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. These hemorrhoids often occur with chronic constipation, diarrhea, or pregnancy, but they can also appear on their own.

Today the doctor cut off the skin over the clot and removed the clotted hemorrhoid. You have had a partial hemorrhoidectomy. The wound was either left open or closed with absorbable suture. If absorbable suture was used, this stitch will fall out on its own. The doctor put a dressing over the wound to soak up any blood or discharge.

Symptoms and Care:
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 relieve the pain. Do not take aspirin or products containing aspirin for at least seven days as they promote bleeding. Occasionally, your doctor may need to prescribe something else in addition to relieve the pain. Topical anesthetic ointments available over the counter, such as Xylocaine® and Analpram®, may also help with the pain. A small amount of bleeding is normal. Leave the dressing in place for approximately 12 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 discomfort, bleeding, discharge, pus, or itching occur during this time; it is 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 plenty of water (8 to 10 glasses a day). If you are constipated, take a fiber supplement (for example, Metamucil® or Konsyl-D®). 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.

If you need a refill for a pain medication prescription, you must call your doctor during normal business hours. Our policy is that we do not refill pain medication prescriptions after hours or on weekends because your chart is not available. The doctor on call is not allowed to refill your prescription.

If any of the following problems occur, please call our office and speak with a nurse who will help you with your problem or have the doctor call you.

• 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
• 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.