External hemorrhoids are dilated blood vessels beneath redundant skin folds located around the anal verge. External hemorrhoids are commonly associated with internal hemorrhoids and treatment of internal hemorrhoids, with rubber banding, leads to external hemorrhoid shrinkage. External hemorrhoids can cause itching, and the feeling of lumps around the anus. External hemorrhoids may also bleed but less so often than internal hemorrhoids. The most common complication of external hemorrhoids is acute thrombosis. Thrombosis occurs suddenly and spontaneously and results from a blood clot forming within the lumen of a dilated hemorrhoid blood vessel. The clotted blood vessel stretches the overlying skin resulting in a tender purple color lump at the edge of the anus.
Pain is severe. Successful treatment in the first 24 hours after pain onset is simple. It requires excision of the thrombosed blood vessel resulting in immediate pain relief. Excision can be performed in an office setting with local sedation. Sitz baths following surgery keep the area clean and promote healing. Patients with thrombosed external hemorrhoids who present late after onset of pain are best treated with hemorrhoid creams and Sitz bath. Excision of thrombosed hemorrhoid is not recommended 48 hours after onset of symptoms. It may in fact exacerbate rather than alleviate pain. If you suffer from hemorrhoid disease and develop acute onset pain, give us a call and let the Houston Hemorrhoid experts alleviate your pain.