Perianal Hematoma: Causes and Relief Options
Quite often there are situations when a person gropes for a painful “bump” in the anus. As a rule, such patients already know firsthand what hemorrhoids are, but they don’t rush to the doctor. We are talking about thrombosis of the hemorrhoid, which in most cases is an exacerbation of chronic hemorrhoids. The fact of the appearance of the so-called acute hemorrhoids finally pushes a person to turn to a proctologist for help, although this had to be done much earlier. However, there are not rare cases when the “bump” occurs completely unexpectedly, causing panic in its “owner”. The main thing here is not to blunder, not to “pull the cat by the tail”, but to ask the doctor of the desired specialty all questions of interest.
We will learn from the coloproctologist, candidate of medical sciences Maxim Vladimirovich Zubenkov from the Global Clinic Medical Center , what the most conscious patients do in such a situation, what questions they ask and what delicate answers .
– Doctor, what is this “bump”?
– The diagnosis of “hemorrhoidal thrombosis” is not rare in proctology. This disease is manifested by the formation of dense painful nodes (usually one or two) in the anus, which are very painful to touch. In some cases, such nodes can be located around the anus, as well as be deeper in the anal canal. Patients describe the reason for going to the doctor in different ways: “bump”, “swelling”, “densification”, “prolapse of the knot” and even “outflow of hemorrhoids”. The cause of the patient’s suffering is a blood clot (blood clots) inside these nodes, which, when exerted, “stretches” the walls of the node and acts on the nerve endings, causing pain.
MaximaVladimirovich Zubenkov, doctor-coloproctologist, candidate of medical sciences.
Hemorrhoidal thrombosis is usually a complication of chronic hemorrhoids. Depending on the place of localization, thrombosis of external, internal hemorrhoidal nodes, as well as combined thrombosis (of those and other nodes) are distinguished. Thrombosis can also occur in a person who has not previously experienced hemorrhoidal disease. The reason in this case is a “bursting” or partially damaged vessel in the region of the anus, in the place of which a blood clot forms.
– Describe the symptoms that bother you?
– Patients complain of a sensation of a neoplasm and pain in the anus, aggravated by emptying, physical exertion, sitting position. Pain may be minor, but more often they are pronounced, especially in the first time after the occurrence of thrombosis. Often, the early stage of the disease is characterized by a burning sensation, itching, and may be accompanied by bloody discharge from the anus. These manifestations at first may be minor and not cause expressed concern. In the future, they can intensify, causing significant discomfort.
– Why exactly with me?
– There are many reasons for the formation of thrombosis in hemorrhoids and it is sometimes impossible to exclude them from our lives. The most common cause of a blood clot is problems with intestinal emptying (constipation, diarrhea), and women still have a period of pregnancy and childbirth. An increase in venous pressure during straining and attempts can lead to a violation of the venous outflow and contribute to stagnation of blood in the hemorrhoid, that is, to the formation of a thrombus. In principle, any tension that provokes a rush of blood into the pelvis can cause overstretching or rupture of the vessel in the anus. Provoking factors also include frequent and uncontrolled physical activity, a sedentary lifestyle, or, conversely, prolonged standing, hypothermia, spicy foods, alcohol, anal sex, etc..
– What should I be afraid of?
– Thrombosis can affect the entire circumference of the skin around the anus, cause perianal edema and the inflammatory process in the node and surrounding tissues. A blood clot is able to evacuate spontaneously, “breaking through” the mucous membrane or skin, thereby causing excessive bleeding, which is very scary for patients. In addition, such an evacuation, as a rule, is incomplete. In place of the painful “bump” there are “skin folds”, the so-called anal fringes. These painful folds of perianal skin are often mistaken for external hemorrhoidal nodes.
Anal fringes prevent careful hygiene. If an infection gets, they can become inflamed, cause itching, soreness and bleeding. By the way, thrombosis can also be periodically observed inside hemorrhoidal fringes, which, in turn, are a consequence of a previous exacerbation of hemorrhoids.
In the absence of treatment, necrosis can occur in the nodes that have fallen out, their mucous membrane ulcerates, which threatens the development of acute paraproctitis (severe purulent complications) or bleeding.
– Doctor, help!
– Treatment of hemorrhoidal thrombosis should be started as early as possible. It includes anti-inflammatory drugs, analgesics, local anticoagulants, restriction of “walking”, physical activity, diet, and the exclusion of alcohol. As a result of treatment, the pain, as a rule, goes away in 2-7 days, swelling disappears. In addition to drug therapy, instrumental treatment is often performed – excision of a blood clot under local anesthesia. This procedure lasts only a few minutes. Subsequently, it is also necessary to conduct minimally invasive treatment of chronic hemorrhoids (if any). After excision of thrombosis, the pain disappears, the wound heals in a few days. Within two three days, slight discomfort in the anus is possible. After treatment, the patient remains able to work, only temporarily limiting physical activity, which is not unimportant for many. Of course, the patient also needs to normalize bowel function, eliminate problems with intestinal emptying.
“Could this happen again?”
– Unfortunately, it can. Guarantees for the whole life of the patient are not possible to give. Do not forget that the excision of thrombosis does not mean a cure for hemorrhoids per se. Subsequently, thrombosis can again form, but not at the excision site, but at a different place in the perianal region. However, you can significantly reduce the risk of recurrence of thrombosis if you cure hemorrhoids in time, follow the doctor’s recommendations and exclude the effects of negative factors from our lives as much as possible. It should also be remembered that thrombosis of the hemorrhoid, as well as hemorrhoids itself, is best amenable to early treatment, and therefore, do not neglect a visit to a proctologist.