Top signs of a thrombosed hemorrhoid include pain, rectal bleeding, inability to walk, sit or stand normally, and worsening itching and irritation in the sensitive area near the anus. If your hemorrhoids are turning painful and the irritating symptoms make it challenging for you to carry on routine activities, schedule an appointment with board-certified physicians at Manhattan Gastroenterology for practical solutions. The top-rated doctors use minimally invasive and advanced equipment to treat your hemorrhoids and ease the pain. You can look forward to saying goodbye to the embarrassment and discomfort of thrombosed hemorrhoids with safe and hassle-free treatment options and remedies that provide lasting relief and prevent further development of hemorrhoids.

The anal canal is lined with blood vessels. When these blood vessels become dilated or swollen, they can form hemorrhoids. Hemorrhoids can be on the inside of the anal passage or form on the outside of the anus. Hemorrhoids, on the inside, are called internal hemorrhoids, and those on the outside are called external hemorrhoids.

Hemorrhoids are a common condition that affects millions of people around the world. They often get better with time, but many suffer from hemorrhoids longer than necessary and need medical assistance. Symptoms of hemorrhoids vary and are mild enough for many, but they should not be ignored as they can become painful and restrict your activities if you are not careful.

What Is a Thrombosed Hemorrhoid?

Thrombosed hemorrhoids occur when an internal or external hemorrhoid gets filled with blood clots. The term thrombosed comes from the word “thrombosis,” which means clotting. Thrombosed hemorrhoids can become tender and painful.

They are not signs of a severe medical condition or a threat to overall wellbeing, but they should be treated promptly to avoid complications. The thrombosed hemorrhoid can become painful and make everyday activities challenging, such as walking, sitting, or going to the toilet.

Signs of Thrombosed Hemorrhoids

Commonly experienced signs and symptoms of thrombosed hemorrhoids include:

  • Pain while sitting, walking, or going to the toilet to pass stool
  • Itching around the anus
  • Bleeding when passing a stool
  • Swelling or lumps around the anus

Thrombosed hemorrhoids can become infected, which can lead to an abscess. In such a case, you may develop other symptoms, including fever.

Thrombosed hemorrhoids make their presence known in the following ways:

Worsening Itching and Irritation

As they develop under the sensitive skin near the anus, external hemorrhoids can be irritating and cause discomfort. They can result in itching, burning, and a general feeling of irritation. Compared to them, internal hemorrhoids develop inside the rectum, underneath the sensitive tissue, and do not cause any physical discomfort but lead to bloody stools.

If external hemorrhoid develops a blood clot and becomes thrombosed, your itching and irritation will worsen. The discomfort level may increase, and you will have problems performing daily life activities as before. It has been observed that thrombosed hemorrhoids develop quickly, and the discomfort worsens particularly during the first 48 hours and then improves slightly.

Sitting Becomes Painful

Severe anal pain is one of the most commonly experienced signs of a thrombosed hemorrhoid. Due to the location of this hemorrhoid, sitting becomes too painful, and you may find yourself searching for the best position to sit without discomfort. External thrombosed hemorrhoids can also aggravate the anal pain.

Bleeding After Passing Stool

Bleeding with or after a bowel movement is common with all hemorrhoids, including a thrombosed hemorrhoid. Even if your hemorrhoids are not painful or do not cause any discomfort, bloody stools or bleeding after passing a stool is not something you should ignore. Call your doctor if you notice rectal bleeding or severe anal pain during bowel movements.

The doctor will make an accurate diagnosis based on your symptoms to rule out other causes of bleeding, such as colon cancer or inflammatory bowel disease, and recommend the best treatment to make you feel better.

Hardening of the External Hemorrhoid

If your external hemorrhoid develops a small blood clot, it will harden, and you will feel like you are sitting on a stone. Blood clots are semi-solid clumps of blood created by the platelets and proteins in response to an injury.

What Causes Thrombosed Hemorrhoids?

The constant stretching of the tissues in the rectum can weaken and thin the walls of the blood vessels. With time, these blood vessels may swell and bulge and create hemorrhoids. When blood gets trapped in the swollen veins, clots can develop and lead to thrombosed hemorrhoids.

Other factors related to the hemorrhoidal disease include:

  • Weakening of the supportive connective tissue within the anal cushions
  • Advancing age as it weakens the tissues as a person gets old
  • Lack of fiber in the diet, which causes constipation and pressure on the anal passage in passing stool
  • Reduced blood flow to the perianal area
  • Increased intra-abdominal pressure

Risk factors associated with the development of thrombosed hemorrhoids include:

  • A history of constipation
  • Prolonged straining during bowel movements
  • Heavy lifting
  • Sitting for a long time
  • Obesity
  • Pregnancy

As hemorrhoids develop, the blood pooling within the vessels can lead to the formation of blood clots, resulting in thrombosis. This condition can worsen if you do not take hemorrhoids seriously and seek timely medical care.

How to Know If It Is a Thrombosed Hemorrhoid?

Hemorrhoids are usually painless unless they are thrombosed, prolapsed, or strangulated, which means their blood supply is cut off. Unusual pain in the perianal area, as well as feeling a hardened, painful lump near the anus, indicates the presence of a thrombosed hemorrhoid.

Treating Thrombosed Hemorrhoids

Thrombosed Hemorrhoid
Thrombosed Hemorrhoid

Most thrombosed hemorrhoids get better on their own. It may take two to three weeks for them to disappear completely but at times, there is no improvement. There are many ways to treat thrombosed hemorrhoids and seek relief from the constant pain and discomfort you are going through.

Thrombosed hemorrhoids are treated with a simple in-office procedure called external thrombectomy. During this procedure, the doctor makes a small incision in the hemorrhoid and drains the trapped blood or the clot. You may have pain after the surgery, but it can be managed with prescribed medications.

This procedure works best if you have it within 24 to 72 hours after hemorrhoid appears. It is an effective and quick solution, but the clots can come back if you do not make the necessary lifestyle changes to prevent them.

If you are not a good candidate for thrombectomy, your doctor may suggest home treatments to ease the discomfort.

At-Home Treatment

Home remedies and self-care options can help improve your symptoms and relieve the pain till the body dissolves the clot on its own. They include:

  • Hemorrhoid cream – Applying over-the-counter hemorrhoid cream can relieve symptoms.
  • Pain relievers – Over-the-counter painkillers can reduce the severity of the pain.
  • Sitz bath – Soaking the affected area in warm water several times a day and gently patting it dry helps with symptoms.
  • Ice treatment – Applying a cold compress or ice pack to the affected area may reduce pain and inflammation.
  • Wipes – Using wet wipes in place of harsh toilet paper can reduce friction and lessen the irritation in the affected area.
  • Aloe Vera – It is known for its anti-inflammatory properties. Applying pure Aloe Vera to the affected area can keep the inflammation down.
  • Stool softeners – A stool softener or fiber supplement can help treat hemorrhoids at home. They make it easier to pass stool, which reduces irritation and further complications.
  • Loose cotton clothing – Avoid wearing tight clothes made of artificial fabrics as they can aggravate the already sensitive and wounded area. Wearing loose cotton clothing can reduce irritation in the affected area and keep it dry.
  • Dietary changes – Eating more fiber and drinking a lot of fluids can reduce frequent straining, constipation, and ensure easy bowel movement, and prevent the formation of hemorrhoids.

If your symptoms do not improve with home remedies and self-care, you may have to undergo a surgical procedure for hemorrhoid removal.


In extreme cases, your healthcare provider may recommend surgery to remove the blood clot. It is the only option if you are in a lot of pain and no other treatment seems to work. Surgery may also keep the thrombosed hemorrhoid from coming back.

You don’t have to keep on suffering as there are many ways to eliminate the irritation, pain, and rectal bleeding caused by thrombosed hemorrhoids. At Manhattan Gastroenterology, the board-certified and experienced gastroenterologists use advanced tools and equipment to accurately diagnose your condition and help you feel better within no time. The top-rated gastro doctors work closely with you, understand what you are going through, and develop the best treatment plans and follow-up care to enhance your quality of life and overall wellbeing. They strive to ease your pain as soon as possible with the best treatments and remedies specially designed to manage your symptoms and ensure your home and work life are not affected.

Updated on Sep 1, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology