A thrombosed external hemorrhoid is considered as a very common problem but it is a poorly studied condition. Some of the risk factors for the condition are constipation, bleeding hemorrhoids and traumatic vaginal delivery. Even though non-surgical treatments, such as increased dietary fiber, stool softeners, warm baths, increased fluid intake and analgesia can provide a resolution against the symptoms of the condition, surgical excision of the hemorrhoids is still considered as the best treatment.
Newer treatments like topical nifedipine has shown advantages compared to traditional treatments. However, compared to surgical techniques, these forms of treatments has not shown evidences that it can actually shorten the duration of the existence of hemorrhoids and provide long term relief against the symptoms of hemorrhoids. Surgical excision of thrombosed hemorrhoids is still recommended in order to obtain permanent relief from the condition. The procedures used are proven safe and has low complication rates.
Do hemorrhoids go away? Hemorrhoids may go away on its own if the severity of the condition is very low. However, acute pain and thrombosis that occurs for 48 to 72 hours definitely calls for an excision. According to experts, a surgical treatment for such condition can provide faster resolution against the symptoms of the condition. It can also lower the chance of recurrence and has low risk of complications.
Absolute contraindications for the excision of a thrombosed external hemorrhoid inside the emergency department usually include the following:
- Concerns that the lesions found are something other than thrombosed hemorrhoids like a painless rectal mass.
- A stage 4 internal hemorrhoid connected to a thrombosed external hemorrhoid
- Severe coagulopathy
- Hemodynamic instability
- Perianal infection
- Allergic reactions to local anesthetics
- Portal hypertension
- Anorectal fissure
- IBD or inflammatory bowel disease
- Any serious comorbidity or systemic illness that would increase the risk of complications
How to know if you have hemorrhoids or if your hemorrhoids are prolapsed? This can be determined by doing a thorough diagnosis. Proper diagnosis of the condition can also help determine its severity, as well as the most effective treatment procedure for it.