of the vessels can lead to gangrene, why doesn't latex hemroids banding cause gangrene? After all, a tight latex band does a pretty good job of blocking all of the blood vessels, so it would stand to reason that this would not be a good idea.

However, it's important to note that only small hemorrhoids are eligible for latex band treatment, and therefore the latex band will successfully cut off all blood flow.

This means that no blood gets in whatsoever, and no blood gets out.

If this is true, then the tissue of the hemorrhoid beyond the latex band will die, but no poisons or infectious material can get back into the body because no blood is flowing back and forth to carry those toxins.

Therefore, only the hemorrhoid dies and doesn't start to affect the rest of the body.

To add my own personal experience here, for a number of non-medical reasons, my surgeon decided to use the rubber band ligation on my hemroids.  My hemroids were too big.  He double banded them in the hope that it may get sufficient biting power to kill some of them off.  Within a few days I was back with a thrombosed hemroid or hemroids.

Looking back, the surgeon and I made the right call at the time. 

Yes, I needed the thrombosis removed, but I managed to avoid the very nasty hemorrhoidectomy and the effects that operation would have had on my role as a carer.

Concluding remarks on thrombosis of hemroids - the how and why.

In closing, while latex banding performed under a doctor's supervision is a safe method of treating hemorrhoids of the right size range, thrombosis is a rather dangerous condition and should be seen to immediately, no matter if the hemorrhoid is internal or external.

Hopefully, the interrelationship between circulation, thrombosis, and hemorrhoids is now a bit clearer and, armed with this information, hopefully you can make important health care decisions with your doctor that are more informed and that will lead to a hemorrhoid-free life.

Research and main write by Loni L. Ice, editing and quality control by D. S. Urquhart.

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