Thrombosed Hemorrhoid – External Hemorrhoids

External hemorrhoids are swollen and distended blood vessels around the outside of the anus. You can see and feel it. A thrombosed hemorrhoid occurs when a blood clot forms within the external hemorrhoid causing an extremely painful condition called thrombosis. It is blue or purple in color and at times may bleed. Extreme pain can be felt when standing, lying and sitting.  Acute pain usually only occurs after the hemorrhoid has become thrombosed.

Causes of Hemorrhoids

Most likely extreme abdominal pressure causes the veins to swell and become susceptible to irritation. Pressure may be caused by obesity, pregnancy, standing or sitting for long periods, constipation, coughing, sneezing, vomiting, and holding your breath while straining to do physical labor and vaginal childbirth.

Diet also can cause or prevent hemorrhoids. People who consistently eat a high-fiber diet are less likely to get hemorrhoids. Those who consume a diet of processed foods, a low-fiber diet or inadequate fluid intake can become constipated. This contributes to hemorrhoids by promoting straining on the toilet. It also aggravates hemorrhoids by producing hard stools which further irritate the swollen veins.


Thrombosed hemorrhoids are usually not serious. The pain usually peaks at 48-72 hours and begins to subside within a week. The thrombosis is slowly absorbed by the body during the course of several weeks. Hemorrhoids may also be pushed back in place inside the rectum.

Hemorrhoids are usually treated with stool softeners, increased dietary fiber, increased fluid intake, warm baths and analgesia (witch hazel, ointments and creams).

A resolving thrombosis may produce bleeding or drainage. If the pain is unbearable, your doctor can remove the thrombosed hemorrhoid, with a surgical procedure called a hemorrhoidectomy. The blood clot can be drained by incision or cutting off of the entire hemorrhoid. Another more common removal method is rubber band ligation, in which a small elastic band is placed around the base of a hemorrhoid. This causes the hemorrhoid the shrink.

Depending on the procedure, hemorrhoids can be treated during an office visit, scheduled surgical removal or by an emergency physician. Stool softeners must be prescribed to help prevent tearing and recurrence.

Internal hemorrhoids

Internal hemorrhoids are far enough inside the rectum that you can’t see or feel them. They usually are not painful because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that internal hemorrhoids are there. Sometimes internal hemorrhoids become enlarged and protrude outside the anus. This then becomes an external hemorrhoid.

Any anal bleeding and pain should be evaluated by a doctor as it can indicate a life-threatening condition, such as colorectal cancer. Hemorrhoids are the number one cause of anal bleeding.