Digestive Problems
Common Symptoms: Hemorrhoids
External Thrombosed Hemorrhoids
Thrombosed external hemorrhoids are blood blisters under the skin of the anal opening. Bowel movements that are too hard scrape across the anal skin and cause a shearing action. This causes the blood vessels below the skin to tear. The stronger skin above is left intact.
The blood vessel which has been torn open leaks blood under the skin and forms a blood clot (thrombosis). This is not dangerous to the rest of the body. However, because it stretches the skin and the nerve endings in the anal skin, it causes severe pain and swelling.
Usually, a thrombosed external hemorrhoid does not cause bleeding unless the skin over the blood clot gets rubbed away. Then, the blood clot can ooze out and cause bleeding.
Thrombosed external hemorrhoids will resolve in four-to-six weeks as the blood clot is re-absorbed by the body. They are generally most tender in the first four days. If the thrombosis is quite painful and has been present for less than 4 days, then surgical excision (removal) is the best treatment. If the thrombosis has been present for more than four days, and is beginning to resolve, it is generally better to leave it alone.
The choice of treatment also depends upon how severe the pain is. If the pain is quite severe and the person finds it difficult to walk, work or sleep, then excising (removing) the clot and the blood vessel will result in quicker relief and improvement. If the pain is relatively mild, the pain seems to be getting better, and the thrombosis seems to be shrinking, then it is best to leave the thrombosis alone and let it resolve by itself.
Removing the hemorrhoid is a fairly simple procedure. The area of the hemorrhoid is cleaned with a betadine or alcohol solution. Marcaine, which is an anesthetic agent like Novocain, is injected around the thrombosed hemorrhoid. The thrombosis (blood clot), the blood vessel, and the skin over the blood clot, are then removed. Generally, no stitches are required. A gauze dressing is applied. Pain pills may be needed for the first few days. The pain from thrombosed hemorrhoids and fissures is generally much improved immediately after surgery.
Internal Hemorrhoids
The mucosal lining of the anal canal and rectum is soft and fragile, velvet-like in its appearance and texture. It is very sensitive to being stretched. Passing hard or small bowel movements causes the anal and rectal mucosa to become stretched. If the stretched mucosa is dragged outside of the anal canal, it forms what is called an internal hemorrhoid. Internal hemorrhoids may be painful, and they may bleed.
Internal hemorrhoids can be pushed back up inside the anal canal. This reduces the pain and slows down the bleeding. If a person must use his hand to push hemorrhoids back up inside after each bowel movement, he has internal, not external, hemorrhoids.