Hemorrhoidectomy for Thrombosed External Hemorrhoids

What are thrombosed hemorrhoids?

All people have blood-filled sacs that cushion the passage of stool through the anal canal. When these sacs become stretched and enlarged, they are called hemorrhoids. Hemorrhoids can occur during or after pregnancy, after long periods in a seated position (such as during long car trips), or because of constipation or diarrhea. Hemorrhoids generally are classified as external (outside of the anal canal), which can be very painful, and internal (inside the anal canal), which can protrude and bleed.

External hemorrhoids can become thrombosed (develop blood clots inside) and become very tender. Large blood clots can produce pain with walking, sitting or passage of stool. It is not clear why healthy people suddenly develop clots in external hemorrhoids.

What treatments are available for thrombosed external hemorrhoids?

The treatments for external hemorrhoids are different from those for internal hemorrhoids. One treatment option is to allow clots in the external hemorrhoids to be slowly absorbed by the body over several weeks. You can try hot baths, ointments or creams for the discomfort. Most experts recommend that the blood clots be surgically removed.

What happens during surgical removal of the thrombosed hemorrhoid?

One

creates an incision (cut) over the clot, allowing the doctor to squeeze out the clot. Unfortunately, this quick and easy procedure frequently results in blood clots reforming and continuing pain. A more extensive procedure (full hemorrhoidectomy) removes the clot and the blood vessels in the hemorrhoid. This procedure is longer and may require sutures (stitches) to close the wound, but can yield better results. Local anesthesia (numbing medicine) is used for both procedures.

Does it matter how long my hemorrhoids have been hurting?

Surgery on thrombosed external hemorrhoids is best performed during the first 72 hours (3 days) after symptoms start. Significant symptom relief can be achieved with early surgery. After 72 hours, the pain relief from the surgery may not be greater than the discomfort from the surgery itself.

How should I prepare for the procedure?

See your

as soon as the pain develops. No enema or colon preparation is required. However, you may want to take 3 or 4 ibuprofen tablets (brand names: Advil, Motrin, Nuprin), in a dosage of 200 mg each, before the procedure to lessen discomfort.

Following Hemorrhoidectomy for Thrombosed External Hemorrhoids

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