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Hemorrhoids (cont.)

Medical Treatment

Thrombosed hemorrhoids
- If you develop a hemorrhoid with a clot (a thrombosed hemorrhoid), you will feel some pain.
- If the pain is not severe and the swelling is not too much, many times the doctor can treat you with hot sitz baths and bulking up the stools.
- If the pain is not tolerable or a large amount of swelling is present, however, it might be necessary to remove the blood clot. This procedure can be done in a doctor's office or emergency department but must not be attempted at home.
- When the clot must be removed, the hemorrhoid is numbed up with an anesthetic, just like at the dentist's office when a cavity must be filled.
- After the area is numb, the doctor will make a small cut in the hemorrhoid to remove the blood clot.
- A small piece of bandage will be put in the hemorrhoid to stop any bleeding and keep the clot from coming back.
- Another bandage will be put on the outside of the hemorrhoid as well. You will be started on sitz baths at home, and the dressing should be removed when you take your first one about 6-12 hours after the clot has been removed.
- Almost everyone has great relief of their pain after the clot is removed and needs only acetaminophen (Tylenol) or ibuprofen (Motrin) for pain.
Prolapsed internal hemorrhoids
- If you have prolapsed internal hemorrhoids, which you are unable to push back through the anus, then your doctor may need to reduce them.
- Many times the doctor is able to gently push the hemorrhoids back into place.
- If the hemorrhoids are too swollen to be pushed back through the anus, then you may need a surgical procedure to relieve the swelling.
- If the hemorrhoids remain swollen and trapped through the anus and nothing is done, then the hemorrhoid will not receive enough blood and start to die.
- If this occurs, the hemorrhoid will become infected, and the infection can spread throughout the blood, making you very sick.