An internal hemorrhoid is a cushion of blood vessels in the lining of the anal canal. All people have hemorrhoids the difference is that not everyone has hemorrhoid causing symptoms. When these hemorrhoids become enlarged, you may have painless rectal bleeding. Swelling of hemorrhoids may cause them to prolapse (slide out) during a bowel movement.
A thrombosed external hemorrhoid is a hemorrhoid with multiple blood clots that can be seen and felt under the skin around your anus. It is usually moderately to severely painful. This type of hemorrhoid usually occurs from chronic constipation, diarrhea, or pregnancy, but they can appear on their own.
There are a number of options for treating internal hemorrhoids, if they were used for external hemorrhoids it would be extremely painful.
Barron ligatures (rubber bands) - A rubber band is put around the hemorrhoid, causing it to wither and fall off over a five to ten day period.
Thermal coagulation - A light source is used to cause a small burn on the surface of the hemorrhoid, causing it to stop bleeding and shrink down to normal size.
Injection of hemorrhoids - A liquid is injected into the hemorrhoid, stopping the bleeding and preventing it from protruding.
The most common way to treat an external thrombosed hemorrhoid is by cutting off the skin over the clot and removing the clotted hemorrhoid. This is referred to as a hemorrhoidectomy. You will have pain after the local anesthetic wears off, it may be moderately strong. You may take acetaminophen (Tylenol) or ibuprofen (Advil) or Motrin, to relive the pain). Do not take aspirin or anything containing aspirin for at least seven days as it promotes bleeding.
A small amount of bleeding is normal. Leave the dressing in place for about 12 hours; then take your first sitz bath. I takes two to four weeks for the wound to heal. Don't worry if some discomfort, bleeding, discharge, pus, or itching occur during this time; it is part of the normal healing process. Anal hygiene is important, you should wash after bowel movements and sit in the tub to soak daily.
Avoid strenuous activity for the rest of the day after the procedure then you may return to normal activity the next day.