You
have a thrombosed external hemorrhoid.
This is a hemorrhoid with a blood clot
that can be seen and felt under the skin
around your anus. It is usually moderately
to severely painful. These hemorrhoids
often occur with chronic constipation,
diarrhea, or pregnancy, but they can
also appear without an apparent cause.
Treatment
If
persistently painful, regardless of duration,
the recommended treatment is removal
in the office under local anesthesia.
The doctors will cut off the skin over
the clot and removed the clotted hemorrhoid.
You have not had a complete hemorrhoidectomy.
The wound will be left open. The doctor
will put a dressing over the wound to
soak up any blood or discharge.
After
Treatment
Symptoms
and Care
You will have pain after the local
anesthetic wears off. It may be moderately
strong. Your doctor will prescribe
something to relieve it. You may also
take acetaminophen (Tylenol®) or
ibuprofen (Advil®, Motrin®,
for example). Do not take aspirin or
products containing aspirin for at
least seven days as they promote bleeding.
Topical anesthetic ointments available
over the counter such as Americaine®,
Xylocaine®, Analpram®, Nupercainal®,
and Anusol-HC®) will also help
with the pain.
A
small amount of bleeding is normal.
Leave the dressing in place for
12 to 24 hours; then take your
first sitz bath. If the dressing
is difficult or painful to remove,
do it after soaking in the bath.
If the wound is still bleeding,
cover it with a pad or gauze.
It
takes two to four weeks for the wound
to heal. Don't worry if some bleeding,
discharge, pus, or itching occur
during this time; they are part of
the normal healing process.
Anal
hygiene is important. Wash or sit
in the tub after bowel movements
or at least twice a day.
You
may have been asked to return to
the office in 7 to 14 days for a
wound check. Your doctor will let
you know if this is necessary and
if you need further treatment or
tests. Diet
It is important to keep your bowel
movements soft and regular. Eat foods
high in fiber and drink lots of water
(6-8 glasses a day). If you are constipated,
take a fiber supplement (for example,
Metamucil®
or Citacell®). Prune juice or small
doses of milk of magnesia may also
be used.
Activity
Avoid strenuous activity for the rest
of the day. Tomorrow you can go
back to your normal activities.
Causes
For Concern
Call
your doctor if you have any of the following
problems:
- Excessive
pain unrelieved by your pain
medication
- Increasing
pain several days after treatment
- Fever
or chills
- Difficulty
urinating
- Severe
bleeding that won't stop with
direct pressure using Kleenex
or gauze
- Severe
constipation (no bowel movement
for three days)
- Diarrhea
(more than three watery bowel
movements within 24 hours)
- Nausea
and vomiting
If
your doctor is unavailable, the on-call
doctor is available 24 hours a day,
every day of the year. After hours,
call any of our offices and the answering
service will locate one of our doctors
on call. In an emergency try to contact
us for advice before you go to the
hospital. A telephone call may save
you a lot of time, discomfort, and
expense.
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