Thrombosed External Hemorrhoids: What to Expect

Hemorrhoid issues

Doctor, will a thrombosed external hemorrhoid definitely go away? I've had my thrombosed external hemorrhoid for a month and a half.
Although it is not painful and is about the size of a peanut, it hasn't gotten any bigger, but it also hasn't shrunk.
I've heard that it usually resolves in 2 to 4 weeks, but it hasn't even decreased in size a little bit, which is starting to make me worry that it might just stay like this indefinitely.

Angel Lin, 40~49 year old female. Ask Date: 2023/03/14

Dr. Ke Fangxu reply Surgery

If there is no reduction in size at all, it is advisable to consult a physician to determine whether it is indeed a thrombosed external hemorrhoid.
If there is no discomfort, it may not require attention; otherwise, you can consider asking the physician to perform a thrombectomy.

Reply Date: 2023/03/14

More Info

Thrombosed external hemorrhoids are a common condition that can cause significant discomfort and concern for those affected. When a blood clot forms in an external hemorrhoid, it can lead to swelling and a painful lump near the anus. However, it is important to understand the natural course of this condition and what to expect.

Typically, thrombosed external hemorrhoids can resolve on their own over time. The duration for resolution can vary significantly among individuals. While many people may notice a decrease in size and discomfort within 2 to 4 weeks, others may experience a longer duration of symptoms. In your case, having had the thrombosed hemorrhoid for a month and a half without significant change is not uncommon.
The lump you describe, about the size of a peanut, may remain for a while even if it is not causing pain. This is because the body gradually reabsorbs the clot, and the tissue may take time to heal. In many cases, the hemorrhoid will eventually shrink and resolve, but it can take several weeks to months.
If the thrombosed hemorrhoid is not painful and does not show signs of infection (such as increased redness, warmth, or discharge), it is often safe to monitor the situation. However, if you notice any changes in symptoms, such as increased pain, bleeding, or signs of infection, it is important to seek medical attention.

In some cases, if the hemorrhoid does not resolve on its own and continues to cause discomfort or concern, medical intervention may be considered. Options include:
1. Conservative Management: This includes dietary changes (increasing fiber intake), hydration, and the use of topical treatments to alleviate symptoms.

2. Surgical Intervention: If the thrombosed hemorrhoid persists and causes significant discomfort, a healthcare provider may recommend a minor surgical procedure to remove the clot or the hemorrhoid itself. This is usually a quick outpatient procedure.

3. Follow-Up: Regular follow-up with a healthcare provider can help monitor the situation and address any concerns that arise.

It is also worth noting that lifestyle factors can play a role in the development of hemorrhoids. Maintaining a high-fiber diet, staying hydrated, and avoiding prolonged sitting can help prevent future occurrences.

In summary, while it is understandable to be concerned about the persistence of a thrombosed external hemorrhoid, many resolve on their own over time. If you have any doubts or if your symptoms change, it is advisable to consult with a healthcare professional for personalized advice and potential treatment options.

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