How to Know if I Have Thrombosed External Hemorrhoids?

Causes of hemorrhoids

Have you ever suffered from hemorrhoids? They're a prevalent benign anorectal disease that affects 3/4 quarters of the U.S population before the age of 50. If you have suffered from hemorrhoids, it is essential to know that they can progress into different types of hemorrhoids when left unchecked.

We will explain what thrombosed external hemorrhoids are and the different symptoms of thrombosed hemorrhoids. Read this article to know more.

Thrombosed External Hemorrhoids

Hemorrhoids or Piles are an anorectal condition characterized by inflamed or swollen veins of the anus and rectal region. Although hemorrhoids generally refer to hemorrhoidal disease, they are regular clusters of hemorrhoidal veins, connective tissue, and smooth muscles that form the anal cushion and serve to protect the anal sphincter.

Hemorrhoidal disease is caused when these structures swell up or protrude through the anal canal. They are divided into three distinct classes. Internal hemorrhoids are the most common types of hemorrhoids and result from inflammation of hemorrhoidal veins inside the anus. On the other hand, external hemorrhoids occur outside the anal region. Thrombosed hemorrhoids are one of the most painful types of hemorrhoids that progress from chronic internal and external hemorrhoids.

Thrombosed hemorrhoids occur when the blood inside hemorrhoidal veins forms clots. The clotting obstructs blood flow and causes the formation of reddish-blue swollen lumps, characteristic of a thrombosed external hemorrhoid. Although not dangerous, they are extremely painful and can cause complications if not treated by a doctor. External hemorrhoids are more likely to become thrombosed, but internal hemorrhoids can also become thrombosed.

There are many treatment options available for hemorrhoids with meager chances of recurrence. A proper diagnosis can be made through an anorectal exam like an Anoscopy. Let's look at the different causes of hemorrhoids.

Causes of Hemorrhoids

The leading cause of hemorrhoids is trauma or pressure against the walls of the anal canal or the lower region of the rectum. The pressure causes hemorrhoidal structures to swell up and form lumps. The sensitive structures can cause extreme pain and discomfort but also heal up on their own. In the case of chronic hemorrhoids, immediate medical assistance is recommended.

Although the primary cause is the same for all types, different types of hemorrhoids can have specific triggers. In the case of thrombosed external hemorrhoids, it is blood clotting. Blood clots develop inside the hemorrhoidal veins to further increase the pain and swelling, giving rise to thrombosed external hemorrhoids.

According to the medical learning forum Osmosis, the hemorrhoidal disease develops from a combination of factors that include the weakening of the supportive tissue within the anal cushions and increased intra-abdominal pressure.

Commonly associated risk factors and causes of hemorrhoids also include the following:

  • History of chronic constipation or diarrhea that puts increased pressure against the walls of the lower rectum
  • Cirrhosis of the liver due to alcoholism can damage cellular rectal DNA and weaken the walls of the anus
  • Prolonged periods of sitting put pressure on the anus
  • Prolonged strenuous or forced bowel movements due to chronic constipation.
  • Anal intercourse can cause tears inside the anal cavity and weaken the connective tissue and muscle inside the hemorrhoidal structures.
  • Pregnancy and childbirth that exert fetal pressure on the rectal cavity
  • Rare causes include irregular bowel movements, obesity, and heavyweight lifting

Many research papers suggest that all chronic hemorrhoids, internal or external, can potentially become thrombosed. Still, it is essential to know that doctors fail to understand the predisposition of certain individuals to develop thrombosed hemorrhoids.

Symptoms of Thrombosed Hemorrhoids

Rectal bleeding is one of the most common symptoms of thrombosed hemorrhoids. It is important to note that rectal bleeding can also indicate other anorectal diseases. One should immediately consult a doctor in cases of rectal bleeding as it can be an early sign of anorectal cancer.

In the case of thrombosed external hemorrhoids, rectal bleeding is induced by ulceration and necrosis of the skin on top of hemorrhoids. A prolapsing internal hemorrhoid is an important symptom of thrombosed hemorrhoids.

Besides rectal bleeding, blood in the stool is also a characteristic of thrombosed hemorrhoids. They also cause sudden intense pain during and after attempting bowel movements. Thrombosed hemorrhoids make sitting down extremely painful. Blood clots also increase the pressure inside hemorrhoidal veins and cause swollen lumps to rupture and bleed. Symptoms like itching and irritation around the anal region are often overlooked.

Another symptom in patients with a history of hemorrhoidal disease is the inability of topical ointments to alleviate pain. Topical ointments help manage pain in less severe cases of hemorrhoidal disease when the pain is on the surface. Thrombosed hemorrhoids are significantly more painful because of the obstruction of blood flow inside the vessels, making the pain internal.

Complications like necrosis or ulceration of hemorrhoidal tissue give rise to specific symptoms. Due to the skin stretching around the anus and rectal cavity, boil-like skin tags can develop from thrombosed external hemorrhoids. These skin tags can develop into pus-filled abscesses over time and are extremely dangerous as well as painful. Although accurate indicators of thrombosed hemorrhoids, these pockets of pus can further develop into perianal abscesses and have to be immediately drained by a doctor; otherwise, they can lead to the formation of fistulas which require corrective surgical treatment.

We hope this article helped you understand what a thrombosed external hemorrhoid is. If you have noticed some of the symptoms of thrombosed hemorrhoids mentioned above, be sure to consult a doctor and opt for a surgical treatment plan that suits you.