Thrombosed Hemorrhoid

What are thrombosed hemorrhoids?

Hemorrhoids are swollen or inflamed veins in the anal and rectum area that can be painful, itchy, and sometimes bleed. They are usually identified as internal hemorrhoids (inside the anal canal, usually painless) and external hemorrhoids (they manifest as protrusions around the skin of the anus and are tender and painful).

According to the Association of Colon & Rectal Surgeons of India (2016), about 50% of the Indian population will have hemorrhoids at least once in their lifetime. And as we age, we have more chances of developing hemorrhoids.

Hard stools, chronic constipation, pregnancy, a low-fibre diet, a sedentary lifestyle which can lead to being overweight, spending too much time trying to pass stool, and not going to the potty when nature calls, can be some reasons contributing to the occurrence of hemorrhoids. Other issues like irritable bowel syndrome, where you often oscillate between constipation and diarrhea, can cause hemorrhoids. The good thing about either of the hemorrhoids is that they are easily treatable and are not fatal. They will, however, disrupt your daily life if not tended to immediately.

Now that we have a brief overview of what hemorrhoids are, we can speak about thrombosed hemorrhoids or thrombosed piles. Thrombosis is the medical term for the formation of blood clots. This phenomenon also occurs in the case of external hemorrhoids, where a blood clot forms in the hemorrhoidal vein. This obstructs the blood flow and inflames the anal tissues, making them tender. Sitting, walking, and defecation can be an ordeal in this case. There is a possibility of rectal bleeding in case the blood clot tears. Thrombosis is not exclusive to external hemorrhoids. It can occur in internal hemorrhoids too.

Diagnosing thrombosed hemorrhoids

In the case of external thrombosed hemorrhoids, they are visible to the naked eye. This is usually bluish. Sometimes because of internal pressure, the hemorrhoids may have necrosis and ulceration of the skin. Internally thrombosed hemorrhoids are on the rarer sides and will not be visible unless they jut out of the anal canal.

Usually, the doctor wants to know the history and severity of the symptoms and pain. A physical exam is followed by this. In the case of internal thrombosed hemorrhoids, the doctor may conduct a digital rectum exam or an anoscopy. If there is any rectal bleeding, a colonoscopy or sigmoidoscopy might be performed to rule out any other possibilities behind the cause.

Thrombosed hemorrhoids treatment

Most cases of hemorrhoids go away on their own with home remedies. These can be:

Sitz bath: To relieve pain, you can sit in a small tub with warm water several times a day. You can also add Epsom salt to this water.

Over-the-counter pain meds and ointments: The doctor can prescribe you painkillers and topical ointments.

Fiber: Besides increasing the fiber intake in food, like consuming greens, and fruits, taking a psyllium husk supplement or other similar supplements will prove helpful.

In the case of thrombosis of hemorrhoid, the pain will be there for about 2-3 days, and there are chances of the clot being reabsorbed into the body, but that can take weeks. Usually, the after-effect of this is an anal skin tag (benign skin growth around the anus) that may feel itchy or uncomfortable.

The surgical route is taken if the typical intervention does not work. The typical step is to create an incision over the clot and squeeze its contents out. This is immediately effective, and the doctor recommends sitz baths, pain meds, and measures to relieve constipation. However, there are chances of the blood clot returning.

When all fails, the doctor can go for a full hemorrhoidectomy, where the blood clot and its vessels are completely removed. Local anesthesia is usually given before the surgery. The patient may or may not need stitches following this procedure.

Preventive measures to avoid hemorrhoids

The best way to avoid the formation or return of hemorrhoids is to ensure that the stool is semi-solid and soft enough to pass through the anal tract. A diet high in fibre (about 25-30 grams) is essential to avoid constipation. Other lifestyle changes like using a squat potty stool to ease defecation without putting pressure on the anus and increasing water and activity can also prove helpful. Going to the bathroom without delays and spending a short time on the pot can help avoid hemorrhoids.

Going to your doctor when you cannot counter this condition and the pain with home remedies is essential. Regardless of what you know about hemorrhoids, it's always best to rely on your doctor's word.

STAPLERS FROM MERIL:

MIRUS™ HEMORRHOIDS STAPLER: This MIRUS™ HEMORRHOIDS STAPLER is used during the surgical intervention (hemorrhoidectomy) for thrombosed hemorrhoids. It also becomes useful during Minimally Invasive Procedure for Prolapsed Hemorrhoids (MIPH) and Stapled Transanal Resection of Rectum (STARR). This device gives security, superior haemostasis, and ease of use. It also has an optimised staple formation with adjustable height staples.

The formation of hemorrhoids in adults is commonplace, and usually, home remedies should suffice. It's only when the condition is severe, as is the case of thrombosed hemorrhoids, does the doctor advise surgical intervention. Even then, the process's success and recovery rates are high. To not experience hemorrhoids of any kind in the long term, it is recommended to bring lifestyle and dietary changes into your routine. These are small steps that you can inculcate into your life to ensure there are no medical setbacks in the future.

References

https://www.merillife.com/medical-devices/endosurgery/endo-mechancial-staplers/open-surgery/mirus-hemorrhoids-stapler
https://www.merillife.com/medical-devices/endosurgery/endo-mechancial-staplers/open-surgery/mirus-circular-stapler
https://www.osmosis.org/answers/thrombosed-hemorrhoid