Thrombosed External Hemorrhoid

As someone who has had to deal with hemorrhoids for a long time, I am the first person to tell you they are no fun at all. Thrombosed external hemorrhoids are, in my view, an experience which you are seriously going to want to avoid.

Before you jump from your seat, here is a reason to heave a sigh of relief: hemorrhoids are painful, but not deadly. So, stay put and continue along with me.

In the following article, I will try to answer your questions by going over thrombosed external hemorrhoid symptoms, causes and treatment options based on the personal experience and knowledge I’ve acquired over the years.

What is a Thrombosed External Hemorrhoid?

To understand what a thrombosed external hemorrhoid is, you first need to know what a hemorrhoid is.

In terms of anatomy, “hemorrhoid” refers to anal “cushions” consisting of a combination of smooth muscle, blood vessels and connecting tissue. 

When someone says they have “hemorrhoids,” they mean that these cushions are swelling. Sometimes, the swelling is severe enough that they stick out from your anus, becoming external. We also call them “piles.”

So, what does it mean to say that an external hemorrhoid has become “thrombosed?”  

There are veins that run through your hemorrhoids. If one of these veins forms a blood clot, then it is thrombosed.

As you would guess, this can lead to some unpleasant symptoms.

Thrombosed External Hemorrhoid Signs and Symptoms

Here are some signs and symptoms that may point toward thrombosed external hemorrhoid: 

  • You may feel rectal pain while you are walking or sitting. 
  • Trying to defecate may be painful.
  • You might discover blood on your toilet paper.
  • The rectal area might itch.
  • There may be a visible lump sticking out of the anal canal. You probably will not be able to get a good look at it yourself, but if you could, you would notice it has a bluish color.

Sometimes thrombosed external hemorrhoids may produce complications such as:

  • The development of an abscess.
  • Fever.

What Causes a Thrombosed External Hemorrhoid?

When it comes to how you ended up with thrombosed external hemorrhoids, you need to understand both what causes hemorrhoids and what increases your risk for blood clots in those hemorrhoids. 

Here is what can cause hemorrhoids:

  • Diarrhea or constipation.
  • Straining to force out stool on the toilet.
  • Long periods of time seated in one place.
  • Pregnancy or childbirth.
  • Changes in hormones.
  • Avoiding using the toilet.

The chances of your hemorrhoids becoming thrombosed increase with the following risk factors:

  • Pregnancy.
  • Aging.
  • Lack of fiber.
  • Sedentary habits.

Some of these factors are unavoidable; you cannot help aging, for example. And if you are pregnant, hemorrhoids may just be one of the many symptoms you are dealing with. 

But some lifestyle factors are within your control. You can certainly avoid sitting in one position for too long just by getting up now and again and walking around. If your job requires you to sit at a desk all day, set yourself some reminders throughout the day. You also can increase the fiber in your diet.

As for straining on the toilet, I know it can be hard to talk yourself out of it when you are constipated. But there are healthier solutions to constipation. Try drinking some prune juice, for instance. You may be startled by how quickly it can get things moving. If you make it a regular habit, it can have a great preventative effect.

How to Treat a Thrombosed External Hemorrhoid

Except in severe cases, you generally can treat hemorrhoids at home; it is often just a matter of waiting for them to go away on their own. This is true for thrombosed external hemorrhoids, just as it is for regular hemorrhoids. 

  • To relieve the pain, you can take an anti-inflammatory medication. Ibuprofen and Tylenol can be effective.
  • If you want more localized relief, there are a number of options for simple but effectual home remedies. You can use a warm or cold compress, witch hazel, aloe vera, or a commercial wipe. 
  • Another option to relieve the pain and itching associated with thrombosed external hemorrhoids is to fill a bathtub with warm water for a good soak.
  • Consider eating more fiber to promote regularity in your bowel movements.
  • Try not to wear clothing that will dig into the hemorrhoids like tight-fitting underwear. Anything that chafes the hemorrhoids will contribute to your discomfort while worsening inflammation and swelling. 

You can expect significant relief within just several days of conservative treatment at home. Healing may continue for up to several weeks.

If you are experiencing especially painful thrombosed external hemorrhoids, your doctor may recommend a surgical procedure called a thrombectomy. There is a relatively short window for this surgery to be worthwhile; if you are within 24-48 hours of the onset of your symptoms, you may be a candidate. 

During a thrombectomy, your doctor creates an incision and drains the clot, bringing down the pain and swelling. The procedure itself is not painful since it takes place using anesthesia.

A thrombectomy usually is sufficient to resolve a thrombosed external hemorrhoid, but in cases where it is not, your doctor may advise a different procedure such as a hemorrhoidectomy, a stapled hemorrhoidopexy, or a rubber band ligation.


Having a thrombosed external hemorrhoid is no walk in the park, but I am here to tell you from experience that it will get better, and likely faster than you think. 

Except in severe cases, your thrombosed external hemorrhoid will probably go away on its own with appropriate care at home. If your pain is severe, however, you should consult with your doctor promptly so you can get the fast treatment you need for rapid relief. 

Hopefully soon, you will be back to feeling more like yourself. Going forward, stick with a diet high in fiber, and avoid sitting for long periods without getting up to take a break. Try not to strain on the toilet, even when you are constipated. All of these measures can go a long way toward preventing another round of thrombosed external hemorrhoids in the future.

About the author

As the author of this website, I have firsthand experience with hemorrhoids and want to share what works and what doesn't when it comes to treating this condition. I hope to offer my experience and support to others struggling with hemorrhoids, and provide helpful tips to live a pain-free life.