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Thrombosed hemorrhoids are a complication of hemorrhoidal disease. In this condition, the hemorrhoidal cushions become swollen, inflamed, and filled with blood clots, causing severe pain and posing potential risks to the patient’s health. When thrombosis occurs, the hemorrhoidal tissue may become acutely inflamed and edematous, leading to marked pain, swelling, and difficulty in daily activities. So, what are thrombosed hemorrhoids, how do they affect the patient, and how should they be treated? The following article provides detailed information to help you better understand this condition.

What are thrombosed hemorrhoids?

Thrombosed hemorrhoids, also known as thrombosed piles or perianal thrombosis, refer to a condition in which the veins within the hemorrhoidal plexus of the anal canal become compressed, ruptured, and form blood clots (thrombi) inside the hemorrhoidal tissue. These clots block blood flow, leading to venous obstruction, inflammation, pain, and bleeding.

The hemorrhoidal masses may appear as a single lump or a round swelling near the anus. In many cases, the blood clot may be gradually reabsorbed by the body, and the symptoms resolve spontaneously.

Thrombosed hemorrhoids may occur externally (beneath the skin around the anus) or internally (within the anal canal). Based on location, the condition is classified into three types:

• Thrombosed internal hemorrhoids, also known as circumferential thrombosed internal hemorrhoids.
• Thrombosed external hemorrhoids, also referred to as external hemorrhoidal thrombosis.
• Thrombosed mixed hemorrhoids, in which both internal and external hemorrhoidal plexuses are affected simultaneously.

Symptoms of thrombosed hemorrhoids

For thrombosed external hemorrhoids

Thrombosed external hemorrhoids usually appear as a small, dark or bluish lump around the anus, caused by the accumulation of a blood clot within the hemorrhoidal vein. In addition to this visible lump, patients may experience several other symptoms, including:

• Severe pain: This is the most typical and common symptom. The pain often occurs suddenly and intensifies when sitting, walking, or during bowel movements.
• Itching around the anus: Itching tends to appear when venous obstruction and inflammation begin to develop in the anal area.
• Anal bleeding: Bleeding may occur due to rupture of the overlying skin or damaged blood vessels. In some cases, the bleeding temporarily relieves pain because it releases the trapped and congested blood.
• Painful and difficult defecation: When the thrombosed hemorrhoidal lump enlarges, it can partially or completely obstruct the anal canal, making bowel movements painful and difficult. In severe cases, the patient may be unable to pass stool without medical intervention.

In addition to the symptoms mentioned above, patients with thrombosed external hemorrhoids may also develop fever. This is a warning sign that the hemorrhoidal mass has become infected or that the patient has developed a perianal abscess. In such cases, the patient should seek immediate medical attention at the nearest healthcare facility for proper examination and prompt treatment to prevent serious complications that could endanger their health.

For thrombosed internal hemorrhoids

Thrombosed internal hemorrhoids usually cause little or no pain, as they develop above the dentate line, an area with few pain-sensitive nerve endings. However, this condition often leads to rectal bleeding, which may occur during or after bowel movements. The amount of bleeding can vary from a few drops to a noticeable flow, depending on the severity of the disease.

Because the clinical symptoms are often subtle, thrombosed internal hemorrhoids are more difficult to detect than thrombosed external hemorrhoids. Nevertheless, patients may still experience several warning signs, including:

• Rectal bleeding: This is the most common symptom, as thrombosed internal hemorrhoids are fragile and prone to rupture. In mild cases, bleeding is minor, appearing as streaks of blood mixed with stool or on toilet paper after defecation. In more severe cases, bleeding may occur in spurts or jets, leading to chronic blood loss and, if untreated, potentially life-threatening anemia.
• Pain during bowel movements: Pain typically appears in the early stages of the disease. Without proper examination and treatment, the pain around the anal area becomes increasingly intense, accompanied by significant swelling and inflammation.
• Fecal leakage: The hemorrhoidal thrombosis can weaken the anal sphincter muscles, causing involuntary leakage of stool.
• Sensation of fullness or obstruction in the rectum: This occurs when the internal hemorrhoidal mass becomes enlarged and prolapsed, creating a constant feeling of blockage or discomfort inside the rectum.
• Itching and burning in the rectum: Inflammation and irritation caused by mucus secretion from the rectal mucosa can lead to burning, itching, and discomfort.
• Prolapse of the hemorrhoidal mass: In advanced stages, the thrombosed internal hemorrhoids protrude through the anal opening, and patients may feel or even see the prolapsed tissue.
• Difficulty with daily activities: Pain and swelling may make walking, standing, sitting, urinating, or defecating extremely uncomfortable and difficult.

Both thrombosed internal hemorrhoids and thrombosed external hemorrhoids cannot heal on their own. Therefore, patients should consult a colorectal specialist as soon as possible for accurate diagnosis and timely treatment, which helps shorten recovery time and reduce overall treatment costs.

Causes of thrombosed hemorrhoids

At present, there is no definitive explanation for why blood clots form in certain individuals with hemorrhoidal disease. However, medical experts have identified several common contributing factors, including:

• Chronic constipation or diarrhea: Frequent straining during bowel movements or repeated episodes of diarrhea increase pressure on the anal veins, leading to the formation of hemorrhoidal masses and potential thrombosis.
• Prolonged sitting and lack of physical activity: Remaining seated for long periods or being physically inactive raises venous pressure in the anal and rectal areas, contributing to hemorrhoid development.
• Unbalanced diet: A diet low in fiber and inadequate water intake (less than 2 liters per day) can cause constipation and reduce intestinal motility, making bowel movements difficult and increasing the risk of hemorrhoids.
• Aging: In older adults, digestive function tends to decline, leading to chronic constipation and a higher likelihood of hemorrhoidal disease.
• Pregnancy, especially in the later months: Hormonal changes and dietary imbalance—such as consuming too much protein and too little fiber—combined with stress and anxiety can cause constipation. In addition, the pressure of the growing fetus on the rectal and anal veins increases venous congestion, raising the risk of hemorrhoids. Straining during childbirth can also injure the anal region and trigger hemorrhoidal thrombosis.
• Underlying medical conditions: Gastrointestinal disorders (such as colitis or anal fissures) and obesity are known risk factors that promote hemorrhoidal formation and thrombosis.
• Habitual stool retention: Frequently delaying bowel movements increases pressure within the rectum and anal canal, potentially leading to hemorrhoids and subsequent thrombosis.

Are thrombosed hemorrhoids dangerous?

Thrombosed hemorrhoids are not a malignant condition, but they can significantly affect a patient’s health and quality of life. In some severe or uncontrolled cases, thrombosed hemorrhoids may lead to serious complications, such as:

• Tissue necrosis: This occurs when the hemorrhoidal mass enlarges significantly, obstructing blood circulation. As a result, the hemorrhoidal tissue becomes deprived of oxygen and nutrients, leading to ischemia and tissue necrosis.
• Pain and inflammation of the thrombosed hemorrhoid

In addition, complications of thrombosed hemorrhoids may include anemia due to chronic blood loss and severe infection of the hemorrhoidal tissue. Therefore, colorectal specialists strongly advise that patients should not self-medicate or use over-the-counter hemorrhoid treatments at home. Inappropriate or delayed treatment can worsen the condition, causing serious complications that may endanger the patient’s health and even life. At the first signs of hemorrhoidal disease, patients should seek medical evaluation from a qualified specialist at a reputable healthcare facility. Early and accurate diagnosis allows for timely and effective treatment, helping to shorten recovery time, minimize pain, prevent complications, and reduce treatment costs.

Reader may also be interested in: 

• Is grade 1 hemorrhoids dangerous? Can it resolve on its own?
• Hemorrhoids: Causes, symptoms, prevention, and treatment

Treatment methods for thrombosed hemorrhoids

The treatment approach depends on the size of the hemorrhoidal mass and the degree of damage. Patients may be prescribed medication or undergo surgical treatment, depending on the severity of the condition.

Medical treatment and lifestyle modification for mild thrombosed hemorrhoids

For mild cases, patients are usually treated with conservative therapy, which includes medications and changes in diet and daily habits. Commonly used medications include:

• Pain relievers: Help reduce pain, inflammation, and swelling of the hemorrhoidal mass.
• Local anesthetics: Work by numbing the hemorrhoidal area to relieve discomfort and pain.
• Topical ointments containing hydrocortisone: Applied directly to the affected area to reduce itching, inflammation, and swelling.
• Sclerotherapy (hemorrhoidal injection therapy): In more severe cases where conventional medications are less effective, physicians may inject a special sclerosing agent directly into the hemorrhoidal tissue. This chemical causes the hemorrhoid to shrink, harden, and eventually detach. However, this method may leave scarring in the anal area.
• Adopt a healthy, fiber-rich diet, including plenty of vegetables, fruits, and whole grains.
• Drink adequate water daily (at least 2 liters) to prevent constipation.
• Exercise regularly for 30–60 minutes per day, 5–7 days a week, to improve blood circulation and bowel function.
• Maintain proper anal hygiene—clean the anal area daily and after each bowel movement with warm water, then gently pat dry with a clean towel.

In addition, patients may combine several supportive methods to help relieve pain and discomfort caused by thrombosed hemorrhoids, such as:

• Over-the-counter hemorrhoid creams: May help reduce inflammation, itching, and mild pain associated with hemorrhoids.
• Over-the-counter pain relievers: Can be used to alleviate pain and discomfort caused by swollen hemorrhoidal tissue.
• Sitz baths: Soak the anal area in warm water several times a day, then gently pat dry to ease pain, itching, and inflammation.
• Cold compresses: Applying a cold pack or ice compress to the anal area helps reduce swelling, pain, and inflammation.
• Use of a donut cushion: Sitting on a ring-shaped pillow can relieve pressure on the anal area, especially during long working hours.
• Moist wipes: Use unscented wet wipes instead of dry toilet paper to minimize friction and irritation after bowel movements.
• Stool softeners: Help make stool easier to pass, reducing the need to strain and thereby lessening pain during defecation.
• Loose cotton clothing: Wearing loose, breathable cotton garments helps reduce anal irritation and keep the area clean and dry.

Surgical treatment for severe thrombosed hemorrhoids

In cases of severe thrombosed hemorrhoids, where there is a high risk of complications or when the condition does not respond to medical therapy, surgical intervention is often required. Surgery helps prevent further complications, alleviate severe symptoms, and restore normal anal function. A colorectal specialist will carefully evaluate the patient’s condition and determine the most appropriate surgical method based on the size, location, and severity of the thrombosis.

For thrombosed external hemorrhoids

Patients are typically administered a local anesthetic injection containing epinephrine to help control bleeding and reduce swelling before surgical removal of the thrombosed hemorrhoid. This procedure may cause postoperative pain lasting for several weeks, but it is generally indicated for cases of severe acute thrombosis accompanied by marked edema, necrosis, or obstruction of mucosal closure.

For thrombosed mixed hemorrhoids

In cases of circumferential or mixed hemorrhoidal thrombosis, surgeons may perform Plasma scalpel hemorrhoidectomy to remove the thrombosed hemorrhoidal tissue. Depending on the extent of thrombosis, the procedure may involve thrombectomy (removal of the blood clot) or excision of the thrombosed hemorrhoidal mass, combined with the Longo procedure to treat the remaining non-thrombosed hemorrhoidal segments.

For thrombosed internal hemorrhoids

Because thrombosed internal hemorrhoids are a complex condition, surgeons will base their approach on factors such as the size of the hemorrhoidal mass and the degree of prolapse to determine the most suitable combination of surgical techniques. In many cases, a combination of hemorrhoidectomy methods is applied to ensure complete removal of the thrombosed tissue, minimize recurrence, and preserve normal anal function.

• Thrombectomy combined with sclerotherapy:
• This method involves removing the blood clot and injecting a sclerosing agent into the hemorrhoidal tissue. It offers several advantages, including single-session treatment, minimal pain, short hospitalization, quick recovery, and low cost. However, it is most effective for bleeding hemorrhoids that are not significantly prolapsed or enlarged.
• Thrombectomy combined with German LHP Laser hemorrhoidectomy: This procedure uses carbon dioxide (CO₂) or Nd:YAG laser technology to precisely cauterize or remove hemorrhoidal tissue. It provides high accuracy, minimal invasiveness, quick results, and is virtually painless.
• Thrombectomy combined with THD (Transanal Hemorrhoidal Dearterialization): A minimally invasive surgical technique that reduces pain, bleeding, and prolapse. Using a Doppler probe, surgeons locate the six main hemorrhoidal arteries within the anal canal, then ligate them with absorbable sutures and use a specialized anoscope to lift and fix excess mucosa.
• Thrombectomy combined with Longo procedure: This method causes minimal postoperative pain, shortens surgical time, promotes faster recovery, and reduces the risk of recurrence. However, as a technically demanding procedure, it may lead to complications such as bleeding from staple lines, sphincter injury, or, in rare cases among women, rectovaginal fistula formation. Therefore, it must be performed by highly skilled and experienced colorectal surgeons to ensure safety and optimal outcomes.

The choice of treatment method must be carefully evaluated based on the condition of the hemorrhoidal masses and the patient’s overall health status. Therefore, colorectal specialists strongly recommend that patients consult a qualified physician at a reputable medical facility for proper diagnosis and necessary diagnostic tests to determine the most effective and appropriate treatment plan. Patients are also advised not to self-medicate or use unverified traditional remedies at home, as improper treatment may worsen the condition and lead to serious health risks.

In addition, patients should strictly follow the prescribed treatment regimen, adopt a healthy lifestyle, and attend regular follow-up appointments as directed by their doctors to ensure the safety and effectiveness of the treatment process.

Where to examine and treat thrombosed hemorrhoids effectively

Thrombosed hemorrhoids are a complex form of hemorrhoidal disease, requiring highly skilled and experienced surgeons. Effective treatment demands a doctor who can combine various techniques appropriately to help patients eliminate hemorrhoids completely, prevent recurrence, reduce pain, shorten recovery time, and lower treatment costs.

As one of the leading private hospitals in Northern Vietnam, Hong Ngoc General Hospital has been a trusted destination for thousands of patients with thrombosed hemorrhoids, offering:

• Highly qualified and experienced medical team: People’s Physician, Assoc. Prof. Dr. Nguyen Xuan Hung – Former Director of the Center for Colorectal and Pelvic Floor Surgery, Viet Duc University Hospital; Vice President of the Vietnam Association of Colorectal Surgery; Member of the French Society of Coloproctology; MSc. Dr. Cu Trung Kien – Specialized training in gastrointestinal surgery in Hong Kong; former surgeon at Bach Mai Hospital; currently Deputy Head of the Department of Gastrointestinal Surgery, Hong Ngoc - Yen Ninh General Hospital; Specialist Level I Doctor Bach Phuc Huy – Over 15 years of experience; Head of the Gastrointestinal Surgery Unit, Hong Ngoc - Phuc Truong Minh General Hospital.
• Modern surgical techniques: Application of advanced technologies in hemorrhoid treatment such as radiofrequency hemorrhoidectomy, PPH stapled hemorrhoidectomy, and Longo stapled hemorrhoidopexy.
• Pain-free hemorrhoid surgery: Implemented under a comprehensive pain management protocol developed by MSc. Dr. Nguyen Thi Thu Ba, who completed advanced residency training in France. A team of highly skilled anesthesiologists provides continuous monitoring throughout the entire surgical process.
• Preemptive pain control strategy: Patients undergo strict pre-anesthesia assessment, continuous intraoperative monitoring, and proactive pain management even before the onset of pain.
• Advanced minimally invasive techniques: Surgery is performed in non-sensitive areas, minimizing tissue injury and postoperative discomfort.
• Dedicated 24/7 patient care: A professional support team provides attentive, round-the-clock care throughout hospitalization.
• Comfortable inpatient facilities: Spacious recovery rooms with hotel-standard amenities, providing patients with a comfortable and private healing environment.

For detailed consultation, please contact:

•  Hotline for specialist appointment: 0911 908 856 
• Hotline for hemorrhoid surgery consultation: 0949 646 556

Note: The information provided in this article by Hong Ngoc General Hospital is for reference purposes only and should not replace professional medical diagnosis or treatment. Patients are advised not to self-medicate. To determine their exact condition and receive appropriate treatment, patients should visit a qualified medical facility for direct examination, diagnosis, and personalized medical advice.

Follow the official fanpage of Hong Ngoc General Hospital for more useful health information and updates on special offers and hospital programs.

Thrombosed hemorrhoids are a complication of hemorrhoidal disease. In this condition, the hemorrhoidal cushions become swollen, inflamed, and filled with blood clots, causing severe pain and posing potential risks to the patient’s health. When thrombosis occurs, the hemorrhoidal tissue may become acutely inflamed and edematous, leading to marked pain, swelling, and difficulty in daily activities. So, what are thrombosed hemorrhoids, how do they affect the patient, and how should they be treated? The following article provides detailed information to help you better understand this condition.

What are thrombosed hemorrhoids?

Thrombosed hemorrhoids, also known as thrombosed piles or perianal thrombosis, refer to a condition in which the veins within the hemorrhoidal plexus of the anal canal become compressed, ruptured, and form blood clots (thrombi) inside the hemorrhoidal tissue. These clots block blood flow, leading to venous obstruction, inflammation, pain, and bleeding.

The hemorrhoidal masses may appear as a single lump or a round swelling near the anus. In many cases, the blood clot may be gradually reabsorbed by the body, and the symptoms resolve spontaneously.

Thrombosed hemorrhoids may occur externally (beneath the skin around the anus) or internally (within the anal canal). Based on location, the condition is classified into three types:

• Thrombosed internal hemorrhoids, also known as circumferential thrombosed internal hemorrhoids.
• Thrombosed external hemorrhoids, also referred to as external hemorrhoidal thrombosis.
• Thrombosed mixed hemorrhoids, in which both internal and external hemorrhoidal plexuses are affected simultaneously.

Symptoms of thrombosed hemorrhoids

For thrombosed external hemorrhoids

Thrombosed external hemorrhoids usually appear as a small, dark or bluish lump around the anus, caused by the accumulation of a blood clot within the hemorrhoidal vein. In addition to this visible lump, patients may experience several other symptoms, including:

• Severe pain: This is the most typical and common symptom. The pain often occurs suddenly and intensifies when sitting, walking, or during bowel movements.
• Itching around the anus: Itching tends to appear when venous obstruction and inflammation begin to develop in the anal area.
• Anal bleeding: Bleeding may occur due to rupture of the overlying skin or damaged blood vessels. In some cases, the bleeding temporarily relieves pain because it releases the trapped and congested blood.
• Painful and difficult defecation: When the thrombosed hemorrhoidal lump enlarges, it can partially or completely obstruct the anal canal, making bowel movements painful and difficult. In severe cases, the patient may be unable to pass stool without medical intervention.

In addition to the symptoms mentioned above, patients with thrombosed external hemorrhoids may also develop fever. This is a warning sign that the hemorrhoidal mass has become infected or that the patient has developed a perianal abscess. In such cases, the patient should seek immediate medical attention at the nearest healthcare facility for proper examination and prompt treatment to prevent serious complications that could endanger their health.

For thrombosed internal hemorrhoids

Thrombosed internal hemorrhoids usually cause little or no pain, as they develop above the dentate line, an area with few pain-sensitive nerve endings. However, this condition often leads to rectal bleeding, which may occur during or after bowel movements. The amount of bleeding can vary from a few drops to a noticeable flow, depending on the severity of the disease.

Because the clinical symptoms are often subtle, thrombosed internal hemorrhoids are more difficult to detect than thrombosed external hemorrhoids. Nevertheless, patients may still experience several warning signs, including:

• Rectal bleeding: This is the most common symptom, as thrombosed internal hemorrhoids are fragile and prone to rupture. In mild cases, bleeding is minor, appearing as streaks of blood mixed with stool or on toilet paper after defecation. In more severe cases, bleeding may occur in spurts or jets, leading to chronic blood loss and, if untreated, potentially life-threatening anemia.
• Pain during bowel movements: Pain typically appears in the early stages of the disease. Without proper examination and treatment, the pain around the anal area becomes increasingly intense, accompanied by significant swelling and inflammation.
• Fecal leakage: The hemorrhoidal thrombosis can weaken the anal sphincter muscles, causing involuntary leakage of stool.
• Sensation of fullness or obstruction in the rectum: This occurs when the internal hemorrhoidal mass becomes enlarged and prolapsed, creating a constant feeling of blockage or discomfort inside the rectum.
• Itching and burning in the rectum: Inflammation and irritation caused by mucus secretion from the rectal mucosa can lead to burning, itching, and discomfort.
• Prolapse of the hemorrhoidal mass: In advanced stages, the thrombosed internal hemorrhoids protrude through the anal opening, and patients may feel or even see the prolapsed tissue.
• Difficulty with daily activities: Pain and swelling may make walking, standing, sitting, urinating, or defecating extremely uncomfortable and difficult.

Both thrombosed internal hemorrhoids and thrombosed external hemorrhoids cannot heal on their own. Therefore, patients should consult a colorectal specialist as soon as possible for accurate diagnosis and timely treatment, which helps shorten recovery time and reduce overall treatment costs.

Causes of thrombosed hemorrhoids

At present, there is no definitive explanation for why blood clots form in certain individuals with hemorrhoidal disease. However, medical experts have identified several common contributing factors, including:

• Chronic constipation or diarrhea: Frequent straining during bowel movements or repeated episodes of diarrhea increase pressure on the anal veins, leading to the formation of hemorrhoidal masses and potential thrombosis.
• Prolonged sitting and lack of physical activity: Remaining seated for long periods or being physically inactive raises venous pressure in the anal and rectal areas, contributing to hemorrhoid development.
• Unbalanced diet: A diet low in fiber and inadequate water intake (less than 2 liters per day) can cause constipation and reduce intestinal motility, making bowel movements difficult and increasing the risk of hemorrhoids.
• Aging: In older adults, digestive function tends to decline, leading to chronic constipation and a higher likelihood of hemorrhoidal disease.
• Pregnancy, especially in the later months: Hormonal changes and dietary imbalance—such as consuming too much protein and too little fiber—combined with stress and anxiety can cause constipation. In addition, the pressure of the growing fetus on the rectal and anal veins increases venous congestion, raising the risk of hemorrhoids. Straining during childbirth can also injure the anal region and trigger hemorrhoidal thrombosis.
• Underlying medical conditions: Gastrointestinal disorders (such as colitis or anal fissures) and obesity are known risk factors that promote hemorrhoidal formation and thrombosis.
• Habitual stool retention: Frequently delaying bowel movements increases pressure within the rectum and anal canal, potentially leading to hemorrhoids and subsequent thrombosis.

Are thrombosed hemorrhoids dangerous?

Thrombosed hemorrhoids are not a malignant condition, but they can significantly affect a patient’s health and quality of life. In some severe or uncontrolled cases, thrombosed hemorrhoids may lead to serious complications, such as:

• Tissue necrosis: This occurs when the hemorrhoidal mass enlarges significantly, obstructing blood circulation. As a result, the hemorrhoidal tissue becomes deprived of oxygen and nutrients, leading to ischemia and tissue necrosis.
• Pain and inflammation of the thrombosed hemorrhoid

In addition, complications of thrombosed hemorrhoids may include anemia due to chronic blood loss and severe infection of the hemorrhoidal tissue. Therefore, colorectal specialists strongly advise that patients should not self-medicate or use over-the-counter hemorrhoid treatments at home. Inappropriate or delayed treatment can worsen the condition, causing serious complications that may endanger the patient’s health and even life. At the first signs of hemorrhoidal disease, patients should seek medical evaluation from a qualified specialist at a reputable healthcare facility. Early and accurate diagnosis allows for timely and effective treatment, helping to shorten recovery time, minimize pain, prevent complications, and reduce treatment costs.

Reader may also be interested in: 

• Is grade 1 hemorrhoids dangerous? Can it resolve on its own?
• Hemorrhoids: Causes, symptoms, prevention, and treatment

Treatment methods for thrombosed hemorrhoids

The treatment approach depends on the size of the hemorrhoidal mass and the degree of damage. Patients may be prescribed medication or undergo surgical treatment, depending on the severity of the condition.

Medical treatment and lifestyle modification for mild thrombosed hemorrhoids

For mild cases, patients are usually treated with conservative therapy, which includes medications and changes in diet and daily habits. Commonly used medications include:

• Pain relievers: Help reduce pain, inflammation, and swelling of the hemorrhoidal mass.
• Local anesthetics: Work by numbing the hemorrhoidal area to relieve discomfort and pain.
• Topical ointments containing hydrocortisone: Applied directly to the affected area to reduce itching, inflammation, and swelling.
• Sclerotherapy (hemorrhoidal injection therapy): In more severe cases where conventional medications are less effective, physicians may inject a special sclerosing agent directly into the hemorrhoidal tissue. This chemical causes the hemorrhoid to shrink, harden, and eventually detach. However, this method may leave scarring in the anal area.
• Adopt a healthy, fiber-rich diet, including plenty of vegetables, fruits, and whole grains.
• Drink adequate water daily (at least 2 liters) to prevent constipation.
• Exercise regularly for 30–60 minutes per day, 5–7 days a week, to improve blood circulation and bowel function.
• Maintain proper anal hygiene—clean the anal area daily and after each bowel movement with warm water, then gently pat dry with a clean towel.

In addition, patients may combine several supportive methods to help relieve pain and discomfort caused by thrombosed hemorrhoids, such as:

• Over-the-counter hemorrhoid creams: May help reduce inflammation, itching, and mild pain associated with hemorrhoids.
• Over-the-counter pain relievers: Can be used to alleviate pain and discomfort caused by swollen hemorrhoidal tissue.
• Sitz baths: Soak the anal area in warm water several times a day, then gently pat dry to ease pain, itching, and inflammation.
• Cold compresses: Applying a cold pack or ice compress to the anal area helps reduce swelling, pain, and inflammation.
• Use of a donut cushion: Sitting on a ring-shaped pillow can relieve pressure on the anal area, especially during long working hours.
• Moist wipes: Use unscented wet wipes instead of dry toilet paper to minimize friction and irritation after bowel movements.
• Stool softeners: Help make stool easier to pass, reducing the need to strain and thereby lessening pain during defecation.
• Loose cotton clothing: Wearing loose, breathable cotton garments helps reduce anal irritation and keep the area clean and dry.

Surgical treatment for severe thrombosed hemorrhoids

In cases of severe thrombosed hemorrhoids, where there is a high risk of complications or when the condition does not respond to medical therapy, surgical intervention is often required. Surgery helps prevent further complications, alleviate severe symptoms, and restore normal anal function. A colorectal specialist will carefully evaluate the patient’s condition and determine the most appropriate surgical method based on the size, location, and severity of the thrombosis.

For thrombosed external hemorrhoids

Patients are typically administered a local anesthetic injection containing epinephrine to help control bleeding and reduce swelling before surgical removal of the thrombosed hemorrhoid. This procedure may cause postoperative pain lasting for several weeks, but it is generally indicated for cases of severe acute thrombosis accompanied by marked edema, necrosis, or obstruction of mucosal closure.

For thrombosed mixed hemorrhoids

In cases of circumferential or mixed hemorrhoidal thrombosis, surgeons may perform Plasma scalpel hemorrhoidectomy to remove the thrombosed hemorrhoidal tissue. Depending on the extent of thrombosis, the procedure may involve thrombectomy (removal of the blood clot) or excision of the thrombosed hemorrhoidal mass, combined with the Longo procedure to treat the remaining non-thrombosed hemorrhoidal segments.

For thrombosed internal hemorrhoids

Because thrombosed internal hemorrhoids are a complex condition, surgeons will base their approach on factors such as the size of the hemorrhoidal mass and the degree of prolapse to determine the most suitable combination of surgical techniques. In many cases, a combination of hemorrhoidectomy methods is applied to ensure complete removal of the thrombosed tissue, minimize recurrence, and preserve normal anal function.

• Thrombectomy combined with sclerotherapy:
• This method involves removing the blood clot and injecting a sclerosing agent into the hemorrhoidal tissue. It offers several advantages, including single-session treatment, minimal pain, short hospitalization, quick recovery, and low cost. However, it is most effective for bleeding hemorrhoids that are not significantly prolapsed or enlarged.
• Thrombectomy combined with German LHP Laser hemorrhoidectomy: This procedure uses carbon dioxide (CO₂) or Nd:YAG laser technology to precisely cauterize or remove hemorrhoidal tissue. It provides high accuracy, minimal invasiveness, quick results, and is virtually painless.
• Thrombectomy combined with THD (Transanal Hemorrhoidal Dearterialization): A minimally invasive surgical technique that reduces pain, bleeding, and prolapse. Using a Doppler probe, surgeons locate the six main hemorrhoidal arteries within the anal canal, then ligate them with absorbable sutures and use a specialized anoscope to lift and fix excess mucosa.
• Thrombectomy combined with Longo procedure: This method causes minimal postoperative pain, shortens surgical time, promotes faster recovery, and reduces the risk of recurrence. However, as a technically demanding procedure, it may lead to complications such as bleeding from staple lines, sphincter injury, or, in rare cases among women, rectovaginal fistula formation. Therefore, it must be performed by highly skilled and experienced colorectal surgeons to ensure safety and optimal outcomes.

The choice of treatment method must be carefully evaluated based on the condition of the hemorrhoidal masses and the patient’s overall health status. Therefore, colorectal specialists strongly recommend that patients consult a qualified physician at a reputable medical facility for proper diagnosis and necessary diagnostic tests to determine the most effective and appropriate treatment plan. Patients are also advised not to self-medicate or use unverified traditional remedies at home, as improper treatment may worsen the condition and lead to serious health risks.

In addition, patients should strictly follow the prescribed treatment regimen, adopt a healthy lifestyle, and attend regular follow-up appointments as directed by their doctors to ensure the safety and effectiveness of the treatment process.

Where to examine and treat thrombosed hemorrhoids effectively

Thrombosed hemorrhoids are a complex form of hemorrhoidal disease, requiring highly skilled and experienced surgeons. Effective treatment demands a doctor who can combine various techniques appropriately to help patients eliminate hemorrhoids completely, prevent recurrence, reduce pain, shorten recovery time, and lower treatment costs.

As one of the leading private hospitals in Northern Vietnam, Hong Ngoc General Hospital has been a trusted destination for thousands of patients with thrombosed hemorrhoids, offering:

• Highly qualified and experienced medical team: People’s Physician, Assoc. Prof. Dr. Nguyen Xuan Hung – Former Director of the Center for Colorectal and Pelvic Floor Surgery, Viet Duc University Hospital; Vice President of the Vietnam Association of Colorectal Surgery; Member of the French Society of Coloproctology; MSc. Dr. Cu Trung Kien – Specialized training in gastrointestinal surgery in Hong Kong; former surgeon at Bach Mai Hospital; currently Deputy Head of the Department of Gastrointestinal Surgery, Hong Ngoc - Yen Ninh General Hospital; Specialist Level I Doctor Bach Phuc Huy – Over 15 years of experience; Head of the Gastrointestinal Surgery Unit, Hong Ngoc - Phuc Truong Minh General Hospital.
• Modern surgical techniques: Application of advanced technologies in hemorrhoid treatment such as radiofrequency hemorrhoidectomy, PPH stapled hemorrhoidectomy, and Longo stapled hemorrhoidopexy.
• Pain-free hemorrhoid surgery: Implemented under a comprehensive pain management protocol developed by MSc. Dr. Nguyen Thi Thu Ba, who completed advanced residency training in France. A team of highly skilled anesthesiologists provides continuous monitoring throughout the entire surgical process.
• Preemptive pain control strategy: Patients undergo strict pre-anesthesia assessment, continuous intraoperative monitoring, and proactive pain management even before the onset of pain.
• Advanced minimally invasive techniques: Surgery is performed in non-sensitive areas, minimizing tissue injury and postoperative discomfort.
• Dedicated 24/7 patient care: A professional support team provides attentive, round-the-clock care throughout hospitalization.
• Comfortable inpatient facilities: Spacious recovery rooms with hotel-standard amenities, providing patients with a comfortable and private healing environment.

For detailed consultation, please contact:

•  Hotline for specialist appointment: 0911 908 856 
• Hotline for hemorrhoid surgery consultation: 0949 646 556

Note: The information provided in this article by Hong Ngoc General Hospital is for reference purposes only and should not replace professional medical diagnosis or treatment. Patients are advised not to self-medicate. To determine their exact condition and receive appropriate treatment, patients should visit a qualified medical facility for direct examination, diagnosis, and personalized medical advice.

Follow the official fanpage of Hong Ngoc General Hospital for more useful health information and updates on special offers and hospital programs.