Thrombosed hemorrhoids – What are they and how to recognize them?

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Thrombosed hemorrhoids

The hemorrhoidal disease can be very annoying. If we then run into complications, such as thrombosed hemorrhoids, our daily life can be compromised. Let’s see what hemorrhoidal thrombosis is and how to manage this unpleasant condition.

Hemorrhoidal disease is the most frequent proctological disease and one of the main reasons for medical consultation. 5% of the world population has symptoms associated with it and, after the age of 50, the prevalence is 50%. Thrombosed hemorrhoids represent the most serious complication of this disorder. Although hemorrhoids are very common starting in adulthood, the thrombosed form requires immediate medical attention. The pain is so severe and excruciating that, in some cases, the patient cannot even sit up. Read on to learn more.

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Hemorrhoidal disease: classification according to the clinical picture

Hemorrhoids are highly vascularized cushions naturally present in the anal canal. Hemorrhoids often become inflamed, becoming symptomatic and giving rise to a series of annoying ailments. In medicine, hemorrhoids are classified into four degrees or stages depending on the severity of the clinical picture:

1st degree. There is an increase in the volume of one or more haemorrhoidal pads with discomfort, itching, and possible bleeding during the expulsion of feces.

2nd degree. The initial hemorrhoidal prolapse occurs (leakage of the hemorrhoids from the anal canal), only at the moment of evacuation, with subsequent spontaneous reduction. Discomfort, itching, and bleeding may appear.

3rd degree. Hemorrhoidal prolapse requires manual reduction. Symptoms include discomfort, itching, bleeding, pain, and mild fecal incontinence.

4th degree. The prolapse is long-lasting, not manually reducible.

Symptoms are pain, intense itching, constant fecal incontinence. Regardless of the degree, the hemorrhoidal disease can sometimes develop into complications, including thrombosed hemorrhoids. Let’s find out immediately what it is. Hemorrhoidal thrombosis: what are we talking about and how to intervene?

This is an acute occurrence, characterized by sudden and intense pain in the anal, due to the presence of coagulated blood (clot or thrombus) inside the hemorrhoids (both internal and external), which are swollen, tense, and bluish/purplish. In fact, there is talk of thrombosed hemorrhoids. The increased pressure on the pelvis can cause a slowing of circulation in the haemorrhoidal blood vessels and cause thrombus formation.

What are the causes of hemorrhoidal thrombosis?

Risk factors include Constipation or diarrhea Effort during evacuation; Sedentary lifestyle; Physical overload / intensive workouts; Previous episodes of hemorrhoidal thrombosis. There are at least three possible therapeutic approaches to manage hemorrhoidal thrombosis. From the least invasive to the most invasive, these approaches are

CONSERVATIVE TREATMENT.

It is the first treatment option and involves remedies and behavioral measures, such as: Take lukewarm water baths several times a day to relieve itching and burning. Indulge the urge to evacuate, so as not to cause fecal stagnation and painful evacuation. Avoid sitting for long so as not to slow down the circulation in the haemorrhoidal vessels. Follow a diet rich in fiber, to facilitate the expulsion of soft stools.

HEMORROIDARY THROMBECTOMY.

It is put into practice when conservative treatment has proved ineffective. This is a minimally invasive surgery, which involves a small incision at the thrombus level and allows you to remove a blood clot inside a hemorrhoidal vessel.

HEMORROIDECTOMY.

It is the therapeutic approach to be practiced when conservative treatment and hemorrhoidal thrombectomy have proved ineffective. This is a surgery that involves the removal of hemorrhoids.

What remedies can manage pathological hemorrhoids?

After having seen how to treat thrombosed hemorrhoids, we can follow some useful general measures to alleviate the symptoms of hemorrhoidal disease and prevent its reappearance. Let’s see which ones:

Balanced nutrition. We avoid “junk food” which can have an irritating action and contribute to worsening congestion and inflammation of external hemorrhoids. Instead, we prefer seasonal fruit and vegetables. Frequent hydration.

No to fizzy drinks and alcoholic beverages. We guarantee our body a water supply of about 1.5 / 2 liters per day. The aim will be to facilitate natural intestinal transit, softening the stool and facilitating its expulsion. Regular lifestyle. We avoid a sedentary lifestyle and nicotine abuse. Sitting too long can slow blood circulation and cause venous stagnation, aggravating swelling. Furthermore, smoking can lead to cardiovascular problems, worsening the haemorrhoidal disorder.

Scrupulous intimate hygiene. We will have to carry out daily intimate hygiene with care. We use a delicate and emollient cleanser, diluted in warm water. Let’s dry by dabbing with a natural fiber cloth. Regular physical activity. Practicing moderate and regular exercise will promote blood circulation and help regulate our intestines, two important aspects for reducing and preventing external hemorrhoids.

Activities such as yoga, swimming, and gentle gymnastics are preferred over bodybuilding, cycling, and sports that place excessive strain on the pelvic floor. These indications do not replace the doctor-patient relationship. For more information, we can contact our trusted doctor.

Main symptoms

According to the portal Colon and Rectal Surgery, in the presence of clots in hemorrhoids, the person experiences intense, continuous, stabbing, and stinging pain. This discomfort is no longer related to defecation and the person cannot even sit down. Before getting to this point, it is possible to detect the disease on the basis of other clinical signs depending on whether it is internal or external hemorrhoids. Examples are the following: Itching or irritation in the anal area (when external hemorrhoids are present).

Pain or discomfort

Swelling around the anus (also outside). Bright red bleeding, as if there is a freshly opened wound, unlike ulcers and other events that occur in the upper gastrointestinal tract that cause black stools because the blood has been partially digested. To prevent hemorrhoidal thrombosis, it is recommended that you see your doctor if you have any of these symptoms. Rectal bleeding can be due to hemorrhoids or worse conditions. Causes of thrombosed hemorrhoids According to sources already cited, hemorrhoids occur when there is too much pressure on the veins around the anus.

The Clinic indicates among the possible causes:

Strive during the evacuation. Sitting on the toilet for a long time. Obesity. Low-fiber diet. Similarly, relatively frequent conditions such as hypertension or spending too much time sitting in the workplace can be additional triggers. Hemorrhoids do not arise from a single specific cause; in most cases, they are due to a series of simultaneous events. Fat intake, a sedentary lifestyle, and obesity greatly favor the appearance of hemorrhoids.

How are thrombosed hemorrhoids diagnosed?

As indicated by the Health Library, the professional proctologist will examine the patient’s anus and rectum using a proctoscope. This device is a short (15cm) metal tube that is lubricated and inserted into the rectum. Thanks to it, mild and thrombosed hemorrhoids and anal polyps can be detected. So that the patient does not feel uncomfortable, local anesthesia can be applied to the area to be analyzed.

Sometimes, however, it is not necessary, since in many cases a digital examination is sufficient. Treatments available The approach can be surgical and non-surgical. Let’s examine each of the possible options in the following lines. Nonsurgical As indicated by the aforementioned portals, milder cases require a conservative approach.

If the clot has formed more than 72 hours before, the treatment can be done at home and includes: Anti-inflammatory creams and suppositories to relieve pain. Wash with lukewarm water for 10 to 15 minutes, 4-5 times a day, to avoid the most acute episodes. Pain relievers to relieve pain. Changes in diet, especially in obese or pregnant patients. Surgical The surgical approach is divided into thrombectomy and hemorrhoidectomy. The first consists of draining the thrombus of external hemorrhoids through an incision under local anesthesia in the clinic.

However, the chances of recurrence are high. Hemorrhoidectomy, on the other hand, involves the removal of hemorrhoids on an outpatient basis or requiring hospitalization, always under local anesthesia and with medical assistance. It is the most indicated and appropriate treatment in most cases, as it effectively solves the problem.

Prevention

In many cases, preventing hemorrhoids is impossible. Human beings are nowadays rather sedentary since many jobs are based on carrying out prolonged activities (more than 7 hours) in the same position in front of a computer. In any case, we can follow some tips to prevent thrombosed hemorrhoids.

These include: Eat foods rich in fiber and take food supplements, always indicated by a doctor or nutritionist. The fiber content in the diet should be around 30 grams per day. Drink plenty of fluids to soften stools and thus reduce strain during defecation. Play sports and avoid a sedentary lifestyle. A healthy lifestyle not only prevents thrombosed hemorrhoids but also hypertension and diabetes.

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Beware of traces of blood in the stool.

Thrombosed hemorrhoids are a rare complication, as this clinical picture generally remains mild and troublesome. In case of symptoms, it is best to consult a doctor promptly. If you notice traces of blood in the stool or if the evacuation requires great effort, the ideal is to consult a doctor. This way you will avoid unpleasant complications. Ask your doctor as the physical examination may show the result for your case. 

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