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Date of last update: 10/15/2017.

Forum Name: Gastroenterology Topics

Question: Possible thrombosed hemorrhoid?

 Salem - Thu Feb 03, 2005 12:49 pm

I am a 27 y/o female and I have what I am pretty sure is hemorrhoids, possibly thrombosed. I am wondering if it is always necessary to visit a doctor (for a thrombosed hemorrhoid) or if this can resolve on its own.

What I am wondering is that all the information I find says that thrombosed hemorrhoids are painful, but this is not painful just irritating as it feels like a 'foriegn' object (ie I can noticeably feel it when I sit down, but it isn't painful). Should I wait a few days to see if it resolves itself or go on to the doctor?

I should mention that it appears to be a small lump in the skin (smaller than a pea), is smooth, is a dark bluish color that can be seen under the skin color, no bleeding, and is in the outer skin of the rectum. I'm sure that it is a hemorrhoid because it appeared after I had a painful bowel movement after being slightly constipated. I had some sharp pain for a few hours afterward, that is now gone, and the next day I noticed the bump. It has been about three days and I just wanted to know how serious this could be.

Any information or advice is appreciated. Thanks.
 erfnp - Mon Jan 12, 2009 2:37 am

My emergency department employs doctors as well as mid level providers such as myself. I am a family nurse practitioner with specialization in emergency medicine and cardiovascular medicine. The nurse practitioners and physician assistants do most of the procedures- suturing lacerations, draining abscesses, and relieving the pain of thrombosed hemorrhoids. In fact, I just did one tonight in a middle-aged man who was suffering from one. He had no known history of hemorrhoids and was not sure what the painful lump on his anus was. He was heterosexual with no history of constipation or straining. In fact, he had a few day history of diarrhea. After cleaning and adequately numbing the hemorrhoid (using 1% lidocaine with epi to decrease bleeding), I made a small incision with a # 11 blade and removed several large clots. There was very little bleeding and almost complete relief of the pain. The procedure is quick and relatively painless, so do not be afraid to have it done if needed. Sometimes it may be necessary to consult a surgeon to have them removed completely, but this is done under anesthesia or with an epidural.... an emergency department family nurse practitioner who loves her job!
 John Kenyon, CNA - Thu Feb 05, 2009 2:36 pm

User avatar Hello -

I've been asked to respond to the question, so here goes: This does indeed sound like a thrombosed hemorrhoid. Since hemorrhoids are often "falling" or pendulous in nature, they are frequently treated by deliberat thrombosing anyway, either via rubber band strangulation (in which case the hemorrhoid dies, withers and sloughs off), or by injection with a thrombolytic causing the same effect. This is done more often when the hemorrhoid is less accessable, as in the case you describe.

I'd give this a few days, since although these can be painful, they are usually described as you have done, as an "annoyance", as they are, for all practical purposes, foreign bodies. This one may follow its own course and resolve on its own, and I'd give it a week at most. If it's still there, still uncomfortable, and/or becomes more bothersome, I would of course suggest being seen with an eye toward having it and/or the clot removed, per the post by erfnp, above, who graphically describes the simple surgical removal of thrombi in cases where the hemorrhoid isn't amenable to thrombolytic or strangulation therapy. Yours may not be, as it appears to be not fully pendulous, at least not yet.

I hope this is helpful. Best of luck to you and please follow up with us as needed.
 mrmac - Mon Aug 03, 2009 3:02 am

I just went through the most painful experience ever, for me anyway.
for several weeks , after having a bm, a small tissue would be out of my anus. I just pushed it back in. well, one time after pushing back in I was immediately uncomfortable. I was unable to do anything but lay on the couch. Could not go to the bathroom at all. Of course I was not aware of what was wrong. Never had a hemroid and never even thought of it. I have many health issues and this one hit me head on. By 7:30 my husband took me to the er. I was impacted and the er physician removed some of it. This was without the benefit of any local pain stuff. Yes, I was crying. then she had someone practically sit on me and then proceeded to do a procedure on a thrombosed hemorrhoid. This was very painful. I do recall her giving me a shot some where down there, but she may as well have givin' me a bullet to bite down on. I cannot even recall right now what I have endured that could be more painful. It is my suggestion to you to go to your doctor asap. get professional advice on diet and maybe referral to a general surgeon. start drinking 8 - 16oz glasses of water a day, now. and if you drink alchohol---get your docs advice on stopping. Also, help with stop smoking if you smoke. seriously, do not ignore this lump. It is no laughing matter until all is healed and well. My sister has numerous hemorrhoid jokes now that I am on the mend. take care and get to your doctor.
 ineedhelp88 - Tue Oct 27, 2009 4:19 pm

i am a young male im 21 years old and after have bouts of bad diarrhea whenever i was cleaning myself i found a small pea sized bump to the side of my anus, it is freaking me out and all these thrombosed hemorrhoids seem to be a blue black color and mine is not its just a bump. it is tender to the touch and not really painful unless i push on it. i feel like it is probably a hemorrhoid but i am not positive and i really don't feel comfortable going to the doctor about it, if its nothing to important or will go away. there is some bruising i knoticed to the side of the bump but i feel like i may have caused that from pinching the bump not knowing what it is so im not forsure if its from the bump or me...any help would be greatly appreciated and is there anything i can do here at home to make it go away?
 John Kenyon, CNA - Fri Oct 30, 2009 10:39 am

User avatar Hi there -- Odds are very great this is a hemorrhoid, and it's not easy to self-assess these things, it's just too awkward. The only other thing it would likely be (and it's pretty unlikely) is an ingrown hair, what's known as a "wild hair" in some circles, since it would be a little bit beyond the usual boundary. It does happen sometimes, but it's much more likely a simple hemmorhoid, and while there are symptomatic treatments for these things, there is no home cure. Sometimes they'll go into remission (shrink back into the background) but even if this happens, they usually just return again and again. The question becomes: Just how much of this are you willing to put up with? It's not a dangerous thing in itself, although if it starts bleeding this presents a whole other dilemma as to self-management. I'd just get it checked -- the doctor is used to this and a lot weirder things, trust me, and just doesn't really care, sees it as part of the job. Your call, however, and not something to worry over too much otherwise.

Hope this is helpful. Good luck with this and let us know how things go.

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