External Thrombosed Hemorrhoids (Piles) - Pain & Bleeding

To give some context: 

I’m a 20 year old American male, I am very active and athletic, I’m in college right now as a nursing student, I’m a full-time firefighter/paramedic, and I’m assigned to the busiest fire station in the city. This plays a role later on. 

Here’s the entire story, little lengthy but I think it gives light to where I am now. 

Roughly 4 days ago I developed an external hemorrhoid. I’ve had internal and external before, but with relatively no pain and little-to-no blood. That morning, I went to the gym and did some power lifting, which I think may have been the instigator. Later that afternoon, I discovered it after a bowel movement, but there wasn’t any blood or pain associated with it, just a small (about peanut sized) lump. Didn’t think much of it, figured it would go away like the others have in the past. 

Fast forward a few hours after I discovered it, (late in the evening around 10pm), I began to feel some pain, but it was more annoying and uncomfortable that an actual ‘hurting pain’. 

The next day, I woke up in a world of hurt. I examined the area, where I discovered that the previously peanut-sized external hemorrhoid had doubled in size and had a small dark blue/purple mark on it. I still didn’t have any bleeding, just excruciating pain. That is when I realized it had become a Thrombosed External Hemorrhoid. 

I soaked in a warm bath for 10 minutes, cleaned the best I could with some wet tissues, applied a generous amount of the prep H cream, took ibuprofen and an ambien and passed out for the next 6 hours (I obviously wasn’t going to class). When I woke up, the pain had decreased, but still hurt a good bit. I soaked in the tub, and repeated the process from earlier, minus the ambien. The next day I had to go to work at the fire department (24 hour shifts, 7am to 7am, every third day, so I have 48 hours off before I go back on shift), so I repeated the process later that night and went to bed feeling a little better. When I woke up I felt some pain but nothing compared to the day before. Went to work, ran a decent amount of emergency calls throughout the day, nothing too strenuous, but the pain had begun to get worse as I was constantly moving. After we got back to the station from a call late in the evening, I went to the dormitory and laid down and tried my best to relieve the pain. It hurt to move any direction, and shortly thereafter we got a house fire call. Long story short, I thought I was going to die, it felt like my anus was a propane tank on fire and was going to explode. By the time we got back to the station I was in unbearable pain. I took a shower and that’s when I noticed a some blood on my boxers. Fast forward to the next morning, I didn’t sleep at all that night, and the pain had gotten unimaginably worse. As soon as I got home I took off my clothes and that’s when I saw that I had bled through my uniform.

I soaked in the bath, cleaned with wet tissues, applied prep-H, iced for 20 minutes, took ibuprofen, then placed some gauze in the region and got in bed.

Woke up a few hours later to find that the bleeding had slowed a lot, and my pain had decreased significantly.

I did the whole regimen once again, and honestly felt pretty good. It didn’t hurt at all moving around, just a slight annoying feeling. 

Then, I had a bowel movement. I thought I was going to have to summon a priest, some of the worst pain I have had since this ordeal started. My stool was relatively normal, not hard or loose, and I had a fat bright red blood clot sitting on top. I sneezed in the middle of it and was almost certain I shot my lower intestines out of my body. I couldn’t wipe, so I resorted to the shower and those wet tissues to clean, and did the same regimen as before, and it seemed like in 30-45 minutes my pain was almost gone. 

Since I have final exams next week, I have to//NEED to study. So I have to sit at my desk for long periods of time. I had no pain sitting for the first few hours, and the bleeding was there but almost nonexistent. Fast forward 6-7 hours later (I got up a few times and walked around) I felt that annoying pain again and discovered I had bled through my clothes once again. 

Now, it has been 12 hours since then, pain is the same, and I’m still bleeding. I’m a paramedic, and a nursing student, I’m well aware of what can happen if bleeding persists. But it’s not a lot, just enough to be slightly concerning when combined with the fact it hasn’t stopped in about 18 hours despite my efforts. 

I looked online and there’s next to nothing about thrombosed external hemorrhoids bleeding, aside from a few mentions about if they aren’t treated by a doctor with a small incision to remove the clot, they will resolve themselves by popping. 

Has anyone had an experience like this? If you’ve had a thrombosed external hemorrhoid, how did you treat it? How long did the bleeding last? How long did it take the pain to go away completely? How much bleeding is too much? Those who had to sit for long periods of time and/or be active, what did you do to manage this? 

I’m past the window my doctor could do anything so I haven’t bothered with him, plus with final exams and work, I don’t  have time to be out for Even just one day now. I have work tomorrow, and I need this to be resolved. Specifically the pain and bleeding, moreso the bleeding. 

Any advice or personal insight/opinion is 100% welcome and a big thanks to those in advance that will reply. 

Well Jason I don't have much bleeding but I have pain after my BM it's more like my rectal area. Try to used Recticare Lidociane 5%Anorectal cream it's helps me for the external Thrombosed it well shrink back a little. Also Jason if you feel your self have to have BM and its hurt at the end of rectal I will say don't stain at all. Also drink lot of water and what will help to easy your BM is Mirlax that's what helps me I still have the the pain After I BM. Find a doctor that can that will see you for your Hemorrhoids. I'm going on Wednesday for mines to see what the Hell going why I'm having pain after my BM an it's hurting my rectal cause if its external please they can removed it. Also when my wife was putting cream on my external hem. She said she saw a white bump on around my rectal and my external hem look big but not that big. So hopefully I have good result about this hemorrhoids. Jason drink lots of water try to buy the cream Recticare eat more food with fiber. And please make a doctor appointment with someone that can help with hemorrhoids. Oh I forgot the tell you my uncle had the same thing you have and he got his removed he said that it was the beat thang that happen to him. The surgery with well it took him three days to heal they gave him fiber for pills to him BM also he said that he have to make sure he diet because it can come back. Now everyone heals different from surgery.

Hi, you can use essential oil for Haemorrhoids, these are the recommended one's, Cypress, Frankincense, Tea Tree, Peppermint, and others, I've used these and work pretty good, according what I've read they are astringent, stop bleeding, pain relief, etc, lots of info online, 2 drops of essential oil to 1 teaspoon of carrier oil like sweet almond oil, or Johoba oil.

To give an update:

After using witch hazel, salt baths, ice, and Advil, I’m still experiencing problems. I still have pain, nowhere near as bad as the day before, but enough to make me wince.

The bleeding is steady, and I still have a clot there because I can see the ‘black dot’ in the hemorrhoid. So I’m guessing it only partially burst and has drained some, but my clot hasn’t come out. After reading about this, it seems that I’m not going to improve until the clot comes out. 

Since I’ve missed the 72 hour window to get the procedure, it’s now a waiting game. A bloody, painful, inconvenient waiting game. 

One article I read said that if the bleeding is steady, to lay on the left side for a few hours and take a day of bed rest. So now, I’m currently laying on my left side for the next little bit to try to relieve some of the pressure on the veins in an effort to lessen the bleeding. But I’m still in my initial problem, I can’t go to work or even study until I can get this resolved. Some people have said theirs bled for 2-3 weeks after, others have said months. 

The bleeding is just one part of it, I can’t go to work because I’ll definitely be on my feet for long hours doing strenuous activities which would put me back at square one. 

For those who’ve dealt with this, how did you manage the bleeding with your daily activities? Is there something I can do to stop it or get the clot out myself?

I’ve used everything people have said, aside from the stool softener because I have no need for that at the moment. 

Any help or just sharing of personal experiences and how you at least managed the symptoms will be so greatly appreciated. 

Thanks lionetta96733. You’re spot on about the diet and water. Luckily I’ve been on a strict nutrition plan for a decent amount and have been regular for the most part. I’ve definitely had major improvement over the last 24 hours. I’m still bleeding, but that’s expected for some time. But I put cotton balls soaked in witch hazel in the freezer. After soaking in the Epsom salt bath for 30 minutes I immediately got out, cleaned off what I could with a medicated wipe (blood continuously showed up, but I wiped until it went from covering an entire wipe to just a speck), then go to my freezer, grab 2-3 frozen witch hazel cotton balls, and lay down with my pelvis above my heart (I used 2 pillows) and placed the cotton balls directly onto the hemorrhoid. I stopped putting prep H on it and just did the cotton balls. It was an unpleasant feeling at first, but after 20 minutes I removed them and put some neosporin on it, and placed gauze in the area and laid on my left side for about 2 hours with pillows under my hip. I repeated this 3 times and not only has the blood volume decreased, but my hemorrhoid has shrunk tremendously. It went from being the size of an almond to a pea in little over 12 hours. 

I still have some pain and consistently bleeding, but I can see and tell a major difference in the last 12 hours. Epsom salt bath, medicated wipes, Frozen witch hazel cotton balls, neosporin, gauze, and elevating the butt above the heart have worked tremendously. I’ll update once I can finally say I’ve resolved the problem. The only issue that’s left is the bleeding. I cant figure out how to stop it.  

Hi Jason I sorry again worried about the amount of blood you keep having. Please make an appointment about this bleeding. I'm glad it's getting easier for you a little. For me it's getting easier sometime but I saw a white bump like at around external hemrriods close to the anal its a size of pea just a little big. But I still have pain not as bad maybe 4 out 6. Still take like Advil gel pills two of them but it ease the pain. Hopefully this Wednesday i can get some answer from my Doctor.

What I do is push the prolapsed hemorrhoid back in. This will give you instant relief. It will come back out, but keep pushing it back in. This makes the pain bearable. Use vaseline or prep-h for lubrication.

Jason, any updates? I’m having your exact symptoms, need help on this myself, any info is appreciated!

Jason, how long did this ordeal last? I recently was dx with thrombosed hemorrhoids s/p childbirth and pushing last week and I'm in AGONY!! I can't sit, stand, kneel - nothing but cry making it especially terrible bc I have a newborn baby to take care of and feed. This is terrible. 

Hope some of you read and follow this and reply too.  I had the runs on January 20th and cleaned too hard with rough toilet paper. Developed two thrombosed external hems.  Weird thing was I didn’t have excruciating pain. Uncomfortable? Yes. I went for a run and the friction caused one of them to bleed. That one healed and was gone within 3 weeks. The other I think was there a short time later and two months plus later it is STILL there. It has reduced in size but still there. I saw a colon and rectal surgeon on 2/12 who said generally 4 to 6 weeks for it to get absorbed by the body. We are past that.  I made another apt for 4/12.  This is ruining my life.  I am fine when lounging at home in sweats or standing or walking. But sitting at work is not fun.  BMs don’t hurt but I am hyper aware of when I go and  making sure it is clean. Not to mention doing all of this at work.  I sitz bath, eat fiber, drink water, etc.  I have taken weekly pics from 2/4 to the present and it is reducing but it is still there but uncomfortable.  I have read this could be 3 months. Only fix is surgery I think but I have also read that is for very extreme cases yet how long do I go before that?  My next doctor apt will be around the three month mark so we shall see.  I am 48 years old, active, good shape.  Anyone with any insight or similar story/advice? 

I've been in extreme pain all week. I guess I strained too hard over the weekend and am now paying the price. Didn't have bleeding just extreme pain. I started with Prep H wipes and the cooling gel. At night I apply the tel then fold up a wipe and run it between my cheeks and leave it in there a good 8 hours. While at work I was using the $24 tube of Prep H with the extreme lidocaine. Last night I started with soaking in the Epson salt bath. Well tonight I stopped at the store to try the paste of mixing Epsom salt and glycerin and really felt the need to go. It was like a knife going up my butthole. I finally made it home and started the hot bath and stripped down and then hit the toilet. Not as painful as I was expecting or it has been but when I stood up the toilet was full of blood. Lots of clots on the wet wipe I used to clean myself. Did it burst? I have to admit I feel much better! I'm soaking in the salt water and still plan on applying the salt/glycerin mixture when I get out. Is the worst over??

it could be an anal fissure that's making you hurt after you poo, it also makes you bleed and feels like your ripping your arse open with shards of glass

It sounds like you have a skin tag, when you get a thrombosed pile the creams and ointments wont do a thing until your body has reabsorbed the blood clot that is where the pain comes from. once your body reabsorbed the pain stop and the fat pile starts to go down in size it can take awhile, if it doesnt go away that skin need to be removed so that it doesnt keep filling with blood and cause problems again. I got thrombosed hemorrhoid was put on cocodamol didnt poo for 5 days starting taking lactulose and had a poo, it tore my bum hole I developed a fissure along with the thrombosed hemorrhoid I havent been able to work in 4 weeks I'm in pain all the time at times I wish I would die, its embarrassing and cant tell people cause unless they have had the same they cant understand the pain. first 2 days of thrombosed hemorrhoid I literally never slept. I'm nowhere near as sore as the first 2 weeks but every morning I go to the toilet I suffer I spend 5 hours in the bath then take too many co codamol to help with the pain about 5 or 6, but going onto week 5 and still in pain for most of my day

best advice I can give is you need to stop all and every strenuous activity until you have properly healed try eating less I take lactulose to soften poo it should be almost like water so there is less pressure on rectal area, squat when you poo swear its nasty but this is how humans are meant to poo like animals it's better for your bum, I find eating less food also makes it better, not healthy but I dont care I'd rather eat nothing than be in pain. I havent been able to work in 4 weeks, but I had an anal fissure alongside thrombosed hemorrhoid. thrombosed hemorrhoids take about 2 weeks to stop hurting, anal fissures 4-6 it's so depressing really gets me down. I'm same as you I eat healthy I'm only 30 I exercise and only relief I get is when I soak 5 hours in the bath tub.

this has been my life for 5 years and thats even with halo surgery in between. i havent found anything which will make it stop. but to manage life i use vaseline when i use the loo and lidocaine cream after i soak in the bath after every BM I use transamic acid when the bleed is more than 2 weeks and i eat a low fodmap diet and live on paracetamol sorry i couldnt help more if you find anything let me know

hello, can someone give me advice about this? im having this problem for 1week now. everytime ill make a BM its like that a knife is exiting the anus. after that ofcourse the hems are out there so it gets me trouble putting it back because its hurt so bad like im dying, evertime i do BM the hems are getting out. at first i just have this severe pain doing BM, but this past 3days im seeing blood in the toilet. im already taking pills like daflon and pain reliever. im also putting cream on it 3tines a day as the doctor says, im also taking stool softener now. im doing sitz bath also it helps relieves pain mostly after having. i dont know if this pain every BM's are normal =( im having trauma doing BM's now cause it really is a nightmare=( can you guys give me some advice for relieving pains atleast while doing BM's? and putting back hems after. Thanks!

How are you doing? Did you find the help and answers you were looking for? I'm dealing with this as well and am considering surgery. I'm doing everything the Dr has told me to do but nothing is helping. Everyday is a struggle.

So I know this an old post but I was wondering what happened to your thrombosed hemroid that would not go away? I am in the same boat having a thrombosed hemroid for 3 weeks. Did yours ever go away? This is debilitating .

Can you tell me if you had to have surgery? I have had a thrombosed hemroid for three weeks and it is very painful. Would love to know how you managed yours?

it did eventually go away! took a LONG time but slowly it did subside and then go. Hang in there! I know how bad it is.